@article{ref1,
title="Evaluation of a lay first responder program in Sierra Leone as a scalable model for prehospital trauma care",
journal="Injury",
year="2020",
author="Eisner, Zachary J. and Delaney, Peter G. and Thullah, Alfred H. and Yu, Amanda J. and Timbo, Sallieu B. and Koroma, Sylvester and Sandy, Kpawuru and Sesay, Abdulai Daniel and Turay, Patrick and Scott, John W. and Raghavendran, Krishnan",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="INTRODUCTION: Few countries in Sub-Saharan Africa have robust emergency medical services (EMS). The World Health Organization (WHO) recommends scaling-up lay first responder programs as the first step toward formal EMS development.   MATERIALS AND METHODS: We trained and equipped 4,529 lay first responders (LFRs) between June-December 2019 in Bombali District, Sierra Leone, with a 5-hour hands-on, contextually-adapted prehospital trauma course to cover 535,000 people. Instructors trained 1,029 LFRs and 50 local trainers in a training-of-trainers (TOT) model, who then trained an additional 3,500 LFRs. A validated, 23-question pre-/post-test measured knowledge improvement, while six- and nine-month follow-up tests measured knowledge retention. Incident reports tracked patient encounters to assess longitudinal impact.   RESULTS: Median pre-/post-test scores improved by 43.5 percentage points (34.8% vs. 78.3%, p<0.0001). Knowledge retention was assessed at six months, with median score dropping to 60.9%, while at nine months, median score dropped to 43.5%. Lay first responders participating in courses led by TOT trainers had a pre-/post-test median score improvement of 30.4 percentage points (21.7% vs. 52.2%, p<0.0001). LFRs treated 1,850 patients over six months, most frequently utilizing hemorrhage control skills in 61.2% of encounters (1,133/1,850). The plurality of patients were young adult males (36.8%) and 48.7% of encounters were motorcycle injury-related.   CONCLUSION: A 5-hour first responder course targeting laypeople demonstrates significant emergency care knowledge improvement and retention. By training networks of transportation providers, lay first responder programs represent a robust and scalable prehospital emergency care alternative for low-resource settings.<p /> <p>Language: en</p>",
language="en",
issn="0020-1383",
doi="10.1016/j.injury.2020.09.001",
url="http://dx.doi.org/10.1016/j.injury.2020.09.001"
}