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The Effect of Sleep Loss and Fatigue on Cardiovascular Perfusion Students: A Mixed Methods Study

Ashley Hodge MBA, CCP, FPP Medical University of South Carolina College of Health Professions . The Effect of Sleep Loss and Fatigue on Cardiovascular Perfusion Students: A Mixed Methods Study. “Nothing seems to bring as much clarity to the function of sleep as spending a night without it.”

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The Effect of Sleep Loss and Fatigue on Cardiovascular Perfusion Students: A Mixed Methods Study

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  1. Ashley Hodge MBA, CCP, FPP Medical University of South Carolina College of Health Professions The Effect of Sleep Loss and Fatigue on Cardiovascular Perfusion Students: A Mixed Methods Study

  2. “Nothing seems to bring as much clarity to the function of sleep as spending a night without it.” -William Killgore

  3. Introduction

  4. History • 1896 – Patrick and Gilbert • First report of decreased response time • 2004- Frey et al. • Arithmetic

  5. History • Time-on-task (Lim and Dinges, 2008) • Psychomotor vigilance • Progressive worsening exacerbated during fatigue • Single night of sleep loss • “Wake State Instability” (Doran et al., 2001) • Inhibiting neurobiological systems • Individual Differences • Age

  6. Fatigue, alcohol and performance impairment • Hand-eye tracking • Performances during sleep deprivation vs. Blood Alcohol Concentration (BAC): 28 hours • 17 hours: BAC 0.05% • After 24h wakefulness, corresponded to BAC 0.10%- Legal limit for intoxication

  7. The Effects of Sleep Loss and Fatigue on Resident-Physicians

  8. Study • Using a mixed-methods design, the current study aims to determine the effect of acute sleep deprivation on perfusion students, during performance of clinically-relevant tasks utilizing high fidelity simulation.

  9. Study Design • Mixed methods • Quantitative • High Fidelity Simulation Tasks • Qualitative • Survey • Focus Groups

  10. Population • n = 7 • Senior Perfusion Students • Age: 22-37 • Gender: • Male: 4 • Female: 3

  11. Focus Group

  12. Describe Personal Experiences “2 cases per day leads to exhaustion” “I have nodded off while on CPB… could have caused an accident while on CPB” “Couldn’t remember if I fed my dog” Concerned about driving home

  13. Sleep loss affects on personal life “I do not get to see my son” “I am irritable with my significant other” “I find myself venting or lashing out at loved ones because of fatigue” “Chronic Fatigue” “Weight gain/loss”

  14. Coping Mechanisms “Sleep all weekend” “I take naps daily” “Melatonin / 5 hour energy” -Room available

  15. Changes

  16. Stanford Sleepiness Scale

  17. Stanford Sleepiness Scale

  18. Epworth Sleepiness Scale (ESS)

  19. ESS Averages vs. Time

  20. Simulation Tasks

  21. Surgeon Protocol

  22. Mock OR

  23. Mock OR

  24. Response Time • Minute 1: Decrease in pO2 • Minute 2: Decrease in venous return • Minute 3: Ventricular Fibrillation • Minute 4: Protamine Dosage Calculation • Minute 5: Decrease in MAP

  25. Simulation Sessions

  26. Learning Curve vs. Response Time

  27. Decreased pO2 24 hrs

  28. Poor Venous Return

  29. Ventricular Fibrillation 24 hrs

  30. Drug Calculation

  31. Decreased MAP

  32. Drained Venous Reservoir

  33. Incorrect Drug Calculation

  34. Conclusions • Sleep loss negatively impacts our participants interpersonal relationships, their health and mental well being and caused irritability in most cases • Over time, the self-assessedalertness decreased • Sleep loss affects performance over time, specifically high functioning cognitive tasks

  35. Study Limitations • Discussion • Inactivity • Student participants • Sample size

  36. Thank You

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