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|Queensland University of Technology, Australia|
|Keynote: J Women's Health Care|
|Obstetric cases make up a small portion of the overall case-load of frontline paramedics. Historically, paramedic practice does not place emphasis on obstetric care. The Queensland Ambulance Service [QAS] have recently implemented more woman friendly guidelines to improve outcomes for mothers, babies and families. The most notable is the introduction of delayed cord clamping, oxytocin, and modified active management of third stage of labour [MAMTSL]. Methodology: A review of pre-hospital peer reviewed literature was undertaken to establish a base level of paramedic obstetric practice. A retrospective review of de-identified QAS data from pre-hospital births pre and post guideline change was completed to examine the impact of the revised physiological cephalic delivery protocol. Results: Obstetric literature highlights the overwhelming benefits of MAMTSL. Paramedic literature on this topic is effectually absent, possibly due to MAMTSL being a new development in the pre-hospital discipline. QAS data shows improvements in practice, as seen through the use of uterotonic agents. While obstetric literature states controlled cord traction [CCT] should be performed by trained birth attendants. It is yet to be determined whether the critical application of this literature is appropriate for paramedics. Conclusion and significance: There is room for improvements in paramedic obstetric practice worldwide. The introduction of MAMTSL to frontline paramedics is a foundational approach to introducing women friendly midwifery principles to the prehospital environment. The appropriateness of CCT in the pre-hospital environment needs review. The significance of clinical protocol such as MAMTSL could prove to be ground-breaking in pre-hospital practice worldwide.|
Shonel Hall has her expertise in Advanced Care Paramedic. She is Associate Lecturer in Queensland University of Technology, Australia.
Email: [email protected]
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