Hospitals worldwide are short of saline. We can’t just switch to other IV fluids – here’s why
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.
Last week, the Australian Therapeutic Goods Administration added intravenous (IV) fluids to the growing list of medicines in short supply. The shortage is due to higher-than-expected demand and manufacturing issues.
Two particular IV fluids are affected: saline and compound sodium lactate (also called Hartmann’s solution). Both fluids are made with salts.
There are IV fluids that use other components, such as sugar, rather than salt. But instead of switching patients to those fluids, the government has chosen to approve salt-based solutions by other overseas brands.
So why do IV fluids contain different chemicals? And why can’t they just be interchanged when one runs low?
We can’t just inject water into a vein
Drugs are always injected into veins in a water-based solution. But we can’t do this with pure water, we need to add other chemicals. That’s because of a scientific principle called osmosis.
Osmosis occurs when water moves rapidly in and out of the cells in the blood stream, in response to changes to the concentration of chemicals dissolved in the blood plasma. Think salts, sugars, nutrients, drugs and proteins.
Too high a concentration of chemicals and protein in your blood stream leads it to being in a “hypertonic” state, which causes your blood cells to shrink. Not enough chemicals and proteins in your blood stream causes your blood cells to expand. Just the right amount is called “isotonic”.
Mixing the drug with the right amount of chemicals, via an injection or infusion, ensures the concentration inside the syringe or IV bag remains close to isotonic.
What are the different types of IV fluids?
There are a range of IV fluids available to administer drugs. The two most popular are:
- 0.9% saline, which is an isotonic solution of table salt. This is one of the IV fluids in short supply
- a 5% solution of the sugar glucose/dextrose. This fluid is not in short supply.
There are also IV fluids that combine both saline and glucose, and IV fluids that have other salts:
- Ringer’s solution is an IV fluid which has sodium, potassium and calcium salts
- Plasma-Lyte has different sodium salts, as well as magnesium
- Hartmann’s solution (compound sodium lactate) contains a range of different salts. It is generally used to treat a condition called metabolic acidosis, where patients have increased acid in their blood stream. This is in short supply.
What if you use the wrong solution?
Some drugs are only stable in specific IV fluids, for instance, only in salt-based IV fluids or only in glucose.
Putting a drug into the wrong IV fluid can potentially cause the drug to “crash out” of the solution, meaning patients won’t get the full dose.
Or it could cause the drug to decompose: not only will it not work, but it could also cause serious side effects.
An example of where a drug can be transformed into something toxic is the cancer chemotherapy drug cisplatin. When administered in saline it is safe, but administration in pure glucose can cause life-threatening damage to a patients’ kidneys.
What can hospitals use instead?
The IV fluids in short supply are saline and Hartmann’s solution. They are provided by three approved Australian suppliers: Baxter Healthcare, B.Braun and Fresenius Kabi.
The government’s solution to this is to approve multiple overseas-registered alternative saline brands, which they are allowed to do under current legislation without it going through the normal Australian quality checks and approval process. They will have received approval in their country of manufacture.
The government is taking this approach because it may not be effective or safe to formulate medicines that are meant to be in saline into different IV fluids. And we don’t have sufficient capacity to manufacture saline IV fluids here in Australia.
The Australian Society of Hospital Pharmacists provides guidance to other health staff about what drugs have to go with which IV fluids in their Australian Injectable Drugs Handbook. If there is a shortage of saline or Hartmann’s solution, and shipments of other overseas brands have not arrived, this guidance can be used to select another appropriate IV fluid.
Why don’t we make it locally?
The current shortage of IV fluids is just another example of the problems Australia faces when it is almost completely reliant on its critical medicines from overseas manufacturers.
Fortunately, we have workarounds to address the current shortage. But Australia is likely to face ongoing shortages, not only for IV fluids but for any medicines that we rely on overseas manufacturers to produce. Shortages like this put Australian lives at risk.
In the past both myself, and others, have called for the federal government to develop or back the development of medicines manufacturing in Australia. This could involve manufacturing off-patent medicines with an emphasis on those medicines most used in Australia.
Not only would this create stable, high technology jobs in Australia, it would also contribute to our economy and make us less susceptible to future global drug supply problems.
Nial Wheate, Professor and Director Academic Excellence, Macquarie University and Shoohb Alassadi, Casual academic, pharmaceutical sciences, University of Sydney
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!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Move – by Caroline Williams
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.
- Get 150 minutes of moderate exercise per week, says the American Heart Association
- There are over 10,000 minutes per week, says the pocket calculator
Is 150/10,000 really the goal here? Really?
For Caroline Williams, the answer is no.
In this book that’s practically a manifesto, she outlines the case that:
- Humans evolved to move
- Industrialization and capitalism scuppered that
- We now spend far too long each day without movement
Furthermore, for Williams this isn’t just an anthropological observation, it’s a problem to be solved, because:
- Our lack of movement is crippling us—literally
- Our stagnation affects not just our bodies, but also our minds
- (again literally—there’s a direct correlation with mental health)
- We urgently need to fix this
So, what now, do we need to move in to the gym and become full-time athletes to clock up enough hours of movement? No.
Williams convincingly argues the case (using data from supercentenarian “blue zones” around the world) that even non-exertive movement is sufficient. In other words, you don’t have to be running; walking is great. You don’t have to be lifting weights; doing the housework or gardening will suffice.
From that foundational axiom, she calls on us to find ways to build our life around movement… rather than production-efficiency and/or convenience. She gives plenty of tips for such too!
Bottom line: some books are “I couldn’t put it down!” books. This one’s more of a “I got the urge to get up and get moving!” book.
Get your get-up-and-go up and going with “Move”—order yours from Amazon today!
Share This Post
-
Planning Festivities Your Body Won’t Regret
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.
The Festive Dilemma
For many, Christmas is approaching. Other holidays abound too, and even for the non-observant, it’d be hard to escape seasonal jollities entirely.
So, what’s the plan?
- Eat, drink, and be merry, and have New Year’s Resolutions for the first few days of January before collapsing in a heap?
- Approach the Yuletide with Spartan abstemiousness and miss all the fun while simultaneously annoying your relatives?
Let’s try to find a third approach instead…
What’s festive and healthy?
We’re doing this article this week, because many people will be shopping already, making plans, and so forth. So here are some things to bear in mind:
Make your own mindful choices
Coca-Cola company really did a number on Christmas, but it doesn’t mean their product is truly integral to the season. Same goes for many other things that flood the stores around this time of year. So much sugary confectionary! But remember, they’re not the boss of you. If you wouldn’t buy it ordinarily, why are you buying it now? Do you actually even want it?
If you really do, then you do you, but mindful choices will invariably be healthier than “because there were three additional aisles of confectionary now so I stopped and looked and picked some things”.
Pick your battles
If you’re having a big family gathering, likely there will be occasions with few healthy options available. But you can decide what’s most important for you to avoid, perhaps picking a theme, e.g:
- No alcohol this year, or
- No processed sugary foods, or
- Eat/drink whatever, but practice intermittent fasting
Some resources:
Fight inflammation
This is a big one so it deserves its own category. In the season of sugar and alcohol and fatty meat, inflammation can be a big problem to come around and bite us in the behind. We’ve written on this previously:
Positive dieting
In other words, less of a focus on what to exclude, and more of a focus on what to include in your diet. Fruity drinks and sweets are common at this time of year, but you know what’s also fruity? Fruit!
And it can be festive, too! Berries are great, and those tiny orange-like fruits that may be called clementines or tangerines or satsumas or, as Aldi would have it, “easy peelers”. Apple and cinnamon are also a great combination that both bring sweetness without needing added sugar.
And as for mains? Make your salads that bit fancier, get plenty of greens with your main, have hearty soups and strews with lentils and beams!
See also: Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
Your gut will thank us later!
Get moving!
That doesn’t mean you have to beat the New Year rush to the gym (unless you want to!). But it could mean, for example, more time in your walking shoes (or dancing shoes! With a nod to today’s sponsor) and less time in the armchair.
See also: The doctor who wants us to exercise less; move more
Lastly…
Remember it’s supposed to be fun! And being healthy can be a lot more fun than suffering because of unfortunate choices that we come to regret.
Take care!
Share This Post
-
No, COVID-19 vaccines don’t cause ‘turbo cancer’
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.
What you need to know
- COVID-19 vaccines do not cause “turbo cancer” or contain SV40, a virus that has been suspected of causing cancer.
- There is no link between rising cancer rates and COVID-19 vaccines.
- Staying up to date on COVID-19 vaccines is a safe, free way to support long-term health.
Myths that COVID-19 vaccines cause cancer have been circulating since the vaccines were first developed. These false claims resurfaced last month after Princess Kate Middleton announced that she is undergoing cancer treatment, with some vaccine opponents falsely claiming Middleton has a “turbo cancer” caused by COVID-19 vaccines.
Here’s what we know: “Turbo cancer” is a made-up term for a fake phenomenon, and there is strong evidence that COVID-19 vaccines do not cause cancer or increase cancer risk.
Read on to learn how to recognize false claims about COVID-19 vaccines and cancer.
Do COVID-19 vaccines contain cancer-causing ingredients?
No. Some vaccine opponents claim that COVID-19 vaccines contain SV40, a virus that has been suspected of causing cancer. This claim is false.
A piece of SV40’s DNA sequence—called a “promoter”—was used as starting material to develop COVID-19 vaccines, but the virus itself is not present in the vaccines. The promoter does not contain the part of the virus that enters the cell nucleus, so it poses no risk.
COVID-19 vaccines and their ingredients have been rigorously studied in millions of people worldwide and have been determined to be safe. The National Cancer Institute and the American Cancer Society agree that COVID-19 vaccines do not increase cancer risk or accelerate cancer growth.
Why are cancer rates rising in the U.S.?
Since the 1990s, cancer rates have been on the rise globally and in the U.S., most notably in people under 50. Increased cancer screening may partially explain the rising number of cancer diagnoses. Exposure to air pollution and lifestyle factors like tobacco use, alcohol use, and diet may also be contributing factors.
What are the benefits of staying up to date on COVID-19 vaccines?
Staying up to date on COVID-19 vaccines is a safe way to protect our long-term health. COVID-19 vaccines prevent severe illness, hospitalization, death, and long COVID.
The CDC says staying up to date on COVID-19 vaccines is a safer and more reliable way to build protection against COVID-19 than getting sick from COVID-19.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
Share This Post
-
Asbestos in mulch? Here’s the risk if you’ve been exposed
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.
Mulch containing asbestos has now been found at 41 locations in New South Wales, including Sydney parks, schools, hospitals, a supermarket and at least one regional site. Tests are under way at other sites.
As a precautionary measure, some parks have been cordoned off and some schools have closed temporarily. Fair Day – a large public event that traditionally marks the start of Mardi Gras – was cancelled after contaminated mulch was found at the site.
The New South Wales government has announced a new taskforce to help investigate how the asbestos ended up in the mulch.
Here’s what we know about the risk to public health of mulch contaminated with asbestos, including “friable” asbestos, which has been found in one site (Harmony Park in Surry Hills).
What are the health risks of asbestos?
Asbestos is a naturally occurring, heat-resistant fibre that was widely used in building materials from the 1940s to the 1980s. It can be found in either a bonded or friable form.
Bonded asbestos means the fibres are bound in a cement matrix. Asbestos sheeting that was used for walls, fences, roofs and eaves are examples of bonded asbestos. The fibres don’t escape this matrix unless the product is severely damaged or worn.
A lot of asbestos fragments from broken asbestos products are still considered bonded as the fibres are not released as they lay on the ground.
Asbestos sheeting was used for walls and roofs.
Tomas Regina/ShutterstockFriable asbestos, in contrast, can be easily crumbled by touch. It will include raw asbestos fibres and previously bonded products that have worn to the point that they crumble easily.
The risk of disease from asbestos exposure is due to the inhalation of fibres. It doesn’t matter if those fibres are from friable or bonded sources.
However, fibres can more easily become airborne, and therefore inhalable, if the asbestos is friable. This means there is more of a risk of exposure if you are disturbing friable asbestos than if you disturb fragments of bonded asbestos.
Who is most at risk from asbestos exposure?
The most important factor for disease risk is exposure – you actually have to inhale fibres to be at risk of disease.
Just being in the vicinity of asbestos, or material containing asbestos, does not put you at risk of asbestos-related disease.
For those who accessed the contaminated areas, the level of exposure will depend on disturbing the asbestos and how many fibres become airborne due to that disturbance.
However, if you have been exposed to, and inhaled, asbestos fibres it does not mean you will get an asbestos-related disease. Exposure levels from the sites across Sydney will be low and the chance of disease is highly unlikely.
The evidence for disease risk from ingestion remains highly uncertain, although you are not likely to ingest sufficient fibres from the air, or even the hand to mouth activities that may occur with playing in contaminated mulch, for this to be a concern.
The risk of disease from exposure depends on the intensity, frequency and duration of that exposure. That is, the more you are exposed to asbestos, the greater the risk of disease.
Most asbestos-related disease has occurred in people who work with raw asbestos (for example, asbestos miners) or asbestos-containing products (such as building tradespeople). This has been a tragedy and fortunately asbestos is now banned.
There have been cases of asbestos-related disease, most notably mesothelioma – a cancer of the lining of the lung (mostly) or peritoneum – from non-occupational exposures. This has included people who have undertaken DIY home renovations and may have only had short-term exposures. The level of exposure in these cases is not known and it is also impossible to determine if those activities have been the only exposure.
There is no known safe level of exposure – but this does not mean that one fibre will kill. Asbestos needs to be treated with caution.
As far as we are aware, there have been no cases of mesothelioma, or other asbestos-related disease, that have been caused by exposure from contaminated soils or mulch.
Has asbestos been found in mulch before?
Asbestos contamination of mulch is, unfortunately, not new. Environmental and health agencies have dealt with these situations in the past. All jurisdictions have strict regulations about removing asbestos products from the green waste stream but, as is happening in Sydney now, this does not always happen.
Mulch contamination is not new.
gibleho/ShutterstockWhat if I’ve been near contaminated mulch?
Exposure from mulch contamination is generally much lower than from current renovation or construction activities and will be many orders of magnitude lower than past occupational exposures.
Unlike activities such as demolition, construction and mining, the generation of airborne fibres from asbestos fragments in mulch will be very low. The asbestos contamination will be sparsely spread throughout the mulch and it is unlikely there will be sufficient disturbance to generate large quantities of airborne fibres.
Despite the low chance of exposure, if you’re near contaminated mulch, do not disturb it.
If, by chance, you have had an exposure, or think you have had an exposure, it’s highly unlikely you will develop an asbestos-related disease in the future. If you’re worried, the Asbestos Safety and Eradication Agency is a good source of information.
Peter Franklin, Associate Professor and Director, Occupational Respiratory Epidemiology, The University of Western Australia
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!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Krill Oil vs Fish Oil – Which is Healthier?
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.
Our Verdict
When comparing krill oil to fish oil, we picked the krill oil.
Why?
Both of these products are good sources of omega-3 fatty acids EPA and DHA, and for the specific brand depicted above, in both cases 2 softgels will give you the recommended daily amount (which is generally held to be 250–500mg combined omega-3s per day).
This brand’s fish oil gives more (640mg combined omega-3s per 2 softgels, to the same brand’s krill oil’s 480mg per 2 softgels), but since the krill oil is already in the high end of RDA territory, the excess beyond the RDA is not helpful, and not a huge factor. More quantity is not always better, when the body can only process so much at a time.
However, the krill oil gives some extra things that the fish oil doesn’t:
- Astaxanthin, a “super-antioxidant”
- and neuroprotectant, heart-healthy phospholipids
Additional considerations
We have declared “the winner” based on health considerations only. That’s a sticking point for us in all our writings; we’ll occasionally look at and mention other factors, but we know that health is what you’re here for, so that’s what we’ll always treat as most critical.
However, in case these factors may interest you and/or influence you to one or the other:
• The fish oil is about 30% cheaper financially
• The krill oil is a lot more sustainable environmentallyBack to the health science…
Read more:
• What Omega-3 Fatty Acids Really Do For Us
• Astaxanthin: Super-Antioxidant & NeuroprotectantWant some? Here for your convenience are some example products on Amazon:
(brands available will vary per region, but now you know what to look out for on the labels!)
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:
-
The AFib Cure – by Dr. John Day & Dr. Jared Bunch
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.
The authors—cardiologists and AFib specialists—make the case that if you have atrial fibrillation, you do in fact have more options than “take these pills and suffer”.
To be clear: they’re not anti-medication per se and they also acknowledge that for some people the meds may still have their place (safety first, and all), but they do fall on the side of “it would be nice to not have to, if possible, so let’s see what we can do”.
Rather, they recommend lifestyle adjustments (no surprises there), and certain biomarker optimizations (this is where it gets more in-depth), which have a good record of reducing symptoms to the point of remission and freedom from medications.
The book is first a primer on the topic of AFib, and then a how-to manual of fixing the problems that you now understand, by biomarker monitoring, lifestyle optimization, and if those things don’t work, ablative therapy which they argue is safer, easier, and more successful than you might think.
The style is clear and easy to understand, with frequent scholarly citations throughout. On the downside, the tone can sometimes be a little on the pushy side for this reviewer’s tastes, but if one overlooks that, it doesn’t detract from the useful content.
Bottom line: if you or a loved one have AFib and would like more treatment/management options than have hitherto been presented, this book will give you that.
Click here to check out The AFib Cure, and look after your heart!
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:
