Report into oxytocin reinforces it delivers in preventing primary postpartum haemorrhage QAS paramedic researcher Brendan Schultz and Queensland University of Technology (QUT) paramedic academic and midwife Shonel Hall have reinforced intramuscular administration of oxytocin as the gold standard in managing out of hospital (OOH) births and primary postpartum haemorrhage, with their research findings recently published in the journal Prehospital Emergency Care.
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Brendan, an Operational Research Officer based in the QAS Information Support, Research and Evaluation (ISRE) Unit, was the lead investigator of the study which details the occurrence of OOH births attended by QAS paramedics and found oxytocin can be safely administered as a treatment adjunct to prevent postpartum haemorrhage. “This study highlights the high quality of care that is provided by our staff when attending our state’s newest mums,” Brendan said. “Working within two to four minutes of administration, this uterotonic ensures fast placental delivery. On average, paramedics administered this drug within 14 minutes of the baby’s arrival, with placental delivery typically occurring within ten minutes.” Reflecting on the study and his own experiences in managing obstetric cases, Brendan said oxytocin was a reliable and safe intervention when managing this low‑frequency, high‑risk cohort. “No two births are the same, and even the most textbook deliveries can rapidly change pace raising the devasting prospect of serious post-partum bleeding–knowing we have an effective option to prevent this, backed by current literature, is extremely reassuring,” he said. “Balancing this with respecting a woman’s choice to decline this treatment is
paramount, provided we ensure their decision is based on receiving clear, informed and unbiased advice.” Brendan said the study is one of the first to describe the utilisation of a prehospital uterotonic and its findings reaffirm oxytocin’s place in contemporary paramedicine practice. “QAS was the first ambulance jurisdiction in the world to incorporate and evaluate oxytocin in the third stage of labour–a decision that has no doubt improved outcomes for many women post-delivery,’’ he said. “It is amazing to see the recognition of paramedics from vocation to profession and building on foundation research is a core part of this journey. “Additionally, this work has also allowed us to quantify the number of births paramedics in Queensland attend annually and identify the rate of obstetric complications, which were very low–an incidental but helpful finding to inform clinical practice into the future,’’ he said. “This publication reinforces the service’s commitment to clinical guidelines that are based on contemporary research. This study would not have been possible without the expertise of ISRE Director Dr Emma Bosley, Medical Director Dr Stephen Rashford and Acting Director, Medical Director’s Office Lachlan Parker.”
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Shonel said her experiences as a paramedic assisting women in labour drove her desire to learn more–completing her midwifery degree almost five years ago. She enjoys a great balance between her two professions, along with an academic appointment at QUT. “I’m very passionate about educating and empowering paramedics when it comes to obstetric cases. Relatively straightforward births can turn on a dime and it is imperative paramedics have the right therapies and confidence to manage these events,” Shonel said. “Having attended more than ten births as a paramedic, some as a single officer in rural areas, I knew early on there was an opportunity to strengthen my skill set and ensure what should be the happiest day of these patients lives stays that way. “Being able to contribute to the literature alongside my operational peers has been wonderful and I look forward to the next steps this research will take–appraising the outcomes of these patients through hospital linked data.” Shonel is one of several paramedics within the service who hold midwifery degrees, with QAS veteran of 14 years, Metro North Critical Care Paramedic (CCP) Rory Jackson the most recent graduate.
