The Resus Council updated their guidelines for management of anaphylaxis in May 2021. Click here for more information. The first line treatment remains IM adrenaline. Corticosteroids are no longer advised. The guidelines are heavily weighed towards anaphylactic shock, while in children the vast majority have airway and breathing rather than circulatory problems. In these children, they are often better positioned sitting up rather than lying, and refractory cases are likely to require airway management due to pharyngeal obstruction or severe bronchospasm rather than shock.