Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-26T09:18:37.164Z Has data issue: false hasContentIssue false

Heart Rate as a Marker of Stress in Ambulance Personnel: A Pilot Study of the Body's Response to the Ambulance Alarm

Published online by Cambridge University Press:  25 March 2011

Kåre Karlsson
Affiliation:
Borås University, School of Health Sciences, Borås, Sweden
Patrik Niemelä
Affiliation:
Borås University, School of Health Sciences, Borås, Sweden
Anders Jonsson*
Affiliation:
Borås University, School of Health Sciences, Borås, Sweden Swedish Armed Forces, Centre for Defence Medicine Västra, Frölunda, Sweden
*
Correspondence: Anders Jonsson Högskolan i BoråsRoom E 525School of Health SciencesKnowledge Centre for Prehospital CareSE- 501 90 BoråsSWEDEN. E-mail: [email protected]

Abstract

Introduction: Studies have demonstrated the presence of stress and post-traumatic stress among ambulance personnel, but no previous research has focused on the body's reaction in the form of the change in heart rate of ambulance staff in association with specific occupational stress.

Hypothesis: The purpose of this study is to investigate whether work as an ambulance professional generates prolonged physiological arousal that can be measured by heart rate in different situations.

Methods: Twenty participants carried a pulse-meter in the form of a wristwatch, which continuously measured and stored their heart rate 24 hours per day for a period of seven days. All ambulance alarms that occurred during the test period were recorded in journals, and the participants completed diaries and a questionnaire describing their experiences. The alarms were divided into different phases. Correlations between heart rate in the different phases were computed.

Results: Analysis of study data indicated a significant rise of heart rate unrelated to physical effort during an emergency alarm and response. This increased heart rate was noticed throughout the mission and it was not related to the length of experience the staff had in the ambulance profession. In addition, a non-significant trend suggested that alarms involving acutely ill children lead to an even higher increase in heart rate. In addition, this research showed that constant tension existed during sleep, while available for an emergency, indicated by a noticeable increase in heart rate during sleep at work compared to sleeping at home.

Conclusions: A rise in heart rate was experienced during all acute emergency missions, regardless of a subject's experience, education, and gender. Missions by themselves generated a rate increase that did not seem to correlate with physical effort required during an emergency response. This study shows that working on an ambulance that responds to medical emergencies is associated with a prolonged physiological arousal.

Type
Original Research
Copyright
Copyright Karlsson © World Association for Disaster and Emergency Medicine 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Jonsson, A, Segesten, K: Daily stress and concept of self in Swedish ambulance personnel. Prehosp Disaster Med 2004;19:226234.CrossRefGoogle ScholarPubMed
Socialstyrelsen. Socialstyrelsens allmänna råd. Ändring i allmänna råd om kompetensbeskrivningar för sjuksköterskor och barnmorskor 1995:5. SOSFS 1997:18. Available at http://www.socialstyrelsen.se. Accessed 26 January 2009.Google Scholar
Socialstyrelsen. Socialstyrelsens föreskrifter och allmänna råd om läkemedelhantering i hälso- och sjukvård. SOSFS 2000:1. Available at http://www.socialstyrelsen.se. Accessed 26 January 2009.Google Scholar
Socialstyrelsen. Läkemedelshantering inom ambulanssjukvården från och med den 1 November 2005. Meddelandeblad. Available at http://www.socialstyrelsen.se. Accessed 26 January 2009.Google Scholar
Dahlberg, K, Segesten, K, Nyström, M, Suserud, BO, Fagerberg, I: Att förstå vårdvetenskap. 1st ed. Lund: Studentlitteratur, 2003.Google Scholar
Bruce, K, Dahlberg, K, Suserud, BO: Ambulance nursing assessment: Part two. Emergency Nurse 2003;11:1418.Google Scholar
Arbetsmiljöverket. Kartläggning av ambulanspersonalens arbetsmiljö. Rapport nr 7. Available at http://www.av.se/dokument/publikationer/rapporter/RAP1998_07.pdf. Accessed 21 Mars 2009.Google Scholar
Wireklint Sundström, B: Förberedd på att vara oförberedd. Växjö: Växjö University Press, 2005.Google Scholar
Bruce, K, Suserud, BO: Ambulance nursing: Part three. Emergency Nursing 2003; 11:1621.Google ScholarPubMed
Svensson, A, Fridlund, B: Experiences of and actions toward worries among ambulance nurses in their professional life: A critical incident study. Int Emerg Nurs 2008;16:3542.CrossRefGoogle Scholar
Thomas, MR, Dyrbye, LN, Huntington, JL, Lawson, KL, Novotny, PJ, Sloan, JA, Shanafelt, TD: How do distress and well-being relate to medical student empathy? A multicenter study. Society of General Internal Medicine 2007;22:177183.CrossRefGoogle ScholarPubMed
Nordby, H, Nöhr, Ö: Communications and empathy in an emergency setting involving persons in crisis. Scand J Trauma, Resusc Emerg Med. Available at http://www.sjtrem.com/content/16/1/5. Accessed 13 February 2009.CrossRefGoogle Scholar
Halpen, J: What is clinical empathy? Journal of General Medicine 2003;18:670674.Google Scholar
Aasa, U, Brulin, C, Ängquist, KA, Barnekow–Bergkvist, M: Work-related psychosocial factors, worry about work conditions and health complaints among female and male ambulance personnel. Scandinavian Journal of Caring Science 2005;19:251258.CrossRefGoogle ScholarPubMed
Alexander, DA, Klein, S: Ambulance personnel and critical incidents. Br J Psychiatry 2001;178:7681.CrossRefGoogle ScholarPubMed
Jonsson, A, Segesten, K, Mattsson, B: Post-traumatic stress among Swedish ambulance personnel. Emergency Medicine Journal 2003;20:7984.CrossRefGoogle ScholarPubMed
Jonsson, A, Segesten, K: Guilt, shame and need for a container: A study of post-traumatic stress among ambulance personnel. Accid Emerg Nurs 2004; 12:215223.CrossRefGoogle Scholar
Sterud, T, Ekeberg, Ö, Hem, E: Health status in ambulance services: A systematic review. BMC Health Serv Res 2006;6:8291.CrossRefGoogle ScholarPubMed
van der Ploeg, E, Kleber, RJ: Acute and chronic job stressors among ambulance personnel: predictors of health symptoms. Occupational Environment Medicine 2003;60:4046.CrossRefGoogle ScholarPubMed
Grillon, C, Duncko, R, Covington, MF, Kopperman, L, Kling, MA: Acute stress potentiates anxiety in humans. Biol Psychiatry 2007;62:11831186.CrossRefGoogle ScholarPubMed
Carnethon, MR, Yan, L, Greenland, P, Garside, DB, Dyer, AR, Metzger, B, Davidglus, ML: Resting heart rate in middle age and diabetes development in older age. Diabetes Care 2008;31:335339.CrossRefGoogle ScholarPubMed
Kannel, WB, Kannel, C, Paffenbarger, RS, Cupples, LA: Heart rate and cardiovascular mortality: The Framingham study. Am Heart J 1987;113:14891494.CrossRefGoogle ScholarPubMed
Kamarch, TW, Shiffman, SM, Smithline, L, Goodie, JL, Paty, JA, Gnys, MYi-Kuan Jong, J: Effects of task strain, social conflict, and emotional activation on ambulatory cardiovascular activity: Daily life consequences of recurring stress in a multiethnic adult sample. Health Psychol 1998;17:1729.CrossRefGoogle Scholar
Shigetoh, Y, Adachi, H, Yamagashi, S, Enomoto, M, Fukami, A, Otsuka, M, Kumagae, S, Furuki, K, Nanjo, Y, Imaizumi, T: Higher heart rate may predispose to obesity and diabetes mellitus: 20–year prospective study in a general population. Am J Hypertens 2008;22:151155.CrossRefGoogle ScholarPubMed
Palatini, P, Casiglia, E, Julius, S, Pessina, AC: High heart rate. Arch Internal Med 1999;159:585592.CrossRefGoogle ScholarPubMed
Palatini, P: Heart rate: A strong predictor of mortality in subjects with coronary artery disease. Eur Heart J 2005;26:943945.CrossRefGoogle Scholar
Diaz, A, Bourassa, MG, Guertin, MC, Tardif, JC: Long-term prognostic value of resting heart rate in patients with suspected or proven coronary artery disease. Eur Heart J 2005;26:967974.CrossRefGoogle ScholarPubMed
Evans, O, Steptoe, A: Social support at work, heart rate, and cortisol: A self-monitoring study. J Occup Health Psychol 2001;6:361370.Google Scholar
Palatini, P, Thijs, L, Staessen, JA, Fagard, RH, Bulpitt, CJ, Clement, DL, de Leeuw, PW, Jaaskivi, M, Leonetti, G, Nashev, CO'Brien, ET, Parati, G, Rodicio, JL, Roman, E, Sarti, C, Toumilehto, J: Predictive value of clinic and ambulatory heart rate for mortality in elderly subjects with systolic hypertension. Arch Internal Med 2002;162:23132321.CrossRefGoogle ScholarPubMed
Vetenskapsrådet. Forskningsetiska principer. Available at http://www.vr.se/download/18.668745410b37070528800029/HS%5B1%5D.pdf. Accessed 16 January 2009.Google Scholar
Kuorinka, I, Korhonen, O: Firefighters' reaction to alarm, an ECG and heart rate study. Journal of Occupational Medicine 1981;23:762766.CrossRefGoogle ScholarPubMed
Sterud, T, Hem, E, Ekeberg, Ö, Lau, B: Occupational stressors and its organizational and individual correlates: A nationwide study of Norwegian ambulance personnel. BMC Emergency Medicine. Available at http://www.biomedcentral.com/1471–227x/8/16. Accessed 08 April 2009.CrossRefGoogle Scholar
Gula, LJ, Krahn, AD, Skanes, AC, Yee, R, Klein, GJ: Clinical relevance of arrhythmias during sleep: Guidance for clinicians. Heart 2004;90:347352.CrossRefGoogle ScholarPubMed