Accuracy of Needle Chest Decompression Site Selection in Simulated High Stress Environments Among Air Force Healthcare Professionals: A Randomized Controlled Trial

A simulated high-stress environment did not affect NCD site selection accuracy in this population. The significant difference in accuracy between the 2 sites, combined with the lack of difference in perceived ease, suggests that current Tactical Combat Casualty Care (TCCC) training may be inadequate, particularly for the 5ICS site. Our study's strengths include its randomized design and the use of live models, but it is limited by its single-center recruitment and the small sample size for real-life experience. These results underscore a critical need for improved hands-on training methods, such as cadaver-based learning, to ensure military medical professionals can competently perform NCD under all conditions. Future studies should explore the impact of different training methods and the influence of body habitus on site selection accuracy.