X-Message-Number: 27951
Subject: Standby
Date: Thu, 18 May 2006 20:10:18 +0000

       In response to Hank Hirsch's post, funeral directors will generally not 
       wait at bedside for cardiac arrest, and will not be able provide 
       cardiopulmonary support and rapid cooling if they do.  They are not 
       trained to establish intravenous access (a skill distinct from raising 
       vessels for embalming), so the efficacy of heparin administration is in 
       doubt.  Even professional paramedics can have difficulty establishing 
       I.V. access in dehydrated patients during cardiac arrest.  For this 
       reason, Alcor has gone to an intraosseus infusion system, and even that 
       is not foolproof.  Even if heparin administration is successful, funeral 
       directors cannot prevent hours of warm ischemic injury.  Surface 
       conduction cooling is too slow.

       If personal circumstances do not permit arranging for standby services, 
       then one can only do the best one can do.  But certainly no one should be
       encouraged to avoid standby if they can arrange it based on any belief 
       that it is superfluous or detrimental.  In cases of unexpected clinical 
       death, Alcor has a policy of using local funeral directors if they can 
       respond faster than standby teams, and I'm sure CI does too for members 
       who choose SA services.


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