Effectiveness of Nonresuscitative First Aid Training in Laypersons: A Systematic Review
Study objective
This study reviewed evidence on the effects of nonresuscitative first aid training on competence and helping behavior in laypersons.
Methods
We identified randomized and nonrandomized controlled trials and interrupted time series on nonresuscitative first aid training for laypersons by using 12 databases (including MEDLINE, EMBASE, and PsycINFO), hand searching, reference checking, and author communication. Two reviewers independently evaluated selected studies with the Cochrane Effective Practice and Organisation of Care Review Group quality criteria. One reviewer extracted data with a standard form and another checked them. In anticipation of substantial heterogeneity across studies, we elected a descriptive summary of the included studies.
Results
We included 4 studies, 3 of which were randomized trials. We excluded 11 studies on quality issues. Two studies revealed that participants trained in first aid demonstrated higher written test scores than controls (poisoning first aid: relative risk 2.11, 95% confidence interval [CI] 1.64 to 2.72; various first aid cases: mean difference 4.75, 95% CI 3.02 to 6.48). Two studies evaluated helping responses during unannounced simulations. First aid training improved the quality of help for a bleeding emergency (relative risk 25.94; 95% CI 3.60 to 186.93), not the rate of helping (relative risk 1.13; 95% CI 0.88 to 1.45). Training in first aid and helping behavior increased the helping rates in a chest pain emergency compared with training in first aid only (relative risk 2.80; 95% CI 1.05 to 7.50) or controls (relative risk 3.81; 95% CI 0.98 to 14.89). Participants trained in first aid only did not help more than controls (relative risk 1.36; 95% CI 0.28 to 6.61).
Conclusion
First aid programs that also train participants to overcome inhibitors of emergency helping behavior could lead to better help and higher helping rates.
Author contributions: This review was made on behalf of Belgian Red Cross-Flanders. SVDV, BA, and DR conceived and designed the study. SVDV implemented and wrote the review. AH was the second reviewer and screened retrieved papers against inclusion criteria, appraised the methodological quality of studies, and checked if data extraction was accurate. BA and DR gave methodological advice. AR provided a medical education perspective. PV provided general advice on the review. B Aertgeerts was the guarantor of the study.
Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. This study was funded by the Belgian Red Cross–Flanders. Belgian Red Cross–Flanders is one of the 186 National Societies of the International Red Cross and Red Crescent Movement. First aid training is an important activity of the organization. To further improve the quality and effectiveness of the first aid programs, the Belgian Red Cross–Flanders aims at the establishment of evidence-based practice in first aid. S Van de Velde and P Vandekerckhove are in employment at the Belgian Red Cross-Flanders, which provides training in first aid.
Publication date: Available online January 21, 2009.
Reprints not available from the authors.
PII: S0196-0644(08)02005-2
doi:10.1016/j.annemergmed.2008.11.005
© 2008 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
