Monday, July 9, 2007

Overview of Suspended Animation Vehicles

The distinction between “short-range” and “long-range” vehicles, (as reflected on SA’s web site), is inappropriate. Distinctions between the vehicles should be based on the purpose of the vehicles, rather than the single factor of distance.

The Bus:

The bus is described on the web site as a “Long-Range Transport Vehicle” for “distances of up to 1,000 miles.” This might work out in the event that someone at such a distance would call SA and say, “This client is imminently terminal, but you have at least two days to get here,” but that is highly unlikely to happen. If they had an emergency call from a client situated 1,000 miles away, would they drive approximately 20 hours to reach that client? If they made this choice, that client could possibly be well beyond “legally dead” by the time they arrived. If they were to get a call concerning a client who was located a long distance from their facility, they would most likely take their kits and fly to the location, in which case they should use a smaller vehicle that is easy to park, to transport their equipment to the airport.

In actuality, if such a distinction must be made, the bus is an excellent short-range vehicle. If SA had a case a short distance away, (up to several hundred miles), they could arrive there in this vehicle in less time than it would take them to get their personnel and equipment to the airport, and fly halfway across the country. With the proper development of this vehicle, SA could perform a washout and cooldown in the vehicle, eliminating the need to find a cooperative local mortuary.

This vehicle should be equipped with wide rear doors and a lift gate, as per my previous report on ramps. All relevant SA personnel have been in agreement that a lift gate is desirable; the possible addition of a lift gate is even mentioned on the SA web site. The plan Gary, Kelly and I agreed to at a management meeting following Platt's resignation, was as follows:

1. As soon as the Sprinter could be made ready to deploy, (Gary indicated this would a very short time), we would move all standby equipment from the bus to the Sprinter, so that the bus could be made ready for washout and cooldown procedures, as previously planned.

2. Gary was to research the purchase of a lift gate, (one that included the feature of backup manual operation), in the hopes of getting Saul’s approval to install a lift gate long before the conference in May 2007. The lift gate would be installed in-house, if approved.

In mentioning the possible addition of a lift gate, the SA web site states the rear door is “just tall enough to allow access by the ice bath with Thumper mounted across it,” but is it wide enough to accommodate loading a patient via a lift gate? This issue was to be addressed in Gary’s investigation of suitable lift gates.

In addition, though SA intended to use the Thumper, (along with massive quantities of pure oxygen), in this vehicle, the vehicle had no windows or other suitable ventilation source. After attention was called to this issue, Gary sealed up one of the Thumpers and built an exhaust system for it. (The Thumper has no built-in exhaust for the oxygen; the oxygen just leaks out through all the joints, seams and/or screw holes.) While this was an improvement, carrying two “H” cylinders of oxygen in the vehicles still seemed somewhat dangerous, especially in light of the sparking winch incident at a training session. In addition, standby team members don’t get a lot of practice, and might forget to connect the exhaust, and there is always the danger of a motor vehicle accident.

The Sprinter:

On the web site, the Dodge Sprinter is described as a “Short-Range Transport Vehicle” for “pickup and transport of patients over distances of 200 miles or less,” but it is really not suitable for transporting patients in need of washout and vitrification procedures, at any distance, as the vehicle is too small for even minimal intervention. Even if SA had a case within minutes of their facility, they may want to perform surgical procedures in the vehicle, and the Sprinter is simply not large enough for this, (see image, on SA's web site). They cannot assume the absence of delays in getting a patient to the facility or to a mortuary, so they should be prepared to provide care for the patient in the vehicle. The bus, which is equipped for procedures, is much more suitable for short-range cases, (see the second paragraph under the heading, “The Bus,” above, for further explanation).

Image of interior of Dodge Sprinter shows it is too small for procedures.
(Click on: “More... under image of Dodge Sprinter).

SA invested a lot of time and money for the design and installation of an LED lighting system, that required the hand-soldering of a rather large number of LEDs, for this vehicle. Though the designer of this lighting system, Charles Platt, has described it on one of the cryonics forums as "really cool," it is not only grossly inadequate, but the lighting effects are hideous. Additional lighting had to be installed after the completion of the LED system. Superior lighting, that would have been much less expensive, should have been purchased and installed, in the beginning.

The web site also states that “the Sprinter is not suitable for a lift gate powerful enough to raise our fully-loaded ice bath,” but this is inaccurate. TommyGate manufactures lift gates, specifically for this vehicle, that will lift up to 1,000 pounds. Whether this is desirable, or not, would depend on the intended future use of this vehicle.

The height of the vehicle has often been given as an advantage, but it seems more like a handicap. Again, the vehicle is far too small for procedures, so it’s unlikely the vehicle would be stationary, once the patient was loaded. Since the vehicle is really only suitable for transport, there is no need for personnel to stand up in the vehicle. (Imagine EMTs standing in an ambulance en route to a hospital.) If this vehicle were not as tall as it is, it would be ideal for rapidly deploying standby kits and personnel to an airport, but it is too tall to park in airport garages. (Platt's answer to this was they would leave the van at the curb and let it be towed.)

In discussing the cooldown and long-distance cryogenic transport of patients, the advantages of transporting patients in a vehicle, (rather than dealing with the transport issues and regulations associated with using commercial aircraft, or delivery services such as FedEx), was considered. The Sprinter might be suitable for this purpose. It’s comfortable and economical, and really not of much use in other capacities, once the build-out of the larger vehicle is completed. In addition, the use of the Sprinter for cryogenic transport would provide the added advantage of continuous patient monitoring by personnel in the vehicle, something that would be unavailable when using commercial shipping. SA should consider studies of the feasibility and projected cost of converting the Sprinter for cryogenic transport, and make comparisons to other methods of cryogenic shipping. If it is not suitable for cryogenic transport, it should be replaced with a van suitable for rapidly deploying standby equipment and personnel to the airport.

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