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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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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A shortcut review was carried out to establish whether levosimendan improves outcome in septic shock. Eight studies were directly relevant to the question. ⋯ The clinical bottom line is that there is as yet no evidence that levosimendan reduces mortality from septic shock. The LeoPARDS trial may change that.