International Journal of Healthcare Simulation
Adi Health+Wellness
46 ‘Born Too Soon’ Virtual Simulation for Ambulance Services On Premature Babies Born Unexpectedly in the Community
DOI 10.54531/SBGL9631, Volume: 1, Issue: Supplement 1, Pages: A50-A50
Article Type: Innovations, Article History

Table of Contents





Premature infants are at risk of death or neurodevelopmental impairment unless prompt effective care is delivered [1]. When born unexpectedly in the community, this risk increases due to limited resources and expertise. In 2020, West Midlands Ambulance Service (WMAS) attended 3594 unplanned births, yet paramedics do not receive specific training for the management of premature infants. Simple and timely measures can significantly improve the outcome of these infants [2].


The aim of the study was to introduce a recurring virtual simulation workshop for WMAS on optimizing the initial care for vulnerable premature infants born unexpectedly in the community.


Our local WMAS lead identified a training need through informal feedback from paramedics about the lack of training and confidence in dealing with premature births. Our workshop, designed to address this need, begins with an overview of prematurity. A simulation session follows, demonstrating basic Neonatal Life Support skills using equipment available to pre-hospital teams, focussing on thermoregulation. It concludes with a question-and-answer session. To enhance pre-hospital thermal care, we also put forward a successful business case for heated gel mattresses to be introduced across the WMAS and incorporated training for its use in the workshop.

Implementation outline:

Two virtual training workshops have been delivered so far. In 2020, seven paramedics attended, and two completed the feedback and found the session valuable. After advertising, a second workshop was delivered in March 2021. Over 330 WMAS personnel registered, 219 attended and 132 gave feedback. There were representatives of various grades from 16 hubs across the region. Before the session, 12.2% of participants reported feeling somewhat confident/confident attending unplanned premature births of infants <32 weeks’ gestation. Following the session, this improved to 66.7% of participants. Attendees commented on how ‘useful’, ‘fabulous’ and ‘fantastic’ they found the session. The sharp rise in interest in this virtual workshop confirms the training need whilst the positive feedback highlights the effectiveness of the virtual simulation workshop. With enhanced technical support, we will improve the learning experience of participants in the future. This project also led to the successful introduction of heated gel mattresses which are now carried on every WMAS ambulance. We expect that with increased staff training and confidence, the incidence of babies admitted with hypothermia following an unexpected birth in the community will improve with time. Our vision is to expand this project to other regions to empower pre-hospital staff to support premature infants born unexpectedly in the community and improve outcomes.

Aguirre, Henry, Fernandez, and Brown: 46 ‘Born Too Soon’ Virtual Simulation for Ambulance Services On Premature Babies Born Unexpectedly in the Community



Lawn JE. Born too soon: care for the preterm baby. Reproduct Health; 10:120.


L’Herault J, Petroff L, Jeffrey J. The effectiveness of a thermal mattress in stabilizing and maintaining body temperature during the transport of very low–birth weight newborns. Appl Nurs Res. 2001;14(4):210219. ‘Born Too Soon’ Virtual Simulation for Ambulance Services On Premature Babies Born Unexpectedly in the Community&author=&keyword=&subject=Innovations,