One of the reasons that might make you postpone your sign-up for cryonics is the worry that the medical SST team won’t be notified of your death. After all, if the experts don’t start the procedure in a timely manner, the cellular degradation happening in your body could damage your brain and with it your memories and personality. At Tomorrow Bio, the fastest-growing human cryopreservation provider, we are well aware of this problem. For this reason, we have put in place a whole series of systems that will cover you in your time of need.

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Why Is Fast Response Important

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Cryonics, or human cryopreservation, is an advanced medical procedure that aims to preserve a patient after legal death through the use of very low temperatures. If the purpose of this technique were simply to preserve the body for religious or practical reasons, a bit like mummification in the past and embalming today, acting promptly wouldn’t be so important. The ultimate purpose of cryonics, however, is to revive patients in the future, when medical technology will be able to cure their causes of death and give them a chance at an extended life.

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It follows that the person revived tomorrow should be the same person who was cryopreserved today. The structures in the brain that encode memory and personality need to be stored intact, or with minimal loss. Thanks to various research project, we know that human cryopreservation technology allows us to preserve those parts of the brain responsible for memories. However, this is only the case if the brain hasn’t been damaged before the procedure takes place.

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Unfortunately, once the heartbeat stops, the body undergoes a process that leads to degradation and causes cells (including those in the brain) to start dying.

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Ischemic Damage

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This process is called Ischemia and it’s defined as inadequate supply of oxygenated blood to one or more parts of the body. This can be caused by a blockage of the vessels supplying the area (common effect of arteriosclerosis) or by cessation of cardiac activity. Simply put, when the heart stops beating and pumping blood, the body's cells do not get the oxygen they need to function. At this point, they enter a state called autophagy in which they consume their own proteins, until they die.

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To prevent ischemic damage to brain cells, which hold memories and personality, the fast response of the SST (Standby, Stabilization and Transportation) team is essential. This is a group of medical experts specialized and trained in human cryopreservation. At Tomorrow Bio we have SST teams available for dispatch 24/7. This means that once notified of your death (imminent or sudden), they’ll reach you as soon as possible by any means.

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But how are we notified of your death?

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How Do We Get Notified of Your Death

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No one can predict the day they will die. Considering, however, that the average life expectancy of the European population is around 80 years, it’s correct to assume that deaths due to the aggravation of age-related diseases are more common than sudden deaths at a young age. This makes the work of cryonics organizations a little easier, as “deaths of old age” are often preceded by warning signs.

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So, who is responsible for notifying us in cases of possible imminent death?

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Imminent Death

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To start with, we ask our members to notify us in case they are hospitalized or have to undergo a medium or high risk operation. Therefore, the first person who should alert us is you. Of course, in many cases a patient that is about to die is not conscious enough to make a phone call to their cryonics provider and ask them to dispatch an SST team.

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In this case, your family members, loved ones and/or your attending physician should inform us of the possibility of death. We always advise our members to inform people around them and their doctor of their wish to be cryopreserved after legal death. 

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Moreover, after signing up for a plan with Tomorrow Bio, we send all our members a Welcome Box containing various useful materials. Inside it there are: 

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• 4 emergency cards. Each card contains an explanation of the member’s wishes to be cryopreserved and specific instructions to proceed in case of emergency. It also contains Tomorrow Bio’s contact information. You should give your emergency cards to people who are close to you (family, friends) so that they know how to act in time of need.
• If that were not enough, we also provide our members with a Patient Advance Directive (PAD) template. In some cases, the fact that a member has created a PAD can help us be more quickly notified in the event of death. This applies to both imminent and sudden death. If you are incapacitated, your attending physician will often check whether or not you have a PAD to indicate your wishes. The template we provide instructs the medical personnel to alert Tomorrow Bio as soon as possible. We recommend that you give a copy to your doctor and/or put it somewhere easily accessible. 

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Sudden Death

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To avoid delays even in the less common cases of sudden death (when it occurs unexpectedly), we created additional emergency systems. 

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Imagine you are walking down the street and, suddenly, you have a cardiac arrest or are the victim of an accident. In these situations, the systems illustrated above may not be as efficient, as time may pass from the moment of death to the moment when your family and loved ones are notified -and thus alert us. Clearly, your PAD should be sufficient in these cases, but when it comes to your chance at an extended life in the future, better not to put all your eggs in one basket, right?

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Two other emergency notification systems are:

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• Your Tomorrow Bio member’s bracelet or necklace, equipped with a metallic plaque which indicates your status as a body donor and our emergency contact information. We recommend wearing this item, which you will receive in the Welcome Box, constantly, especially when you move away from your home area and your family network. Any person rescuing you in case of sudden death will know who to contact based on the information on it.
• Our Biostasis Emergency App which can be used with or without connecting it to your wearable device. You can download it here for apple devices or here for android devices. Depending on the settings you choose, the app will send you monitoring notifications. In case you don’t respond, it will trigger a series of emergency notifications. If you don't react to any of these, the app will send a message to your chosen emergency contact. After verifying your status, they can inform Tomorrow Bio in case there is an emergency. This app could be of great help in case the member should die suddenly while alone.

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Tomorrow Bio’s SST teams

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Tomorrow Bio's SST teams are available at any time of day or night. We have a team in Berlin, one in Amsterdam through a partner and will soon have one in Switzerland at the long-term storage facility. As soon as the emergency call is received, they will assess how to reach you in the shortest possible time. If you are in central northern Europe, our teams will probably get to you in a fully equipped ambulance. If you are further away, they will use other methods (usually by plane), carrying the portable equipment with them.

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Whenever possible, especially in cases where there are signs of imminent death, the team will try to be at the location before the declaration of legal death. In this way, the delay will be minimal, and with it the ischemic damage to the brain and the body. Statistically, most cases of death will have forewarning.

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Field Cryoprotection

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Tomorrow Bio teams are equipped to carry out field cryoprotection. This ensured the shortest possible delay between legal death and the start of the cryopreservation. In fact, rather than having to send the body to the long-term storage facility, which may be far away, the procedure is carried out on site. The logistics will depend on the specific case and the laws of the state in which the patient passes away.

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In general, when the member's location is reached with the standby ambulance, the body is transferred inside. Here, the SST team lowers the core temperature with an ice bath and gives the patient a range of medications to reduce metabolic load, as well as protect tissues and cells. At the same time, a cardiopulmonary support (CPS) device will circulate oxygenated blood. After initial cooling, blood and water are removed from the patient’s body and replaced with cryoprotective agents (CPAs). These are used to minimize freezing which could damage the tissues and affect the quality of the cryopreservation.

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Only at this point is the body transferred to the long-term storage facility. Here the temperature is lowered to that of liquid nitrogen (-196°C) and the patient is placed in a cryogenic storage dewar to await possible future revival.

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Local First Aid Teams

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Now, all the measures in place for Tomorrow Bio to be notified of a member's death don't always prevent time from passing between legal death and the procedure. This is why we are constantly trying to help and train local cryonics organizations and first aid teams. These can be formed by people signed up for cryopreservation who make themselves available when another member dies. 

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These teams are usually not made up of specialized medical personnel but can still set the necessary first steps in motion while waiting for the SST team to reach them. A simple example is to lower your body temperature after legal death. This decreases metabolic activity, reducing the cells' need for oxygen and slows down the degradation process. 

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Those interested can purchase our Cryopreservation First Aid Kit, which contains everything they need:

• A heavy-duty body bag or disaster pouch
• An LUCAS set (which is an automated CPR machine)
• A respiratory set
• A medication set
• A step-by-step manual explaining do’s and don’ts 

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Having a network available at the time of death can make the difference between high and low quality cryopreservation.

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Conclusion

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Based on current technology and knowledge, high-quality cryopreservation is strongly dependent on timing. The earlier the procedure starts, the better we will be able to preserve the brain. However, this doesn't mean that, should several hours pass, cryopreservation would not be possible. Indeed, we cannot say to what extent future medical technology will be able to develop. Perhaps, one day, it will be possible to revive patients with extensive brain damage. However, as we do not know when and if this will be possible, we at Tomorrow Bio put a lot of effort into ensuring effective emergency notification and fast response.

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If this story has got you curious and you want to know more about our service, take a look at our website. There you’ll find all the information you need about who we are, what services we offer and our prices. If you are looking for a place to chat about cryonics, longevity, and futurism instead, check out our Discord server.

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