Relationship between physiologic and psychological measures of autonomic activation in operating room teams during a simulated airway emergency

Phitayakorn, Roy; Minehart, Rebecca D.; Hemingway, Maureen; Pian-Smith, May C. M.

doi:10.1016/j.amjsurg.2014.08.036

Cited by 23 publications

(29 citation statements)

References 10 publications

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“…Only a minority of trainees identified clinical skills simulation as the most stressful part of their day, despite the physiological data suggesting otherwise, and in keeping with previous literature. 18 Arguably, many junior surgeons may view this course component as the most enjoyable. Conversely, a reverse perspective would concur with earlier reports that surgeons are exposed to repeated mental stress, yet fail to recognise it, implying cognitive dissonance.…”

Section: Discussionmentioning

confidence: 99%

Biosensors, Biomarkers and Biometrics: a Bootcamp Perspective

et al. 2020

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IntroductionCompetitive physical performance is routinely monitored by wearable technology (biosensors), yet professional healthcare is not, despite high prevalence of trainee stress and burnout, notwithstanding the corresponding risk to patient safety. This study aimed to document the physiological stress response of UK Core Surgical Trainees (CSTs) during simulation training.MethodsCSTs (n=20, 10 male) were fitted with Vital Scout Wellness Monitors (VivaLNK, Campbell, California, USA) for an intensive 3-day training bootcamp. In addition to physiological parameters, CST demographics, event diaries and Maslach Burnout Inventory scores were recorded prospectively during exposure to three scenarios: interactive lectures, clinical skills simulation and non-technical (communication) training.ResultsBaseline heart rate (BHR, 60 bpm (range 39–81 bpm)) and baseline respiratory rate (14/min (11–18/min)) varied considerably and did not correlate (rho 0.076, p=0.772). BHR was associated with weekly exercise performed (66 bpm (<1 hour) vs 43 bpm (>5 hour), rho −0.663, p=0.004). Trainee response (standardised median heart rate vs BHR) revealed heart rate was related proportionately to lectures (71 bpm, p<0.001), non-technical skills training (79 bpm, p<0.001) and clinical skills simulation (88 bpm, p<0.001). Respiratory rate responded similarly (p<0.001 in each case). Heart rate during clinical skills simulation was associated with emotional exhaustion (rho 0.493, p=0.044), but maximum heart rate was unrelated to CSTs’ perceived peak stressors.DiscussionStress response, as derived from positive sympathetic heart rate drive varied over two-fold, with a direct implication on oxygen uptake and energy expenditure, and highlighting the daily physical demands placed upon clinicians.

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Section: Discussionmentioning

confidence: 99%

Biosensors, Biomarkers and Biometrics: a Bootcamp Perspective

et al. 2020

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“…Similar pilot studies have been done in other surgical specialties. [18,19] However, this study is the first involving common orthopaedic surgery procedures and physiological responses, since only questionnaire-based studies have been done in this field. [20] Common orthopaedic surgical procedures are unique since they are much more physically demanding than other type of surgeries.…”

Section: Discussionmentioning

confidence: 99%

Physiological and psychological responses to surgery and non-surgery days in orthopaedic surgeons: A case study

Abatzoglou

Milne

Howard

et al. 2017

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Objective: Performing surgical procedures can increase the physiological stress and mental strain experienced by practicing surgeons. This may affect negatively work capacity and quality of patient care by increasing the incidence of burnout, sleep disorders, fatigue and substance abuse. The purpose of this pilot case study was to track physiological and psychological responses to clinical duties in an expert arthroplasty orthopaedic surgeon. Methods: Heart rate (HR), breathing rate, heart rate variability (HRV) and anxiety ratings were observed in an expert orthopaedic surgeon using a wearable Equivital EQO2 physiological monitor and the state-trait anxiety inventory (STAI), respectively. Data was recorded for 8 surgery, 1 clinic and 1 rest day. Physiological data was recorded for 6-8 hours/day. Results: The surgeon spent significantly more time with elevated HRs on surgery days versus either clinic or rest days (10% of the day over 100 bpm). This was not the case for respiratory rate. STAI responses were significantly greater pre versus post surgery and at baseline. Psychological and physiological markers of stress were elevated prior to each surgery regardless of surgery type and task. Notably, the HR never returned to baseline on surgery days. Discussion: This study provides a baseline on which to compare procedural and trainee differences during surgical procedures. Expert surgeons may demonstrate elevated stress levels on days of surgery, as indicated by self-reported anxiety scores as well as physiologic measures. Understanding the stress and anxiety present may direct interventions that enable improved surgeon health, surgical performance, and an improved learning environment.

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“…Unfortunately, there is still a paucity of studies about drone operators, due to the restricted access to them ( Chappelle W. et al, 2014 ). Emotional stability plays a key role in individual and team performance during routine activities and during management of unexpected emergencies ( Phitayakorn et al, 2015 ), and it can be assessed by physiologic and psychologic measurements ( Bradley and Lang, 2002 ). Physiologic measurement of emotional stability includes several kinds of devices conceived to record activation of the hypothalamic–pituitary–adrenal axis through the elevation of heart rate, respiration rate, blood pressure, blink rate, and pupil dilatation ( Timmermans et al, 2013 ).…”

Section: Introductionmentioning

confidence: 99%

Stress Profile in Remotely Piloted Aircraft Crewmembers During 2 h Operating Mission

et al. 2018

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Emotional stability plays a key role in individual and team performance during both routine activities and management of unexpected emergencies. Using a psycho-physiological approach, the stress response was investigated in drone operators in service.Methods: Salivary α-amylase (sAA), galvanic skin response (GSR) and anxiety were assessed over a 2-h operating flight.Results: Compared to baseline values, GSR and sAA values increased in operating conditions. Moreover, these values were higher in Pilots than in Sensor Operators, indicating that their stress response was greater. These results were associated with an increase in anxiety level, highlighting a relationship between autonomic reactivity and anxiety.Conclusion: This is the first report providing experimental evidences of the stress response related to Remotely Piloted Aircraft operations.

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Relationship between physiologic and psychological measures of autonomic activation in operating room teams during a simulated airway emergency

Cited by 23 publications

References 10 publications

Biosensors, Biomarkers and Biometrics: a Bootcamp Perspective

Biosensors, Biomarkers and Biometrics: a Bootcamp Perspective

Physiological and psychological responses to surgery and non-surgery days in orthopaedic surgeons: A case study

Stress Profile in Remotely Piloted Aircraft Crewmembers During 2 h Operating Mission

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