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

Lookup NU author(s): Dr Graham McClellandORCiD

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Abstract

© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ. 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.


Publication metadata

Author(s): Goodwin L, Voss S, McClelland G, Beach E, Bedson A, Black S, Deave T, Miller N, Taylor H, Benger J

Publication type: Article

Publication status: Published

Journal: Emergency Medicine Journal

Year: 2022

Pages: Epub ahead of print

Online publication date: 01/08/2022

Acceptance date: 19/07/2022

ISSN (print): 1472-0205

ISSN (electronic): 1472-0213

Publisher: BMJ Publishing Group

URL: https://doi.org/10.1136/emermed-2021-211970

DOI: 10.1136/emermed-2021-211970

PubMed id: 35914922


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