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Field Brief: Naloxone in Cardiac Arrest — When the Dogma Catches Up to the Street
The 2023 AHA Focused Update said naloxone in cardiac arrest doesn’t improve outcomes. Two cohort studies (UCSF/UC Davis, JAMA Network Open 2024 and 2026) say otherwise. A Field Brief on what the evidence actually shows, the proposed non-opioid mechanism, dosing in arrest, and what to do on your next code — with an embedded 4-case Decision Engine.

John Gomez
1 day ago8 min read


Field Brief: Cool First, Transport Second — The Phoenix Cold Water Immersion Study & the New Science of Heat Emergencies
Phoenix Fire's March 2026 study in Prehospital Emergency Care evaluated their prehospital cold water immersion protocol across 183 heat stroke patients — and quietly buried the load-and-go dogma civilian EMS has run on for two decades. What the data says, why your cooling rate is the only variable that matters, and what to put on your rig before the next heat wave.

John Gomez
Jun 259 min read


Field Brief: The EMS Blood Reckoning - What SWiFT Actually Says, and What It Doesn't
The largest randomized trial ever run on prehospital whole blood, SWiFT, found it no better than component therapy. Here is what the trial actually says, what it doesn't, and what it means for your cooler, your protocol, and your budget.

John Gomez
May 307 min read


Field Brief: TCCC 2026 — Tourniquet Conversion, OTFC Out, and the Pediatric Guidelines We Should've Had a Decade Ago
The May 2026 CoTCCC update expands tourniquet reposition and conversion to ASM and CLS tiers, pulls OTFC and IV fentanyl from first-line analgesia in favor of a suzetrigine-anchored CWMP, and ships the first standalone pediatric TCCC document. Here is what working tac medics — military and civilian — actually need to know.

John Gomez
May 2410 min read


Sepsis Hides in Plain Sight
Sepsis often hids in plain sight. It kills hundreds of thousands of people every year, it took Kyle Busch - what is sepsis and why does it gain the upper hand all-too-often?

John Gomez
May 237 min read


An EMS Guide to Scromiting & Cannabis-Related Emergencies
Contrary to the common perception of marijuana as a benign substance, evidence-based data reveal significant acute side effects that EMS providers must be prepared to recognize and manage. This report (aka "field guide") provides a detailed overview of cannabis-related emergencies and their prehospital management helping EMS leaders shape protocols and prepare crews for these emerging challenges.

John Gomez
Dec 23, 202533 min read


Field Brief: Xylazine & Emerging Non-Opioid Street Drugs
Xylazine – also known by street names like “tranq” or “tranq dope” – is a veterinary sedative that has rapidly infiltrated the illicit drug supply in recent years. Unlike opioids, xylazine is not intended for human use, yet it’s being combined with fentanyl and other drugs, causing unprecedented challenges for emergency medical services (EMS).
This report provides a comprehensive overview of xylazine and similar emerging non-opioid drugs tailored for EMS.

John Gomez
Dec 10, 202564 min read
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