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OP07 Temperature management of babies born in the prehospital setting: an analysis of call-handler advice and staff and patient views
  1. Laura Goodwin1,
  2. Ria Osborne2,
  3. Graham McClelland3,
  4. Emily Beach1,
  5. Adam Bedson2,
  6. Toity Deave1,
  7. Kim Kirby1,2,
  8. Helen McAdam4,
  9. Roisin McKeon-Carter5,
  10. Nick Miller1,
  11. Hazel Taylor6,
  12. Sarah Voss1,
  13. Jonathan Benger1
  1. 1University of the West of England, Bristol, UK
  2. 2South Western Ambulance Service NHS Foundation Trust, Exeter, UK
  3. 3North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne, UK
  4. 4University of Sunderland, UK
  5. 5University Hospitals Plymouth NHS Trust, Plymouth, UK
  6. 6University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK


Background Following prehospital birth, babies can become hypothermic within minutes, sometimes before paramedics arrive. The risk of the baby dying increases by at least 28% for every degree that their temperature drops below <36.5°C. The earlier we can provide effective warming interventions, the lower the risk of poor outcomes. The aim of this project was to 1), examine the neonatal temperature management advice given to people calling 999 about a prehospital birth in the UK and 2), explore NHS staff and patient views about the content and accessibility of advice given.

Methods All 999 calls between January 2021-January 2022 were searched by the Clinical Information and Records teams at two ambulance services using the two different triage systems (AMPDS and NHS Pathways). Thirty eligible calls were selected from postcodes with varying levels of deprivation and passed to the study team for content analysis. Nine focus groups were held with 18 NHS staff (paramedics, midwives, neonatal nurses/doctors, call-handlers), and 22 members of the public who had experienced prehospital birth, to discuss the content and accessibility of the advice given.

Results Five themes were identified as potential barriers to good quality neonatal temperature management: confusing or conflicting advice on where the baby should be placed following birth, vague or unclear instructions on warming the baby, the timing of temperature management advice, the priority given to other instructions, and a lack of importance placed on neonatal temperature. Participants suggested a number of simple changes to advice, including increased focus on the importance of neonatal temperature, encouraging skin-to-skin contact, and providing specific advice on warming the baby.

Conclusions There is an opportunity to improve the neonatal temperature management advice given by 999 call-handlers during calls related to prehospital birth. This could reduce the number of babies arriving at hospital hypothermic, therefore improving outcomes.

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