McLelland Gayle, Morgans Amee, McKenna Lisa
School of Nursing and Midwifery, Monash University, PO Box 527, Frankston, VIC, 3199, Australia.
Research Development Manager, Ambulance Victoria, 375 Manningham Road, Doncaster, 3108, Australia.
BMC Pregnancy Childbirth. 2015 Feb 5;15:13. doi: 10.1186/s12884-015-0430-6.
Although it is generally accepted that paramedics attend unexpected births, there is a paucity of literature about their management of women in labour. This study aimed to investigate the caseload of women in labour attended by a statewide ambulance service in Australia during one year and the management provided by paramedics.
Retrospective clinical data collected on-scene by paramedics via in-field electronic patient care records were provided by Ambulance Victoria. Patient case reports were electronically extracted from the Ambulance Victoria's Clinical Data Warehouse via comprehensive filtering followed by manual sorting. Descriptive statistics were analysed using Statistical Package for Social Sciences (SPSS v.19).
Over a 12-month period, paramedics were called to 1517 labouring women. Two thirds of women were at full-term gestation, and 40% of pre-term pregnancies were less than 32 weeks gestation. Paramedics documented 630 case reports of women in early labour and a further 767 in established labour. There were 204 women thought to be second stage labour, including 134 who progressed to childbirth under paramedic care. When paramedics assisted with births, the on-scene time was significantly greater than those patients transported in labour. Pain relief was provided significantly more often to women in established labour than in early labour. Oxygen was given to significantly more women in preterm labour. While paramedics performed a range of procedures including intravenous cannulation, administration of analgesia and oxygen, most women required minimal intervention. Paramedics needed to manage numerous obstetric and medical complications during their management.
Paramedics provide emergency care and transportation for women in labour. Most of the women were documented to be at term gestation with minimal complications. To enable appropriate decision making about management and transportation, paramedics require a range of clinical assessment skills comprising essential knowledge about antenatal and intrapartum care.
尽管人们普遍认为护理人员会处理意外分娩情况，但关于他们对分娩期妇女的管理的文献却很少。本研究旨在调查澳大利亚一家全州范围的救护车服务机构在一年内处理的分娩期妇女病例数量以及护理人员提供的管理措施。
维多利亚救护车服务机构提供了护理人员通过现场电子患者护理记录收集的回顾性临床数据。通过全面筛选，然后人工分类，从维多利亚救护车服务机构的临床数据仓库中电子提取患者病例报告。使用社会科学统计软件包（SPSS v.19）进行描述性统计分析。
在12个月的时间里，护理人员接到了1517名分娩期妇女的呼叫。三分之二的妇女为足月妊娠，40%的早产孕妇妊娠周数小于32周。护理人员记录了630例分娩初期妇女的病例报告，另有767例已确诊分娩的病例报告。有204名妇女被认为处于第二产程，其中134名在护理人员的照料下分娩。当护理人员协助分娩时，现场停留时间明显长于那些在分娩时被转运的患者。与分娩初期的妇女相比，已确诊分娩的妇女接受止痛措施的频率明显更高。早产妇女吸氧的比例明显更高。虽然护理人员执行了一系列操作，包括静脉插管、给予镇痛剂和吸氧，但大多数妇女只需很少的干预。护理人员在管理过程中需要处理许多产科和医疗并发症。
护理人员为分娩期妇女提供紧急护理和转运服务。大多数妇女记录为足月妊娠，并发症极少。为了能够对管理和转运做出适当决策，护理人员需要一系列临床评估技能，包括有关产前和产时护理的基本知识。
