A PARAMEDIC BASED EMERGENCY DOMICILIARY OBSTETRIC SERVICE - THE SOUTH-GLAMORGAN EXPERIENCE

Objective To assess the potential benefits of using extended trained a mbulance personnel (paramedics) as primary responders for domiciliary obstetric and gynaecological emergencies. Design An observational stud y of performance and analysis of operational data in a newly establish ed service. Setting A mixed urban and rural population served by South Glamorgan Health Authority. Main outcome measures Work load, response times, management and transfer of patients, efficiency of communicati ons and appropriateness of training. Results There was an initial incr ease in requests above that when a hospital-based service operated. Ta rgets for response times were met. The mean response time for providin g appropriate skilled help was halved compared with the previous arran gements and a safe and efficient service was provided. Prompt transpor t and advance notice and preparation for reception in the delivery uni t contributed to optimal management. Medical staff depletion in the de livery unit was minimised. Conclusion An Emergency Domiciliary Obstetr ic Service based on primary response by specially trained ambulance se rvice paramedics can beneficially replace traditional hospital-based O bstetric Flying Squads.