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Journal Feed Weekly Wrap-Up

We always work hard, but we may not have time to read through a bunch of journals. It’s time to learn smarter.
Originally published at JournalFeed, a site that provides daily or weekly literature updates.
Follow Dr. Clay Smith at @spoonfedEM, and sign up for email updates here.

#1: Ideal Rocuronium Dosing – How to Avoid ‘Mostly Paralyzed’

Spoon Feed
Rocuronium doses >1.2 mg/kg improved first-pass intubation success compared with standard dosing but did not affect downstream clinical outcomes.

Source
Rocuronium dosing for rapid sequence intubation: A retrospective analysis in ED and ICU settings. Am J Emerg Med. 2026 Jun 23;109:75-80. doi: 10.1016/j.ajem.2026.06.038. Epub ahead of print. PMID: 42385663.

#2: One and Done? Dexamethasone for Pediatric Asthma

Spoon Feed 
While most children discharged after an asthma exacerbation receive two doses of dexamethasone, this retrospective cohort study found no difference in ED revisits or hospitalizations compared with a single-dose regimen.

Source
Dexamethasone Treatment Regimen and Clinical Outcomes in Children With Asthma Exacerbations. Ann Emerg Med. 2026 Jul;88(1):46-54. doi: 10.1016/j.annemergmed.2025.12.010. Epub 2026 Jan 23. PMID: 41575401.

#3: What Predicts Mortality in Necrotizing Fasciitis?

Spoon Feed 
Variables associated with increased mortality in necrotizing soft tissue infections include older age, chronic liver or kidney disease, high comorbidity index, immunosuppression, hypotension/shock, bacteremia, AKI, and coagulopathy.

Source
Prognostic Factors Associated With Mortality Among Patients With Necrotizing Soft-Tissue Infection: A Systematic Review and Meta-Analysis. Crit Care Med. 2026 Jul 1;54(7):1779-1787. doi: 10.1097/CCM.0000000000007147. Epub 2026 May 15. PMID: 42138515.

#4: Best Needle Decompression Site in Obese Patients

Spoon Feed
In those with obesity, the distance from the skin to the pleura is lower and less sensitive to increasing body mass at the midclavicular second intercostal space compared to the anterior axillary fourth/fifth intercostal space.

Source
Needle Thoracostomy: Implications of Chest Wall Thickness for Anatomical Location and Needle Length. Ann Emerg Med. 2026 Jul 1:S0196-0644(26)00378-1. doi: 10.1016/j.annemergmed.2026.06.014. Epub ahead of print. PMID: 42383960.

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