Withanarachchie Vinuli, Todd Verity, Dicker Bridget, Maessen Sarah E
Clinical Evaluation, Research, and Insights, Hato Hone St John New Zealand, Auckland, New Zealand.
Shore & Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand.
BMC Emerg Med. 2025 May 28;25(1):83. doi: 10.1186/s12873-025-01236-6.
Despite their crucial role in prehospital obstetric emergencies, there is little research exploring emergency medical service (EMS) personnel's perspectives and attitudes on out-of-hospital births, including balancing the numerous needs of the patient. Our aims were to (1) identify how EMS demographics and professional experience related to their confidence and comfort in treating a patient in labour and (2) explore EMS' perspectives on managing emotional needs and administering analgesia in a labour and birth setting in New Zealand (NZ).
This mixed-methods survey invited frontline clinical personnel from Hato Hone St John - the main EMS provider in NZ - to complete an online survey about unplanned out-of-hospital births. Self-reported confidence attending birth events and administering analgesia to women in labour was compared across participant demographic and professional characteristics. Qualitative content analysis was applied to free-text questions.
One hundred and forty-seven personnel completed the survey. Only 37% of respondents felt their training had equipped them to confidently manage births, with more experience with birth associated with higher confidence. Men and those who had not given birth were more comfortable providing analgesia to women in labour. Qualitative analysis identified four main categories: (1) Managing their own emotions, (2) Gender differences in views of unplanned births, (3) Managing interpersonal communication with women in labour, the family, and other health professionals, and (4) Views on pain management. The findings indicate that women in labour may be cared for differently depending on EMS clinicians' personal experiences, communication styles, and attitudes toward pain relief, highlighting the need for these providers to adapt their approach to meet the diverse needs of patients during these high-risk low frequency events.
EMS personnel navigate a range of emotions and high-risk factors related to their patient and the environment during unplanned pre-hospital births, which may adversely affect their temperament and interpersonal communication. A perception of unclear pain relief guidelines and limited available options can exacerbate challenges. In NZ and overseas, multi-disciplinary training with midwives and integrating maternity and newborn care into postgraduate and ongoing professional development could support EMS personnel to confidently manage these events and improve patient outcomes.
Not applicable.
尽管院外产科急救中起着关键作用，但很少有研究探讨紧急医疗服务（EMS）人员对院外分娩的看法和态度，包括如何平衡患者的众多需求。我们的目的是：（1）确定EMS人员的人口统计学特征和专业经验如何影响他们对分娩患者进行治疗时的信心和舒适度；（2）探讨EMS人员对在新西兰（NZ）分娩环境中处理产妇情感需求和给予镇痛措施的看法。
这项混合方法调查邀请了新西兰主要的紧急医疗服务提供商——哈托·霍恩·圣约翰的一线临床人员完成一项关于意外院外分娩的在线调查。根据参与者的人口统计学特征和专业特点，比较了他们自我报告的参与分娩事件和为分娩妇女实施镇痛的信心。对自由文本问题进行了定性内容分析。
147名人员完成了调查。只有37%的受访者认为他们所接受的培训使他们有信心处理分娩情况，分娩经验越多，信心越高。男性和未生育过的人员在为分娩妇女提供镇痛方面更自在。定性分析确定了四个主要类别：（1）管理自身情绪；（2）对意外分娩看法的性别差异；（3）与分娩妇女、其家人及其他医护人员的人际沟通管理；（4）对疼痛管理的看法。研究结果表明，根据EMS临床医生的个人经验、沟通方式和对疼痛缓解的态度，分娩妇女可能会得到不同的护理，这凸显了这些医护人员在这些高风险低频事件中需要调整方法以满足患者的多样化需求。
在意外的院前分娩过程中，EMS人员要应对一系列与患者和环境相关的情绪和高风险因素，这可能会对他们的性情和人际沟通产生不利影响。对疼痛缓解指南不明确以及可用选择有限的认知会加剧挑战。在新西兰和其他国家，可以通过与助产士进行多学科培训，并将孕产妇和新生儿护理纳入研究生及持续专业发展中，来支持EMS人员自信地处理这些情况并改善患者结局。
不适用。
