Emergency medicine journal : EMJ
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A shortcut review was carried out to establish whether steroids prevent biphasic anaphylactic reactions in children. Seven papers were directly relevant to the question. ⋯ The clinical bottom line is that there are no trials to show that steroids prevent biphasic reactions. However, there are other grounds for using them in anaphylactic reactions and they are still recommended in guidelines.
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Telephone calls for emergency ambulances are rising annually, increasing the pressure on ambulance resources for clinical problems that could often be appropriately managed in primary care. ⋯ Many calls are based on fundamental misconceptions about the types of treatment other urgent-care avenues can provide, which may be amenable to educational intervention. This is particularly relevant for patients with chronic conditions with frequent exacerbations. Callers who have care responsibilities often default to the most immediate response available, with decision making driven by a lower tolerance of perceived risk. There may be a greater role for more detailed triage in these cases, and closer working between ambulance responses and urgent primary care, as a perceived or actual distance between these two service sectors may be influencing patient decision making on urgent care.
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This subjective review is based on a presentation made at the College of Emergency Medicine Scientific Conference in September 2013. My theme was that there are certain features of the critically ill which cause understandable anxiety, namely hypoxia, haemorrhage and hypotension. So, I have selected papers relevant to the management of these frightening situations.
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Only a few cardiac-arrest victims receive external chest compression (ECC) by a bystander. ⋯ The better 'advantages over disadvantages' score for the automated ECC device over manual ECC indicated that the general public might envisage use of the device. This could contribute to increase the frequency of resuscitation attempts by bystanders.