Propofol

Propofol

Joined: April 30th, 2006, 1:38 am

February 11th, 2010, 3:21 pm #1

I was thinking about a discussion we had, a while back, about propofol. I made a mistake and stated that, if a cryonics team was to revive a patient, they would be obligated to attempt to keep that person alive. It was one of those "duh" moments, in which I neglected to consider patients who have a "DNR" (Do Not Resuscitate) order in place. Of course, there's a huge dilemma, here. Cryonics procedures cannot be performed on the living, so if a patient was to wake up, (something I think unlikely to happen, given the circumstances in most cryonics cases), legally, cryonics care providers would be obligated to stop their procedures and wait for the patient to die, again. So, they want to give a medication that will prevent this from happening, hence the phrases everyone who has worked in cryonics has heard, in regard to certain drugs, "...keep them down..." or "...maintain unconsciousness..."

Steve Harris wrote: "Presently, stocking and transferring of propofol is no different than handling of penicillin. Before Michael Jackson, it was one of those little medical secrets. One which is due to get all screwed up now, to my annoyance."
http://www.network54.com/Forum/291677/m ... n+Cryonics

What does Harris mean by "one of those little medical secrets"? Does he mean regulatory agencies have yet to realize someone like him can write a prescription for propofol, so that people who would normally never be allowed to have free access to such a drug, (maybe even laymen with addiction problems), can transport it all over the country, (along with needles and syringes), and administer it to people, at the time of death? It may be legal, but that's reckless, at best, and not something many, (if any), reputable medical doctors would agree to do. Thinking this is legal is probably not entirely accurate, since cryonics care providers may be giving these injections in states where the law prohibits laymen from performing procedures, (including giving injections to), dead people. If a doctor was aware that the drug was going to be used, illegally, that makes him culpable. Actually, the laws in some states may prevent cryonics care providers from administering ANY medications, unless they have a licensed embalmer available.

Harris also wanted to act like cryonics was "ahead" of conventional medicine, in recognizing possible pain and suffering, during CPR. We've all heard of lawsuits related to anesthesia awareness, (patients being aware of surgical procedures, when they were supposed to be asleep), but has anyone ever heard of a similar lawsuit, related to CPR? Think about it. CPR has been around for a VERY long time. If patients were suffering, while medical professionals were performing CPR, there would be plenty of lawsuits, but there's not, (in a brief search, I can't even find one). Patients don't suffer during CPR, because they are unconscious.

In response to my objections, regarding laymen having access to propofol, Mathew Sullivan chimed in, with "...propofol does not kill."http://www.network54.com/Forum/291677/m ... k+foolish- Try telling that to the Michael Jackson family.

"(CNN) -- The Los Angeles coroner has concluded preliminarily that singer Michael Jackson died of an overdose of propofol, a powerful sedative he was given to help him sleep, according to court documents released Monday."
http://www.cnn.com/2009/SHOWBIZ/Music/0 ... index.html

I'm not trying to stop cryonics organizations from doing what is best for people who want to be cryopreserved, I'm trying to make them act responsibly, ethically and legally. Whether they realize it, or not, it's in their own best interest. When they act with a total disregard for laws and regulations, they jeopardize the future of cryonics.
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Joined: November 30th, 2005, 4:41 am

February 11th, 2010, 5:54 pm #2

If the information that has been reported in the media is accurate, Michael Jackson was on a cocktail of medications. I was quoting Steve in regards to the protocol of what is available in the med kits which is clearly distinct on more than one front.

On the other hand, maybe everything that can be consumed or injected should be a regulated substance. My understanding is, as little as 15 puréed peach pits are enough to kill an adult from cyanide poisoning, and children are known to die occasionally from cyanide poisoning because they consumed apple seeds. Drinking too much water can also kill you. So, does this mean everyone in society should be required to have a script that can be given to the water fountain policeman who will monitor your activities? Getting back to reality, if someone puts a bottle of water in my backpack that also contains an apple and a peach for a planned daytrip, should I worry about my heath? I don't believe so, and this is even truer if I'm legally dead.

In regards to the med kit, I've been told there is nothing that could be used to kill a patient; although, you could get creative. Maybe burn all the plastic and force the patient to breathe it. I don't know that a biphasic IV set is strong enough to strangle a person, but you could use a Ziploc bag to smother them. Or, maybe even bang the patient over the head with the pelican case.

BTW, I wasn't gloating in regards to recent documents that became available. The thing about sinking boats is they can create a riptide that drags nearby objects down with them when they sink. On the other hand, if you are the prosecuting attorney, it isn't such a bad thing:


Last edited by MathewSullivan on February 11th, 2010, 6:39 pm, edited 1 time in total.
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Joined: October 2nd, 2004, 8:27 pm

February 11th, 2010, 8:05 pm #3

I was thinking about a discussion we had, a while back, about propofol. I made a mistake and stated that, if a cryonics team was to revive a patient, they would be obligated to attempt to keep that person alive. It was one of those "duh" moments, in which I neglected to consider patients who have a "DNR" (Do Not Resuscitate) order in place. Of course, there's a huge dilemma, here. Cryonics procedures cannot be performed on the living, so if a patient was to wake up, (something I think unlikely to happen, given the circumstances in most cryonics cases), legally, cryonics care providers would be obligated to stop their procedures and wait for the patient to die, again. So, they want to give a medication that will prevent this from happening, hence the phrases everyone who has worked in cryonics has heard, in regard to certain drugs, "...keep them down..." or "...maintain unconsciousness..."

Steve Harris wrote: "Presently, stocking and transferring of propofol is no different than handling of penicillin. Before Michael Jackson, it was one of those little medical secrets. One which is due to get all screwed up now, to my annoyance."
http://www.network54.com/Forum/291677/m ... n+Cryonics

What does Harris mean by "one of those little medical secrets"? Does he mean regulatory agencies have yet to realize someone like him can write a prescription for propofol, so that people who would normally never be allowed to have free access to such a drug, (maybe even laymen with addiction problems), can transport it all over the country, (along with needles and syringes), and administer it to people, at the time of death? It may be legal, but that's reckless, at best, and not something many, (if any), reputable medical doctors would agree to do. Thinking this is legal is probably not entirely accurate, since cryonics care providers may be giving these injections in states where the law prohibits laymen from performing procedures, (including giving injections to), dead people. If a doctor was aware that the drug was going to be used, illegally, that makes him culpable. Actually, the laws in some states may prevent cryonics care providers from administering ANY medications, unless they have a licensed embalmer available.

Harris also wanted to act like cryonics was "ahead" of conventional medicine, in recognizing possible pain and suffering, during CPR. We've all heard of lawsuits related to anesthesia awareness, (patients being aware of surgical procedures, when they were supposed to be asleep), but has anyone ever heard of a similar lawsuit, related to CPR? Think about it. CPR has been around for a VERY long time. If patients were suffering, while medical professionals were performing CPR, there would be plenty of lawsuits, but there's not, (in a brief search, I can't even find one). Patients don't suffer during CPR, because they are unconscious.

In response to my objections, regarding laymen having access to propofol, Mathew Sullivan chimed in, with "...propofol does not kill."http://www.network54.com/Forum/291677/m ... k+foolish- Try telling that to the Michael Jackson family.

"(CNN) -- The Los Angeles coroner has concluded preliminarily that singer Michael Jackson died of an overdose of propofol, a powerful sedative he was given to help him sleep, according to court documents released Monday."
http://www.cnn.com/2009/SHOWBIZ/Music/0 ... index.html

I'm not trying to stop cryonics organizations from doing what is best for people who want to be cryopreserved, I'm trying to make them act responsibly, ethically and legally. Whether they realize it, or not, it's in their own best interest. When they act with a total disregard for laws and regulations, they jeopardize the future of cryonics.
For someone who claims to be "not trying to stop cryonics organizations from doing what is best for people who want to be cryopreserved" it is a tad far-fetched for such a person to appear to suggest that an agent such as propofol should not be used to ensure the cryo patient does not awaken after pronouncement, which is obviously the desire of most cryo patients, especially if they have executed a DNR. Or perhaps she will surprise us with a better solution to the dilemma?

However crude the resources and tools of cryo orgs may be, trying to take away what they have without an equivalent or better replacement available, could result in their becoming unable to perform cryo services at all. That of course is the likely motive of some these days who seek to poke holes in cryonics.

I wonder though if enough alcohol could be used to keep the cryo patient down. OTOH perhaps it and peach pits should be declared a controlled substances like propofol. Schools these days are teaching that alcohol is a drug just like cocaine. Perhaps every bottle of wine should need a prescription for purchase. I was surprised to learn when visiting my sister in another state, and wanting to buy a bottle of grain alcohol there to go with some superb fresh fruit cider, that in that state you could only get it if you had a "drug license"! And, there are some backwoods parts of the USA that still have "dry counties" where no alcohol is legal.

So it goes,

FD
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Joined: November 30th, 2005, 4:41 am

February 11th, 2010, 8:53 pm #4

Use chest compressions and cool "rapidly" while a warm brain is deprived of oxygen for an hour or two. I wonder which paper mill this "medical" knowledge sprang forth.
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Joined: April 30th, 2006, 1:38 am

February 12th, 2010, 12:37 am #5

Mathew is grossly distorting the truth, I have never recommended "depriving warm brains of oxygen for an hour or two". I see he's learned well, from his teachers. "Paper mill" degree is how one of his former bosses referred to one of SA's paramedics' PhD.
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Joined: April 30th, 2006, 1:38 am

February 12th, 2010, 1:06 am #6

If the information that has been reported in the media is accurate, Michael Jackson was on a cocktail of medications. I was quoting Steve in regards to the protocol of what is available in the med kits which is clearly distinct on more than one front.

On the other hand, maybe everything that can be consumed or injected should be a regulated substance. My understanding is, as little as 15 puréed peach pits are enough to kill an adult from cyanide poisoning, and children are known to die occasionally from cyanide poisoning because they consumed apple seeds. Drinking too much water can also kill you. So, does this mean everyone in society should be required to have a script that can be given to the water fountain policeman who will monitor your activities? Getting back to reality, if someone puts a bottle of water in my backpack that also contains an apple and a peach for a planned daytrip, should I worry about my heath? I don't believe so, and this is even truer if I'm legally dead.

In regards to the med kit, I've been told there is nothing that could be used to kill a patient; although, you could get creative. Maybe burn all the plastic and force the patient to breathe it. I don't know that a biphasic IV set is strong enough to strangle a person, but you could use a Ziploc bag to smother them. Or, maybe even bang the patient over the head with the pelican case.

BTW, I wasn't gloating in regards to recent documents that became available. The thing about sinking boats is they can create a riptide that drags nearby objects down with them when they sink. On the other hand, if you are the prosecuting attorney, it isn't such a bad thing:

I was betting someone would come back with the "almost anything can be deadly, in sufficient quantity" logical fallacy. Mathew needs to take his own advice, and "get back to reality." Comparing water and peach pits, to propofol, isn't realistic. As if that wasn't bad enough, after arguing that "everything that can be consumed or injected" can be deadly, Mathew then stated, "In regards to the med kit, I've been told there is nothing that could be used to kill a patient..." Mathew's post is a little non-sensical, but it also appears he is claiming to have been quoting Dr. St teve Harris, when he (Mathew) put forth that propofol could not be used to kill someone. I hope Dr. Harris didn't really say that, because that would be a very foolish statement, for a physician to make.
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Joined: November 30th, 2005, 4:41 am

February 12th, 2010, 3:55 am #7

Mathew is grossly distorting the truth, I have never recommended "depriving warm brains of oxygen for an hour or two". I see he's learned well, from his teachers. "Paper mill" degree is how one of his former bosses referred to one of SA's paramedics' PhD.
...that the average RUP can answer?

Under the right conditions, would it be appropriate to place the patient into an icebath, establish an open airway for ventilation with an O2 concentration of choice, apply chest compressions at a rate of choice, and circulate appropriate medications, until the patient reaches a given temperature where surgery will commence? Granted, this will not apply to all cryonics cases.
Last edited by CFHelp on February 12th, 2010, 3:58 am, edited 1 time in total.
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Joined: November 30th, 2005, 4:41 am

February 12th, 2010, 4:18 am #8

I was betting someone would come back with the "almost anything can be deadly, in sufficient quantity" logical fallacy. Mathew needs to take his own advice, and "get back to reality." Comparing water and peach pits, to propofol, isn't realistic. As if that wasn't bad enough, after arguing that "everything that can be consumed or injected" can be deadly, Mathew then stated, "In regards to the med kit, I've been told there is nothing that could be used to kill a patient..." Mathew's post is a little non-sensical, but it also appears he is claiming to have been quoting Dr. St teve Harris, when he (Mathew) put forth that propofol could not be used to kill someone. I hope Dr. Harris didn't really say that, because that would be a very foolish statement, for a physician to make.
The volume of medications in the med kits has a fixed quantity/volume and the information for such is readily available on the Internet. Melody, are you publicly claiming that if I inject all those medications into me at this very moment it will kill me?
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Joined: November 30th, 2005, 4:41 am

February 12th, 2010, 5:43 am #9

Mathew is grossly distorting the truth, I have never recommended "depriving warm brains of oxygen for an hour or two". I see he's learned well, from his teachers. "Paper mill" degree is how one of his former bosses referred to one of SA's paramedics' PhD.
If you want to know what the five words the moderator clipped out of the title of my post, send me a private email.
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Joined: April 30th, 2006, 1:38 am

February 12th, 2010, 12:18 pm #10

Couldn't care less
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