Haemodynamic effects of mental stress during cardiac arrest simulation testing on advanced life support courses.
We investigated the haemodynamic response to the mental stress induced by being evaluated as a team leader in simulated advanced life support (ALS) scenarios.


METHODS
Healthcare providers participating as candidates to ALS courses were monitored while acting as team leaders in a cardiac arrest testing scenario (CASTest). Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured before, during and after the CASTest. The correlation between the haemodynamic responses and sex, age, body mass index (BMI) and marks on course multiple choice questions (MCQs) were studied using multiple linear regression.


RESULTS
Eighty-eight subjects (46 women, 42 men, mean age 34.9+/-6.8 years) were enrolled. Mean HR, SBP and DBP increased significantly during the CASTest and reached a peak after a phase of the scenario which included an unsuccessful defibrillation. Ten minutes after the CASTest, HR, SBP and DBP were still significantly higher than their respective baseline values. A significant positive correlation was found between the DBP and SBP response during the scenario and the BMI, and between the DBP response and the candidates' age. The haemodynamic stress response was neither correlated with the candidates' marks in the course MCQ nor with their instructor potential (IP).


CONCLUSIONS
During the testing scenario the ALS candidates showed a significant haemodynamic response to mental stress, which depended mainly on their age and BMI rather than on their knowledge and skills.
Sandroni
Claudio
C
Department of Anaesthesiology and Intensive Care, Catholic University School of Medicine, Rome, Italy. sandroni@rm.unicatt.it
Fenici
Peter
P
Cavallaro
Fabio
F
Bocci
Maria Grazia
MG
Scapigliati
Andrea
A
Antonelli
Massimo
M
D000328:Adult; D022561:Advanced Cardiac Life Support / Q000523:psychology*; D000367:Age Factors; D000704:Analysis of Variance; D015992:Body Mass Index; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007857:Leadership; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D013315:Stress, Psychological / Q000523:psychology*