Scary Driving Events While Sleepy in EM Residents

Written by Aaron Lacy

Spoon Feed
EM residents who drove after night shifts were at risk for motor vehicle crashes. There was higher risk earlier in training, and all training levels underestimated how at risk they were.

Why does this matter?
Sleep deprivation and poor sleep hygiene increase the risk of driving related adverse events. In particular, those who work nights are at high risk, with one study finding 80% of near-crashes and 75% of all MVCs involving emergency physicians came after a night shift. The first step in fixing a problem is identifying it.

Don’t Drive Drowsy
Fifty postgraduate year (PGY) 1-4 EM residents completed self-administered surveys after working overnight shifts at a community site 20 minutes from the main campus. The surveys addressed 15 yes or no questions related to adverse or dangerous driving events. The participants also completed the Karolinska Sleepiness Scale, a validated measure of sleepiness, before and after the drive home.

Between PGY1 and 2 residents, 88% reported an adverse driving event, with an average of 2.79 per drive. Of PGY3 and PGY4 trainees, 79% and 75% reported an adverse event with an average 2.57 and 1.33 adverse events per drive, respectively.  The job of an overnight medical provider, and particularly the job of trainees, puts them at high risk of sleepiness, which is associated with increased adverse events. This could lead to catastrophic consequences.  Employers must consider options to mitigate this risk, such as car-pooling, taxi service, post-shift sleep rooms etc., to keep trainees and the public safe.

Source
The Association of Sleep Hygiene and Drowsiness with Adverse Driving Events in Emergency Medicine Residents. West J Emerg Med. 2020 Oct 27;21(6):219-224. doi: 10.5811/westjem.2020.8.47357.

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