Moores Jonathan, de Jesus Gustodio A
Timor Leste National Ambulance Service, Dili, Timor Leste.
Emerg Med Australas. 2018 Dec;30(6):814-819. doi: 10.1111/1742-6723.13153. Epub 2018 Sep 3.
Timor Leste has one of the highest maternal death rates in the world at 215 per 100 000 live births. Post-partum haemorrhage (PPH) accounts for 27% of maternal deaths globally. Annually the Timor Leste National Ambulance Service (TLNAS) attends over 20 000 cases, of which 2% are diagnosed with PPH. The objective of this study was to evaluate prehospital care of PPH patients transported by the TLNAS.
A retrospective audit of PPH patients transported between May 2015 and May 2017. The inclusion criteria were patients diagnosed with PPH and transported during the study period.
Data from the patient care records of 214 TLNAS PPH patients were abstracted using the PPH care evaluation tool. Paramedics diagnosed 211 (97%) PPH patients, took observations on 181 (85%) and obtained a patient history from 193 (90%) patients. TLNAS paramedics did not regularly provide other treatment including oxygen 36 (17%), intravenous isotonic crystalloid fluid 117 (55%), uterine massage 0 (0%), external aortic compression 0 (0%) and non-pneumatic anti-shock garments 9 (4%).
This research has shown that paramedics are not consistently using available clinical interventions.
东帝汶是世界上孕产妇死亡率最高的国家之一，每10万例活产中有215例孕产妇死亡。产后出血（PPH）占全球孕产妇死亡的27%。东帝汶国家救护服务局（TLNAS）每年接诊超过20000例病例，其中2%被诊断为PPH。本研究的目的是评估由TLNAS转运的PPH患者的院前护理情况。
对2015年5月至2017年5月期间转运的PPH患者进行回顾性审计。纳入标准为在研究期间被诊断为PPH并被转运的患者。
使用PPH护理评估工具从214例TLNAS PPH患者的护理记录中提取数据。护理人员诊断出211例（97%）PPH患者，对181例（85%）患者进行了观察，并从193例（90%）患者那里获取了病史。TLNAS护理人员没有定期提供其他治疗，包括氧气36例（17%）、静脉等渗晶体液117例（55%）、子宫按摩0例（0%）、外部主动脉压迫0例（0%）和非充气抗休克服9例（4%）。
本研究表明，护理人员没有始终如一地使用现有的临床干预措施。
