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.

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.

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