Health consequences of stress, workload, patient safety, quality of care
Conditions
Interventions
Group 1: Central to the research question is the data collection from 40 healthy emergency physicians who staff the MIC (Medical Intervention Car) at the Heidelberg Department of Anesthesiology. The
Sponsors
Universitätsklinikum Heidelberg
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: • MIC emergency physicians and/or RTH emergency physicians • ?Granting of written consent • ?Completion of one MIC or RTH assignment during the observation period
Exclusion criteria
Exclusion criteria: • Known pregnancy • Pre-existing heart disease (valvular heart disease > Class I), • Any form of cardiomyopathy or channelopathy that can be diagnosed by ECG, echocardiogram, or exercise testing • History of coronary artery disease • History of myocarditis • Known high-frequency (> 1% of all beats within 24 hours) premature atrial or ventricular beats, atrial fibrillation, or conduction disturbances • Any antiarrhythmic therapy • Any implanted cardiac device • Known overt hyperthyroidism
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The aim of the study is to assess the stress response of emergency physicians during their shifts in the MIC and while working in the operating room. Using eye tracking, ST-T segment analysis in the ECG, salivary cortisol, the NASA Task Load Index (TLX), and HRV, the study aims to gain an understanding of the balance between stress and recovery among emergency physicians on duty. In addition, the study will examine the influence of single and repeated stressors on these parameters. The primary Endpoints are: 1. Reduction in HRV during and after MIC deployment compared to baseline 2. Persistent reduction in HRV after MIC deployment in the operating room 3. Fixation-related parameters are influenced by stressors during MIC deployment 4. Correlation between AOI-based parameters (Areas of Interest) and decision-making during MIC deployment 5. Occurrence of ST-T segment changes exceeding 0.1 mV in two corresponding leads for more than 30 seconds during routine clinical practice and MIC deployment HRV is recorded using an “HRM-600” chest strap and the “Forerunner 165” watch (Garmin Deutschland GmbH). ST-T segment changes are recorded using a portable 12-lead ECG “DARWIN2” (Schiller GmbH, Munich). Eye-tracking parameters are recorded using the “TOBII PRO GLASSES 3” (Tobii, Stockholm, Sweden). | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Increase in pupil diameter during MIC deployment compared to baseline 2. Individual stressors during MIC deployment are indicated by saccade-related parameters 3. Recovery of HRV to baseline levels before the start of the next shift 4. Higher HRV under stress and at rest indicates better performance in decision-making and cognitive tasks 5. Repeated exposure to stressors during MIC operations leads to an adaptation of HRV 6. Elevated salivary cortisol levels before and after MIC operations compared to baseline 7. The NASA-TLX questionnaire, used as a measure of subjectively perceived stress during MIC operations, correlates with HRV | — |
Countries
Germany
Contacts
Public ContactOle Keim
Universitätsklinikum Heidelberg
Outcome results
None listed