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The Path Forward—Changing the 24-hour Paradigm
- Field & lab studies, across disciplines, show consistent performance decline after 12-16h
- Residents' working 24-30 hour shifts make 36% more serious errors, 5 times as many serious, diagnostic errors, have twice the odds of crashing their cars, and suffer 61% more percutaneous injuries post-call
- Perform at a level commensurate with a blood alcohol of 0.05-0.10%; drop in performance of 1.5 to 2 standard deviations
- Sleep deprivation impairs learning
- Sign-out systems need to be improved to minimize hand-off errors
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