Background Relatively little is currently known about the effectiveness of first-aid training for children and laypeople. We have undertaken a systematic review to synthesise the evidence and inform policy and practice in this area.

Methods A range of bibliographic databases were searched. Studies were eligible if they used experimental designs, provided first-aid training to laypeople or children and reported first-aid knowledge, skills behaviours or confidence. Studies were selected for inclusion, data extracted and risk of bias assessed by two independent reviewers. Findings were synthesised narratively.

Results 23 studies (14 randomised controlled trials and 9 non-randomised studies) were included, 12 of which recruited children or young people (≤19 years old). Most studies reported significant effects favouring the intervention group; 11 out of 16 studies reported significant increases in first-aid knowledge; 11 out of 13 studies reported significant increases in first-aid skills; 2 out of 5 studies reported significant improvements in helping behaviour; and 2 out of 3 studies reported significant increases in confidence in undertaking first aid. Only one study undertook an economic evaluation; finding an intensive instructor-led course was more effective, but had significantly higher costs than either a less-intensive instructor-led course or a video-delivered course. Most studies were at risk of bias, particularly selection, performance or detection bias.

Conclusions There is some evidence to support provision of first-aid training, particularly for children or young people, but many studies were judged to be at risk of bias. Conclusions cannot be drawn about which first-aid training courses or programmes are most effective or the age at which training can be most effectively provided. Few studies evaluated training in adult laypeople. High-quality studies are required assessing effectiveness and cost-effectiveness of standardised first-aid training to inform policy development and provision of first-aid training.