This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Original research
Ann-Chatrin Linqvist Leonardsen
Østfold University College: Hogskolen i Ostfold
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5608-9401
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Postpartum hemorrhage (PPH) is a serious obstetric emergency, and one of the top five causes of maternal mortality globally. The most common causes of PPH include uterine atony, placental disorders, birth trauma and coagulation defects. Timely diagnosis and early management are critical to reduce morbidity, the need for blood transfusion or even mortality. External, manual aortic compression (AC) has been suggested as an intervention that reduce PPH and extend time for control of bleeding or resuscitation. This procedure is not commonly utilized by healthcare personnel. The incidence of home-births is increasing, and competence in PPH handling is essential in prehospital personnel. The objective was to explore prehospital personnel’s competence in PPH and AC, utilizing different tools.
Methods: The study was conducted in a county in South-eastern Norway, including five ambulance stations. All prehospital personnel (n=250) were invited to participate in a questionnaire study. The questionnaire included the PPH self-efficacy (PPHSE) and PPH collective efficacy (PPHCE) tools, as well as a developed tool. Descriptive statistics were used to analyse the quantitative data, while quantitative content analysis was used to analyse free-text responses.
Results: A total of 87 prehospital personnel responded to the questionnaire, 57.5 percent male, mean age 37.9 years. 80.4 percent were ambulance workers and/or paramedics, and 96.6 and 97.7 percent respectively reported to need more education or training in PPH. Results show that prehospital personnel lack knowledge about what PPH is, how to estimate and handle PPH, and how to perform AC. 82.8 percent reported having experienced PPH, but only 2.9 percent had performed AC. Mean self-efficacy varied from 3.3 to 5.6, while collective efficacy varied from 1.9 to 3.8. Educational background did not seem to have any impact on participants’ responses.
Conclusions and implications: This study indicates that prehospital personnel lack knowledge about PPH and AC, and also report to need more education and training. Hence, PPH should be included in educational programs at all levels of the education, as well as in quality improvement initiatives. After the conduction of this study, prehospital personnel attended a digital course in PPH, as well as a practical course in AC.
Keywords
postpartum hemorrhage, manual aortic compression, prehospital, ambulance, questionnaire, delphi technique, self-efficacy, collective efficacy
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Original research
Ann-Chatrin Linqvist Leonardsen
Østfold University College: Hogskolen i Ostfold
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5608-9401
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 10 Dec, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Critical Care & Emergency Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Postpartum hemorrhage (PPH) is a serious obstetric emergency, and one of the top five causes of maternal mortality globally. The most common causes of PPH include uterine atony, placental disorders, birth trauma and coagulation defects. Timely diagnosis and early management are critical to reduce morbidity, the need for blood transfusion or even mortality. External, manual aortic compression (AC) has been suggested as an intervention that reduce PPH and extend time for control of bleeding or resuscitation. This procedure is not commonly utilized by healthcare personnel. The incidence of home-births is increasing, and competence in PPH handling is essential in prehospital personnel. The objective was to explore prehospital personnel’s competence in PPH and AC, utilizing different tools.
Methods: The study was conducted in a county in South-eastern Norway, including five ambulance stations. All prehospital personnel (n=250) were invited to participate in a questionnaire study. The questionnaire included the PPH self-efficacy (PPHSE) and PPH collective efficacy (PPHCE) tools, as well as a developed tool. Descriptive statistics were used to analyse the quantitative data, while quantitative content analysis was used to analyse free-text responses.
Results: A total of 87 prehospital personnel responded to the questionnaire, 57.5 percent male, mean age 37.9 years. 80.4 percent were ambulance workers and/or paramedics, and 96.6 and 97.7 percent respectively reported to need more education or training in PPH. Results show that prehospital personnel lack knowledge about what PPH is, how to estimate and handle PPH, and how to perform AC. 82.8 percent reported having experienced PPH, but only 2.9 percent had performed AC. Mean self-efficacy varied from 3.3 to 5.6, while collective efficacy varied from 1.9 to 3.8. Educational background did not seem to have any impact on participants’ responses.
Conclusions and implications: This study indicates that prehospital personnel lack knowledge about PPH and AC, and also report to need more education and training. Hence, PPH should be included in educational programs at all levels of the education, as well as in quality improvement initiatives. After the conduction of this study, prehospital personnel attended a digital course in PPH, as well as a practical course in AC.
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