PubMed1983
Free urine adrenaline, noradrenaline, (additional free plasma catecholamines in the physicians), and blood lactate were determined in 11 ambulance men and 5 physicians to assess stress during medical service. Stress was evaluated employing a stress index, based on difficulties in driving, traffic, severity of injuries or illness. Emergency cases with seriously injured subjects or reanimation were judged to have a 4-fold higher stress index than routine cases where strong physiological or psychological stress was absent. Urine catecholamines and stress indices were estimated in 3-h intervals. The calculations were based on the stress induced catecholamine concentrations minus the basal excretion during the same 3-h interval. Urine adrenaline and noradrenaline in ambulance men and physicians correlated directly with the stress index, as well as the plasma catecholamines of the physicians. Lactate levels showed similar behaviour and a descriptive direct correlation with the plasma catecholamines. Urine adrenaline increased more--dependent on the stress index--than urine noradrenaline. This over-proportional adrenaline response may be an indicator for the additional psychological stress in emergency cases. Therefore physicians showed--based on the same stress index--a tendency to higher urine adrenaline excretion and blood lactate levels than the ambulance men, which might be the consequence of the overall responsibility of the physicians. Because of the observed catecholamine responses during medical service, coronary insufficiency or hypertension might be contra-indications for participation in the medical service; regular clinical investigations including ergometric tests are advisable.