All posts by Ryan Davis Philip

 

Likelihood of having current CPR training declines with age

CPR Training Canberra. Cheap rate $60. Excellent Trainers. Great First Aid Techniques. Nationally Recognised Certificates. Courses never cancelled.
By Anne Harding

Older people are the group most likely to need cardiopulmonary resuscitation (CPR), but they are the least likely to have training in the life-saving technique, according to new findings.

“This mismatch may translate into lives lost, because if someone collapses at home who is 65 years old and their 62-year-old spouse does not know CPR, they have to wait for the ambulance to arrive and it may be too late,” said Dr. Benjamin S. Abella, who directs the Center for Resuscitation Science at the University of Pennsylvania in Philadelphia. “We need to be more creative about our approach to CPR training in this population.”

Receiving prompt CPR from a bystander more than doubles a person’s chances of surviving a sudden cardiac arrest, but fewer than one-third of sudden cardiac arrest victims receive bystander CPR, Abella and his team noted in a report in the Journal of the American Heart Association. To better understand low rates of bystander CPR, Abella and his colleagues surveyed a nationally representative sample of about 9,000 U.S. adults on their CPR training status.

Just 18 percent had current training in CPR, while 65 percent said they had received training in the past. The older a study participant was, the less likely he or she was to have current CPR training, or to have ever received CPR training. People with a graduate school education or higher were more than three times as likely have current CPR training. However, lower education and lower household income were both associated with not having received CPR training.

Traditionally, people get certified to perform CPR by attending classes sponsored by the American Heart Association or the American Red Cross, often at universities, schools or hospitals. CPR certification is time-consuming, and can be expensive, Abella told Reuters Health in a telephone interview.

“There’s an important mantra in resuscitation, which is ‘something is better than nothing,’” he added. New ways to teach CPR, he suggested, might be through training offered by video at places where people are going to be waiting anyhow, like the department of motor vehicles, the airport, or the doctor’s office.

“Breaking outside of the classroom and the traditional model of CPR training is going to be important,” Abella said. “There are many locations where we can bring CPR to the public, as opposed to asking the public to come find ways to learn CPR.”

More information about CPR training in the U.S. or worldwide is available from the American Heart Association, here: bit.ly/19Wb4pT.

SOURCE: bit.ly/2qwWxu2 The Journal of the American Heart Association, online May 17, 2017.

 

‘Giving up drinking saved me $4000 a year’

First Aid Training Canberra. An interesting article on the benefits of not drinking for the wallet. But remember there are many benefits health wise also.

Kate Robertson

Published: May 30 2017 – 7:07AM

When I was forced to quit alcohol because of long-term medication, I was not very impressed.

Neither, honestly, was anyone else. Very few people were not surprised, uncomfortable, or occasionally argumentative – I definitely heard “just the one will be fine!” more than once. But I did not really have a choice.

After a few dry months, I realised there was a benefit I hadn’t considered – I had a lot more money.

I knew I would save calories when I stopped drinking, but I had not really thought about saving money. I regularly read (and ignore) advice to give up my $3.50 coffee, but cutting back on alcoholic beverages? Surely that’s just un-Australian?

I still went out, just not as often (or for as long). The people I saw the most were supportive about compromises, splitting the tab differently or requesting I bring desserts to dinner instead of wine. I felt more comfortable when I realised I could drink soda and lime in a short glass, and no one would know it didn’t contain vodka. Occasionally I’d buy a mocktail, which, sadly, is never the same.

Drinking is an expected part of life in Australia, and we consume a lot of it. The Bureau of Statistics estimates Australians drank more than 1.74 billion litres of beer and 543 million litres of wine in 2014. In 2012 Australians spent $14.1 billion on alcohol, meaning the average spend for a single person under 35 was $24 a week or $1248 a year. Given that’s averaged across the whole population and more than one in five people do not drink at all, it means the typical drinker is spending far more.

Let’s say in a typical week you buy two $15 bottles of wine for home, and spend $50 on Friday nights after work. If you go out for a meal, you might spend another $40 for a cocktail and half a bottle of wine. Every two months you have one big night out and spend $150. That’s $7140 in a year. Then think about how much that might skew for celebrations and holidays.

Natasha Janssens, founder of financial education business Women with Cents, says “when it comes to saving, most of us make the common mistake of looking for one big ticket item we are spending our money on.

“The reality for most, however, is that we underestimate how much all our little expenses add up.”

It is obviously easy to lose track of money spent on alcohol, especially with late nights or bar tabs. It is just as easy to forget about that one quick $8 beer after work, or picking up a $20 six-pack of cider on the way to a friend’s house. Janssens says it’s a common trap to try to make a mental note of spending but it doesn’t work, because people always under-estimate.

Personal wealth coach Lisa Barber estimates nine out of 10 clients don’t know their cost of living and where all their money goes, and says alcohol is a big part of that. Barber has advised a client who spent just over $2000 in a year on alcohol, as well as a couple who enjoyed premium wines and spent over $14,000 annually. She has found that tracking this spending “often leads to a change in their lifestyle choices”.

In one year of not drinking, I saved about $4000. This is not including the terrible food I used to order at the end of the night and the next morning to combat the hangover. It took me more than three months to realise why I had this leftover cash, so I really wasn’t tracking my spending very well. This made me more aware of my finances and a more active saver overall.

I might not have made the choice to stop drinking, but at least I know it’s an enforced saving plan.

This story was found at: http://www.smh.com.au/content/adaptive/smh/money/saving/giving-up-drinking-saved-me-4000-a-year-20170528-gwez3y.html

 

‘When it was knocked back by the government, it was just a kick in the guts’

 

 

First Aid Course Canberra. CPR Training. Nationally Recognised Certificate. Free first aid course manual and CPR face mask. Experienced Trainers.

BRISBANE-based cardiologist Rolf Gomes dreams big.

The 25-metre “Heart Bus” he conceived, built and remortgaged the family home to help pay for, is proof of that.

But when the Queensland Government refused to support a funding proposal for his cardiology ‘clinic on wheels’ long-term — saying public programs were better value for money — it felt like a body blow.

“When Rolf was knocked back by the State Government, it was basically just a kick in the guts, really,” Gomes’ wife, Kylie, tells ABC’s Australian Story tonight.

“Rejection for some people is debilitating [but] for Rolf it has the opposite effect.”

Eighteen months into a pilot program he knew was saving lives, Dr Gomes kept looking for a way to keep his heart bus dream alive.

“It did take the wind out of my sails,” says Gomes.

“A big part of your vision has just been eliminated. But you never know what’s around the corner.”

Salvation came two days before Christmas, 2016, in the form of a million-dollar mystery donor with heart, keen to deliver on the dream of a dead man.

The family told him their late father loved the bush, and knew that at the heart of every bush community was the doctor.

“Their father had also wanted to try to get doctors to the bush, and spent years trying to create a program with the government, but hit brick walls,” Dr Gomes says.

He ran out of time, passing away before he could do it.

“They said ‘we’d like to support you, how does a million toward building the second clinic sound?’” Dr Gomes says.

“I said that sounded pretty good.”

“Not every day does someone offer you a million to build your dream. Like the phoenix … we’ve risen from the ashes.”

TELL HIM HE’S DREAMING

Dr Gomes came to Australia as a child, his parents bringing the family from Calcutta after the death of their oldest son.

“My dad stepped off a plane with $200, four suitcases and four children to come to a country so his kids could have a better life,” Dr Gomes tells Australian Story.

All his parents wanted was for Rolf to do well at school. He duly delivered.

He worked as an electrical engineer, realised he liked “people more than computers” and studied medicine.

A career in cardiology beckoned, and stints working in the bush during his residency saw him frustrated by the limitations and difficulties which meant he couldn’t do as much medically for country people as he could in the city.

When a man injured in a quad bike accident refused X-rays because “I just can’t travel”, Dr Gomes put him in a neck collar, sent him home, and wondered during the night “is this guy going to be able to move his legs in the morning?”

The first seeds of a plan to take specialist services to the bush were sewn.

“Heart disease is still the biggest killer,” he says.

“If you live in the bush away from the city centre you actually have a 44 percent greater chance of dying of heart disease.

“You can’t look at a situation like that and say the way to address that is to maintain the status quo.

“You do something like this because there has got to be a passion for doing something worthwhile. Giving something back to the country which had given me everything.”

Many admired the plan, the drive and the vision. Others told him he was dreaming.

He needed $1 million to set up the bus, another $1 million a year to run the program.

THE HEART BUS

The Heart Bus launched in 2014. By that time Dr Gomes had written countless letters, hit up everyone from the Federal Government down, secured some corporate supporters and sponsorships, and put his own “skin in the game”, remortgaging his family home to the tune of $800,000

“I was in a funny way unencumbered by wealth and reputation. For me the only way was up,” he says.

The bus is fitted with all the specialist equipment of a city practice, and covers 8000 kilometres of outback Queensland a month, visiting 12 regional towns.

In the first six months of operation, Dr Gomes sent nine people off for lifesaving open heart surgery.

It’s now seen about 3000 patients. The drive to Winton might take 15 hours. Patients will drive another couple of hours to meet it.

Ironically, the Queensland State Government which put a one-off $250,000 into the clinic, but won’t fund its expansion long-term.

The million-dollar mystery donation means a second mobile clinic will launch in 2018, with the plan to expand the specialist services beyond cardiology.

“The truth is the program is going to stay one way or another. It; ’s going to get bigger. It’s going to get more expansive, and it can’t be ignored,” Dr Gomes says.

“I do what I do because I really like doing it. I don’t know what people look to achieve in their lives, but if I achieve nothing else, this would perhaps be enough.”

Australian Story: The Beat Goes On airs Monday at 8pm on ABC and ABC iview

 

Graphene-based sensor could help ward off asthma attacks

 

Being able to predict the onset of attacks could help asthma sufferers avoid attacks without the use of drugs.

 

 

Body Cooling May Help Brain After Cardiac Arrest

 

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By Robert Preidt

HealthDay Reporter

WEDNESDAY, May 10, 2017 (HealthDay News) — Cooling the body may reduce the risk of brain damage for cardiac arrest patients in a coma, a leading group of U.S. neurologists says.

The new guideline from the American Academy of Neurology recommends that families of these patients ask if their loved one qualifies for body cooling.

“People who are in a coma after being resuscitated from cardiac arrest require complex neurologic and medical care, and neurologists can play a key role in improving outcomes by providing body cooling,” said guideline committee chair Dr. Romergryko Geocadin.

This guideline recommends that cooling be used more often for patients who qualify, said Geocadin, who is with Johns Hopkins University School of Medicine in Baltimore.

In cardiac arrest, the heart suddenly stops beating. This means blood and oxygen no longer flow to the brain. The longer the heart goes without beating, the greater the risk of brain damage or death.

Research suggests that body cooling reduces the risk of brain damage in cardiac arrest patients. The body is cooled on the surface with cold packs or special blankets, or internally with devices that cool the blood inside the vessels, according to a news release from the academy.

The guideline authors found “strong evidence” that cooling the body to 89.6 to 93.2 degrees Fahrenheit for 24 hours (called therapeutic hypothermia) improves the chance of recovering brain function. “Moderate evidence” supported an approach called targeted temperature management — keeping the body at 96.8 degrees F for 24 hours followed by re-warming to 99.5 degrees F over eight hours.

“While there has been debate about which cooling protocol is best, our guideline found that both therapies have shown the same result,” Geocadin said in the news release. “Families may want to ask their doctor if their loved one qualifies for body cooling.”

The guideline, based on a review of studies conducted over the last 50 years, was published online May 10 in the journal Neurology.

Future studies should attempt to determine optimal temperatures, rates of cooling and re-warming the body, and which cooling methods work best, according to the guideline.

 

First Aid Courses Canberra

 

First Aid Courses Canberra provide all the training needs of you and your family. We provide first aid courses Canberra with great trainers, excellent hands on experiences and free first aid manuals, parking and CPR face mask.

Women who are exposed to polluted air and stressful situations during their pregnancy are more likely to have children with asthma, a new study claims.

Boys whose mothers were exposed to both of the risk factors were more likely to develop the condition by age six.

Researchers at Mount Sinai said there was already a known link between the race of the mother and the likelihood of being exposed to air pollution.

Now the experts are saying these factors contribute to the respiratory health disparities that ethnically mixed urban populations commonly have.

Women who are exposed to polluted air while they are stressed, have an increased chance their children will have asthma, a new study claims

Lead author Dr Alison Lee, of the Icahn School of Medicine at Mount Sinai, said the research was done to examine why these factors contribute to poor respiratory health in urban communities.

She said: ‘We know from prior research that lower income, ethnically mixed urban populations are more greatly burdened with asthma and other respiratory health problems.

‘Given that populations disproportionately exposed to ambient air pollution are also more likely to be exposed to social stressors such as financial strain, discrimination, housing difficulties, and crime or violence, we were particularly interested in combined effects of both factors starting in early development, even in pregnancy.’

The study looked at more than 700 women who were primarily African-American and Latina, and were pregnant and living in urban settings.

The researchers found that being exposed to high amounts of air pollution during a woman’s second trimester increased the odds for the child developing asthma.

When this was combined with mothers reporting being stressed during this time period, boys had an increased chance of having asthma.

Dr Lee added: ‘Prevention is not a matter of eliminating stress but rather, we need to develop strategies to reduce stress to more normative levels – for example, implementing prenatal programs that provide resources to address the more prevalent stressors or to promote better coping strategies, particularly among disadvantaged, high-risk populations.’

In a recent study by experts at the University of California, Berkeley, they found a correlation between children and teenagers exposed to high levels of traffic pollution and premature aging and asthma.

Those with higher levels had a specific type of DNA damage called telomere shortening – the main cause of age-related break down of our cells.

Telomeres are vital to our health – they can be described as the caps at the end of each strand of DNA that protect our chromosomes, like the plastic tips at the end of shoelaces.

‘Children may be especially vulnerable to the effects of telomeric DNA damage due to their physical development as well as developing immune system,’ wrote Dr John Balmes from the University of California, Berkeley, and his colleagues who carried out the study published in the Journal of Occupational and Environmental Medicine.

A new study by the Imperial College London found the first evidence that diesel fumes can cause coughing and shortness of breath.

It was known that people with asthma are worse affected than those in less polluted areas.

Researchers can now explain the effect of diesel particles, which are so tiny that the body mistakes them for natural molecules and draws them deep into the lungs.

They discovered diesel fumes trigger a receptor in the airway, starting a chain reaction which causes nerves in the lungs to fire wrongly.

Read more: http://www.dailymail.co.uk/health/article-4531750/Stressed-women-likely-children-asthma.html#ixzz4hriHwzug
Follow us: @MailOnline on Twitter | DailyMail on Facebook

 

Burns from Sunscreen

Winter first aid training sessions book now. This poor child. I cant believe this is from sunscreen.  Make sure you book in to a winter first aid training session with Canberra First Aid. We offer training on how to treat burns and also severe allergic reactions.

A CANADIAN mother is pleading with other parents to be cautious when using aerosol spray sunscreen on their children after her 14-month-old daughter suffered second-degree chemical burns on her face.

Rebecca Cannon had purchased Banana Boat Kids SPF50 to protect her daughter Kyla from the sun despite overcast weather, according to a May 8 Facebook post.

“As the day went on, she got a little redder and redder and the next morning she woke up and was swollen, she was bright red, there were blisters starting to pop up,” Cannon told CBC.ca. “We immediately took her up to the doctors and found out she has second degree burns.”

While Cannon acknowledged that she should have used baby-specific sunscreen, she figured that using a child-specific block advertised as alcohol-free to protect her daughter against the sun was better than nothing.

“I figured just putting it mildly on her face, for some protection rather than having none at all, would be OK and yeah, it didn’t go over well,” Cannon told CBC.ca.

Cannon told the news outlet that her 3-year-old nephew had used the same sunscreen without any adverse effects, but that a doctor treating Kyla said it wasn’t the first case he had seen, and it had the potential to be a severe allergic reaction.

Cannon updated followers on Facebook in a May 11 post that included details from a visit to a dermatologist. She said the doctor confirmed Kyla suffered second degree chemical burns to her face.

“We are greatly concerned when any person encounters a reaction using our products,” Banana Boat told CBC.ca in a statement.

“We have spoken with the consumer and asked for the product so that our quality assurance team can look into this further. Without examining the product, it is difficult to determine what may have caused the problem as described.”

Cannon has been sharing other consumer horror stories online and told the CBC.ca she doesn’t understand how the product is still available for purchase.

“I would have never — in a million years — imagined her to get a burn so severe from sunscreen,” Cannon told the news outlet.

Banana Boat has been criticised by many Australian consumers, who say their children also suffered serious burns after using the sunscreen.

The Australian Therapeutic Goods Administration says it tested Banana Boat products in 2016 after a number of complaints and found “no evidence of a problem with the quality of any of the sunscreens”.

Banana Boat says research indicates complaints about ineffective sunscreen can often be the result of inaccurate application and not using enough.

It recommends at least seven teaspoons per adult per application.

This article originally appeared on Fox News.

 

Anaphylaxis

First Aid Course Canberra. Here are the details on how to treat anaphylaxis. Even if you don’t get to one of our first aid courses you will have the information to help.

What is anaphylaxis?

Anaphylaxis is a serious allergic response that often involves swelling, hives, lowered blood pressure and in severe cases, shock and death. Anaphylaxis requires immediate medical treatment, including a prompt injection of epinephrine and a trip to a hospital emergency room. If anaphylactic shock isn’t treated immediately, it can be fatal.

Isn’t this a FD/Paramedic issue?

Ideally, yes. However, if you are on patrol you may be the closest to respond to the 911 call. Anaphylaxis is a severe and sudden allergic reaction. It occurs within minutes of exposure to an allergen. If not treated appropriately, anaphylaxis can turn deadly very quickly. Anaphylactic shock can also occur while a suspect is in your custody both in or outside of a detention facility.

Additionally, failure to recognize anaphylaxis and to seek prompt, appropriate treatment tends to upset everyone who has more stripes or stars than you do, elected officials, and family members as well.  This is truly an ounce of prevention and quick action scenario.

What are the symptoms of an anaphylactic reaction?

The major difference between anaphylaxis and other allergic reactions is that anaphylaxis typically involves more than one system of the body.

  • Red rash (usually itchy and may have welts/hives)
  • Swollen throat or swollen areas of the body
  • Wheezing
  • Loss of consciousness
  • Chest tightness
  • Trouble breathing
  • Hoarse voice
  • Trouble swallowing
  • Vomiting
  • Diarrhea
  • Stomach cramping
  • Pale or red color to the face and body

It is important to remember that, like other allergic reactions, an anaphylactic reaction does not usually occur after the first exposure to an allergen but after a subsequent exposure. You may have an allergic reaction to a bee sting, but the next sting could lead to anaphylaxis.

 

Teenagers with asthma have increased risk of anaphylaxis

 

Teenagers with food allergy are four times more likely to report having asthma than those without, according to new data from the Murdoch Children’s Research Institute.

The link between asthma and anaphylaxis was made from the results of a study of 10,000 adolescents (aged 10-14) in metropolitan Melbourne.

It found people with multiple food allergies report 10 times the incidence of asthma.

The link has prompted concerns among health professionals, that a teenager’s anaphylactic reaction could be mistaken for an asthma attack, leading to a delay in the administration of a life-saving adrenaline auto injector.

“If a person is coughing, wheezing or experiencing breathing difficulties, sometimes it can be hard to work out if they are having an asthma attack or having anaphylaxis,” said lead researcher Professor Katie Allen, from the Murdoch Children’s Research Institute.

“Instead of immediately administering valuable time can be wasted administering the asthma inhaler.”

The findings come at the launch of Food Allergy Week 2016, which runs from May 15 to 21, and aims to raise awareness about food allergies.

Every year there are around 30,000 new cases of food allergy in Australia. Experts estimate that, at the current rate, there will be 7.7 million Australians with allergy by 2050.

Maria Said, President of Allergy & Anaphylaxis Australia, said the rate of allergy incidence in Australia was growing at “an alarming rate.”

“Australia has one of the highest rates of food allergy in the world … With such a rapid increase in food allergy over the last 10 to 15 years, our current generation of teenagers is one of the fastest-growing demographics for allergy management.”

She pointed to the story of 15-year-old Jack Irvine, who tragically died in 2012 after mistakenly eating biscuit containing macadamia nuts.

Suffering from both nut allergies and asthma, Jack’s symptoms initially presented as asthma-related, however his reaction was later identified as anaphylaxis.

Ms Said said Jack’s story proved the importance of allergy education within the community.

In Australia up to two per cent of children and adolescents aged between 10 and 14 suffer from a nut allergy, while five per cent suffer from food allergy.

Professor Allen said the results of the Institute’s study allowed researchers to look at the full spectrum of food allergic disease, including patients who were seeing doctors about their allergies and those who were not.

“A study of this type and size has never been undertaken anywhere in the world,” she said.

“There have unfortunately been some deaths from anaphylaxis in recent years where children with food allergy and asthma have not been seeing an allergist for their problems and we wonder whether they have been poorly educated about the signs and symptoms and that’s been a factor in their death.”

If a person believes they may have eaten a food they are allergic to and they experience breathing difficulties, even if they have asthma, “anaphylaxis should be top consideration,” Professor Allen said.

“And it’s certainly not going to hurt to give the adrenaline anyway.”

The story Teenagers with asthma have increased risk of anaphylaxis, study finds first appeared on The Sydney Morning Herald.

 

Anaphylaxis in aged care – First Aid Course Canberra

 

An aged care executive is calling on the sector to remove latex from workplaces and be more allergen aware, particularly in kitchens, as part of efforts to raise awareness about dangerous allergic reactions.Ananda Aged Care clinical director Dr Pooja Newman founded Global Anaphylaxis Awareness and Inclusivity (Globalaai) last month, four days after she experienced a near-fatal allergic reaction.Dr Newman was attending a concert in Adelaide when balloons covered in latex powder were unexpectedly released.

Her campaign, which has already gained thousands of supporters globally, aims to help reduce the stigma of anaphylaxis – a severe and potentially life threatening allergic reaction – and increase safety for those at risk.

Globalaai is calling for:

  • widespread availability of emergency adrenaline – EpiPens – in public venues and food outlets
  • mandatory training for the hospitality industry
  • social awareness and
  • latex-free services in healthcare, retail and public venues.

 

Pooja Newman

Dr Newman, a medical doctor and the deputy chair of South Australia’s Aged Care Industry Association, wants to create change in aged care and is aiming to introduce a practical template for allergy safety in facilities.

“Ask the questions around anaphylaxis and identify at-risk individuals, support them and be inclusive,” Dr Newman told Australian Ageing Agenda.

“I am lobbying to remove latex in aged care and be allergen aware particularly in kitchens.”

Allergic diseases are among the fastest growing chronic conditions in Australia, affecting one in five Australians while deaths from anaphylaxis have increased by 7 per cent per year for the last seven years, according to the National Allergy Strategy.

Dr Newman, who has survived 30 anaphylactic episodes, is severely allergic to peanuts, all tree nuts and latex including latex associated fruits such as bananas.

“This has been the most severe anaphylaxis I have had and it has taken me longer than usual to recover from feeling weak, a little breathless and flat,” she said.

The release of the balloons covered in latex-powder – done without pre-concert caution that only mentioned strobe lights, pyrotechnics and confetti – was followed by the injection of three EpiPens and four days in intensive care.

Dr Newman is seeking global awareness so people with allergies can be better informed about the risks they may face.

Risks in aged care

Latex, for example, was the cause of occupational latex allergy, which had mild symptoms including a rash, asthma and very rarely anaphylaxis, Dr Newman said.

“We know that latex allergy occurs from exposure to latex and if it is minimised in aged care then latex anaphylaxis could potentially become a problem of the past.”

She said Ananda has been latex free since its inception and that latex-free products including gloves made of vinyl or nitrile were freely available and cost neutral.

Poor awareness and education among aged care staff, cognitive decline among clients and the stigma attached to anaphylaxis were among other key issues for the aged care and retirement living sectors, said Dr Newman.

She is currently discussing her campaign with aged care peak bodies.

Kitchens, particularly in aged care, are not suitably trained for anaphylaxis food safety and cross contamination is an issue that urgently needs to be addressed, Dr Newman argued.

“Older Australians with cognitive decline may not be in a position to advocate for the safety of themselves in terms of identifying their allergies appropriately.

“I see staff in workplaces currently not necessarily declaring life threatening allergies and potentially having their EpiPen in their bag in their locker and having the potential for a life threatening reaction in their workplace,” she said.

Dr Newman said workplaces did not have general use EpiPens, which saved lives as seconds counted from the commencement of an anaphylactic reaction to reversing the process and preventing morbidity and mortality associated with anaphylaxis.

“Aged care facilities in particular often have contractors and visitors including friends and family of residents and these people potentially are at risk from anaphylaxis if staff are not adequately trained to recognise and treat anaphylaxis.”

See the campaign’s website and social media for more information or contact Dr Newman at [email protected].

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