Emergency Department Provider Fatigue and Shift Concerns

Pediatric emergency medicine poses unique challenges to preventing medical errors because it combines the difficulties inherent in emergency medicine practice with the problems of pediatric patients. In emergency medicine, procedures requiring psychomotor skill are part of routine practice. In addition, most emergency departments are busy 24 hours per day. The requirement for emergency physicians to perform competently through the evening and overnight hours pits professional and societal expectations for round-the-clock work against certain fundamentals of biology. Acknowledgement and understanding of our intrinsic nature can help emergency physicians to manage their abnormal sleep and work schedules to optimize performance in our demanding field. Scientific, medical, and industrial researchers have provided us with the requisite knowledge about sleep physiology and human performance. This article discusses fatigue reduction as a strategy to prevent medical errors in pediatric emergency medicine.