Procedures


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Please note that the scenario described here is for an optimal case in which we receive sufficient warning that a client may be facing a health crisis. Actual procedures in each case may vary depending on the patient’s condition and other circumstances beyond our control.
3. Deployment

Logistics duties:

Verify informed consent, funding, and legal documents.
Confer with family members, cryonics membership organization.
Initiate moving equipment and supplies to the patient’s general location.
Call personnel, and select team members.
Make air travel arrangements, and get people to the airport.
Make car rental arrangements.
Make lodging arrangements.
Obtain information about local amenities (mortuary, welding gas supply, ice).
Guide team members to the patient’s location.
Establish air shipping options.

Team leader duties:

Establish team relationships with family, medical staff, others.
Establish bedside equipment near the patient.
Obtain ice and ice chests.
Establish washout equipment at the cooperating mortuary.
Continue to assess the likely prognosis.
Rent a van for transport, if time permits; obtain oxygen.
Establish shift rotations for team members.
Ask medical staff to attach a “do not remove” tag to IV line.
If no IV line, explore possibilities for medical staff to place one.
Establish pulse oximeter if medical staff are willing to do so.
Track patient’s vital signs in cooperation with medical staff if possible.
Get death certificate ready, with basic info filled in.

4. Agonal Phase

Draw medications.
Refresh ice.
Unfold ice bath and install liner.
Move ice bath as close as possible to patient.
Establish shipping supplies, perfusion equipment, and ice at mortuary.
Verify all aspects of readiness, especially:
l Vehicle parking.
l Availability of staff to pronounce legal death.
l Availability of staff to sign death certificate.
l Availability of mortician or surgeon.
l Any unexpected developments involving family or medical staff.
Pay special attention to oxygen saturation, pulse, BP, temperature, respiration, agonal breathing.
Set up ATP at mortuary.
Establish ice chests at mortuary.
Verify airline/air charter schedules.
Synchronize time stamps on voice recorders.

5. Post-Pronouncement Stabilization

Start voice recorders.
Get legal custody of patient (affirmation of legal death).
Move patient onto the lifting sling and transfer into (dry) ice bath.
Simultaneously:
Ventilate patient with bag and mask.
Place temporary ice (bagged) on head and neck.
Prepare Thumper and monitoring/logging equipment. Start logging.
Next, simultaneously:
Intubate and secure ET tube.
Place IV if none exists (allow a maximum of one minute).
Apply chest compressions with CardioPump.
Place icewater recirculation tubing.
Next, simultaneously:
Attach end-tidal CO2 detector.
Administer Propofol, Streptokinase, Heparin.
Place Thumper on side rails, and secure it.
Place rectal temperature probe.
Next, simultaneously:
Attach impedance valve.
Continue administering medications.
Start pulse oximeter and secure it. Position suction cup and lower the piston.
Add 100 lbs ice to the ice bath.
Next, simultaneously:
Connect Thumper to ET assembly.
Add 5 gallons of water to ice bath, plus small amount of bleach.
Place nasopharyngeal probe.
Start Thumper and adjust stroke depth.
Start icewater recirculation pump.
Continuation:
Substitute loose ice for the bagged ice on the head.
Monitor the Thumper.
Update scribe data sheets.
Verify data logging.
Add privacy cover to ice bath.
Transfer patient to surgical area (usually a mortuary) while continuing CPS.

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