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PURPOSE OF THE STUDY: HEMS crew are subject to various sources of environmental, physical and psychological stress. Heart rate variability (HRV) measures the interaction between the sympathetic and parasympathetic nervous system through heart rate variability. The aim of the study was to assess the relationship between subjective self-report stress detected through the administration of questionnaires and objective stress detected through HRV measurement in a sample of HEMS crewmembers in Pieve di Cadore (Italy). Furthermore, the study aims to validate the capability of a new ECG-device to highlight over-stress situations during the various mission’s phases in relation to the skills and know-how of the different crew member. The pilot study was performed from May to September 2017 and were collected data from 40 crew members. MATERIALS AND METHODS: Mini-ECG-Holter Faros 180 Mega (Finland) was used for HRV(Figure 3) detection during all phases of the missions. Time domain, frequency domain and non- linear methods were analyzed by Kubios HRV software (University of Kuopio, Finland) The psychometric test NASA-TLX was administered to the crew at the beginning and at the end of each mission, GHQ-12 and RCSQ only at the beginning of the workday, instead VRS at the beginning and at the end of the shift. RESULTS: We analyzed 313 surveys to obtain the baseline reference values for helicopter rescue crew. SDNN, pNN50, VLF / HFpw, VLFpower, HRmean, SD1, SD2 (p <0.05) correlate with the variations of sympathetic and parasympathetic activity of the analyzed subjects. CONCLUSIONS: For the first time it was possible to record sympathetic / parasympathetic activity of helicopter rescue crew during special procedures, specifically winch, hovering, take-off and landing. The innovative use of HRV in the HEMS context for the comparison of subjective and surveyed data provided reproducible methods and significant parameters, allowing the implementation of stress management policies, both on an individual and collective basis to increase safety in the workplace. Differences between detected and perceived stress were underlined. References: 1. Winkler R. Occupational Stress in Western Australian Ambulance Officers. In: The 14th Convention of Ambulance Authorities. Perth, Australia; 1980. 2. Zużewicz K, Biernat B, Kempa G, Kwarecki K. Heart rate variability in exposure to high altitude hypoxia of short duration. Int J Occup Saf Ergon. 1999;5(3):337-346. 3.Togo F, Takahashi M. Heart Rate Variability in Occupational Health ―A Systematic Review. Ind Health. 2009;47(6):589-602. ABBREVIATIONS: HRV-Heart Rate Variability; VRS-Rapid Stress Assessment, GHQ-12 General Health Questionnaire-12; RCSQ-Richard Campbell Score Questionnaire, SDNN- Standard Deviation of Normal-Normal intervals; pNN50- mean number of times per hour in which the change in consecutive normal sinus (NN) intervals exceeds 50 milliseconds; VLF-Very Low Frequencies; HF-High Frequencies; SD1- short-term variability; SD2-long-term variability; HEMS-Helicopter Emergency Medical Services
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