Abstract

Background: Community First Responder (CFR) schemes support lay people to respond to medical emergencies,
working closely with ambulance services. They operate widely in the UK. There has been no previous review of UK
literature on these schemes. This is the first systematic scoping review of UK literature on CFR schemes, which
identifies the reasons for becoming a CFR, requirements for training and feedback and confusion between the CFR
role and that of ambulance service staff. This study also reveals gaps in the evidence base for CFR schemes.
Methods: We conducted a systematic scoping review of the published literature, in the English language from
2000 onwards using specific search terms in six databases. Narrative synthesis was used to analyse article content.
Results: Nine articles remained from the initial search of 15,969 articles after removing duplicates, title and abstract
and then full text review.
People were motivated to become CFRs through an altruistic desire to help others. They generally felt rewarded by
their work but recognised that the help they provided was limited by their training compared with ambulance
staff. There were concerns about the possible emotional impact on CFRs responding to incidents. CFRs felt that
better feedback would enhance their learning. Ongoing training and support were viewed as essential to enable
CFRs to progress. They perceived that public recognition of the CFR role was low, patients sometimes confusing
them with ambulance staff. Relationships with the ambulance service were sometimes ambivalent due to confusion
over roles. There was support for local autonomy of CFR schemes but with greater sharing of best practice.
Discussion: Most studies dated from 2005 and were descriptive rather than analytical. In the UK and Australia CFRs
are usually lay volunteers equipped with basic skills for responding to medical emergencies, whereas in the US they
include other emergency staff as well as lay people.
Conclusion: Opportunities for future research include exploring experiences and perceptions of patients who have
been treated by CFRs and other stakeholders, while also evaluating the effectiveness and costs of CFR schemes.