Welcome back! Three more papers for you this month to inform and improve our care in acute and critical illness. First up and following on from the recent DoseVF paper, we take a look at a study looking at the combined effect of vector change, esmolol and capping adrenaline administration in refractory VF with regards patient out ones. Could this be associated with even better patient outcomes? Secondly we take a look at the utility of fentanyl lozenges in providing effective analgesia to patients in remote settings. Does this have potential for both prehospital and in-hospital patients prior to iv access. Finally we cover a paper looking at prehospital management of acute behavioural disturbance; the need for restraint, the need for sedation and the subsequent effects on the patients. Once again we’d love to hear any thoughts or feedback either on the website or via twitter @TheResusRoom. Simon & Rob