At Biostasis2022, speaker Eric Vogt highlighted the two main challenges that SST teams (Standby, Stabilization, and Transportation) face: time and distance. In an ideal cryopreservation case, an SST team is notified prior to legal death. In these conditions, a patient usually demonstrates clear signs that their health is declining, giving the team time to reach and wait at their location before the pronouncement. They can then be quickly dispatched and ready to carry out the cryoprotection procedure with little delay. However, sometimes this isn’t the case.
In cases where a patient dies suddenly, it can be a challenge to reach the patient quickly. We do have emergency systems such as our membership bracelet with our contact information, emergency contact cards, and our Biostasis emergency app (available on Apple and Google Play). However, it can take time to reach our member’s location. This can impact the quality of the preservation.
That doesn’t mean that nothing can be done to prevent this. One solution is learning about Tomorrow’s first-aid cryopreservation response. By understanding what we do, you, your loved ones, and medical professionals can help ensure a quality preservation.
So, who are the people that carry out this procedure? The SST team is composed of trained medical professionals available 24/7. When a patient’s health is in decline, or in the event of an unexpected death, the SST team is notified and then dispatched to the location. Once onsite, the team will wait until legal death has been declared to begin the stabilization procedure. Once the body is stabilized and fully perfused, the team transports them to the European Biostasis Foundation’s (EBF) long-term facility in Rafz, Switzerland. Speed is critical in this procedure.
In addition to SST teams, Tomorrow Bio will, whenever possible, coordinate with local resources and medical professionals to inform them how to slow the cellular degradation process while the professional team is on its way. One of Tomorrow Bio’s initiatives is to support training and hands-on support for local teams to provide first assistance, as well as establish other biostasis organizations capable of this. Individuals and institutions interested in this procedure can purchase a cryopreservation first aid kit from us. This kit contains the following:
So, what is the stabilization process? Let’s find out.
The first step for first-aid cryopreservation response is to wait until after legal death has been declared. This is important because depending on where the patient is upon their death, certain medical procedures and examinations may need to occur before a declaration. Not to mention, if they’re alive by the time perfusion takes place, the process to vitrify them would kill them (by the current definition of death) in the process.
Once legal death has occurred, the main objective is to cool the patient. This is achieved by circulating oxygenated blood while simultaneously using cardiopulmonary support (CPS). In addition, medication needs to be administered to aid the cryoprotectant perfusion and neuroprotection during the procedure..
These two objectives are essential to reducing the risk of ischemic damage in both the body and especially the brain. How is it a risk to cryoprotection? When someone dies, the cells in the body become deprived of oxygen. Oxygen is needed for cells to carry out basic functions. When the oxygen supply stops, cells change from aerobic to anaerobic. The longer cells are deprived of oxygen, the more they will consume their own cellular components until they die. In cryonics, the sooner the procedure can take place, the lower the risk of ischemia which means information stored in the brain is better preserved. Any damage to the brain could impact a patient’s chance of future revival.
After legal death has been declared, it’s critical to cool the patient’s body. In first-aid cryopreservation response, this can be achieved by placing the patient in the heavy-duty body bag and filling it with a mixture of ice and water. Adding the water is important, as ice alone will have less cooling surface over the patient.
But why do we need to cool the patient? Low temperatures slow down the metabolic rate, which impacts the amount of energy required for a person to function. Metabolism requires both calories and oxygen to operate. By reducing the body temperature of a patient, we reduce the amount of oxygen needed to function. This is important for reducing cellular decay and preventing ischemia from setting in. We can see instances where people have survived for extended periods of time without oxygen after having been exposed to hypothermia. The same principle applies to our procedure.
At the same time medication is being administered, it’s important to keep oxygenated blood flowing. Stagnated blood runs the risk of clotting which can impact the perfusion of cryoprotectant agents (CPAs) by the SST team, resulting in a lower-quality preservation.
An SST team will use an automated CPS device called a LUCAS to do this. Chest compressions are physically taxing and can tire a person out quickly. In a Tomorrow Bio cryopreservation first aid kit, a LUCAS is provided along with additional equipment to help with this process. This device can carry out chest compressions for long periods of time with the same efficiency from the start to when the SST team arrives. While the LUCAS is running, it’s important to apply oxygen to the patient. The respiratory set provided will facilitate this. If you do not have this kit, then the only thing that can be done is to continue with chest compressions.
This can only be done by a medical doctor. While CPS and respiration are taking place, the final step is to administer medication. This is used mainly to reduce the occurrence of any blood clots that could bring down the quality of cryoprotection as well as neuroprotection. The bone marrow needle can be used to gain intraosseous access, which means that medication can be administered directly into the bone marrow. The equipment in the first aid kit allows responders to address issues before the SST team arrives.
When carrying out first-aid cryopreservation, there are things that you must be aware of beforehand.
Speed and skill are essential when it comes to a successful cryopreservation. One of the goals of Tomorrow Bio is to develop a network of local teams that can assist in the initial cooling process in conjunction with the SST teams. To facilitate this endeavor, Tomorrow Bio is looking to provide organized training sessions, and hands-on support and advice to help the preservation process. Providing training and assistance to local teams will allow for quality standby procedures even in remote locations and in the case of sudden death.
Time is critical in human cryopreservation. The faster an SST team can reach you, the higher the quality of the procedure. Depending on where you are in the world, it may take time to reach you prior to your legal death, or in the event of unexpected death. Understanding how this procedure works can help improve cryoprotection while waiting for the SST team to arrive.
If you want to learn more about how you can ensure a quality cryopreservation, check out some of our articles on Tomorrow Insight. We cover topics such as how to legally ensure this service, how to improve your body’s response to the procedure and more.
If you would like to learn more about our first aid training initiatives, contact us at firstname.lastname@example.org, and see you tomorrow!