ALERT- reminder of changes to handbook from DEC 2016 MOAB: 1. Change in needle D. site to only 5th ICS Mid Axillary Line. 2. Addition of combat dose of ketamine for sedation.3. Administer TXA by slow IV push over 2-3 minutes giving a cc at a time.4.Discontinue training upper extremity and thigh fasciotomies, only leg (tip-fib) will remain for training. Do not perform fasciotomy without proper training and sign off. Next MOAB 21-22 JUN.