Heart rate responses in critical care trainees during airway intubation: a comparison between the simulated and clinical environments

BMC Emergency Medicine

Research

Heidi Helene Graham Thies¹  Bridget Langley¹  Clarissa Torcasio²  Julian van Dijk²  Jackson Ji³  Anjalee Brahmbhatt⁴  Neil Cunningham⁵  Rachel Zordan⁶ 

[1]Department of Anaesthesia and Acute Pain Medicine, St Vincent’s Hospital, Melbourne, Australia

[2]Education and Learning, St Vincent’s Hospital Melbourne, Melbourne, Australia

[3]Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia

[4]Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia

[5]Department of Anaesthesia and Acute Pain Medicine, St Vincent’s Hospital, Melbourne, Australia

[6]Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia

[7]Department of Emergency Medicine, St Vincent’s Hospital, Melbourne, Australia

[8]Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia

[9]Education and Learning, St Vincent’s Hospital Melbourne, Melbourne, Australia

关键词: Medical simulation;    Airway intubation;    Critical care doctors;    Heart rate;    Stress response;   

DOI  :  10.1186/s12873-023-00832-8

 received in 2022-11-25, accepted in 2023-05-24,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectiveThis study aimed to compare the heart rate response to stress during airway intubations in clinical practice and a simulated environment.MethodsTwenty-five critical care registrars participated in the study over a 3-month period. Heart rate data during intubations was recorded by a FitBit® Charge 2 worn by each participant during their clinical practice, and during a single simulated airway management scenario. The heart rate range was calculated by subtracting the baseline working heart rate (BWHR) from the maximum functional heart rate (MFHR). For each airway intubation performed participants recorded an airway diary entry. Data from intubations performed in the clinical environment was compared to data from a simulated environment. Heart rate changes were observed in two ways: percentage rise (median) across the 20-min intubation period and; percentage rise at point of intubation (median).ResultsEighteen critical care registrars completed the study, mean age 31.8 years (SD = 2.015, 95% CI = 30.85–32.71). Throughout the 20-min peri-intubation recording period there was no significant difference in the median change in heart rates between the clinical (14.72%) and simulation (15.96%) environment (p = 0.149). At the point of intubation there was no significant difference in the median change in heart rate between the clinical (16.03%) and the simulation (25.65%) environment groups (p = 0.054).ConclusionIn this small population of critical care trainees, a simulation scenario induced a comparable heart rate response to the clinical environment during intubation. This provides evidence that simulation scenarios are able to induce a comparable physiological stress response to the clinical environment and thus facilitates effective teaching of a high-risk procedure in a safe manner.

【 授权许可】

CC BY   
© The Author(s) 2023

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