Evidence map›Paper›PMID 41878140›Full record

ArticleTrauma surgery & acute care open2026

Establishing the Standardized EMS Metrics for Survival in Transfusion and Advanced Resuscitation: the SEMSTAR project.

Matthew J Levy, Holly O'Byrne, Kaytlin Hack, Amanda Staudt, Remle Crowe, Eric A Bank, Joshua B Brown, Timothy Brown, Armand Cayer, David Edwards and 22 more

Abstract read
In one paragraph

Article in Trauma surgery & acute care open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

32 authors.

Matthew J LevyEmergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.ORCID https://orcid.org/0000-0001-8144-3281
Holly O'ByrneDepartment of Fire and Rescue Services, Government of the District of Columbia, Washington, District of Columbia, USA.ORCID https://orcid.org/0009-0004-2160-2737
Kaytlin HackEmergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Amanda StaudtThe Geneva Foundation, JBSA Fort Sam Houston, Texas, USA.ORCID https://orcid.org/0000-0002-0353-437X
Remle CroweESO Solutions, Austin, Texas, USA.
Eric A BankEMS, Harris County Emergency Services District No. 48, Katy, Texas, USA.
Joshua B BrownSurgery, Univ Pittsburgh, Pittsburgh, Pennsylvania, USA.ORCID https://orcid.org/0000-0002-6936-035X
Timothy BrownThompson Valley Emergency Medical Services, Loveland, Colorado, USA.
Armand CayerEmergency Medical Services, University Hospital, Newark, New Jersey, USA.
David EdwardsThompson Valley Emergency Medical Services, Loveland, Colorado, USA.
Gabriel H GanDepartment of Fire and Rescue Services, Government of the District of Columbia, Washington, District of Columbia, USA.
Eric GarfinkelEmergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Craig GoolsbyEmergency Medicine, Harbor-UCLA Medical Center, Torrance, California, USA.
Frances GuyetteEmergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.ORCID https://orcid.org/0000-0002-9151-4896
Ryan B FransmanTrauma Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.ORCID https://orcid.org/0009-0000-7054-735X
John B HolcombSurgery, University of Alabama at Birmingham Health System, Birmingham, Alabama, USA.ORCID https://orcid.org/0000-0001-8312-9157
Dionne HugginsEmergency Medical Services, Hackensack Meridian Hackensack University Medical Center, Hackensack, New Jersey, USA.
Donald H JenkinsSurgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
Michelle KobayashiEmergency Medical Services, Hackensack Meridian Hackensack University Medical Center, Hackensack, New Jersey, USA.
N Clay MannPediatrics, The University of Utah School of Medicine, Salt Lake City, Utah, USA.
Asa M MargolisEmergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Kevin NicholesPediatrics, The University of Utah School of Medicine, Salt Lake City, Utah, USA.ORCID https://orcid.org/0009-0005-1005-1308
Shaun PattersonEmergency Medical Services, Hackensack Meridian Hackensack University Medical Center, Hackensack, New Jersey, USA.
Art SamarasCritical Care Transport, Atlantic Health System, Morristown, New Jersey, USA.
Randall SchaeferSchaefer Consulting, LLC, New Braunfels, Texas, USA.
Philip SpinellaUniversity of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
David VitbergEmergency Medicine, Sibley Memorial Hospital, Washington, District of Columbia, USA.
Christopher M WendEmergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.ORCID https://orcid.org/0000-0002-3302-8646
Kelsey WilhelmEmergency Medicine, Harbor-UCLA Medical Center, Torrance, California, USA.ORCID https://orcid.org/0009-0000-8490-7950
Christopher WincklerEmergency Health Sciences, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
Tung-Lin Jesse YuanEmergency Medical Services, University Hospital, Newark, New Jersey, USA.ORCID https://orcid.org/0000-0003-0018-1158
Jon KrohmerEmergency Medicine, Michigan State University, Grand Rapids, Michigan, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Prehospital blood transfusion is increasingly recognized as an important early resuscitation intervention for patients with hemorrhagic shock. However, comprehensive evaluations of such programs have been limited by heterogeneity in data collection, outcome definitions, and reporting methodologies. This impedes effective benchmarking, quality improvement initiatives, research efforts, and the creation of protocols and policies. The Standardized Emergency Medical Service (EMS) Metrics for Survival in Transfusion and Advanced Resuscitation (SEMSTAR) project sought to develop consensus-driven data elements and standardized outcome definitions to facilitate consistent reporting of prehospital blood transfusion programs. Methods: Initial data metrics were identified through a literature review and surveyed across US EMS systems that perform prehospital transfusions. A modified Delphi methodology was then used by a multidisciplinary panel of 28 subject-matter experts in EMS, trauma surgery, transfusion medicine, and resuscitation science. Predefined thresholds analyzed metric inclusion, classification as either core or expanded elements, and endorsement of standardized outcome definitions. Results: 89 EMS systems completed the initial survey of 208 potential data elements. Of these, 193 (93%) advanced to expert review. Experts reached consensus on 168 data elements: 86 core metrics for universal reporting and 82 expanded metrics for comprehensive analysis. Consensus was also achieved on standardized definitions for hemorrhagic circulatory collapse, including stratification by pretransfusion circulatory collapse status and survival after prehospital transfusion. Wherever possible, the resulting framework draws from existing data infrastructure, including the National Emergency Medical Services Information System and trauma registry variables. Conclusion: SEMSTAR establishes the first national, consensus-driven framework for standardized data collection and outcome reporting among prehospital blood transfusion programs. By defining core and expanded metrics with standardized survival definitions, this framework enables benchmarking, quality improvement, and multicenter research across diverse EMS systems. SEMSTAR adoption will enable rigorous program evaluation and support the development of a national registry to advance evidence-based care for patients with hemorrhagic shock. Level of evidence: IV.

Indexed as

blood transfusionEmergency Medical ServiceshemorrhageShock, Hemorrhagic

Identifiers

PMID41878140
PMCPMC13007121

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.