The Center for Disaster Medicine and Traumatology

National Research Center for Traumatology assigned by the Swedish National Board of Health and Welfare

Performance under pressure – first aid under stress

Performing first aid actions can be stressful for a medical layperson. Researchers at KMC have studied how stress affects first aid measures; the study is the first to investigate how laypeople are affected by stress in a first aid-situation where tourniquets are applied compared with trained professionals. Performing heart compressions and application of a tourniquet under calm and under stressful circumstances were investigated in the study.

“Previous studies have looked at how medical professionals and soldiers handle stressors, and how stress affects the quality of the first aid measures they take”, says Marc Friberg, PhD student at KMC and first author of the paper.

After brief training, study participants performed heart compressions and tourniquet application in a calm classroom environment. The tasks were then repeated under stressful circumstances, specifically from running between stations and being under paintball gun fire. The results show stress was increased in laypeople, but that the quality of tourniquet application did not suffer from stress in laypersons. However, some aspects of CPR performance declined under stressful circumstances. Stressors were evaluated by self-evaluation forms, physiological markers such as heart rate, and task load evaluations.

“There has been a notion that laypersons cannot handle the stress in a real-life first aid situation. Our study shows that laypersons can perform, under stress and with only a short training to help”, says Marc Friberg.   

Friberg M, Jonson C-O, Jaeger V, Prytz E.
The Effects of Stress on Tourniquet Application and CPR Performance in Layperson and Professional Civilian Populations. 
Human Factors. May 2021. doi:10.1177/00187208211021255

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