The effect of external bleeding control training courses on lay first-person responders'knowledge, skills, and attitudes in low- and middle-income countries: a systematic review

<h3>Background</h3><p dir="ltr">Exsanguinating hemorrhage is the most common cause of preventable trauma death at the injury scene, and it is often due to the inability to control bleeding immediately. Training layperson first responders (LFR) in trauma care, particularly...

وصف كامل

محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Husham Abdelrahman (768893) (author)
مؤلفون آخرون: Ahammed Mekkodathil (4578838) (author), Ayman El-Menyar (440103) (author), Rafael Consunji (768892) (author), Sandro Rizoli (67238) (author), Hassan Al-Thani (440106) (author)
منشور في: 2025
الموضوعات:
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author Husham Abdelrahman (768893)
author2 Ahammed Mekkodathil (4578838)
Ayman El-Menyar (440103)
Rafael Consunji (768892)
Sandro Rizoli (67238)
Hassan Al-Thani (440106)
author2_role author
author
author
author
author
author_facet Husham Abdelrahman (768893)
Ahammed Mekkodathil (4578838)
Ayman El-Menyar (440103)
Rafael Consunji (768892)
Sandro Rizoli (67238)
Hassan Al-Thani (440106)
author_role author
dc.creator.none.fl_str_mv Husham Abdelrahman (768893)
Ahammed Mekkodathil (4578838)
Ayman El-Menyar (440103)
Rafael Consunji (768892)
Sandro Rizoli (67238)
Hassan Al-Thani (440106)
dc.date.none.fl_str_mv 2025-07-14T09:00:00Z
dc.identifier.none.fl_str_mv 10.1007/s00068-025-02917-4
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/The_effect_of_external_bleeding_control_training_courses_on_lay_first-person_responders_knowledge_skills_and_attitudes_in_low-_and_middle-income_countries_a_systematic_review/30859841
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Human society
Development studies
Hemorrhage control
Trauma Injury
Training
Low- and middle-income country
Layperson
Systematic review
dc.title.none.fl_str_mv The effect of external bleeding control training courses on lay first-person responders'knowledge, skills, and attitudes in low- and middle-income countries: a systematic review
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Background</h3><p dir="ltr">Exsanguinating hemorrhage is the most common cause of preventable trauma death at the injury scene, and it is often due to the inability to control bleeding immediately. Training layperson first responders (LFR) in trauma care, particularly hemorrhage control, has been recommended to address this trauma care gap. We conducted a systematic review (SR) to analyze the effect of hemorrhage control training courses for LFRs on knowledge, skill, and attitude to intervene in trauma patients.</p><h3>Methods</h3><p dir="ltr">PubMed and Google Scholar databases were used to identify relevant peer-reviewed research articles describing evaluations of hemorrhage control courses for LFR between 2013 and 2024. Studies examined whether the training course was implemented in low- and middle-income countries (LMICS); trainees were LFR and had outcome measures, including knowledge, skills, attitudes (confidence gained, willingness, comfort, and likelihood to intervene) toward care utilization for trauma patients, as well as outcomes.</p><h3>Results</h3><p dir="ltr">The SR included 12 articles. The quality of the selected studies was generally high. Five studies (42%) reported improved willingness, confidence, comfort, and the likelihood of responding safely to trauma. Nine studies (75%) used pre-and post-tests to document knowledge acquired, and five studies (42%) used knowledge retention evaluation at different intervals and reported substantial knowledge and skill reductions after a few months (1–3 months, 3–6 months, or both 6 and 9 months or up to 3 years). A few studies followed incident reports to document the utilization of knowledge and skills acquired during training. None reported patient outcomes.</p><h3>Conclusion</h3><p dir="ltr">Bleeding control training courses for layperson first responders in LMICS significantly improve knowledge, skill, confidence, and willingness to intervene to apply bleeding control techniques to trauma patients. Evaluating clinically relevant outcomes is needed to strengthen the evidence.</p><h2>Other Information</h2><p dir="ltr">Published in: European Journal of Trauma and Emergency Surgery<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s00068-025-02917-4" target="_blank">https://dx.doi.org/10.1007/s00068-025-02917-4</a></p>
eu_rights_str_mv openAccess
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network_acronym_str Manara2
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spelling The effect of external bleeding control training courses on lay first-person responders'knowledge, skills, and attitudes in low- and middle-income countries: a systematic reviewHusham Abdelrahman (768893)Ahammed Mekkodathil (4578838)Ayman El-Menyar (440103)Rafael Consunji (768892)Sandro Rizoli (67238)Hassan Al-Thani (440106)Biomedical and clinical sciencesClinical sciencesHuman societyDevelopment studiesHemorrhage controlTrauma InjuryTrainingLow- and middle-income countryLaypersonSystematic review<h3>Background</h3><p dir="ltr">Exsanguinating hemorrhage is the most common cause of preventable trauma death at the injury scene, and it is often due to the inability to control bleeding immediately. Training layperson first responders (LFR) in trauma care, particularly hemorrhage control, has been recommended to address this trauma care gap. We conducted a systematic review (SR) to analyze the effect of hemorrhage control training courses for LFRs on knowledge, skill, and attitude to intervene in trauma patients.</p><h3>Methods</h3><p dir="ltr">PubMed and Google Scholar databases were used to identify relevant peer-reviewed research articles describing evaluations of hemorrhage control courses for LFR between 2013 and 2024. Studies examined whether the training course was implemented in low- and middle-income countries (LMICS); trainees were LFR and had outcome measures, including knowledge, skills, attitudes (confidence gained, willingness, comfort, and likelihood to intervene) toward care utilization for trauma patients, as well as outcomes.</p><h3>Results</h3><p dir="ltr">The SR included 12 articles. The quality of the selected studies was generally high. Five studies (42%) reported improved willingness, confidence, comfort, and the likelihood of responding safely to trauma. Nine studies (75%) used pre-and post-tests to document knowledge acquired, and five studies (42%) used knowledge retention evaluation at different intervals and reported substantial knowledge and skill reductions after a few months (1–3 months, 3–6 months, or both 6 and 9 months or up to 3 years). A few studies followed incident reports to document the utilization of knowledge and skills acquired during training. None reported patient outcomes.</p><h3>Conclusion</h3><p dir="ltr">Bleeding control training courses for layperson first responders in LMICS significantly improve knowledge, skill, confidence, and willingness to intervene to apply bleeding control techniques to trauma patients. Evaluating clinically relevant outcomes is needed to strengthen the evidence.</p><h2>Other Information</h2><p dir="ltr">Published in: European Journal of Trauma and Emergency Surgery<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s00068-025-02917-4" target="_blank">https://dx.doi.org/10.1007/s00068-025-02917-4</a></p>2025-07-14T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1007/s00068-025-02917-4https://figshare.com/articles/journal_contribution/The_effect_of_external_bleeding_control_training_courses_on_lay_first-person_responders_knowledge_skills_and_attitudes_in_low-_and_middle-income_countries_a_systematic_review/30859841CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/308598412025-07-14T09:00:00Z
spellingShingle The effect of external bleeding control training courses on lay first-person responders'knowledge, skills, and attitudes in low- and middle-income countries: a systematic review
Husham Abdelrahman (768893)
Biomedical and clinical sciences
Clinical sciences
Human society
Development studies
Hemorrhage control
Trauma Injury
Training
Low- and middle-income country
Layperson
Systematic review
status_str publishedVersion
title The effect of external bleeding control training courses on lay first-person responders'knowledge, skills, and attitudes in low- and middle-income countries: a systematic review
title_full The effect of external bleeding control training courses on lay first-person responders'knowledge, skills, and attitudes in low- and middle-income countries: a systematic review
title_fullStr The effect of external bleeding control training courses on lay first-person responders'knowledge, skills, and attitudes in low- and middle-income countries: a systematic review
title_full_unstemmed The effect of external bleeding control training courses on lay first-person responders'knowledge, skills, and attitudes in low- and middle-income countries: a systematic review
title_short The effect of external bleeding control training courses on lay first-person responders'knowledge, skills, and attitudes in low- and middle-income countries: a systematic review
title_sort The effect of external bleeding control training courses on lay first-person responders'knowledge, skills, and attitudes in low- and middle-income countries: a systematic review
topic Biomedical and clinical sciences
Clinical sciences
Human society
Development studies
Hemorrhage control
Trauma Injury
Training
Low- and middle-income country
Layperson
Systematic review