I have a query which has come up on a couple of calls recently. The baby has been born and PAIs are being followed after F9, and in F10 the mother or the caller asks when they can pick the baby up/hold it/feed it. The EMDs are a little stuck on how to answer this as there is no instruction for them to read; can you give us some advice?
EOC Audit Lead
East of England Ambulance Service NHS Trust
Melbourne, England, (U.K.)
When a clinician is in attendance, the infant is often placed skin to skin to suckle and keep warm. However, this is done with care not to raise the infant too high above the level of the placenta as this can cause blood to flow from baby to placenta and potentially exsanguinate the baby.
In dispatch, we keep the baby at the level of the mother’s bottom for three minutes before tying the cord to prevent this from happening whilst allowing for the normal and healthy blood flow that occurs during the first couple of minutes after birth.
So, the answer to your question is, yes, they can pick up, hold, or feed the baby—after the cord is tied. Before that, we need to ensure that the baby is breathing and warm, so use that time to communicate the importance of these things to the caller. If they ask why they can’t pick the baby up, it’s okay to tell them why and keep them involved until then.
Hope that helps.
On occasion the cord has been tied, and we are waiting for the placenta, which is when they start to ask what to do next—hold him or feed him? It’s good to know they are OK to say they can once the cord is tied.
Glad I could help.
Brett A. Patterson
Academics & Standards Associate
Chair, Medical Council of Standards
International Academies of Emergency Dispatch
Brett Patterson is Academics & Standards Associate and Chair of the Medical Council of Standards for the IAED. His role involves protocol standards and evolution, research, training, curriculum, and quality improvement. Prior to working with the IAED, he spent 10 years working in the Pinellas County EMS System, Florida. He answers members’ protocol questions in the Journal FAQ column.