Fatigue is a state of physical or mental weariness characterized by a
lessened capacity for work and a reduced efficiency of accomplishment.
It may result from a period of intense or prolonged exertion or
alternatively may occur after time spent on unchallenging or monotonous
tasks. In clinical practice, it is associated with long hours of
wakefulness, sustained mental effort, and shift working. Fatigue
negatively affects performance and is associated with increased risks to
patient safety and to the well-being of the anaesthetist. The increase
in shift working for trainees as a consequence of the European Working
Time Directive (EWTD) and the increasing likelihood of a 24-h
consultant-delivered service have increased concerns that fatigue may
become more prevalent in front-line anaesthetists with predictable
implications for safety and clinical effectiveness.
CASE A 22-year-old man was brought to the ED complaining of abdominal pain after a rollover motor vehicle accident. He was the front seat passenger and was wearing a seat belt. Although he was trapped in the vehicle and it caught on fire, he did not suffer any cutaneous burns. History The patient's past medical history was significant for attention-deficit hyperactivity disorder. He admitted to using tobacco and alcohol socially, but denied illicit drug use. He denied any medication use or drug allergies. A review of systems was positive for complaints of abdominal pain and anxiety. Physical examination The patient's vital signs were: BP, 112/51 mm Hg; heart rate, 110 beats/minute; respirations, 23; SpO 2 , 95% on room air; and temperature, 37.4° C (99.3° F). On ED arrival, he was awake, alert, and oriented but appeared anxious and agitated. His pupils were equal, round, and reactive to light. His head was normocephalic with a 2-cm laceration on the left ear. The pati...
Commentaires
Enregistrer un commentaire