@FromGermany:
Perhaps I had retrieved the wrong study, there is no mention of the flow rate formula you have cited. In fact, the entire study is about denitrogenation with anesthetic systems, and not about cbt. I would appreciate it if you would highlight the reference for our benefit.
Additionally, you had mentioned a Dignitas disaster. Please be more specific as to what you are referring to.
I have nothing against increasing the flow rate to 20lpm but the 15lpm has proven sufficient. Thank you.
Best, G
The study I have mentioned, was discussed on Journal of Medical Ethics, March 2010 - Assisted suicide by oxygen deprivation with helium at a Swiss right-to-die organisation - , I quote the direct reference to the study "To completely replace expired air, and thus insure the highest possible concentration of helium, the flow rate of added gas (helium), has been determined to be a volume of at least two and one half times the subject's minute volume. This would be true with either the bag and mask as used by Dignitas, or with the use of a large hood."
Dignitas due to ethically reasons used masks instead of exit bags. Because it's not permitted for them to put a finger on their clients during CTB, there have been some O2 problems and so one person died only after probably more than 40 minutes, because they had to put a new tape into the recorder. So long it lasted.
In this Medical Ethics report every single incident, every minute of all clients are described, what really happened, based on the video recordings.
It doesn't matter, if there is an exit bag or a mask or a hood, the flow rate is the most critical point, and PPH made their own 15 Liter "Study" because it has fit well with Nitschkes regulator, he wants to sell.
One example, how PPH is deceiving the readers on this matter. In the August version there is a test with the 3M Helmet. I have told many times here on the forum after investigating this helmet, that it probably would not work after people start to breath, because the cotton is not airtight. Their test is only a gas filling test.
They came to the result, that 25 L/Minute is good. What they don't tell you, that they high likely made also tests with 15 Liter and 20 Liter and that they failed. If a test with 15 Liter would be fine with 3M, they would have published it. It's not only important, what people or organisations show and tell you. It's important, what they don't show or tell you.
All that organisations never reported about failures. It's almost impossible, that there are no failures by chance. In my fantasie there is place for a situation, where a 70+ CTB client without video recording had a failure with brain damage, they removed the set and put her into the care home and so she was forgotten for the rest of her life and no one ever talks about that. No failure. Everything is fine. Again, it's important, what they don't show or tell you.
A fantastic post about gases, better than most books, but the author himself did not die of gas, he went to Pegasos.
If I had the choice, I would also prefer Peagsos, but it's the old story of guides. I have now read so many so called guides, with the exception of the SN guide, because I am no expert on that and can not make a judgement, the guides of CO, Scuba and EEBD are not working and most likely the authors never had the intention to use that for themselves, what they are writing. For me this is exactly the point.
From Ger
I agree it's better to potentially overdo and be safe than sorry. I think purchasing a 40 Sq. ft. tank is better. What happened at the Dignitas disaster that you mentioned?
Case 4 (Female)
The member exhaled prior to placing the mask in the working position and after 30 seconds she appeared conscious.
At 33 seconds she nodded "yes" to an attendant's query whether she was breathing. Immediately afterwards the member's eyelids blinked rapidly. It is estimated that consciousness was lost 55 seconds after the mask was put in place.
At 1:11 her eyeballs rolled, and there were tremors in both hands. The tremors continued to 2:06 and then the body appeared relaxed.
At 2:09 the breathing rate quickened for about 6 seconds.
At 3:03 there was a slow extension and contraction of both arms, which then relaxed at the member's sides at 3:26.
At 3:58 breathing began to accelerate, pausing occasionally, and then accelerating again.
From 5:36 to 10:12 there was intermittent moaning. During this same period the eyelids were open and the eyeballs were moving, but without appearance of control.
Between 10:13 to 38:16, intermittent patterns of accelerated breathing, relaxed breathing, and moaning continued. During this period a number of movements occurred: at 26:03 the head tilted back; at 30:41 the shoulders shrugged and left arm contracted; at 34:55 the left shoulder shrugged; at 37:06 both arms contracted for 10 seconds after which the member appeared quite inert.
At 38:16 the camera was turned off, to replace the video tape. The time elapsed for this is not known. The duration of the second tape is 26:57.
At 0:49 of part 2 the member let out a deep gasp and the head tilted back to 0:57.
At 1:31 the tongue extended slightly and withdrew. This tongue movement continued at 15 – 20 second intervals until 3:45, after which no further signs of life were apparent. The camera continued to run from 3:45 to 26:57, but the member appeared dead.
The recorded time from the start of the procedure to cessation of all signs of life was approximate 42 minutes. The actual time from start to finish is not known due to the change of 15 video tape. The changes in breathing patterns, moaning, and longer dying time appeared to concern and confuse the Dignitas attendants.
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This will happen, if there is a O2 problem and/or a flow problem. No death within a few minutes as it is suggested so often. How do PPH talks about convulsions in their PPeH? Do they at all? Is there anybody from Exit who talks in public about those things? If one does not fix his upper body and partially fix the arms, not only SI can be the enemy, also convulsions and what will happen then to the bag or mask or hood.
