A new April 2026 cadaveric study put another dent in needle decompression — 76% success in ideal lab conditions. A 2024 retrospective had finger thoracostomy at 93% versus 47%. The evidence has stacked up for a decade. Civilian ground EMS still won't pick up the scalpel.

The 2020 AHA guidelines say firm surface, and every EMS crew has been arguing about backboards and floor transfers ever since. A 2024 ILCOR meta-analysis and new June 2026 research quietly show the argument is aimed at the wrong variable — and the real fix has nothing to do with the mattress.

Two NEJM randomized trials in four months — SWiFT and TOWAR — both failed to show prehospital whole blood is superior to component therapy. Here's what the numbers actually say, what they don't, and what your program should do this week.

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.

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.

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.

Excited delirium is a discredited term, buried by the AMA, ACEP, and California law. But the hyperthermic, acidotic patient who codes in restraint is real. A BLS and ALS field guide to the myth, the mechanism, and the sedation trap that can kill him.

A working clinician's guide to tranexamic acid in trauma — the why, the when, and the calls people get wrong. Updated for the August 2025 NAEMSP/ACEP/ACS-COT joint position statement.

Why Intraosseous Access Is Still One of the Most Underused Tools in Emergency Care

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.

It’s 1430 hours when your crew is dispatched to a construction site for a worker who “passed out.”