Layperson trauma training in low- and middle-income countries: A review

Tyler E. Callese, Christopher T. Richards*, Pamela Shaw, Steven J. Schuetz, Nabil Issa, Lorenzo Paladino, Mamta Swaroop

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


Background Prehospital trauma systems are rudimentary in many low- and middle-income countries (LMICs) and require laypersons to stabilize and transport injured patients. The World Health Organization recommends educating layperson first responders as an essential step in the development of Emergency Medical Services systems in LMICs. This systematic review examines trauma educational initiatives for layperson first responders in resource-poor settings. Materials and methods Layperson first-responder training and education program publications were identified using PubMed MEDLINE and Scopus databases. Articles addressing physicians, professional Emergency Medical Services training, or epidemiologic descriptions were excluded. Publications were assessed by independent reviewers, and those included underwent thematic analysis. Results Thirteen publications met inclusion criteria. Four themes emerged regarding the development of layperson first-responder training programs: (1) An initial needs assessment of a region's existing trauma system of care and laypersons' baseline emergency care knowledge focuses subsequent educational interventions; (2) effective programs adapt to and leverage existing resources; (3) training methods should anticipate participants with low levels of education and literacy; and (4) postimplementation evaluation allows for curriculum improvement. Technology, such as online and remote learning platforms, can be used to operationalize each theme. Conclusions Successful training programs for layperson first responders in LMICs identify and maximize existing resources are adaptable to learners with little formal education and are responsive to postimplementation evaluation. Educational platforms that leverage technology to deliver content may facilitate first-responder trauma education in underresourced areas. Themes identified can inform the development of trauma systems of care to decrease mortality and physiological severity scores in trauma patients in LMICs.

Original languageEnglish (US)
Pages (from-to)104-110
Number of pages7
JournalJournal of Surgical Research
Issue number1
StatePublished - Jul 2014


  • Education
  • First-responder
  • Global surgery
  • International
  • LMIC
  • Layperson
  • Resource-poor
  • Systematic review
  • Trauma
  • Trauma system development

ASJC Scopus subject areas

  • Surgery


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