For the upgraded ARS for Needle Decompression from North American Rescue, the best minds in the field were applied to the best available data. The result? Our patented design improves the probability of success when managing casualties who present with signs and symptoms of a tension pneumothorax. To achieve this end, we participated in a two-year collaboration with pre-hospital providers. We continuously analyzed data obtained from ongoing combat operations for patients whose symptoms suggested a collapsed lung (difficulty in breathing, chest drains, etc.). We applied the Analytical Thinking, Evidence-based Medicine and Human Factors engineering model to identify inherent survival stress behaviors. Then, North American Rescue went one step further. We incorporated failsafe characteristics into the product design. For example, an easy-open container protects the needle from damage during deployment. Also, we removed the flash cap from the needle system to allow immediate confirmation of placement.