October 6, 2009
The level of training and credentials of personnel performing human cryopreservation procedures has been an important issue in cryonics since its inception. It has always been subject to constraints of geography, logistics, resources, and the relatively small number of people who actually make cryonics arrangements.
Cryonics began with the involvement of morticians in replacing blood with cryoprotectant solutions. In the 1980s a division occurred: the Cryonics Institute (CI) advocated that all phases of cryopreservation be performed by morticians, whereas Trans Time and Alcor/CryoVita used medical professionals or degreed biological researchers to perform surgeries and cryoprotective perfusions.
Laypeople have long had a role in cryonics "field work." Field work is the initial recovery and stabilization of a legally deceased person for shipment to a cryonics facility for cryoprotective perfusion and cooling. It involves placement in an ice bath, administering chest compressions, and administering intravenous medications through an existing IV line or intraosseous infusion kit.
These field stabilization procedures are comparable in difficulty to the types of skills taught to laypeople in advanced first aid courses, first responder training programs, or home management of IV central lines. Alcor trains laypeople who wish to learn cryonics field procedures.
It is present Alcor policy to send trained professionals to perform cryonics field procedures whenever notice of impending death is timely enough to permit it. Alcor employs a staff paramedic for this purpose. When there is not sufficient time, local laypeople with training in field stabilization skills are sometimes the only available response resource. With only a few cryonics cases scattered across the county every year, having cryonics-trained medical professions always nearby to perform field stabilization is impossible.
There are certain procedures that Alcor presently restricts to professionals. These are procedures that involve surgery or blood replacement (perfusion), especially cryoprotective perfusion. Surgery is performed by personnel with experience in either human surgery or animal research surgery, and perfusion is performed by trained medical professionals (including clinical perfusionists) or scientists with laboratory perfusion experience. Sometimes morticians may be used to access blood vessels for field blood replacement. Alcor does not utilize people without appropriate training to perform invasive procedures. Personnel available to Alcor include a retired neurosurgeon.
The procedures used by Alcor have been developed by professional scientists and physicians who are cryonics experts. The procedures are implemented under their oversight. Perhaps someday cryonics will become popular enough to support having cryonics-trained medical professionals wherever and whenever they may be needed. In the meantime, personnel with various levels of training and expertise depending on their role are used to perform procedures as described above.