Abstract

Introduction:The majority of births in the United Kingdom happen in hospital or at stand-alone midwife led centres, or with the support of midwives in a planned fashion outside of hospital. The unplanned birth of a baby in the pre-hospital setting is a rare event which may result in an ambulance being called, so attendance at a birth is a rare event for ambulance clinicians. A service evaluation was conducted to report which clinical observations were recorded on babies born in the pre-hospital setting who were attended by ambulance clinicians from the North East Ambulance Service (NEAS) over a one-year period.Methods:A retrospective service evaluation was conducted using routinely collected data. All electronic patient care records covering a one-year period between 1 October 2017 and 30 September 2018 with a primary impression of ‘childbirth’ were examined.Results:This evaluation identified 168 individual pre-hospital childbirth cases attended by NEAS clinicians during the evaluation timeframe. The majority (85%) of babies were born to multiparous mothers with a median gestation of 39 weeks. Very few clinical observations were recorded on the babies (respiratory rate 23%, heart rate 21%, temperature 10%, APGAR 8%, blood sugar 1%) and no babies had all five of these observations documented. Only 5% of babies had any complications documented.Conclusion:This study showed that NEAS ambulance clinicians rarely attend babies born in the pre-hospital setting and that complications were infrequently recorded. There was a lack of observations recorded on the babies, which is an issue due to the clear link between easily measurable characteristics such as temperature and mortality and morbidity.

Highlights

  • The majority of births in the United Kingdom happen in hospital or at stand-alone midwife led centres, or with the support of midwives in a planned fashion outside of hospital

  • A retrospective service evaluation was conducted using routinely collected data to determine what clinical observations were recorded on babies born in the pre-hospital setting who were attended by North East Ambulance Service (NEAS) clinicians over a one-year period

  • The electronic patient care records (ePCRs) were filtered using the inclusion and exclusion criteria, which resulted in 168 individual childbirth cases being included in this service evaluation

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Summary

Introduction

The majority of births in the United Kingdom happen in hospital or at stand-alone midwife led centres, or with the support of midwives in a planned fashion outside of hospital. Babies born in an unplanned fashion in the pre-hospital setting have an increased risk of complications such as hypothermia, perinatal mortality, low birth weight and admission to neonatal intensive care (Loughney et al, 2006; Thornton & Dahlen, 2018; Unterscheider et al, 2011). Despite these increased risks, the literature indicates that most pre-hospital births require minimal interventions from ambulance clinicians (McLelland, McKenna, Morgans, & Smith, 2018)

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