McClelland Graham, Burrow Emma, McAdam Helen
North East Ambulance Service NHS Foundation Trust: ORCID iD: http://orcid.org/0000-0002-4502-5821.
North East Ambulance Service NHS Foundation Trust.
Br Paramed J. 2019 Dec 1;4(3):43-48. doi: 10.29045/14784726.2019.12.4.3.43.
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.
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.
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.
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.
在英国,大多数分娩发生在医院、独立的助产士主导中心,或在医院外以有计划的方式在助产士的支持下进行。在院前环境中意外分娩是一种罕见事件,可能会导致呼叫救护车,因此对于救护车临床医生来说,参与分娩是罕见的情况。进行了一项服务评估,以报告在一年时间里,东北救护车服务(NEAS)的救护车临床医生护理的院前出生婴儿记录了哪些临床观察结果。
使用常规收集的数据进行回顾性服务评估。检查了2017年10月1日至2018年9月30日这一年期间所有主要印象为“分娩”的电子患者护理记录。
该评估确定在评估时间段内有168例NEAS临床医生护理的院前分娩个案。大多数(85%)婴儿的母亲为经产妇,中位妊娠期为39周。对婴儿记录的临床观察结果非常少(呼吸频率23%、心率21%、体温10%、阿氏评分8%、血糖1%),没有婴儿记录了所有这五项观察结果。只有5%的婴儿记录有任何并发症。
本研究表明,NEAS救护车临床医生很少护理院前出生的婴儿,且很少记录并发症。对婴儿缺乏观察记录,鉴于诸如体温等易于测量的特征与死亡率和发病率之间存在明确联系,这是一个问题。