Strózik Mateusz, Wiciak Hanna, Raczyński Andrzej, Smereka Jacek
2nd Department and Clinic of Gynecology and Obstetrics, Wroclaw Medical University, Poland.
Department of Emergency Medical Service, Wroclaw Medical University, Poland.
Adv Clin Exp Med. 2024 Mar 20. doi: 10.17219/acem/184141.
Emergency medical teams are a crucial component of healthcare systems, routinely providing essential care to pregnant patients in various situations.
To evaluate the rate and outcomes of out-of-hospital deliveries attended by Emergency Medical Services (EMS) in Poland and identify areas for improvement in the care provided by emergency medical teams.
This retrospective study was based on 41,335 EMS emergency calls to women in advanced pregnancy, of which 879 births were delivered directly by medical teams between January 2018 and December 2022. Data were obtained from the Polish National Monitoring Center for Emergency Medical Services, encompassing all EMS interventions in Poland.
The study involved 879 EMS team interventions for pregnant women, with an average patient age of 29.87 years. Most patients were in their 2nd pregnancy (28.26%) and delivering for the 2nd time (25.77%). The postnatal condition of newborns, assessed using the Apgar score, was missing in 408 cases (46.52%) due to incorrect completion of documentation. Emergency Medical Services teams, predominantly P-type (basic) teams, handled 69.78% of deliveries, while S-type (specialist) teams were involved in 30.22% of cases. Medical procedures often performed during childbirth included manual assistance in spontaneous delivery, pulse oximetry, physical examination, examination of systemic blood pressure, obtaining peripheral intravenous access, and gynecological examination.
Given the rate of encountered cases and the gaps identified in medical documentation, there is merit in potentially implementing a dedicated form to be completed by medical teams when caring for a pregnant patient. Ongoing training and enhancements in the range of assistance provided to the mother and newborn are imperative for ensuring appropriate care.
紧急医疗团队是医疗保健系统的重要组成部分,通常在各种情况下为孕妇提供基本护理。
评估波兰紧急医疗服务(EMS)参与的院外分娩率及结局,并确定紧急医疗团队所提供护理中有待改进的方面。
这项回顾性研究基于对41335例晚期妊娠女性的EMS紧急呼叫,其中2018年1月至2022年12月期间有879例分娩由医疗团队直接接生。数据来自波兰国家紧急医疗服务监测中心,涵盖了波兰境内所有的EMS干预措施。
该研究涉及879次EMS团队对孕妇的干预,患者平均年龄为29.87岁。大多数患者处于第二次妊娠(28.26%)且为第二次分娩(25.77%)。由于文件填写不正确,408例(46.52%)新生儿的产后状况(采用阿氏评分评估)缺失。紧急医疗服务团队,主要是P型(基础)团队,处理了69.78%的分娩,而S型(专科)团队参与了30.22%的病例。分娩期间经常进行的医疗程序包括自然分娩时的人工辅助、脉搏血氧饱和度测定、体格检查、全身血压检查、建立外周静脉通路以及妇科检查。
鉴于所遇到的病例发生率以及医疗文件中发现的差距,在护理孕妇时,医疗团队可能有必要使用专门的表格进行填写。持续培训并扩大对母亲和新生儿的援助范围对于确保适当护理至关重要。