Capitolo 5: Fare il salto di qualità

Cryopreservation is a time-sensitive procedure. The more time between circulatory arrest and the onset of cryoprotection, the more cellular death occurs. However, no cryopreservation procedures can be performed before legal pronouncement. Even in cases where the worsening of the conditions clearly indicate imminent death, the standby team must wait for a specialized person to officially confirm the patient's death in writing. That’s why, for a better chance at high-quality cryopreservation, it’s important to have an efficient notification system in place. This ensures that no unnecessary time is wasted. Tomorrow.bio’s specialized standby teams are one solution to minimizing the time sensitivity issue.

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The SST

The cryopreservation process should begin as soon as possible following legal death. This increases the quality of preservation of both your brain and body. To improve the likelihood of this scenario, Tomorrow.bio is focusing on building standby teams that are highly trained and available 24/7. SST teams, or some colloquially called standby teams, aim to decrease the time between legal death and the onset of cryoprotection procedures. They include doctors, EMTs, and personnel specifically trained for cryopreservation procedures. 

In best case scenarios,  the attending doctor or medical team contacts Tomorrow.bio to inform us that a member might die in a few hours or days (i.e., they’re in critical condition). This allows our team to arrive on site, so we can begin stabilization as soon as possible. As we mentioned earlier, this cannot happen until AFTER legal death has been pronounced. Once a medical professional declares the patient legally dead, the standby team initiates the process of cryoprotection. Once the patient is fully perfused and cooled down to around -20°C, most of the major biological processes are virtually paused. Following perfusion, the patient is moved to EBF, where they go into a computer-controlled cooling box to continue lowering their temperature to about -196°C (the temperature of liquid nitrogen). Once this is achieved, the patient can be transferred to a cryogenic storage dewar, which is filled with liquid nitrogen. 

The above situation describes perfect circumstances and the “best case scenario.” Although in most cases the potential death of a member is known beforehand, death can be unexpected. Still, in sudden death scenarios, the equipped standby team is dispatched and deployed as quickly as possible after we’re notified. 

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How is Tomorrow.bio notified in case of sudden death? 

As described, best case scenarios allow Tomorrow.bio to begin the stabilization and cryoprotection process almost immediately. However, some deaths can be sudden and unexpected. In the case of a sudden death, many people wonder about all of the “Who? What? Why? Where? When? How?” questions. 

Who notifies Tomorrow.bio? What happens when they’re notified? Why might the notification process be challenging? Where does Tomorrow.bio go after they receive notification? When will they arrive? How do they get there? 

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The steps of notification 

All of the above questions can be answered by walking through the steps of notification. This is a working model at Tomorrow.bio and we intend to continue developing it over time. However, as of now, it remains to be an effective way to respond to cases of sudden death. There are a few situations that dictate how our standby team is notified: through the Tomorrow.bio wristband, using our integrated app (coming soon), through the next of kin, or via the attending physician. 

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Notification through Tomorrow.bio’s wristband or necklace

When you become a member at Tomorrow.bio, you receive a Welcome Box. Inside will be: 

• Your membership card
• Emergency wristband
• Emergency necklace
• A few emergency cards
• A template for your last will
• A template for your patient advance directive (PAD)
• A letter from our CEO, Dr. Emil Kendziorra welcoming you to the Tomorrow Bio community. 

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The included cards will include all of the relevant information in case you have an emergency. However, for the sake of notifications, the Tomorrow.bio wristband is an important accessory. 

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In the event of a sudden death, the first person who notices the bracelet should contact Tomorrow.bio. Medical ID bracelets are normal for many conditions, so doctors, first responders, EMTs, and other medical staff might see them and respond appropriately. If, for some reason, the medical team does not contact Tomorrow.bio directly, the patient’s family should reach out as soon as possible to begin the cryopreservation process quickly following legal death. To make sure your family members and friends know how to behave in case of sudden death, give them one of the emergency cards you can find in your Welcome Box.

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Once Tomorrow.bio is notified, our standby team is dispatched immediately. If the patient is local, we will take either the Tomorrow.bio equipped ambulance or one of our fast response vehicles. If the patient can not be reached quickly by land transport, our standby team utilizes either commercial or private air travel, whichever is faster, cost is also factored into this decision. In these cases, the team will use our portable equipment for in loco cryoprotection. To make sure this process goes smoothly, always confirm the receipt of your welcome package once it arrives at your home. 

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Notification through next of kin 

In the case of a sudden death, another way Tomorrow.bio can be notified is through next of kin. Patients who have communicated their plans to be cryopreserved may have shared how to respond in the case of death with their emergency contacts. To make sure they have our emergency number within reach in case of need, give them one of the emergency cards you find in your Welcome Box. This can decrease the window between legal death and the time our standby team is dispatched. 

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Notification through the attending physician 

Tomorrow.bio can also be notified by the attending physician. This process can be expedited with a patient advance directive, as it informs your doctor of who to contact regarding medical decisions if you’re incapacitated. When you create your patient advance directive, it’s important to name Tomorrow.bio on the document. You will find a template in your Welcome Box to help you write your own PAD. This will prompt your doctor to contact us in the case of a medical emergency. Once Tomorrow.bio is contacted through the attending physician and told a member is in critical condition, a standby team is dispatched to their location. 

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How to improve circumstances for sudden death

The best way to improve your circumstances in case of a sudden death situation is to be prepared. Make sure you sign up for cryopreservation with Tomorrow.bio, receive your Welcome Box, and put on your medical ID wristband. Additionally, inform people close to you about your decision and what actions they have to take in case of need.

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It’s also important for you to create a patient advance directive that states what actions you want taken for your health if you’re no longer able to communicate them. A personal belief statement can also be useful, as it makes it more difficult for outside parties to try and say you didn’t want to be cryopreserved. The fewer legal problems that occur after legal death, the sooner cryopreservation can begin. 

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What happens one we get notified - your journey with us

Inizia il processo di invecchiamento

Vi rendete conto che l'invecchiamento è inevitabile, ma vi rifiutate di accettarlo come definitivo, scegliendo di sfidare la fine. Scoprite la biostasi e decidete di prendere il controllo razionale del vostro futuro.

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Diventa un membro di Tomorrow.bio

Siete entrati a far parte della nostra Community! Ora è il momento di garantire il vostro futuro creando un finanziamento. Dal momento che la vita è imprevedibile, avere un piano finanziario pronto vi darà la massima tranquillità.

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Vivi la tua vita migliore

Con il vostro piano di conservazione assicurato, siete liberi di concentrarvi su ciò che conta di più. Vivete pienamente, prendetevi dei rischi, inseguite i vostri sogni e godetevi la nostra Community, sapendo di essere preparati per qualsiasi cosa accada.

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Approcci alla fine della vita

In questo momento critico, voi e la vostra famiglia potete concentrarvi su ciò che più conta. Le vostre disposizioni finanziarie si attivano automaticamente e il nostro team di professionisti gestisce ogni aspetto del processo di conservazione con cura e competenza.

Il nostro team SST viene inviato sul posto per garantire una crioconservazione di alta qualità.

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Muori

La vostra vita biologica finisce, ma il vostro viaggio di conservazione inizia immediatamente. Il nostro team inizia la crioprotezione sul campo e vi trasporta nella nostra struttura svizzera, dove il raffreddamento controllato a -196°C vi preserva per il futuro.

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Siete crioconservati

La vostra conservazione è completa. Siete conservati nella nostra struttura all'avanguardia in Svizzera, protetti da molteplici sistemi di backup e da un monitoraggio continuo.