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Does emergency transportation induce a stress-response in probationers

Introduction

Common opinion is that emergency transportation is a stressful event for patients. The question is if simulated emergency transportation might be a useful model to measure the levels of stress-responsive with a high ecological validity.

Methods

After approval by the local ethical committee 32 male probationers (age 18–40) were randomized into two groups ('strain', 'control'). The following values were taken: plasma-hormones (epinephrine E, norepinephrine NE, cortisol C) and CVS-values (BP, MAP, HR). The 'strain'-group was carried downstairs from a third floor flat and taken into an ambulance for an emergency transport. Blood samples were taken in the flat after informing the probationer (A), at the ground-floor (B) and at the end of a 15 min emergency transportation under defined conditions (C). The CVS-values were recorded continuously. The `control'-group had to sit on a chair for 5 min and afterwards to lay on a stretcher for 15 min. The blood samples were done at equivalent times. The results were evaluated by a two-factor variance analysis with repetition of the values for the factor measuring time.

Results

Our study shows that a simulated emergency transportation induces stress. Differences in stress-responses depending on the period of the simulated emergency transport were found. The increase of E, NE, C and HR during the transport of the probationer down the stairs was significant (P < 0.001); no significant alterations could be shown in the `control' group. The emergency transport in the ambulance appears to be clearly less of a strain to the patient. This was shown by a significant decrease of HR, E and NE levels (P < 0.001) compared to the downstairs part.

Conclusion

More attention should be focused on the period of emergency transport from on-scene to the ambulance to influence positively the most stressing event. Further studies concerning sedation before transportation appear to be necessary.

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Doerges, V., Dix, S., Ocker, H. et al. Does emergency transportation induce a stress-response in probationers. Crit Care 3, P228 (2000). https://doi.org/10.1186/cc601

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Keywords

  • Public Health
  • Blood Sample
  • Cortisol
  • Norepinephrine
  • Epinephrine