The Committee on Tactical Combat Casualty Care published a refreshed guideline set on 1 May 2026, drawing on casualty data from the war in Ukraine and Joint Trauma System evidence. It consolidates a run of interim changes into one card. Three of them will date your kit and your SOPs if you have not caught up.
- **The field antibiotic changed.** The parenteral choice is now ceftriaxone 2g, given once daily, reconstituted with normal saline only — replacing ertapenem. The oral fallback is now cefadroxil 1g (preferred) or cephalexin, replacing moxifloxacin. If your IFAK still carries ertapenem and moxi, it is out of date. - **The airway sequence shifted.** Supraglottic airways are no longer the first-line choice in Tactical Field Care; the guidance leads with the recovery position for an unconscious casualty who is breathing, and makes capnography mandatory after a surgical airway. - **Tourniquet reassessment is tightening.** A proposed change brings in a reassessment inside two hours, with conversion beyond that limited to medical personnel — "repositioning", not "replacement". - **On tranexamic acid,** the principle is unchanged: give it as early as possible after injury. Reporting on whether the absolute three-hour window has been relaxed in light of the Ukraine (CRITICAL) data is mixed, so confirm against your current CoTCCC card before you change that SOP — but do not withhold TXA because you think a clock has run out. - **For operators:** pull your medics' cards and your IFAK contents against the 1 May guidelines now. The antibiotic swap and the airway change are the two that most often sit wrong in a kit that was packed last year.
