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Temperature measurement of babies born in the pre-hospital setting: Analysis of ambulance service data and qualitative interviews with paramedics

Goodwin, Laura; Voss, Sarah; McClelland, Graham; Beach, Emily; Bedson, Adam; Black, Sarah; Deave, Toity; Miller, Nick; Taylor, Hazel; Benger, Jonathan

Temperature measurement of babies born in the pre-hospital setting: Analysis of ambulance service data and qualitative interviews with paramedics Thumbnail


Authors

Laura Goodwin

Sarah Voss Sarah.Voss@uwe.ac.uk
Professor of Emergency and Critical Care

Graham McClelland

Emily Beach

Adam Bedson

Sarah Black

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Toity Deave Toity.Deave@uwe.ac.uk
Associate Professor in Child & Family Health

Nick Miller Nick.Miller@uwe.ac.uk
Senior Lecturer in Paramedic Science

Hazel Taylor

Jonathan Benger



Abstract

Background: Birth before arrival at hospital (BBA) is associated with unfavourable perinatal outcomes and increased mortality. An important risk factor for mortality following BBA is hypothermia, and emergency medical services (EMS) providers are well placed to provide warming strategies. However, research from the UK suggests that EMS providers (paramedics) do not routinely record neonatal temperature following BBA. This study aimed to determine the proportion of cases in which neonatal temperature is documented by paramedics attending BBAs in the South West of England and to explore the barriers to temperature measurement by paramedics. Methods: A two-phase multi-method study. Phase I involved an analysis of anonymised data from electronic patient care records between 1 February 2017 and 31 January 2020 in a single UK ambulance service, to determine 1) the frequency of BBAs attended and 2) the percentage of these births where a neonatal temperature was recorded, and what proportion of these were hypothermic. Phase II involved interviews with 20 operational paramedics from the same ambulance service, to explore their experiences of, and barriers and facilitators to, neonatal temperature measurement and management following BBA. Results: There were 1582 'normal deliveries' attended by paramedics within the date range. Neonatal temperatures were recorded in 43/1582 (2.7%) instances, of which 72% were below 36.5°C. Data from interviews suggested several barriers and potential facilitators to paramedic measurement of neonatal temperature. Barriers included unavailable or unsuitable equipment, prioritisation of other care activities, lack of exposure to births, and uncertainty regarding responsibilities and roles. Possible facilitators included better equipment, physical prompts, and training and awareness-raising around the importance of temperature measurement. Conclusions: This study demonstrates a lack of neonatal temperature measurement by paramedics in the South West following BBA, and highlights barriers and facilitators that could serve as a basis for developing an intervention to improve neonatal temperature measurement.

Citation

Goodwin, L., Voss, S., McClelland, G., Beach, E., Bedson, A., Black, S., …Benger, J. (2022). Temperature measurement of babies born in the pre-hospital setting: Analysis of ambulance service data and qualitative interviews with paramedics. Emergency Medicine Journal, 39, 826-832. https://doi.org/10.1136/emermed-2021-211970

Journal Article Type Article
Acceptance Date Jul 19, 2022
Online Publication Date Aug 1, 2022
Publication Date 2022-11
Deposit Date Jul 21, 2022
Publicly Available Date Jul 21, 2022
Journal Emergency Medicine Journal
Print ISSN 1472-0205
Electronic ISSN 1472-0213
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 39
Pages 826-832
DOI https://doi.org/10.1136/emermed-2021-211970
Keywords Birth before arrival, emergency medical services, paramedics, temperature measurement, hypothermia
Public URL https://uwe-repository.worktribe.com/output/9717661
Publisher URL https://intjem.biomedcentral.com/?gclid=EAIaIQobChMIuu7RneiJ-QIVFeDtCh0uBg1IEAAYASAAEgL-3vD_BwE

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