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.

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.