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March 15, 2019AEM Education and TrainingOpen Access

Mean HRV before intubation (17.88 ± 9.22) and during intubation (21.17 ± 13.46) was significantly lower than resting baseline (32.09 ± 15.23; p < 0.001 and p = 0.02, respectively), and preintubation anxiety negatively correlated with HRV (r = -0.39, p = 0.001).

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Why the study?

Emergency physicians face high acute psychological stress during medical emergencies, but objective stress markers are difficult to measure clinically. The authors explored the relationship between heart rate variability and self-reported acute stress in residents learning intubation.

Does performing intubation alter heart rate variability as a measure of acute stress in novice airway managers?

Comparison

Before and during intubation vs resting baseline

Design

Single-center prospective study

Follow-up

1-month anesthesia rotation

Authors

JMJason MeffordUniversity of California Davis Medical CenterSKSarah KahleMIND Research InstituteSGShikha GuptaMahatma Gandhi Memorial Medical College

Discussion

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Member takes

Overview

HRV may track self-reported stress in EM residents; leaves open its role for real-time monitoring or intervention.

Structured PICO

Does performing intubation alter heart rate variability as a measure of acute stress in novice airway managers?

P
Population
8 postgraduate year 1 (PGY-1) emergency medicine residents at a single academic medical center during their 1-month anesthesia rotation (64 intubations recorded)
I
Intervention
Performing first intubation attempt of the day on actual patients
C
Comparator
Resting baseline
O
Outcome
Heart rate variability (HRV) measured by root mean square of successive differences immediately before and during intubationsurrogate

Heart rate variability significantly decreases during intubation attempts by novice emergency medicine residents, correlating with self-reported anxiety, suggesting its utility as an objective marker of acute psychological stress.

Cite This Study

Mefford et al. (2019) studied this question.

synapsesocial.com/papers/6a77df772ea07b97ffae0d7ehttps://doi.org/10.1002/aet2.10335
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 11260: HEART RATE VARIABILITY AS A MARKER OF STRESS IN TRAINEE PERFORMANCE OF CRITICAL PROCEDURES2026
  2. 2Assessment of Stress in Anesthesiologists Using Heart Rate Variability during Anesthetic Induction: An Observational Study2019 · 2 citations
  3. 3Heart rate variability and physician performance during airway management simulations: an exploratory pilot study2026
  4. 4Resident stress levels during simulated patient encounters2026
  5. 5Heart rate variability as a strain indicator for psychological stress for emergency physicians during work and alert intervention: a systematic review2021 · 44 citations