McLelland Gayle, McKenna Lisa, Morgans Amee, Smith Karen
School of Nursing and Midwifery, Monash University, PO Box 527, Frankston, VIC 3199, Australia.
School of Nursing and Midwifery Monash University, Building 13C, Clayton Campus, Clayton 3800, Australia.
Midwifery. 2016 Jul;38:71-7. doi: 10.1016/j.midw.2016.02.007. Epub 2016 Feb 11.
to report findings from a study performed prior to the introduction of publicly funded home birth programmes in Victoria, Australia, that investigated the incidence of planned home births attended by paramedics and explored the clinical support they provided as well as the implications for education and practice.
retrospective data previously collected via an in-field electronic patient care record (VACIS(®)) was provided by a state-wide ambulance service. Cases were identified via a comprehensive filter, manually screened and analysed using SPSS version 19.
over a 12-month period paramedics attended 26 intended home births. Eight women were transported in labour, most for failure to progress. Three called the ambulance service and their pre-organised midwife simultaneously. Paramedics were required for a range of complications including post partum haemorrhage, perineal tears and neonatal resuscitation. Procedures performed for mothers included IV therapy and administering pain relief. For infants, paramedics performed intermittent positive pressure ventilation, endotracheal intubation and external cardiac compression. Of the 23 women transferred to hospital, 22 were transported to hospital within 32minutes.
findings highlight that paramedics can provide clinical support, as well as efficient transportation, during perinatal emergencies at planned home births. Cooperative collaboration between ambulance services, privately practising midwives and maternity services to develop guidelines for emergency clinical support and transportation service may minimise risk associated with planned home births. This could also lead to opportunities for interprofessional education between midwives and paramedics.
报告在澳大利亚维多利亚州引入公共资助的家庭分娩计划之前进行的一项研究结果，该研究调查了护理人员参与的计划家庭分娩的发生率，探讨了他们提供的临床支持以及对教育和实践的影响。
通过全州范围的救护车服务提供先前通过现场电子患者护理记录（VACIS(®)）收集的回顾性数据。通过全面筛选识别病例，使用SPSS 19版进行人工筛选和分析。
在12个月的时间里，护理人员参与了26例计划家庭分娩。8名产妇在分娩时被转运，大多数是因为产程进展不顺利。3名产妇同时呼叫了救护车服务和她们预先安排好的助产士。护理人员应对了一系列并发症，包括产后出血、会阴撕裂和新生儿复苏。为母亲实施的程序包括静脉治疗和给予止痛措施。对于婴儿，护理人员进行了间歇正压通气、气管插管和胸外心脏按压。在23名被转运至医院的产妇中，22名在32分钟内被送往医院。
研究结果表明，在计划家庭分娩的围产期紧急情况下，护理人员可以提供临床支持以及高效的转运服务。救护车服务、私人执业助产士和产科服务之间的合作协作，以制定紧急临床支持和转运服务指南，可能会将与计划家庭分娩相关的风险降至最低。这也可能为助产士和护理人员之间的跨专业教育带来机会。
