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Be prepared—there is much in this issue. Many aspects of emergency medicine are addressed that will take time to consider. However, I would ask you to begin by taking five minutes to read Hodgetts’ “A day in the life” experience from the latest Gulf war. It puts our own “bad days” into context. See page 129
Anaphylaxis, stings, and electricity
If you had a systemic allergic reaction to jack jumper ant would you volunteer to have the insect attached to your forearm for a minute so it could sting you? Brown et al found 68 otherwise healthy volunteers as part of their experiment looking at ant venom immunotherapy. In this article they review the 19 patients who developed anaphylaxis. Invaluable clinical information is provided on the physiological effect of anaphylaxis and implicates a neurocardiogenic mechanism in some lethal reactions. In addition, the authors rekindle the issue of intravenous administration of adrenaline for treatment of anaphylaxis. This topic is discussed further in Tony Brown’s editorial. Together the articles will cause readers to review their current management of this rare but life threatening emergency condition. The consequences of falsely diagnosing an allergic response are addressed in …