Updated March 2015
“Long shifts are challenging, but chronic sleep loss leading up to these shifts is a set-up for errors and accidents,” Daniel A. Cohen, M.D., at Brigham and Women’s Hospital in Boston, told Research Monitor. We know from other studies that being awake for 24 hours can hamper skill levels to a level similar to being legally drunk. But stay awake for 24 hours after chronic sleep loss—in other words, two to three weeks of six hours of sleep, or less, each 24 hours—and performance deteriorates about tenfold.
The decline in performance begins a few hours after waking and worsens each hour that tick-tocks closer to bedtime, Cohen and colleagues report. They found this in performance tasks among nine healthy volunteers aged 21 to 34 who followed a 38-day laboratory-regulated chronic sleep-loss protocol vs. eight 18- to 30-year-old subjects who did the same tasks but slept eight hours every 24.
No one knows how long it takes to reverse the effects of chronic sleep loss, but as Cohen said: “We know that it takes more than just a few days of good sleep.” — Science Translational Medicine 2(14):14ra3, Jan. 13, 2010.
Blame begets blame
Studies have found that people blamed for some discretion or mistake are more likely to blame others for subsequent faux pas. But Nathanael J. Fast, Ph.D., at the University of Southern California in Los Angeles, told Research Monitor, “Merely observing someone else getting blamed is enough to make the practice spread.”
His team found this while observing behavior experiments in three groups of 100 or more adults, and one group of nearly 75 adults.
Fast suggests that managers avoid public displays of blame when addressing a worker’s mistake. Rather than focusing on incompetence, he advises discussing missteps in ways that avoid defensiveness—for example, by pointing out what can be learned from an error. — Journal of Experimental Social Psychology 46(1):97–106, January 2010.
CPR quality during transport
Got a hunch that CPR quality declines during transport? Bentley Bobrow, M.D., medical director for the Arizona Department of Health Services in Phoenix, and colleagues have facts to show it does. They measured chest compression rate and depth in 45 adult OOHCA patients transported by ambulance. The percentage of compressions complying with AHA 2005 guidelines—depth, 1.5 to 2 inches; rate, 100 per minute—was nearly double on-scene as it was during transport. Overall on-scene compression rates varied by 18 per minute; during transport, they varied 26 per minute.
Bobrow’s team suggests additional investigations to determine the cause of these differences. — Presented at the National Association of EMS Physicians 2010 Conference in Phoenix, Jan. 8, 2010.
Not in cardiac arrest? CPR won’t seriously harm
Bystander CPR, as guided by a 911 dispatcher, does not cause a high rate of serious injury to patients who are not in cardiac arrest, report Lindsay White, MPH, and colleagues at Public Health Seattle–King County and Seattle’s University of Washington. They evaluated records from June 2004 through January 2007 of 313 adults not actually in cardiac arrest but who received bystander chest compressions, aided by an emergency medical dispatcher, in response to suspected cardiac arrest. Of the 247 with complete outcome records, none had visceral organ injury, 29 reported discomfort, and six sustained injuries—five fractures, presumably from chest compressions. These findings, the researchers suggest, do not diminish the overall benefits of bystander CPR. — Circulation, doi:10.1161/CIRCULATIONAHA.109.872366, published online Dec. 21, 2009.
Stroke news
Reports from the International Stroke Conference 2010 in San Antonio, Texas:
- Compared with whites, 45- to 54-year-old African-Americans appear 2.5 times more likely to have a stroke, reports Virginia Howard, Ph.D., at the University of Alabama at Birmingham. Her group kept nearly five years of phone contact with 26,500 adults with no prior stroke history, during which time 299 had strokes. They also report that people in Alabama, Arkansas, Georgia, Louisiana, Mississippi and the Carolinas have about 12 percent greater risk for stroke death than other U.S. residents. — Newswise, Feb. 28, 2010.
- Kids, particularly with sickle-cell disease, other illnesses or whiplash-type injury, are also at risk for ischemic stroke, reports Rebecca Ichord, M.D., at The Children’s Hospital of Philadelphia. Her group’s 2003 to 2009 assessments of 90 kids, about 6 years old, treated for stroke, showed 12 with recurrences. In six, the first stroke went undiagnosed until a subsequent stroke occurred. Ichord notes that kids’ often subtle changes in vision, speech, gait or limb function highlight the need for improved awareness of their stroke risk. — EurekAlert, Feb. 24, 2010.
