• Brendan V Schultz, Shonel Hall, Lachlan Parker, Stephen Rashford, and Emma Bosley.
• Received February 12, 2020 from Queensland Ambulance Service, Queensland Government Department of Health, Brisbane, Australia (BVS, SH, LP, SR, EB); School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia (SH, SR, EB) Revision received June 14, 2020; accepted for publication June 19, 2020.
• Prehosp Emerg Care. 2021 May 1; 25 (3): 412-417.

AimPrimary postpartum hemorrhage (PPH) is a life-threatening obstetric emergency that can be mitigated through the administration of a uterotonic to actively manage the third stage of labor. This study describes the prehospital administration of oxytocin by paramedics following attendance of out-of-hospital (OOH) births.MethodsA retrospective analysis was undertaken of all OOH births between the 1st January 2018 and 31st December 2018 attended by the Queensland Ambulance Service. The demographic and epidemiological characteristics of patients that were administered oxytocin and the occurrence of adverse side effects were described.ResultsIn total, 350 OOH births were included in this study with the majority involving multigravidas women (94.3%) and all but two involving singleton pregnancies. Oxytocin was administered following 222 births (63.4%), while 67 patients (19.1%) declined administration preferring a physiological third stage of labor, and in 61 cases (17.4%) oxytocin was withheld by the attending paramedic. There were no documented adverse events or side effects following administration. Oxytocin administration occurred on average 14 minutes (interquartile range 9-25) following the time of birth. The median time from oxytocin administration to placenta delivery was 10 minutes (interquartile range 5-22).ConclusionOxytocin is well accepted and safe treatment adjunct for the management of the third stage of labor in OOH births and should be considered for routine practice by other emergency medical services.

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