Lucy Hannah Rose Bailey

guidelines dystocia was a known hazard;, and that the different specifically provided ior the Paramedic to put the motherhratot positions to try to assist a natural birth. The evidence paramedic process prohibited the paramedic was that the baby's head, or providing any internal or external providing traction to the the mother's vagina. manipulation of the baby whilst in The standard reference documents on paramedic the Institute of Health Care Development training are provided by Royal Colleges Aabulance DavsoopCrenmiHeD JRGAing Qaideainand the Joint (JRCALC) guidelines. insiructed by HM Cooner itaptovobstetricseand Fetal Maternal Medicine, was Inquest he felt it thet thetaide a independent report; In his evidenceat the soft tissue dystocikerathet than E was large, and that the birth was hindered by been in a position to provide shoulder dystocia. He felt that had the parareedic internal manipulation gentlethands on traction oi thebaby s head &r gentle of the baby whilst in been born without injury: then may have He went on to suggest that it was hands on assistance in appropriate for paramedic to provide for thanbabin beirgrinuregiviag Beivlec ction t0 the baby s head and that the risk to starvation if was likely to be less than the risk of devastating such assistance was not provided, oxygen Areticed bhich cf taken, may prevent a future fatality created by such circumstances or reduce the risk of death That consideration should be given to amend the training provide for training of paramedics to assist manuals and guidelines to the baby's head andlor gentle internal birth by providing gentle traction to vagina, manipulation of the baby whilst in mothers Following the Inquest into Lucys death there has been of e mail correspondence between someverv helpful exchange Obstetrician; who is reviewereed author oarre Consultant exchange of emails are attached andutr the JRCALC quidance Copies of the to be expected that the birtacateendadttoneas hat agrees that it was downwards on baby's head after would apply gentle traction outwards and 'two contraction had elapsed. tin his e mail says: "In order to know if manoeuvre) has worked, the person delivering McRoberts (or any other traction to the head (with maternal MUST apply appropriate gentle Just applying McRobert's (with viffou)i in order to see if the shoulders will deliver: gentle traction to head will or without suprapubic pressure) but not not likely lead fo completion of delivenot applying Distribution of this Letter Reply_required_ Lucy day, the training birthing training from training likely baby Lucy training the the the the from:

JRCALC Chairman , South Central Ambulance Service NHS Foundation rust East Midlands Ambulance Service, through their solicitors, Brown Jacobson: For_information to: Lecesersne saieguarding Children Board The Chief Coroner Time for Response This letter is being sent out on the 6"h August 2013. therefore calculate that the detailed reply should be received by 1st October 2013. have power pursuant to Regulation 29 to extend period of 56 days for the reoponse if application is made by the recipient of this letter and sets out detailed grounds which are sufficient to persuade me that an extension of timeois required , await hearing from you accordingly. Yours sincerely, 4e Robert Chapman Assistant Deputy Coroner the