Bridging the gap in pre-hospital maternity care: emergency personnel's knowledge and clinical skills in managing obstetric emergencies.
Source: PubMed, NCBI / U.S. National Library of Medicine
Pre-hospital obstetric emergencies are unpredictable and time-sensitive, requiring competent and well-trained emergency personnel. Limited preparedness in managing such events can lead to preventable maternal and neonatal complications. This study aimed to investigate the knowledge and clinical skills of pre-hospital emergency personnel in providing obstetric services, offering an integrated overview of the current state at the Tehran Emergency Center. This cross-sectional study was conducted in March 2022 at the Tehran Emergency Center. A total of 97 pre-hospital emergency personnel were selected through simple random sampling from the operational staff list. Data were collected using a self-reporting knowledge and clinical skill (SRKCS) questionnaire, a knowledge test, and four objective structured clinical examination (OSCE) checklists. Data were analyzed using SPSS version 26 with Pearson's correlation, independent t-test, repeated measures, and Kruskal-Wallis tests. Participants demonstrated moderate knowledge (mean ± SD = 46.6 ± 10.9%) and clinical skill levels (mean ± SD = 58.4 ± 8.7%). Among the OSCE stations, personnel performed best in managing cardiac arrest in pregnant women (mean ± SD = 83.2 ± 11.1%) and weakest in handling childbirth and postpartum hemorrhage (mean ± SD = 33.3
Abstract
Pre-hospital obstetric emergencies are unpredictable and time-sensitive, requiring competent and well-trained emergency personnel. Limited preparedness in managing such events can lead to preventable maternal and neonatal complications. This study aimed to investigate the knowledge and clinical skills of pre-hospital emergency personnel in providing obstetric services, offering an integrated overview of the current state at the Tehran Emergency Center. This cross-sectional study was conducted in March 2022 at the Tehran Emergency Center. A total of 97 pre-hospital emergency personnel were selected through simple random sampling from the operational staff list. Data were collected using a self-reporting knowledge and clinical skill (SRKCS) questionnaire, a knowledge test, and four objective structured clinical examination (OSCE) checklists. Data were analyzed using SPSS version 26 with Pearson's correlation, independent t-test, repeated measures, and Kruskal-Wallis tests. Participants demonstrated moderate knowledge (mean ± SD = 46.6 ± 10.9%) and clinical skill levels (mean ± SD = 58.4 ± 8.7%). Among the OSCE stations, personnel performed best in managing cardiac arrest in pregnant women (mean ± SD = 83.2 ± 11.1%) and weakest in handling childbirth and postpartum hemorrhage (mean ± SD = 33.3 ± 14.0%). A significant positive correlation (P < 0.05) was observed between OSCE performance and both actual and self-reported knowledge and skill levels. The findings highlight critical gaps in pre-hospital readiness for obstetric emergencies, particularly in childbirth and postpartum bleeding management. Incorporating structured, simulation-based training and interdisciplinary collaboration with midwifery educators into emergency personnel education programs could substantially enhance preparedness and improve maternal outcomes in pre-hospital settings.