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Emergency care with lay responders in underserved populations: a systematic review

OBJECTIVE: To assess the individual and community health effects of task shifting for emergency care in low-resource settings and underserved populations worldwide. METHODS: We systematically searched 13 databases and additional grey literature for studies published between 1984 and 2019. Eligible s...

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Autores principales: Orkin, Aaron M, Venugopal, Jeyasakthi, Curran, Jeffrey D, Fortune, Melanie K, McArthur, Allison, Mew, Emma, Ritchie, Stephen D, Drennan, Ian R, Exley, Adam, Jamieson, Rachel, Johnson, David E, MacPherson, Andrew, Martiniuk, Alexandra, McDonald, Neil, Osei-Ampofo, Maxwell, Wegier, Pete, Van de Velde, Stijn, VanderBurgh, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: World Health Organization 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8243031/
https://www.ncbi.nlm.nih.gov/pubmed/34248224
http://dx.doi.org/10.2471/BLT.20.270249
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author Orkin, Aaron M
Venugopal, Jeyasakthi
Curran, Jeffrey D
Fortune, Melanie K
McArthur, Allison
Mew, Emma
Ritchie, Stephen D
Drennan, Ian R
Exley, Adam
Jamieson, Rachel
Johnson, David E
MacPherson, Andrew
Martiniuk, Alexandra
McDonald, Neil
Osei-Ampofo, Maxwell
Wegier, Pete
Van de Velde, Stijn
VanderBurgh, David
author_facet Orkin, Aaron M
Venugopal, Jeyasakthi
Curran, Jeffrey D
Fortune, Melanie K
McArthur, Allison
Mew, Emma
Ritchie, Stephen D
Drennan, Ian R
Exley, Adam
Jamieson, Rachel
Johnson, David E
MacPherson, Andrew
Martiniuk, Alexandra
McDonald, Neil
Osei-Ampofo, Maxwell
Wegier, Pete
Van de Velde, Stijn
VanderBurgh, David
author_sort Orkin, Aaron M
collection PubMed
description OBJECTIVE: To assess the individual and community health effects of task shifting for emergency care in low-resource settings and underserved populations worldwide. 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. 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). 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.
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spelling pubmed-82430312021-07-09 Emergency care with lay responders in underserved populations: a systematic review Orkin, Aaron M Venugopal, Jeyasakthi Curran, Jeffrey D Fortune, Melanie K McArthur, Allison Mew, Emma Ritchie, Stephen D Drennan, Ian R Exley, Adam Jamieson, Rachel Johnson, David E MacPherson, Andrew Martiniuk, Alexandra McDonald, Neil Osei-Ampofo, Maxwell Wegier, Pete Van de Velde, Stijn VanderBurgh, David Bull World Health Organ Systematic Reviews OBJECTIVE: To assess the individual and community health effects of task shifting for emergency care in low-resource settings and underserved populations worldwide. 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. 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). 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. World Health Organization 2021-07-01 2021-04-29 /pmc/articles/PMC8243031/ /pubmed/34248224 http://dx.doi.org/10.2471/BLT.20.270249 Text en (c) 2021 The authors; licensee World Health Organization. https://creativecommons.org/licenses/by/3.0/igo/This is an open access article distributed under the terms of the Creative Commons Attribution IGO License (http://creativecommons.org/licenses/by/3.0/igo/legalcode (https://creativecommons.org/licenses/by/3.0/igo/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organization or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.
spellingShingle Systematic Reviews
Orkin, Aaron M
Venugopal, Jeyasakthi
Curran, Jeffrey D
Fortune, Melanie K
McArthur, Allison
Mew, Emma
Ritchie, Stephen D
Drennan, Ian R
Exley, Adam
Jamieson, Rachel
Johnson, David E
MacPherson, Andrew
Martiniuk, Alexandra
McDonald, Neil
Osei-Ampofo, Maxwell
Wegier, Pete
Van de Velde, Stijn
VanderBurgh, David
Emergency care with lay responders in underserved populations: a systematic review
title Emergency care with lay responders in underserved populations: a systematic review
title_full Emergency care with lay responders in underserved populations: a systematic review
title_fullStr Emergency care with lay responders in underserved populations: a systematic review
title_full_unstemmed Emergency care with lay responders in underserved populations: a systematic review
title_short Emergency care with lay responders in underserved populations: a systematic review
title_sort emergency care with lay responders in underserved populations: a systematic review
topic Systematic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8243031/
https://www.ncbi.nlm.nih.gov/pubmed/34248224
http://dx.doi.org/10.2471/BLT.20.270249
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