A new emergency procedure for cardiac arrests aims to save more lives – here’s how it works
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
As of January this year, Aotearoa New Zealand became just the second country (after Canada) to adopt a groundbreaking new procedure for patients experiencing cardiac arrest.
Known as “double sequential external defibrillation” (DSED), it will change initial emergency response strategies and potentially improve survival rates for some patients.
Surviving cardiac arrest hinges crucially on effective resuscitation. When the heart is working normally, electrical pulses travel through its muscular walls creating regular, co-ordinated contractions.
But if normal electrical rhythms are disrupted, heartbeats can become unco-ordinated and ineffective, or cease entirely, leading to cardiac arrest.
Defibrillation is a cornerstone resuscitation method. It gives the heart a powerful electric shock to terminate the abnormal electrical activity. This allows the heart to re-establish its regular rhythm.
Its success hinges on the underlying dysfunctional heart rhythm and the proper positioning of the defibrillation pads that deliver the shock. The new procedure will provide a second option when standard positioning is not effective.
Using two defibrillators
During standard defibrillation, one pad is placed on the right side of the chest just below the collarbone. A second pad is placed below the left armpit. Shocks are given every two minutes.
Early defibrillation can dramatically improve the likelihood of surviving a cardiac arrest. However, around 20% of patients whose cardiac arrest is caused by “ventricular fibrillation” or “pulseless ventricular tachycardia” do not respond to the standard defibrillation approach. Both conditions are characterised by abnormal activity in the heart ventricles.
DSED is a novel method that provides rapid sequential shocks to the heart using two defibrillators. The pads are attached in two different locations: one on the front and side of the chest, the other on the front and back.
A single operator activates the defibrillators in sequence, with one hand moving from the first to the second. According to a recent randomised trial in Canada, this approach could more than double the chances of survival for patients with ventricular fibrillation or pulseless ventricular tachycardia who are not responding to standard shocks.
The second shock is thought to improve the chances of eliminating persistent abnormal electrical activity. It delivers more total energy to the heart, travelling along a different pathway closer to the heart’s left ventricle.
Evidence of success
New Zealand ambulance data from 2020 to 2023 identified about 1,390 people who could potentially benefit from novel defibrillation methods. This group has a current survival rate of only 14%.
Recognising the potential for DSED to dramatically improve survival for these patients, the National Ambulance Sector Clinical Working Group updated the clinical procedures and guidelines for emergency medical services personnel.
The guidelines now specify that if ventricular fibrillation or pulseless ventricular tachycardia persist after two shocks with standard defibrillation, the DSED method should be administered. Two defibrillators need to be available, and staff must be trained in the new approach.
Though the existing evidence for DSED is compelling, until recently it was based on theory and a small number of potentially biased observational studies. The Canadian trial was the first to directly compare DSED to standard treatment.
From a total of 261 patients, 30.4% treated with this strategy survived, compared to 13.3% when standard resuscitation protocols were followed.
The design of the trial minimised the risk of other factors confounding results. It provides confidence that survival improvements were due to the defibrillation approach and not regional differences in resources and training.
The study also corroborates and builds on existing theoretical and clinical scientific evidence. As the trial was stopped early due to the COVID-19 pandemic, however, the researchers could recruit fewer than half of the numbers planned for the study.
Despite these and other limitations, the international group of experts that advises on best practice for resuscitation updated its recommendations in 2023 in response to the trial results. It suggested (with caution) that emergency medical services consider DSED for patients with ventricular fibrillation or pulseless ventricular tachycardia who are not responding to standard treatment.
Training and implementation
Although the evidence is still emerging, implementation of DSED by emergency services in New Zealand has implications beyond the care of patients nationally. It is also a key step in advancing knowledge about optimal resuscitation strategies globally.
There are always concerns when translating an intervention from a controlled research environment to the relative disorder of the real world. But the balance of evidence was carefully considered before making the decision to change procedures for a group of patients who have a low likelihood of survival with current treatment.
Before using DSED, emergency medical personnel undergo mandatory education, simulation and training. Implementation is closely monitored to determine its impact.
Hospitals and emergency departments have been informed of the protocol changes and been given opportunities to ask questions and give feedback. As part of the implementation, the St John ambulance service will perform case reviews in addition to wider monitoring to ensure patient safety is prioritised.
Ultimately, those involved are optimistic this change to cardiac arrest management in New Zealand will have a positive impact on survival for affected patients.
Vinuli Withanarachchie, PhD candidate, College of Health, Massey University; Bridget Dicker, Associate Professor of Paramedicine, Auckland University of Technology, and Sarah Maessen, Research Associate, Auckland University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Recommended
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Super-Nutritious Shchi
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Today we have a recipe we’ve mentioned before, but now we have standalone recipe pages for recipes, so here we go. The dish of the day is shchi—which is Russian cabbage soup, which sounds terrible, and looks as bad as it sounds. But it tastes delicious, is an incredible comfort food, and is famous (in Russia, at least) for being something one can eat for many days in a row without getting sick of it.
It’s also got an amazing nutritional profile, with vitamins A, B, C, D, as well as lots of calcium, magnesium, and iron (amongst other minerals), and a healthy blend of carbohydrates, proteins, and fats, plus an array of anti-inflammatory phytochemicals, and of course, water.
You will need
- 1 large white cabbage, shredded
- 1 cup red lentils
- ½ lb tomatoes, cut into eighths (as in: halve them, halve the halves, and halve the quarters)
- ½ lb mushrooms sliced (or halved, if they are baby button mushrooms)
- 1 large onion, chopped finely
- 1 tbsp rosemary, chopped finely
- 1 tbsp thyme, chopped finely
- 1 tbsp black pepper, coarse ground
- 1 tsp cumin, ground
- 1 tsp yeast extract
- 1 tsp MSG, or 2 tsp low-sodium salt
- A little parsley for garnishing
- A little fat for cooking; this one’s a tricky and personal decision. Butter is traditional, but would make this recipe impossible to cook without going over the recommended limit for saturated fat. Avocado oil is healthy, relatively neutral in taste, and has a high smoke point for caramelizing the onions. Extra virgin olive oil is also a healthy choice, but not as neutral in flavor and does have a lower smoke point. Coconut oil has far too strong a taste and a low smoke point. Seed oils are very heart-unhealthy. All in all, avocado oil is a respectable choice from all angles except tradition.
Note: with regard to the seasonings, the above is a basic starting guide; feel free to add more per your preference—however, we do not recommend adding more cumin (it’ll overpower it) or more salt (there’s enough sodium in here already).
Method
(we suggest you read everything at least once before doing anything)
1) Cook the lentils until soft (a rice cooker is great for this, but a saucepan is fine); be generous with the water; we are making a soup, after all. Set them aside without draining.
2) Sauté the cabbage, and put it in a big stock pot or similar large pan (not yet on the heat)
3) Fry the mushrooms, and add them to the big pot (still not yet on the heat)
4) Use a stick blender to blend the lentils in the water you cooked them in, and then add to the big pot too.
5) Turn the heat on low, and if necessary, add more water to make it into a rich soup
6) Add the seasonings (rosemary, thyme, cumin, black pepper, yeast extract, MSG-or-salt) and stir well. Keep the temperature on low; you can just let it simmer now because the next step is going to take a while:
7) Caramelize the onion (keep an eye on the big pot, stirring occasionally) and set it aside
8) Fry the tomatoes quickly (we want them cooked, but just barely) and add them to the big pot
9) Serve! The caramelized onion is a garnish, so put a little on top of each bowl of shchi. Add a little parsley too.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
- The Magic Of Mushrooms: “The Longevity Vitamin” (That’s Not A Vitamin)
- Easily Digestible Vegetarian Protein Sources
- The Bare-Bones Truth About Osteoporosis
- Some Surprising Truths About Hunger And Satiety
Take care!
Share This Post
-
Reishi Mushrooms: Which Benefits Do They Really Have?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Reishi Mushrooms
Another Monday Research Review, another mushroom! If we keep this up, we’ll have to rename it “Mushroom Monday”.
But, there’s so much room for things to say, and these are fun guys to write about, as we check the science for any spore’ious claims…
Why do people take reishi?
Popular health claims for the reishi mushroom include:
- Immune health
- Cardiovascular health
- Protection against cancer
- Antioxidant qualities
- Reduced fatigue and anxiety
And does the science agree?
Let’s take a look, claim by claim:
Immune health
A lot of research for this has been in vitro (ie, with cell cultures in labs), but promising, for example:
Immunomodulating Effect of Ganoderma lucidum (Lingzhi) and Possible Mechanism
(that is the botanical name for reishi, and the Chinese name for it, by the way)
That’s not to say there are no human studies though; here it was found to boost T-cell production in stressed athletes:
Cardiovascular health
Here we found a stack of evidence for statistically insignificant improvements in assorted measures of cardiovascular health, and some studies where reishi did not outperform placebo.
Because the studies were really not that compelling, instead of taking up room (and your time) with them, we’re going to move onto more compelling, exciting science, such as…
Protection against cancer
There’s a lot of high quality research for this, and a lot of good results. The body of evidence here is so large that even back as far as 2005, the question was no longer “does it work” or even “how does it work”, but rather “we need more clinical studies to find the best doses”. Researchers even added:
❝At present, lingzhi is a health food supplement to support cancer patients, yet the evidence supporting the potential of direct in vivo anticancer effects should not be underestimated.❞
Check it out:
Anticancer effects of Ganoderma lucidum: a review of scientific evidence
Just so you know we’re not kidding about the weight of evidence, let’s drop a few extra sources:
- Ganoderma lucidum: a rational pharmacological approach to surmount cancer
- Ganoderma lucidum as an anti-cancer agent
- Extract from Ganoderma lucidum suppresses cervical cancer cell malignancy
- Ganoderma lucidum spore oil induces apoptosis of breast cancer cells
- Ganoderma lucidum enhances carboplatin chemotherapy effect
- Ganoderma lucidum inhibits prostate cancer cell migration
- Ganoderma lucidum fruiting body extracts inhibit colorectal cancer
- Inhibitory activity of medicinal mushroom Ganoderma lucidum on colorectal cancer
- Ganoderma lucidum (reishi mushroom) for cancer treatment
By the way, we shortened most of those titles for brevity, but almost all of the continued with “by” followed by a one-liner of how it does it.
So it’s not a “mysterious action” thing, it’s a “this is a very potent medicine and we know how it works” thing.
Antioxidant qualities
Here we literally only found studies to say no change was found, one that found a slight increase of antioxidant levels in urine. It’s worth noting that levels of a given thing (or its metabolites, in the case of some things) in urine are often quite unhelpful regards knowing what’s going on in the body, because we get to measure only what the body lost, not what it gained/kept.
So again, let’s press on:
Reduced fatigue and anxiety
Most of the studies for this that we could find pertained to health-related quality of life for cancer patients specifically, so (while they universally give glowing reports of reishi’s benefits to health and happiness of cancer patients), that’s a confounding factor when it comes to isolating its effects on reduction of fatigue and anxiety in people without cancer.
Here’s one that looked at it in the case of reduction of fatigue, anxiety, and other factors, in patients without cancer (but with neurathenia), in which they found it was “significantly superior to placebo with respect to the clinical improvement of symptoms”.
Summary:
- Reishi mushroom’s anti-cancer properties are very, very clear
- There is also good science to back immune health claims
- It also has been found to significantly reduce fatigue and anxiety in unwell patients (we’d love to see more studies on its benefits in otherwise healthy people, though)
Share This Post
-
Stand Up For Your Health (Or Don’t)
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
You may have heard the phrase “sitting is the new smoking”, and while the jury’s out on whether that’s accurate or not in terms of exactly how damaging it is, one thing that is universally agreed-upon is that sitting is indeed very bad.
It’s especially bad for your spine (because of being folded in ways it shouldn’t be), your muscles and associated nerves of the lower back and hip area, your abdominal organs (because of being compressed in ways they shouldn’t be), and your heart (because of arteries and veins being squashed up in ways they shouldn’t be), and if you remember how “what’s good for your heart is good for your brain”, the inverse is true, and what’s bad for your heart is also bad for your brain, which won’t get nourished with oxygen and nutrients and which won’t have its detritus removed as efficiently as it should; that’ll be left to build up in the brain instead.
First, elephant in the room: not everybody can stand, and of those who can, not everybody can stand for long. So obviously, work within what’s attainable for you.
Also note that while sitting is the disease-bringer/worsener, standing isn’t the only solution, for example:
- Walking is better than standing. You may be wondering: “who can’t stand but can walk?” and the answer is, a lot of people with certain kinds of chronic pain, for whom walking is less chronic-pain-exacerbating than standing, because the human body is built for movement and inactivity can worsen things even more than movement.
- See also: Managing Chronic Pain (Realistically)
- Lying down is better than sitting. One of the major problems with sitting is that your organs are all bunched up in ways they shouldn’t be. Lying down is, in this regard, closer to standing than sitting, because your body has a nice straight line to it.
- Sitting can be made less bad! For example:
- Sitting in a recliner chair in the reclined position is… Not great, if you’re then tilting your skull forwards to compensate, but if you’re just sitting back and relaxing, this is a lot better than sitting in the usual seated position, because again, it’s closer to lying down, which is closer to standing.
- Sitting in seiza (the traditional Japanese kneeling position) is, provided you do it correctly and with good posture, better than sitting in the traditional Western manner. The reason for this is simple: instead of having your torso and legs at 90°, they are at 120°ish, give or take the size of your thighs and butt (bigger being better in this regard), and even that angle can be made even better if you use a meditation bench like this one ← we’re eyeballing it and didn’t get out a protractor, but if you look at the model’s torso and thighs, that’s about 135° difference, which is huge improvement over the 90° you get while sitting Western-style.
For most of us a lot of the time though, we can stand to sit less. Think about the places you most often sit, and what can be done to reasonably minimize those, for example:
- Car: minimize driving (or being a passenger in a car); walk where reasonably possible. Public transport, if available, may have standing options.
- Office: a standing desk is, of course, the way to go. You can even use a standing desk converter, like this one. Just make sure to set it at the correct height, both in terms of where the keyboard and mouse go (the same height as your elbows are when your arms are dropped to your sides), and where the monitor goes (center of the monitor should be at eye-level).
- Note: laptops will never be right for this, unless the natural resting distance between your elbows and your eyes is about 4½ inches, which will only be the case if your total height is approximately 1 foot and 2 inches. For anyone taller than that, laptops are still great to have when on the move and as a backup, but not great for ergonomics.
- Workaround: if for some reason you must use a laptop for your day-to-day work, consider using a bluetooth keyboard so that you can still set them the appropriate height-distance apart and thus not have to hunch over them.
- Dining room: sitting to eat a main meal is reasonable, but consider standing options for lighter bites; a standing-height “brunch bar” is great if you can arrange one.
- Lounge: let it live up to its name, and actually lounge: if you’re not going to stand, then horizontal lounging is an improvement over sitting—as is sitting on the floor, and changing your position frequently. Who knew, kids had it right in that regard!
- Note: if, like this writer, you do a lot of reading, the same applies regardless of which room you’re doing it in.
- Bedroom: a culprit for many will be sitting while doing a beauty routine and/or possibly make-up. Easily avoided if you set a well-lit mirror at the correct height to use while standing.
- Note: at the correct height though! While hunching up over a wall-mounted mirror is an improvement over hunching up at a seated vanity, it’s not a great improvement. You want to be able to stand with good posture and do it comfortably.
- Bathroom: leave your phone outside—which is also a good approach for avoiding hemorrhoids! See also: Half Of Americans Over 50 Have Hemorrhoids, But They Can Be Prevented!
Want to know more?
We reviewed this book recently, which goes into all of the above in much more detail than we have room for here, plus also discusses a lot of social reframes that can be used (since a lot of sitting is a matter of social expectations, not actual need). It’s a very useful read:
Take care!
Share This Post
- Walking is better than standing. You may be wondering: “who can’t stand but can walk?” and the answer is, a lot of people with certain kinds of chronic pain, for whom walking is less chronic-pain-exacerbating than standing, because the human body is built for movement and inactivity can worsen things even more than movement.
Related Posts
-
The Energy Plan – by James Collins
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
There’s a lot of conflicting advice out there about how we should maintain our energy levels, for example:
- Eat fewer carbs!
- Eat more carbs!
- Eat slow-release carbs!
- Eat quick-release carbs!
- Practise intermittent fasting!
- Graze constantly throughout the day!
- Forget carbs and focus on fats!
- Actually it’s all about B-vitamins!
…and so on.
What Collins does differently is something much less-often seen:
Here, we’re advised on how to tailor our meals to our actual lifestyle, taking into account the day we actually have each day. For example:
- What will our energy needs be for the day?
- Will our needs be intense, or long, or both, or neither?
- What kind of recovery have we had, or do we need, from previous activities?
- Do we need to replace lost muscle glycogen, or are we looking to trim the fat?
- Are we doing a power-up or just maintenance today?
Rather than bidding us have a five-way spreadsheet and do advanced mathematics for every meal, though, Collins has done the hard work for us. The book explains the various principles in a casual format with a light conversational tone, and gives us general rules to follow.
These rules cover what to do for different times of day… and also, at different points in our life (the metabolic needs of a 13-year-old, 33-year-old, and 83-year-old, are very different!). That latter’s particularly handy, as a lot of books assume an age bracket for the reader, and this one doesn’t.
In short: a great book for anyone who wants to keep their energy levels up (throughout life’s ups and downs in activity) without piling on the pounds or starving oneself.
Click here to check out The Energy Plan on Amazon and fuel your days better!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
“I Stretched Every Day For 30 Days: Game Changer!”
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
How much can an unflexible person really improve in just 20 minutes per day for a month? Makari Espe finds out:
Consistency really is key
We’re supposed to stretch at least 3 times per week; for many people, the reality is often more like 2 times per year (often the 1st and 2nd of January).
So, how quickly can such neglect be turned around?
Upon initial testing, she found she was even less flexible than thought, and set about her work:
The stretches she used were from random 20-minute full body stretch videos on YouTube, of which there are many, but she used a different one each day. As she went along, she found some favorite kinds of stretching and some favorite instructors, and settled on mostly Peloton stretching videos—she also switched to evening stretching sessions instead of morning.
Along the way, she already noticed gradual improvement in mobility and reduced body tension, and after 3 weeks, it had become a habit that she started craving.
The final test? There’s a marked improvement; see the video:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Yoga Teacher: “If I wanted to get flexible in 2025, here’s what I’d do”
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
8 Critical Signs Of Blood Clots That You Shouldn’t Ignore
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Blood clots can form as part of deep vein thrombosis or for other reasons; wherever they form (unless they are just doing their job healing a wound) they can cause problems. But how to know what’s going on inside our body?
Telltale signs
Our usual medical/legal disclaimer applies here, and we are not doctors, let alone your doctors, and even if we were we couldn’t diagnose from afar… But for educational purposes, here are the eight signs from the video:
- Swelling: especially if only on one leg (assuming you have no injury to account for it), which may feel tight and uncomfortable
- Warmness: does the area warmer to the touch? This may be because of the body’s inflammatory response trying to deal with a blood clot
- Tenderness: again, caused by the inflammation in response to the clot
- Discolored skin: it could be reddish, or bruise-like. This could be patchy or spread over a larger area, because of a clot blocking the flow of blood
- Shortness of breath: if a clot makes it to the lungs, it can cause extra problems there (pulmonary embolism), and shortness of breath is the first sign of this
- Coughing up blood: less common than the above but a much more serious sign; get thee to a hospital
- Chest pain: a sharp or stabbing pain, in particular. The pain may worsen with deep breaths or coughing. Again, seek medical attention.
For more on recognizing these signs (including helpful visuals), and more on what to do about them and how to avoid them in the first place, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Further reading
You might like to read:
Dietary Changes for Artery Health
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: