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 'we're too close for blood' argument collapses under real urban transport-time distributions, the SWiFT/TOWAR fine print, and the Murphy-factor tail. A three-tier framework — with an embedded 5-scenario Decision Engine — that beats the false binary.

Push-dose epinephrine took over prehospital shock management — and brought a nasty error tail with it. A Field Brief on why the mix keeps killing, and what the best protocols do to catch it before it reaches the patient.

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.