A paramedic based emergency domiciliary obstetric service: the South Glamorgan experience

ABSTRACT Objective To assess the potential benefits of using extended trained ambulance personnel (paramedics) as primary responders for domiciliary obstetric and gynaecological emergencies. Design An observational study of performance and analysis of operational data in a newly established 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 communications and appropriateness of training. Results There was an initial increase in requests above that when a hospital‐based service operated. Targets for response times were met. The mean response time for providing appropriate skilled help was halved compared with the previous arrangements and a safe and efficient service was provided. Prompt transport and advance notice and preparation for reception in the delivery unit contributed to optimal management. Medical staff depletion in the delivery unit was minimised. Conclusion An Emergency Domiciliary Obstetric Service based on primary response by specially trained ambulance service paramedics can beneficially replace traditional hospital‐based Obstetric Flying Squads.