RELATIONSHIP BETWEEN THE DEGREE OF DEHYDRATION IN EMERGENCY MEDICINE RESI- DENTS AT THE BEGINNING AND END OF CLINICAL SHIFTS WITH COGNITIVE PERFORMANCE, MOOD, AND ANXIETY AT EMAM KHOMEINI HOSPITAL (JUNE 2016 UNTIL THE END OF THE SAME YEAR)

SEYED MOJTABA AGHILI¹, FAHIME SHAHJOOIE², MOHAMMAD AFZALI MOGHADAM³, ZAHRA KHAZAEIPOUR⁴, MOHAMMAD VASEIE5, MARYAM KIA⁶

¹Assistant Professor of Emergency Medicine, Tehran University of Medical Sciences, Imam Khomeini Hospital, Emergency Department - ²Tehran University of Medical Science, Imam Khomeini Hospital, Emergency Department - ³Assistant Professor of Emergency Medicine, Tehran University of Medical Science, Imam Khomeini Hospital, Emergency Department - ⁴Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences - 5Tehran University of Medical Science ,Imam Khomeini Hospital, Emergency Department - ⁶Assistant Professor of Internal Medicine, Tehran University of Medical Sciences, Ziaeian Hospital, Internal Medicine Department

Study’s background and aim: The physical condition of emergency department (ED) residents plays an important role in deci- sion making for diagnosis and treatment of the patient, and any problem in their physical status may lead to irreparable medical errors; thus, an investigation in to dehydration and its effects on cognitive performance is needed.

Materials and methods: A cross-sectional study was performed in 44 ED residents. Urine sample of all individuals were col- lected at the beginning and end of shifts. Residents’ weight, weight changes, and vital signs were measured at the beginning and end of their shifts. Participants were asked about the amount of sleep acquired before and the amount of food and water intake during shifts. Mood and anxiety as well as cognitive behavior were assessed before and after shifts.

Results: Urine specific gravity (P<0.001) increased significantly during a shift. Residents’ weight (P=0.024) and percentage concentration of urine (P=0.001) were significantly lower after a shift than before a shift. Emergency crowding and percentage of concentration after a shift (P<0.001), emergency crowding and concentration changes (P<0.001), and also the amount of water intake and urine specific gravity after a shift (P=0.01) demonstrated significant negative correlations, while emergency crowding and urine specific gravity before (P<0.001) and after (P<0.001) a shift and also emergency crowding and urine specific gravity changes(P=0.024) demonstrated a significant positive correlations.

Conclusions: It seems necessary that residents be much more conscientious about fluid intake during shifts and set aside some time to consume fluids in order to prevent impaired decision-makingand decrease possible medical errors.