TY  - JOUR
PY  - 2021//
TI  - Emergency care with lay responders in underserved populations: a systematic review
JO  - Bulletin of The World Health Organization
A1  - Orkin, Aaron M.
A1  - Venugopal, Jeyasakthi
A1  - Curran, Jeffrey D.
A1  - Fortune, Melanie K.
A1  - McArthur, Allison
A1  - Mew, Emma
A1  - Ritchie, Stephen D.
A1  - Drennan, Ian R.
A1  - Exley, Adam
A1  - Jamieson, Rachel
A1  - Johnson, David E.
A1  - Macpherson, Andrew
A1  - Martiniuk, Alexandra
A1  - McDonald, Neil
A1  - Osei-Ampofo, Maxwell
A1  - Wegier, Pete
A1  - Van de Velde, Stijn
A1  - VanderBurgh, David
SP  - 514
EP  - 528H
VL  - 99
IS  - 7
N2  - OBJECTIVE: To assess the individual and community health effects of task shifting for emergency care in low-resource settings and underserved populations worldwide. <br><br>METHODS: We systematically searched 13 databases and additional grey literature for studies published between 1984 and 2019. Eligible studies involved emergency care training for laypeople in underserved or low-resource populations, and any quantitative assessment of effects on the health of individuals or communities. We conducted duplicate assessments of study eligibility, data abstraction and quality. We synthesized findings in narrative and tabular format. <br><br>FINDINGS: Of 19 308 papers retrieved, 34 studies met the inclusion criteria from low- and middle-income countries (21 studies) and underserved populations in high-income countries (13 studies). Targeted emergency conditions included trauma, burns, cardiac arrest, opioid poisoning, malaria, paediatric communicable diseases and malnutrition. Trainees included the general public, non-health-care professionals, volunteers and close contacts of at-risk populations, all trained through in-class, peer and multimodal education and public awareness campaigns. Important clinical and policy outcomes included improvements in community capacity to manage emergencies (14 studies), patient outcomes (13 studies) and community health (seven studies). While substantial effects were observed for programmes to address paediatric malaria, trauma and opioid poisoning, most studies reported modest effect sizes and two reported null results. Most studies were of weak (24 studies) or moderate quality (nine studies). <br><br>CONCLUSION: First aid education and task shifting to laypeople for emergency care may reduce patient morbidity and mortality and build community capacity to manage health emergencies for a variety of emergency conditions in underserved and low-resource settings.<p />  <p>Language: en</p>
LA  - en
SN  - 0042-9686
UR  - http://dx.doi.org/10.2471/BLT.20.270249
ID  - ref1
ER  -