Medical personnel often experience stress when responding to a medical emergency. A known stress-response is a measurable reduction in heart rate variability. It is currently unknown if crisis simulation can elicit the same stress response as real clinical emergencies. We aim to compare heart rate variability changes amongst medical trainees during simulated and real medical emergencies. We performed a single center prospective observational study, enrolling 19 resident physicians. Heart rate variability was measured in real time, using a 2-lead heart rate monitor (Bodyguard 2, Firstbeat Technologies Ltd) worn during 24 h critical care call shifts. Data was collected at baseline, during crisis simulation and when responding to medical emergencies. 57 observations were made to compare participant's heart rate variability. Each heart rate variability metric changed as expected in response to stress. Statistically significant differences were observed between baseline and simulated medical emergencies in Standard Deviation of the N-N interval (SDNN), Root mean square standard deviation of the N-N interval (RMSSD), Percentage of successive R-R intervals that differ by more than 50 ms (PNN50), Low Frequency (LF) and Low Frequency: High Frequency ratios (LF:HF). No statistically significant differences between simulated and real medical emergencies were identified in any heart rate variability metrics. We have shown using objective results, that simulation can elicit the same psychophysiological response as actual medical emergencies. Therefore, simulation may represent a reasonable way to practice not only essential skills in a safe environment but has the additional benefit of creating a realistic, physiological response in medical trainees.

中文翻译：

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使用心率变异性比较真实危机和模拟危机期间的压力反应：一项试点研究。

医务人员在应对医疗紧急情况时经常会感到压力。已知的压力反应是心率变异性的显着降低。目前尚不清楚危机模拟是否能够引发与真实临床紧急情况相同的应激反应。我们的目的是比较医学实习生在模拟和真实医疗紧急情况下的心率变异性变化。我们进行了一项单中心前瞻性观察研究，招募了 19 名住院医师。使用 24 小时重症监护呼叫轮班期间佩戴的 2 导联心率监测器（Bodyguard 2，Firstbeat Technologies Ltd）实时测量心率变异性。数据是在基线、危机模拟期间和应对医疗紧急情况时收集的。进行了 57 次观察来比较参与者的心率变异性。每个心率变异性指标都会随着压力的变化而发生预期的变化。在 NN 间隔的标准差 (SDNN)、NN 间隔的均方根标准差 (RMSSD)、相差超过 50 毫秒的连续 RR 间隔的百分比 (PNN50) 方面观察到基线和模拟医疗紧急情况之间存在统计显着差异、低频 (LF) 和低频：高频比率 (LF:HF)。在任何心率变异性指标中都没有发现模拟的医疗紧急情况和真实的医疗紧急情况之间存在统计学上的显着差异。我们已经使用客观结果证明，模拟可以引起与实际医疗紧急情况相同的心理生理反应。所以，