Emergency medical service transport-induced stress? An experimental approach with healthy volunteers

This randomized controlled trial was designed to evaluate the effects of si mulated emergency medical service (EMS) transport related stress on hemodyn amic variables, and catecholamine plasma levels. A total of 32 healthy male volunteers were randomized to being carried by paramedics from a third-flo or apartment through a staircase with subsequent high-speed EMS transport w ith lights and sirens (stress; n = 16); or sitting on a chair for 5 min, an d lying on a stretcher for 15 min (control; n=16). Blood samples and hemody namic Variables were taken in the apartment before transfer, at the ground floor, and at the end of EMS transport in the stress group, and at correspo nding time points in the control group. The stress versus control group had both significantly (P<0.05) higher mean+/-SEM epinephrine (71+/-7 versus 3 7+/-3 pg/ml), and norepinephrine (397 +/- 29 Versus 299 +/- 28 pg/ml) plasm a levels after transport through the staircase. After EMS transport, the st ress Versus control group had significantly higher epinephrine (48 +/- 6 ve rsus 32 +/- 2 pg/ml), but not norepinephrine (214 +/- 20 Versus 264 +/- 31 pg/ml) plasma levels. Heart rate increased significantly from 72 +/- 2 to 8 4 +/- 3 bpm after staircase transport, but not during and after EMS transpo rt. In conclusion, volunteers being carried by paramedics through a stairca se had a significant discharge of both epinephrine and norepinephrine resul ting in increased heart rate, but only elevated epinephrine plasma levels d uring EMS transport. Transport through a staircase may reflect more stress than emergency EMS transport. (C) 2001 Elsevier Science Ireland Ltd. All ri ghts reserved.