Handling obstetric emergencies: Paramedic, health informatics, and nursing interventions in prehospital care
Keywords:
Maternal mortality, obstetric emergencies, sepsis, hemorrhage, prehospital care, paramedic interventionsAbstract
Background: Maternal mortality rates in the UK have shown only a statistically insignificant decline, highlighting the need for urgent action. Obstetric emergencies remain a critical concern, contributing significantly to maternal mortality. The MBRRACE report underscores the challenges associated with direct and indirect causes of maternal death, particularly emphasizing conditions such as sepsis and hemorrhage. Aim: This article aims to explore paramedic and nursing interventions in managing obstetric emergencies during prehospital care, emphasizing the critical nature of timely and effective treatment. Methods: A comprehensive review of the existing literature was conducted, focusing on the management of obstetric emergencies, particularly sepsis and hemorrhage. Clinical guidelines were analyzed, highlighting key interventions and outcomes related to maternal care. Results: The findings reveal that obstetric emergencies, including sepsis and significant hemorrhage, require immediate and coordinated care from paramedics and nursing staff. Key interventions include early recognition, implementation of the sepsis-3-hour bundle, and effective communication within multidisciplinary teams. Conclusion: Enhancing the knowledge and preparedness of paramedic and nursing teams in managing obstetric emergencies is crucial in reducing maternal morbidity and mortality. Further research and continuous training are necessary to ensure that healthcare providers can respond effectively to these critical situations.
Downloads
References
Knight, M., Bunch, K., Tuffnell, D., & MBRRACE-UK. (Eds.). (2021). Saving lives, improving mothers’ care: Lessons learned to inform maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2017-19. National Perinatal Epidemiology Unit, University of Oxford.
Greer, O., Shah, N. M., & Johnson, M. R. (2020). Maternal sepsis update: Current management and controversies. Obstetrics & Gynaecology, 22, 45-55. https://doi.org/10.1111/tog.12623 DOI: https://doi.org/10.1111/tog.12623
Royal College of Obstetricians and Gynaecologists. (n.d.). Sepsis in pregnancy, bacterial (Green-top Guideline 64a). https://www.rcog.org.uk/globalassets/documents/guidelines/gtg_64a.pdf
Evans, L., Rhodes, A., Alhazzani, W., et al. (2021). Executive summary: Surviving sepsis campaign: International guidelines for the management of sepsis and septic shock 2021. Critical Care Medicine, 49(November), e1063-e1143. https://doi.org/10.1097/CCM.0000000000005337 DOI: https://doi.org/10.1097/CCM.0000000000005337
Singh, S., McGlennan, A., England, A., et al. (2012). A validation study of the CEMACH recommended modified early obstetric warning system (MEOWS). Anaesthesia, 67, 12-18. DOI: https://doi.org/10.1111/j.1365-2044.2011.06896.x
Kumar, A., Roberts, D., Wood, K. E., et al. (2006). Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Critical Care Medicine, 34, 1589-1596. DOI: https://doi.org/10.1097/01.CCM.0000217961.75225.E9
O'Connor, M., Smith, A., Nair, M., et al. (2015). UKOSS annual report 2015. National Perinatal Epidemiology Unit, University of Oxford.
Resuscitation Council UK & Obstetric Anaesthetists’ Association. (2021). Obstetric cardiac arrest quick reference guide. UK Resuscitation Council.
Royal College of Obstetricians and Gynaecologists. (2001). Green-top Guideline 56: Maternal collapse in pregnancy and the puerperium. http://www.rcog.org.uk/womens-health/clinical-guidance/maternal-collapse-pregnancy-and-puerperium-green-top-56
The Association of Anaesthetists of Great Britain & Ireland. (2010). Management of severe local anaesthetic toxicity 2. http://www.aagbi.org/sites/default/files/la%20toxicity%202010%200.pdf
Metodiev, Y., Ramasamy, P., & Tuffnell, D. (2018). Amniotic fluid embolism. BJA Education, 18, 234-238. DOI: https://doi.org/10.1016/j.bjae.2018.05.002
Royal College of Obstetricians and Gynaecologists. (n.d.). Classification of urgency of caesarian section – A continuum of risk. https://www.rcog.org.uk/globalassets/documents/guidelines/goodpractice11classificationofurgency.pdf
Obstetric Anaesthetists’ Association / Difficult Airway Society. (2015). OAA DAS obstetric airway guidelines. https://www.oaa-anaes.ac.uk/assets/%20managed/cms/files/Clinical%20Guidelines/Guideline%20Algorithms%202015.pdf
RCOG, Royal College of Midwives, UK Teratology Information Service, & MacDonald Obstetric Medicine Society. (2022). RCOG Guidelines: Coronavirus (COVID-19) infection in pregnancy.
Merién, A. E. R., Van de Ven, J., Mol, B. W., et al. (2010). Multidisciplinary team training in a simulation setting for acute obstetric emergencies: A systematic review. Obstetrics & Gynecology, 115, 1021-1031. DOI: https://doi.org/10.1097/AOG.0b013e3181d9f4cd
Published
How to Cite
Issue
Section
Copyright (c) 2023 International journal of health sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.