Awareness of the cumulative stress placed on first responders and tactical operators is required to manage acute fatigue, which can impair occupational performance, and may precipitate negative chronic health outcomes. The aim of this review was to investigate the utility of heart rate variability (HRV) to monitor stress and allostatic load among these populations. A systematic search of Academic Search Complete, MEDLINE complete, PsycINFO, SPORTDiscus and Scopus databases was conducted. Eligibility criteria: original peer reviewed research articles, written in English, published between 1985 and 2020, using human participants employed as a first responder or tactical operator, free from any psychological disorder. Of the 360 articles screened, 60 met the inclusion criteria and were included for full text assessment. Articles were classified based on single or repeated stressor exposure and the time of HRV assessment (baseline, during stressor, post stressor). Singular stressful events elicited a reduction in HRV from baseline to during the event. Stressors of greater magnitude reduced HRV for extended durations post stressor. Lower resting HRV was associated with lower situational awareness and impaired decision-making performance in marksmanship and navigation tasks. There were insufficient studies to evaluate the utility of HRV to assess allostatic load in repeated stressor contexts. A reduction in HRV occurred in response to acute physical and cognitive occupational stressors. A slower rate of recovery of HRV after the completion of acute occupational stressors appears to occur in response to stressors of greater magnitude. The association between lower HRV and lower decision-making performance poses as a useful tool but further investigations on within subject changes between these factors and their relationship is required. More research is required to investigate the suitability of HRV as a measure of allostatic load in repeated stress exposures for fatigue management in first responder and tactical operators.

中文翻译：

---

使用心率变异性监测急救人员和战术操作员的压力和稳态负荷：系统评价

需要意识到急救人员和战术操作员承受的累积压力，以管理急性疲劳，这会损害职业表现，并可能导致负面的慢性健康结果。本综述的目的是研究心率变异性 (HRV) 在监测这些人群的压力和稳态负荷方面的效用。对 Academic Search Complete、MEDLINE complete、PsycINFO、SPORTDiscus 和 Scopus 数据库进行了系统搜索。资格标准：原始同行评审研究文章，用英语撰写，发表于 1985 年至 2020 年之间，使用人类参与者作为第一响应者或战术操作员，没有任何心理障碍。在筛选的 360 篇文章中，60 篇符合纳入标准，并被纳入全文评估。文章根据单一或重复的压力源暴露和 HRV 评估时间（基线、压力源期间、压力源后）进行分类。单一的压力事件导致 HRV 从基线到事件期间降低。更大程度的压力源在压力源后的较长时间内降低了 HRV。较低的静息 HRV 与较低的情境意识以及射击和导航任务中的决策能力受损有关。没有足够的研究来评估 HRV 在重复压力源环境中评估平衡负荷的效用。HRV 降低是对急性身体和认知职业压力源的反应。在完成急性职业压力源后，HRV 的恢复速度较慢，似乎是对更严重的压力源做出反应。较低的 HRV 和较低的决策绩效之间的关联是一个有用的工具，但需要进一步调查这些因素之间的主题变化及其关系。需要更多的研究来调查 HRV 作为测量重复应力暴露中的平衡负荷的适用性，以用于急救人员和战术操作员的疲劳管理。