Résumé
For the past 30 years, we have been witnessing a saturation of French emergency departments. The non-physiological night hours increase the arduousness of the emergency work. In this context of a surge of the number of consultations, we wondered wether the practice of 24-hour shiftswas safe for both patients and physicians. The aim of the present study was to compare the impact of 24-hour shifts (from 8:30 am to 8:30 am) to that of 14-hour night shifts (from 6:30 pm to 8:30 am) on emergency physicians.Materials and methods: we assessed the vigilance of emergency physicians at the University Hospital of Nîmes using the PVT-3 (Psychomotor Vigilance Test over 3 minutes), performed on a touchscreen phone at the beginning (J0) and end of the shift (J1). The doctors also completed a questionnaire about their characteristics, well-being, and perceived sleepiness at J0 and J1.Results: 56 inclusions were made on 40 different physicians (interns, junior doctors and senior doctors) from November, 2022, to January, 2023. Although in both groups (14h and 24h) studied independently physicians were significantly less alert at the end of the shift (p <0.001 for 24-hour shifts; p <0.05 for 14-hour shifts), no significant difference was found when comparing the two groups. Similarly, a significant increase in fatigue (p <0.001 in the 14-hour and 24-hour group), a significant decrease in anxiety (p <0.05 in the 14-hour and 24-hour group), and a significant alteration of mood (p <0.01 in the 14-hour and 24-hour group) were observed at the end of the shift compared to the beginning. However, no significant difference was found for anxiety, fatigue, mood, sleep quality, nutrition, number of coffee and cigarette, and sleepiness level according to the KSS (Karolinska Sleepiness Scale) when comparing the two groups. When physicians could sleep during their shift, no significant difference was found on KSS-scores, response time to the PVT-3, anxiety, fatigue, and mood, compared to practitioners couldn’t sleep. Sleep duration was longer during 14-hour shifts compared to 24-hour shifts (p <0.05).Conclusion: the PVT-3 test demonstrates a significant impairment of alertness after 14 hours as well as 24 hours of shift. Nevertheless we could not demonstrate a significant difference between the impact of 14-hour shift and 24-hour shifts on the vigilance of practitioners. However, it appears that the likelihood of having time to sleep is higher during a 14-hour shift than during a 24-hour shift, which could indicate that the efficiency of doctors is better preserved during a shorter shift.