Bmj Usa: Letter

RAPID RESPONSES FROM BMJ.COM: Risk management is overdue

BMJ 2003; 327 doi: (Published 19 November 2003) Cite this as: BMJ 2003;327:E82
  1. APJ Lake (, consultant anesthetist
  1. Glan Clwyd Hospital, Rhyl. LL18 5UJ, UK
  2. Stamford Hospital, Stamford, CT 06902
  3. Berlin Chamber of Physicians
  4. Department of Surgery, Royal Infirmary of Edinburgh, UK

    This article originally appeared in BMJ USA

    Editor—The article by Grantcharov et al was concerning but not surprising. They report a shift system where the trainees were expected to sleep on duty, and this sleep disturbance no doubt contributed to the observed outcomes. I'm sure that a measurable decrease in performance would have been more obviously detectable for activities other than elective laparoscopy, particularly those requiring quick decisions in a life-threatening situation.

    I disagree fundamentally with their final paragraph. Results such as these should not lead us to develop and evaluate countermeasures that can maximize alertness and reduce fatigue, but rather, should …

    View Full Text

    Log in

    Log in through your institution


    * For online subscription