Medical staff in emergency situations: Severity of patient status predicts stress hormone reactivity and recovery

Background: Although repetitive exposure to stressful situations is thought to habituate the physical stress responses, work stress is experienced by medical personnel in emergency and intensive care units; performance should, however, remain stable over time. Aims: To investigate the neuroendocrine reactions (reactivity during and recovery after work) in experienced emergency caregivers during emergency situations. Methods: A within subjects pre-post design was studied in the natural work environment of 20 municipal Dutch emergency caregivers. A stress protocol was developed in which the biomarker cortisol was measured in saliva at baseline, during the emergency period, and during recovery. Four scenarios were tested between subjects in which the severity of the emergency situation and the time of day were taken into account. Results: Greater endocrine reactions were shown during and after the handling of patients in direct life threatening situations during morning hours compared to the handling of patients who were not in direct life threatening situations.