September 2026; papers of the month

Welcome back to September 2026's Papers of the Month, and this month we've got three papers that are really focused on the practical end of emergency and prehospital care.

First up, we're looking at what happens after we've performed a prehospital RSI. We put a huge amount of emphasis on getting the induction right, but what about maintaining adequate anaesthesia afterwards? This paper looks at intermittent bolus sedation following prehospital emergency anaesthesia, the variation in dosing between patients, and whether we might actually be running the risk of under-sedating some of them and compromising their care.

Then we're staying prehospital and asking a really simple question in trauma: how good are the physiological numbers we use to identify the sick patient? We've all used shock index, but could NEWS actually do a better job of predicting mortality, transfusion requirements and subsequent resource utilisation?

And finally, we're back to RSI and rocuronium. A variety of dosing strategies can be seen in practice but could going higher improve first-pass success? And importantly, does that relationship still hold in patients with obesity or hypoperfusion?

Three clinically relevant papers, plenty to challenge our current practice, and as always, lots to get into.

Once again we'd love to hear any thoughts or feedback either on the website or via social media @TheResusRoom!

Simon & Rob

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