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emergency medical services personnel  \nJon Krohmer, 1,2 Holly O’Byrne  ,3 Randall Schaefer,4 Eric A Bank,5  \nJohn B Holcomb  ,6 William J Bullock,7 Ronnie L Hill,8 Matthew Levy  9  \n1Emergency Medicine, Michigan State University, East Lansing, Michigan, USA  \n2EMSMD, Grandville, Michigan, USA  \n3Department of Fire and Rescue Services, Government of the District of Columbia, Washington, DC, USA 4Schaefer Consulting, New Braunfels, Texas, USA  \n5EMS, Harris County Emergency Services District No 48, Katy, Texas, USA  \n6Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA  \n7San Antonio Fire Department, City of San Antonio Fire Department, San Antonio, Texas, USA  \n8Department of Pathology and Area Laboratory Services, Landstuhl Regional Medical Center, Landstuhl, Germany 9Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA  \nCorrespondence to  \nDr Jon Krohmer; krohmerj@ [msu.edu](msu.edu)  \nReceived 19 October 2025 Accepted 3 December 2025  \n© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.  \nTo cite: Krohmer J, O’Byrne H, Schaefer R, et al. Trauma SurgAcute Care Open 2026;11:e002132 .  \nPURPOSE  \nThese competencies establish the coalition’s recommendations for comprehensive educational standards and competency requirements for emergency medical services (EMS) personnel authorized toadminister blood products in the prehospital environment. This guideline serves as a resource document to ensure that EMS clinicians possess the requisite knowledge, skills, and competencies to safely and effectively perform blood transfusions, recognize and manage complications, and maintain quality standards. Implementation of standardized training programs requires systematic curriculum development in alignment with established educational principles, competency validation, ongoing education, quality improvement measures, and close medical oversight in accordance with established standards and best practices.1–3  \nThe content and recommendations within this document should be implemented in coordination with local medical oversight, regulatory requirements, and organizational policies, along with accepted pedagogical and evaluative principles. Regular review and updates ensure continued relevance and effectiveness in preparing EMS clinicians for safe and competent blood product administration.  \nINTRODUCTION  \nThe administration of blood products in the prehospital setting requires specialized training beyond standard paramedic education. As prehospital blood transfusion programs continue to expand across civilian EMS systems, there is a critical need for standardized training competencies to ensure patient safety and optimal clinical outcomes.4–6 Early blood product administration significantly improves survival in patients with hemorrhagic shock, making proper training essential for successful program implementation.7–10  \nThis document establishes evidence-based training standards that address the unique challenges of prehospital blood administration. These competencies encompass medical knowledge requirements, operational competencies, administrative responsibilities, technical skills, and ongoing professional development. These standards should be implemented in coordination with local medical oversight and are designed to complement existing EMS education frameworks while addressing the  \nspecialized requirements of blood product administration.11 12  \nEffective training programs must incorporate multiple educational modalities, including didactic instruction, simulation-based learning, practical skills assessment, transfusion case study analysis and ongoing competency validation, using established frameworks such as Kern’s six-step model.13 The goal of this training should be to develop cl","cbCaigr5qMJpBpxP","https://ap.wps.com/l/cbCaigr5qMJpBpxP","pdf",289180,"English","# Purpose\n# Introduction\n# Training principles and framework\n## Competency-based education model\n## Systematic curriculum development\n## Multimodal learning approach\n## Continuous training quality improvement\n# Core competency domains\n## Medical knowledge competencies","[{\"question\":\"What is the document’s purpose regarding prehospital blood transfusion training?\",\"answer\":\"It provides coalition recommendations for educational standards and competency requirements so EMS personnel can administer blood products safely and effectively in prehospital environments.\"},{\"question\":\"Why are standardized competencies considered critical for EMS personnel in this setting?\",\"answer\":\"Prehospital blood product administration requires specialized training beyond standard paramedic education, and early administration in hemorrhagic shock can improve survival, making safe implementation essential.\"},{\"question\":\"What training principles and frameworks does the guideline recommend?\",\"answer\":\"It supports competency-based education, systematic curriculum development, multimodal learning (didactic, simulation, case/scenario-based assessment), and continuous quality improvement with evaluation, feedback, and performance measurement.\"}]","Prehospital blood transfusion coalition core competencies for emergency medical services personnel | PDF",1790719901,13]