Effectiveness of nonresuscitative first aid training in laypersons: a systematic review

Ann Emerg Med. 2009 Sep;54(3):447-57, 457.e1-5. doi: 10.1016/j.annemergmed.2008.11.005. Epub 2009 Jan 21.


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.

Publication types

  • Editorial
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Clinical Competence*
  • Evidence-Based Medicine
  • First Aid*
  • Health Education*
  • Helping Behavior
  • Humans
  • Outcome Assessment, Health Care
  • Program Evaluation
  • Randomized Controlled Trials as Topic