Google Lat Long: Making Google Maps more comprehensive with biggest Street View update ever

Google Lat Long: Making Google Maps more comprehensive with biggest Street View update ever

The helium method

The helium method became widely used few years ago and is now in use by reputable organisations like Dignitas. It is based on the fact that breathing inert gas like helium does not produce any feeling of suffocation but depletes the body of oxygen, leading to loss of consciousness and death. Compared to other methods: All parts (helium tank, plastic tubing etc) can be legally bought and possessed. Can be done at home,in one's own convenience. Does not put others at risk. Complete setup requires significant amount of handwork. Some people find having plastic bags over their heads disgusting. One must be very accurate in technically applying the method in order to succeed. [edit] How is inert gas asphyxia different from smothering? Often, people confuse inert gas asphyxia with smothering (which is not peaceful at all). Feeling of suffocation: not enough air or too much CO2? Everyone knows the unpleasant sensation when holding a breath for a long time. However, this sensation is not caused by lack of oxygen; the main factor is build-up of CO2 in blood. Even if our body constantly needs oxygen, it (surprisingly) does not have a mechanism to measure oxygen levels; instead, it relies on CO2 reflex to avoid asphyxia. Under normal conditions, this reflex works reliably to protect us from high CO2 levels and from lack of oxygen at the same time: our body constantly produces CO2, so if we are unable to breath or are in area with not enough ventilation, CO2 levels rise causing unpleasant sensation. This is the sensation that forces you to grasp for air when diving in a swimming pool. There is one special situation though: when we are able to freely breathe and exhale CO2, but there is no or not enough oxygen in the mix we inhale. Our body is not built to handle this situation well. When does this situation happen ?: breathing at a high altitude, where air pressure is low. One exhales CO2 freely but the body does not recieve enough oxygen. Because CO2 can be exhaled, CO2 reflex is not triggered, there is no suffocation feeling; often, consciousness is lost without any advance warning. Pilots are likely to face this situation in case of aircraft depressurization. Lack of warning before unconsciousness is so dangerous that US Air Force trains crews to recognize signs of approaching hypoxia.[1] breathing a gas mix with low oxygen. In the next chapter, we focus on this case. [edit] Helium and other inert gases: free breathing, no oxygen Many gases that are more or less nontoxic can cause asphyxia by replacing oxygen from the breathing mixture. as a result, they are dangerous in enclosed areas, but not otherwise. People start showing signs of asphyxia when the concentration of these gases is around 30 percent; severe symptoms at around 50 percent; death at around 75 percent. Argon, helium, and nitrogen - are your best bets in this category. They are all tasteless, odorless, nonirritating, and under these conditions, chemically and physiologically inert. In fact, nitrogen comprises about 78 percent of the air we breathe. Since these inert gases are not poisonous and your lungs have something to inhale, such asphyxia will be minimally traumatic. That is, they will not cause feelings of suffocation (which are due to carbon dioxide buildup, not the lack of oxygen) or haemorrhages (caused by high blood pressure from blocked jugular vein or struggling to breathe against a closed airway). Most medical use of inert gases is for animal euthanasia; however there have been human fatalities from them, too. For example, airline face masks were mistakenly hooked up to inert gas cylinders instead of to oxygen at least ten times during the 1980s in the United States. The fact that these people died without attracting attention is consistent with no traumatic death. Data and differences between the inert gases (pros and cons) Helium (He) - The density of is 0.14 of the weight of the air we breath, which says it is just about 1/7 of the weight of the air we breath. That's why helium rises. Advantages: quite easy to get [will be discussed later], have been supported by most euthanasia books, and have many case reports to show success. Disadvantages: There were cases of failing the method [which we will discuss later]. Though most failures were due to crucial mistakes, yet it needed to take it into account. Another point = 96 the weight of helium and its inclination to rise, makes it crucial to plan your posture and position well when using it. Nitrogen (N2) - a colourless, odourless and tasteless gas that makes up 78.09% (by volume) of the air we breathe. The weight of nitrogen is 0.97 of the weight of the air we breathe, which says it is just slightly lighter than air. Advantages: since nitrogen is 78% of the air we breathe, breathing this gas should be almost similar to breathing air, in terms of sense. Moreover, its weight being almost similar to the air, dispense of the need to address the possibility of this gas sinking down or rising up when we are unconscious. Disadvantages: Poor documented case reports. While this fact by itself does not say it will not be efficient, however, having case reports available may increase our sense of certainty. Argon (Ar) - its specific weight is 1.39 times of the air's weight. Advantages: the gas is way heavier than the air so it sinks to the bottom of the chamber you use, so lying down when performing your attempt is a possibility. Disadvantages: poor case reports about it. the same statement about nitrogen is valid here too, that is, it says nothing about the method reliability. [edit] Where can you get inert gases? Argon is commonly used for inert gas electric welding and helium for balloons. Nitrogen has a variety of uses and may be purchased either as a gas or as a cold (-196 degrees C or -321 degrees F) liquid. All of these are available from industrial gas suppliers. Helium can also be found at party-supply stores. Argon and nitrogen can be found at welding suppliers, or Heating, Ventilating, and Air Conditioning (HVAC) suppliers. None of these gases are dangerous unless they displace oxygen from the breathing mixture. [edit] How to generally use it (specific instructions are given later on) Probably the easiest way to use inert gases for suicide is to enter a tube tent with a gas cylinder, flush the tent with any of the three gases, and seal the ends of the tube. The volume of a tent is such that you won't produce enough carbon dioxide to stimulate breathing reflexes before dying. Since there's little or no residual oxygen in the breathing mixture, minimal amounts of carbon dioxide ought to be exhaled, suggesting that a large inert gas-filled plastic bag over the head should work as well as the tube tent. [edit] The exit bag Another variation of helium method uses an "exit bag", a plastic bag with attached hose. You can either order ready exit bag by post, or make your own one. There is a video demonstrating how to make an exit bag, available by purchasing the e-version of The Peaceful Pill Handbook. Use of exit bag (from Final Exit by Derek Humphry): Important note: in this image, the angle in which the person lies is not the recommended one by most known books (Dr. Nitschke, Dr. Admiraal). You would need to lie half sitting half lying. [edit] Risk of brain damage if rescued The main hazard of this (and all) asphyxia is the possibility of brain damage if the process is interrupted due to intervention, running out of gas, or tearing or removing the gas mask, plastic bag, or tube tent while unconscious. Using a high concentration can minimize this of the anoxic gas, which causes most rapid loss of consciousness. These gases are not a danger to others in anything but a small, sealed space; however it's important that a gas cylinder not be mislabelled, lest it imperil subsequent users. [edit] Experiment with animals In experiments, animals (dogs, cats, rabbits, mink, chickens) show little or no evidence of distress from inert gas asphyxia, become unconscious after one to two minutes, and die after about three to five minutes. Thus, use of any of these three gases, combined with a plastic bag, should be less traumatic than plastic bag asphyxia alone, since there will be little discomfort from carbon dioxide buildup and unconsciousness will be swift. [edit] Helium The following chapter is dealing mainly with helium due to extensive available track record with this inert gas; however, following this chapter, there is a section which makes adjustments regarding other inert gases. [edit] Cause of death Inhalation of 100% pure helium (which is not mixed with oxygen) causes rapid death due to oxygen deprivation (since the helium displace the oxygen).when breathing pure helium inside a plastic bag, unconsciousness follows after about 5 breaths. In 62 cases where "time to unconsciousness" was reported, the average was 35 seconds (range 10-120 seconds). Death will often follow in about 10 minutes, sometimes as quickly as 5 minutes. Elapsed "time to death" was reported in 108 cases. The average was 13 minutes (range was 2 to 40 minutes). [edit] Advantages of using an inert gas While breathing pure helium there is no feeling of suffocation or choking. This is because the breathing of helium permits the lungs to continue exhaling carbon dioxide (see remark 1).the brain never receives any warning signal of suffocation when breathing helium (or any other inert gas).[The Article: "analytical investigation in a death case by suffocation in an Argon atmosphere", in the magazine: Forensic science International. 2004]. Death by inhalation of Inert gas is not detectable through any known toxicity test. Only a witness or materials left in the scene can confirm helium inhalation as a cause of death. That's because helium rapidly dissipates into the surrounding air and does not remain in the body tissues or blood cells. THE METHOD Equipment At least one organization sells a helium suicide kit. Tanks of helium can be purchased from toy stores. [edit] Lethal dose According to the book Guide to a Humane Self-Chosen Death written by Dr. Pieter Admiraal and a committee of medical professionals, nearly in all 119 reported cases used non-refillable party balloon kits. A small tank [4.5 cu ft] is sufficient to bring about death if breathed in a plastic bag. To be sure, I would go for 8.9 cu ft [the following size].the assumptions are that the tank is new and full, and that there are no leaks in the bag. [edit] Sleeping pill The book Final exit recommended taking few Valiums to contract convulsions and so; however, Dr. Admiraal from the Dutch euthanasia group says in his book that: "to be sure that one does not make any errors in the procedure, pills are not recommended". I tend to agree here with the Dutch booklet, since, falling into any sleep, may indeed cause you to act out of shallow or deep sleep, while you may take off the bag or miss some details. Case Reports regarding sleeping pills with helium in 31 reported cases, the patient took no meds at all. no complications were reported and time to death was not influenced. The needed items: Helium tank.8.9 cu ft or more Oven roasting bag (19x24 Inch =45x60cm) Soft plastic hose/tubing 3 meters. The tubing must fit snugly over the tank nozzle. For most party balloon kits it requires tubing with an inner diameter of 3/8 or 5/16 inch A rubber band such as of tennis players [edit] How to adjust the hose to the tank and "make the set" 1. Take off the plastic nozzle of the tank. (Use any pillar for this) (You can also do it carefully with a carpet knife if you have trouble finding out what a pillar is) 2. Put the edge of the plastic pipe in warm water for some minutes to make it softer. 3. Connect the hose to the tank and make sure it is very well adjusted. use a half inch hose clamp (you can get it in hardware stores) and adjust it with a screwdriver. If you're using a "Y"-tube for two tanks, remember to take the tube through the clamp before fitting the tube to the tank (if the clamp can't be opened). 4. Check the bag for holes or leaks. If you blow it with air you would be able to check in case it leaks. [edit] What if you buy the tank from other sources? If you buy directly form a helium supplier, you should buy a regulator from them as well in order to control the gas flow. Never buy other than a new tank of helium, since you can never know otherwise if the tank is full. It is advisable by the Dutch euthanasia group to practice the procedure without helium so that you make sure you know exactly how to do it. Note that testing is problematic; if you get one of the consumer helium tanks, you will most likely have a nozzle that won't shut completely, so if you perform a test of helium output with such a tank, you might eventually lose all of the helium before your actual exit date. However, a helium tank from a commercial helium supplier should not have this problem. [edit] The stepwise guide 1. The position: you have to sit or lean, such that your body is vertical, since the helium tends to rise. 2. Open the valve and close it immediately. that's for the first opening of the tank. 3. Place the bag on your head such that the margins of the bag cover only the ears and your forehead. 4. Now, the most important thing is to get the air out of the bag. If you have air there, you won't lose consciousness quickly. Most literature recommends doing it by squeezing the bag with both hands on your head to deplete the air. However, I suggest that this way there is a good option that air would be present. Alternatively, you can simply put the bag on a flat surface, roll it back and forth to get all the air out and then you may close it tight, while leaving long enough margins (after the place where you close the bag with your hand tight), for placing the bag with the band,back on your forehead and ears. By doing so, you are more likely to get rid of all the air. 5. Now, open the valve and let the bag inflate with helium. You should now be prepared to pull the margins of the bag with the band over your head. The rubber should not be too tight since you need to leave some room for the CO2 you exhale, to get out of the bag through the bottom. 6. Now,VERY IMPORTANT: the Dutch group recommend here, to exhale all the air in your lungs BEFORE pulling the bag over you head. There is logic here, since you need to get rid of all CO2 in your lungs. So you need now to make a big exhale, then hold your breath, pull the inflated bag over your head with the band, and now, you should take a very deep breath(of the Helium in this inflated bag), when inside the bag. 7. Continue to breathe normally, unconsciousness should follow quite quickly. [edit] Statistics and case reports According to Pieter Admiraal's book, in 119 reported successful cases using helium and a plastic bag: Nearly all cases used a non-refillable balloon kit, although, it is less reliable than any industrial size tank. In 62 cases where "time to unconsciousness" was measured and reported by an eyewitness, the average was 35 seconds [10-120 range] in cases where it took longer than average, it was reported that there were difficulties with gas flow, Leaking tube/nozzle connections, or improper seal between the neck and the bag. That's why a good preparation is needed, says the Dutch group. [edit]If using a T-connector instead of a flow regulator If using a T-shaped connector to join the flow of two disposable helium tanks, make sure to use one made of PLASTIC or VINYL. A T-connector is often sold as a "hose barb" or a "garden hose tee". The right size (if using tubing of 1/2" OD and 1/8" ID) is 1/8" OD so the tubing will fit OVER the T-connector perfectly. T-connectors look something like this: http://i.imgur.com/piqQo.jpg. Often sold in the PVC isle of a hardware store. [edit]Time of death info Time to death was reported in 108 cases --- the average was 13 minutes [range 2-40 minutes]. Muscle contractions were reported in half the case reports. it happened between 2 to 8 minutes into the procedure. Arms and legs will tighten and relax few times for about 10seconds to 2 minutes duration. It is not should be interpreted as an attempt to remove the bag. Those contractions are common in anesthesia in surgery settings. Witnesses of several cases with helium said that they have never seen a case in which the hands reached the plastic bag. Patient is unconscious in this stage. Deep gasps are common in the unconscious stage. In 31 cases in which no meds were in used it was found that there is no correlation between meds and contractions. In 11 cases contraction have been present while in 7 non were present. [edit] Reports of failures:analysis of the causes,and insights of how to avoid it [edit] Report on failure - #1 Source: this ASM thread "Speaking from experience, I can say that helium is not as comfortable as it sounds. Breathing it was not a problem. However, moments after beginning, my whole body started feeling all tingly (like a foot that has fallen asleep or something). After that, body started having uncontrollable convulsions. Finally reached up and removed the plastic bag. I was a bright shade of pink for a while after the experience, which I found out later, was a symptom of oxygen deprivation. Was no pain, just a very uncomfortable feeling " Explanations: What might have happened? The man describes what he has done: "What I had done, was place the bag over my whole head/face, ran the hoses up into it, pulled the rubber band down around my neck, and held the rubber bands away from my neck to continue breathing air until I was ready." Mistakes done: That means he had a good breath of air in his lungs when went went in (as he DID NOT exhale first as he should, in order to deplete the lungs from CO2). Moreover -- there was probably quite a bit of oxygen in the bag as well, since the man did not emptied the bag BEFORE streaming helium in. General inferences, following that case: The main goal when using an inert gas, is to have a sudden and intense exposure to the gas. You need to make the best you can to make sure that no oxygen or carbon dioxide is in there to contaminate the helium, with your first few intakes of breath you will be inhaling nearly-pure helium. This is what is required for a quick loss of consciousness. if you proceed by piping helium into a bag (or tent) which currently contains air, that would be quite disastrous -- for a long time there would be enough oxygen to support consciousness, and that consciousness would become very unpleasant before it vanished. [edit] Report of a failure - #2 Quote: "I really tried the helium method as described in the Dutch booklet, and really wanted to go. Before dragging the bag on my head I was even excited and happy that finally all my misery and illness will be history. So with the full of helium bag on my head I started to breathe normally waiting to lose consciousness in 2-5 breaths. Instead of that, after some 15 deep breaths of helium all I felt was pain in my chest, my heart pounding like hell and a HUGE panic. It was everything but pleasant or peaceful. So, I couldn't resist that overwhelming feelings and took the thing of. It took some 10 min. to get back completely. I felt dizzy and had a light headache. I was hoping I didn't damage my brain. What I want to emphasize for you is that this method is not so peaceful as I would have thought." Explanations: What might have happened? I knew of one other person who did not lose consciousness quickly and who felt significant panic (enough to make her stop). In her case I think it may have been because the helium was contaminated with oxygen-containing room air. She wanted to use 3 tanks, to be sure that the helium would not run out too soon, but she joined the various tubing pieces with T- connectors intended for use with copper plumbing pipe. These connectors went on the outside of the tubing rather than on the inside (she had not managed to find the kind that goes inside the tubing, and the hardware- store person told her that the plumbing connectors would be just as good). She put lots of tape over each place where a connector lay over the tubing, but she used electrical tape, which does not have a high degree of stickiness (not as high as duct tape, for instance). There were quite a few of these possibly-leaky connections, and I think that perhaps wherever the helium flowed past a connection it entrained (pulled in) some room air. Also, this above person may have skipped thoroughly forcing all room air out of the bag before filling it with helium, and thoroughly evacuate the lungs by doing a big "Whoof!" immediately before pulling the bag down. If the first thing is not done, there can be quite a bit of oxygen in the bag, and if the second thing is not done, there can be quite a bit of carbon dioxide; breathing carbon dioxide causes panic. However, panic can accompany rapid loss of consciousness even in the (relative) absence of carbon dioxide (I felt it when I passed out from ether, though only for a couple of seconds). [edit] Report of a failure - #3 Source: | this message 11-8-2006 "I recently tried the helium + plastic bag, and I failed. I bought a 20 l helium tank and some big plastic trash bags. The first problem I experienced was that the tank was huge. And I didn't have any tube to connect it to the bag. So I tried a few methods. I first tried lying in bed (slightly upwards so that the helium would concentrate at the top) and had the top part of the tank inside the bag along with my upper body. I closed the bottom part of the bag pretty well to prevent leakage. I had the helium tank running for a little while and my head started to get dizzy, but quickly panic stepped in. I tried to wait it out, but in the end I just couldn't. Anyway, I thought maybe the bag was too contaminated with oxygen, and that's why I kept getting the panic attacks (quick heartbeat etc). So I tried to fill the bag with helium before I actually put it over my head. Then I put it over my head ... same result, although, it lasted longer in that attempt, probably because there was less helium in the bag. I tried a few different postures with the bag over my head and the tank inside, but nothing seemed to work. At the end I was feeling very dizzy, but I just couldn't go through with it. Could anyone give me some advice? I thought this method was supposed to be foolproof and painless, but it just wasn't for me. I felt the same way that I feel when I put a plastic bag over my head and no helium, the panic and increased heart rate steps in pretty quick." Explanations: What might have happened? When somebody does not lose conscious shortly, it is due to excess of oxygen in the bag. It usually happen when the bag is not previously completely depleted out of all the air. That should be done before any helium is blown into the bag. Residual oxygen will make you experience the side effects. Now, as to the panic itself, I would attribute it to a CO2 build up. One should not complexly close the marginal of the bag, and only use a slightly tightened band, to let the CO2 escape form the bottom. During the first attempt, this guy got into a kind of a "tent". This imposes a problem since you have large amount of oxygen there, and you need to either deplete it first, or to create a very strong and steady stream for that. [edit] Report of a failure - #4 Source: An ASM message in this thread Oct. 2004 "I tried this recently. I panicked while nearly passed out and took the bag off, although I only vaguely remember doing it. I used a tank with 15 cubic feet of helium. In the U.S. (at least here in California) you can get these at Party stores. So be sure you take something to relax you or make you sleepy, and be sure that the helium is turned up high enough to keep the bag from getting warm and moist and hitting your face, which is what caused my state of panic. You will start breathing heavily as your body starves for oxygen. I suspect if I'd been in there another 15 seconds I would not have been able to undo it." Explanations: What might have happened? 14.9 cu ft of helium should be well sufficient for succeeding. While Final Exit recommends 1-2 tanks of 9 cu. feet, it was proven that even 4.9 cu ft should be enough. moreover, the Dutch euthanasia group, recommended, following more than 120 case reports, to avoid using more than one tank, since there is a great chance that the connectors would create a leak, if you use more than one tank. It is indeed recommended to make sure the regulator of the tank is at least turned to a one third [full guide is given] to allow sufficient flow of helium. However, using sedatives is not recommended in this method as it may increase the chances to fail, as you are likely to miss some of the accurate instructions if so. The moist and heat in the bag should be prevented once you open the valve sufficiently as instructed. [edit] Report of a failure - #5 July 2007, a report of M.D. : "In the one case of which I have knowledge, there were many difficulties. The size of the tube that was given did not fit the fixture and, at the last moment, had to be reamed out with a makeshift tool. The valve was very hard to open and knuckles were slashed on the sharp handle of the tank as the struggle to open it ensued. "The patient appeared to fall asleep readily and in seconds, but after about a minute eyes opened and the patient sat up slightly and breathed shallowly and extremely rapidly (over 200/minute) for ten to fifteen seconds. This occurred three times. After that, both upper and lower extremities flailed about for fifteen seconds or so. Then, after a few minutes pause, this happened again. Then once again, the movements did not conform to any pattern. The eyes were partially open and it could not be determined if there was any consciousness. "The whole process took about fifteen minutes and was horrifying to the onlooker. The person who had given the verbal instructions for the procedure thought it might be due to the fact that the patient was, due to chronic respiratory difficulty, unable to take a deep breath and exhale at the right moment, but subsequent discussions with anesthesiologists cast great doubt on this notion as total anoxia must have occurred long before much of the seizure like behavior even if not quite as quickly as with a good exhalation. Also, the question was raised if the pacemaker- defibrillator had produced some of the effects, but discussions with cardiologists tended to rule that out as the amount of current was deemed to be too low to produce seizure. Apparently, from some of the current mailings, the helium Method is not the ideal exit that it's touted to be. Norman J Ackerman, M.D." Explanations: What might have happened? The first part can easily be dismissed as not ensuring everything would go off without a hitch, but the actual account of it seems disturbing. I know, I shouldn't be surprised it's not a party, but still. I might be wrong, but this seems to lead to only one conclusion, that oxygen was leaping in from somewhere. That seizures during the process are likely to occur seems to be inevitable, the question is, is the person aware of them or in any pain, when it happens (patient should be unconscious in that point)? If a mask has been used it tends to be less effective in this method. The origin of the helium is another factor which may be missing. [edit] Report of a failure - #6 Source: | ASM message "I failed with helium today. I never passed out; I just got light headed and experienced tingling and numbness in my hands/arms. What I used: 99% Pure helium 14.9 cubic feet tank > tube > plastic bag 2ft x 7 ft non- rebreathable medical mask > tube ----------^ "I should have had enough helium pumping into that bag to do the job but I am still here and I never passed out so something went wrong. My best guess is either (despite the amount of tape I used) there was a leak somewhere on the bag (does helium escape particularly easily?), or the mask wasn't doing its job properly and letting air in. Can anyone help me out with ideas of how to make this work? I have thought about a small tent but after this failed attempt I have a feeling the helium would escape extremely easily. I can't just do it straight from the tank to a mask because there isn't enough helium, I need to contain the helium in something and make sure I waste as little of it as possible. A regular plastic bag over my head wouldn't hold enough either." Explanations: What might have happened? Indeed, helium "escapes" quite quickly in any open space or such as not sealed well enough. Thus any possible leak, either in the tube or in any mask or so, may be a reason for such a failure. In addition, again, the man has not lost conscious, probably due to remnants of oxygen penetrating to the mask. That's why I would say a closed chamber would be better. [for this term, a plastic bag would be considered as a chamber of course] Suggestion: I've heard people purchased the party balloon tanks only to find out when they got them home that the package had already been opened, and when used, found it to be empty. The problem here maybe returned tanks going back on the shelves. So check the package to see its been opened before, make sure its in a sealed box! You could also do a one balloon test. Tell the store you are purchasing it but want to make sure its not leaking, with permission open the valve, blow up one baloon.. if it fills quickly its working the way it should, tanks with leaks would fill a balloon slowly. Tighten the valve very tight once you are through. Calculations An average person will breathe in and out about 12 to 20 times a minute [2]. People who are tall and/or overweight will breathe more than someone who is short and/or thin (based on Body Surface Area, BSA). Each inhalation brings in about 500 ml of air, corresponding to 6 to 10 litres of air per minute, together with any contaminants that the air contains. Please note that people who smoke, and/or have pulmonary sickness will breathe almost 2-3 times more air than an average person[3]. In an average person, the respiratory rate in cubic feet per minute is (worst-case): For a helium tank containing 14.9 cubic feet of helium, the tank should last: For someone with asthma, or heart disease: Making the 14.8 cu ft helium tank last: [edit] Which purity of helium is needed? Q: How important is the purity of the helium, and what's acceptable? A: In general terms, balloon-grade helium is sufficient to cause death if it is the only gas an individual is breathing. Any gas that contains no oxygen will kill you if it's all you're breathing, but some gasses trigger unpleasant responses What is the concern about CO2 in this method? While it's true that any gas mixture without oxygen will black you out pretty quick, I need to add a minor correction about CO2: At concentrations > 30%, CO2 will drop you with little or no warning, even with 'normal' levels of oxygen. At higher concentrations, CO2 acts like an anesthetic and then kills rapidly. The 'unpleasant' effects all come from lower concentrations of CO2. CO2 kills unwary people all the time, including people who deliver it for soft drink fountains, people who hang out in low places near volcanic activity, people who work with agricultural waste, people who work in grain silos, people in coal mines, and people unfortunate enough to be near places like Lake Nyos when it gassed over. In most such cases, they were 'fine' one moment, and unconscious the next. http://www.emedmag.com/html/pre/tox/0500.asp http://www.snopes.com/horrors/freakish/smother.asp [edit] But if the helium runs out wouldn't I suffocate? A: In a sealed-in area, yes you would, eventually. But you'd be more likely to suffocate from CO2 instead of helium, and CO2 suffocation - at least at a slower rates of air infusion - can be very unpleasant. The body's evolved some rather nasty responses to CO2 poisoning because it's a kind of poisoning virtually all oxygen-breathing mammals are prone to - choking, suffocation, etc.... The body has learned when CO2 levels increase, it needs to do whatever it can to make you breathe harder or clear your breathing passages, and so you convulse and cramp in all sorts of nasty, painful ways, Unless of course you can get just about immediately into a very high- concentration of CO2 quickly, where it can drop you pretty fast. But bags over the head relying on CO2 to do the job don't tend to work that well. The body has learned no such response to helium, and while in the early stages of helium, the body can still release CO2 for a time. More so than to acquire oxygen, the primary functions of breathing is to release CO2 from the body. It's the pressure to release CO2 that causes that "I thought my chest was going to explode" feeling in near-drowning victims. Acquiring oxygen is a secondary function of breathing - just as vital, but as strange as it may sound, you can survive longer without oxygen coming into your body than you can without being able to release CO2 (which you can't do if CO2 is what you're breathing - at best, you're shuffling individual CO2 molecules around, and the body doesn't know the difference between one that's already been through and one that's just arriving). Both functions are vital, of course, and we'd die in fairly short-order without the ability to do either one. But CO2 poisoning is the more critical issue to the body, which is why the body reacts to CO2 gas but not to certain other kinds of gas. Other inert, non-irritating gasses allow the continued release of CO2 for a time, which keeps the body off- guard for awhile. With those types of gasses, it's too late for the body to react by the time it realizes it's not receiving any more oxygen. [edit] Q: How is removing CO2 going to kill you? A: If you mean tanks that aren't filled O2, but rather nitrous oxide or helium, then there's no need for scrubbing out CO2. Helium doesn't become CHe when inhaled, it stays helium. Same with nitrous oxide. Your body doesn't convert the gas at all. The same breath of helium can be used over and over until you're dead. >> How to overcome some problems with the hose and >> connecting it to the tank? As far as how to hook >> the hoses etc., that was the most pleasant of the >> whole deal. Since I got my tanks (got 2 just to >> make darn sure) at a party store, they came with a >> regulator and a rubber fitting designed for >> inflating balloons. I took the regulator to the >> local Home Depot and explained that I was doing a >> science project with my kid and that we needed to >> fill several large trash bags with the gas and that >> the rubber valve just wouldn't be practical for that >> purpose. I got the best service I had ever received >> at Home Depot that day!!! The employee walked me >> over to where he had fittings that would screw into >> the regulator to replace the rubber valve with, >> which were designed for a hose to go onto. He then >> walked me over and made recommendations as to which >> fastener would be best for holding the hose onto the >> fitting. He then walked me over to where they had a >> nice selection of hoses that would fit onto the >> fitting he had gotten for me. And finally, he >> walked me over to the plumbing area to get some >> thread sealer so that there would be no leaks. He >> even reminded me before I left to be sure and do the >> experiment in a ventilated area so that no one would >> get hurt by inhaling too much. Ha. I can't say it >> enough that was the best service I had ever gotten >> in a Home Depot. Q: What final exit says and what's missing there? A: The book (I sprung for it finally after failing) suggests running a tube from the helium tank to a plastic bag which is positioned on top of your head with a rubber band or such around your forehead to hold the bag in place. Let the bag fill with helium, EXHALE, and then pull the bag down over your face positioning the rubber band around your neck to hold it in place. [edit] Q: Some issues which may arise when buying the balloon kit tank? A: The gas tanks that are supplied for filling balloons have an unusual outlet. It consists of a spring-loaded nozzle, which when bent, opens a valve to allow the gas out. Filling the balloon in a matter of seconds. When the nozzle is released, the spring forces the nozzle back to the horizontal position and the metal plunger slides back against a stop, cutting off the gas flow. There is a master valve on the top of the cylinder too, but it doesn't allow for much flow regulation. In that case we recommend on getting a proper gas regulator valve, to replace the one on the cylinder. This is one of the reasons I prefer obtaining a proper helium gas directly from the helium supplier (all gas agencies would sell it to you).if they ask you why do you need it, you can obviously say you are starting maybe a party line, and you'd like to first buy a small tank [14.9 cu ft or so]to test is in a private party, "to see how it goes". Most suppliers will offer the regulator immediately, thus preventing the extra hassle of taking care of it. [edit] Q: what is most important to take care of before pulling the bag over the head? A: It is important to make sure there's no air in the bag or in your lungs before starting. having air in the bag would interfere with losing conscious while having air in your lungs would cause panic attack due to CO2 build up.

SHORT EXCERPT FROM "The Peaceful Pill Handbook" Dr Philip Nitschke & Dr Fiona Stewart From chapter HYPOXIC DEATH AND THE EXIT BAG This is why it is important not to confuse the peaceful hypoxic deat h that is possible when an Exit bag is used properly, and the grim deat h that results from an obstruction to the airways. And this is why the media are so remiss when they reinforce this confusion. For example, when referring in 2001 to the importat ion of Canadian Exit bags The Australian newspaper reported these bag s as 'reminiscent of the Khmer Rouge's shopping bag executions in Cambodia's killing fields.' Su ch misinformation shows a significant lack of understanding of the process, and such reports have damaged th e image of the Exit Bag. Hypoxia is the term meaning 'low oxygen', and a death that results from inhaling insufficient oxygen is a hypoxic death.. While there are several ways this might occur, the common method used by those seeking a peacef ul death is to place a plastic bag over one's head. To understand why a plastic bag, low oxygen death is an easy and reliable way to die, a basic understanding of human physiology is helpful. In normal everyday life, we live in an atmosphere that is 21% oxygen. Interestingly, when there is a decline in the level of oxygen in the air we are br eathing, we do not experience any particular alarm or concern. As long as one can breathe easily, the sensation one experiences as the oxygen le vel drops is one of disorientation, confusion, lack of coordination and eventual lo ss of consciousness. This experience is sometimes likened to being drunk (alcohol intoxication). If the oxygen level falls too far death will result. Accidental hypoxic deaths are not uncommon and th ere are a number of scenarios that can bring them about. One example is the su dden drop in oxygen level that occurs when an aeroplane de pressurises at high altitude. This can lead to a rapid loss of consciousness and the death of all those in the plane. When the plane de pressurizes, one can still breath easily but ther e will be little oxygen in the inhaled air. This will cause a sudden drop in the oxygen level in the blood reaching the brain, leading to loss of consciousness and death. It is not unc ommon for planes t hat have suddenly de pressurized to travel on autopilot until they run out of fuel while everyone aboard has died. Witnesses (from planes sent to investigate) say that it often appears as though everyone on board has just gone to sleep. Pneumonia is a more co mmon cause of a hypoxi c death. Its peaceful reputation led to its common description as the 'old person's friend'. While the air inhaled may co ntain the full 21% of oxygen, the inflammation of the lungs (c aused by the pneumonic infection) makes it impossible for the necessary oxygen to be extracted. The blood reaching the brain will have less oxygen than that required for life, and a peaceful death often results. The Role of Carbon Dioxide (CO2) In normal respiration, the body makes use of oxygen and produces as waste the gas, carbon dioxide. Carbon dioxide is removed from the body as we breath out. While the human body is relatively insensitive to falling levels of oxygen, it is very sensitive to any rise in the level of carbon dioxide in inhaled air. When the body detects a slight increase of carbon di oxide in the air that we breathe, a warning message from the brain alerts the person. They will be roused and may react by gasping.. If a person is using a plastic Exit bag, the rise in the level of carbon dioxide within the bag may result in the person strugglin g to pull the bag from their head. This reaction is known as a Hypercapnic (h igh carbon dioxide) Alarm Response. Sleep Apnoea provides an example of hypercapnic alarm. He re the person with sleep apnea snores so heavily that th ey deny themselves the oxygen they nee d. However, it is not the lowering of the o xygen level that alarms and wakes the person, but the accompanying rise in the level of carbon dioxide. If t he fall in oxygen were not accompanied by this rise in carbon dioxide, the Sleep Apnoeic would be far more likely to die. In the depressurized airc raft, the oxygen level drops but there is no accompanying rise in carbon dioxide, hence a peaceful death is the common outcome. Aesthetic and Other Concerns The image of a bag tied tightly around one's neck causing a grim death by obstructing the airway has turned many away from the plastic Exit Bag. Even at Exit International workshops, it is common for participants to voice their di sgust at the Exit Bag, saying 'I don't like the though t of being found like that.' Lisette Nigot (of the documentary Mademoiselle and the Doctor) rejected this method. Lisette likened the plastic Exit Bag to being 'wrapped like a piece of ham.' For Lisette and others, the main concern was one of aesthetics. Despite such concerns, if used correctly, the Exit Bag provides a simple, reliable and peaceful wa y of ending one's life. A Peaceful Death There are two common me thods employed to deal with th e problem of the rising level of carbon dioxide inside the plastic Exit bag. In the following section, we will describe the experiences of two different people, based on eye witness acco unts. These accounts illustrate the different strategies. The first case involved a 75 year old man called Br ian. Brian was diagnosed with bladder cancer in 1999. In 2001, he used a plastic Exit Bag and an overdose of common, non lethal sleeping pills to die peacefully. The second case involved a 69 year old woman called Jo anna. In 2003, Joanna had a heart attack. She survived, but her heart was irreparably damaged and she found herself suffering from congestive cardiac failure. Joanna chose to die peacefully and unassisted, while she still had th e means to do so, and used a plastic Exit Bag together with a canister of helium gas. Here ar e their stories as told by their neighbour and husband respectively. Brian's Story Brian Appleyard (not his real name) made contact with Exit shortly after being diagnosed with bladder cancer. He lived in a retirement village on the Gold Coast and was a well educated man who had served in the airforce during WWII. When Brian made contact with us, he had already done much reading about the use of Exit Bags to achieve a peaceful death. Brian's wife had died some years before and his adult children had long since left home. He was relieved about this because he said he would never want anyone he cared for finding him with a plas tic bag on his head. Several weeks before he died Brian talked to his clos e fiend and neighbo ur Kevin. The plan was that Kevin would not sit with Brian when he used the bag, bu t would visit later and remove and dispose of the bag after 'the event'. Kevin writes: Following information he had learned at an Exit wo rkshop, Brian began his preparation by crushing up a fu ll prescription of temazepam. Authors' note while Brian used Temaze temazepam, he could successfully have used many others, such as oxaz epam Serapax or nitrazepam Mogadon. These common sleeping pills from the benzodiaz epine class of drug are not considered to be lethal even in overdose and are easily obtained. Brian told me that he had learned that while the sleeping tabl ets were not in themselves lethal, they were necessary to keep hi m asleep and to suppress his body's inevitable reaction to the risi ng level of carbon dioxide inside the bag. He prepared the drugs by crushing the full packet of 25 tablets and stirring the powder into a small glass of water. He then prepared a second small glass of a strong alcohol. Brian chose whiskey and said the alcohol would remove the bitter after taste of the mixture. The alcohol wa s also supposed to increase the potency of the sleeping pills, making them act faster and the whole process more efficient. Once these two drinks were prepared, Brian sat in his favourite recliner chair, the drinks on a table by his side. He was well aware that with the Exit Bag, technique was important. He also knew that he did not want to involve me actively in his plan and so would need to carry out his actions without my assistance. Th e idea was that Brian would take the pills, place the bag on his head and fall sleep. While as leep his body would use up the oxygen in the bag. Sleep would give way to unconsciousness and death would follow. The process was expected to take some ti me (up to 1 or 2 hours). Brian adopted the following technique. 1. Prior to placing the Exit bag on his head, Br ian prepared, but did not take, the sleeping pill mixture. He adjusted the elastic at the neck of the Exit bag he had made so that it was a comfortable fit around the neck (not too tight or loose). 2. Brian then tested the bag by placing it over his head and observed it in a mirror. Breathing in and out, he could see the bag expand and collaps e with each breath. 3. When the time was right, Bria n seated himself comfortably, reclining slightly with shoulders supported. He positioned the bag over his head and stretched the elastic neck band horizontally away from his face using the thumbs of both hands. 4. He placed his thumbs inside the neck open ing of the bag, pulling the bag away from his face. By doing this Brian allowed a large opening for fresh air. 5. While keeping the elastic st retched with one hand, with the other hand he drank his prepared drink of str ong sedative mixed with water. He washed the bitter tasting substance down with his whisky. Brian remained seated with the elastic stretched by both hi s thumbs until sleep came, approximately 15 minutes later. At this point his arms relaxe d and lowered and the elastic neck band slipped from his thumbs. The bag posi tioned itself snugly but not tightly around his neck. As Brian fell into a deeper and deeper sleep the bag expanded and contracted in time with his breathing. Each breath lowered the oxygen conc entration inside the bag from the original 21% , each breath raised the level of carbon dioxide. Brian experienced a p eaceful death once the oxygen leve l within the bag dropped to <5%. The large dose of slee ping tablets kept him asleep t ill that point was reached, and prevented him from being woken by the rising level of carbon dioxide in the bag. The bag was not dislodged. A graph showing the decrease of oxygen and associated increase in carbon dioxide inside a plastic bag during the first 4 minutes is shown below (Fig 5.1) Fig 5.1: Exit bag O2 and CO2 levels for first 4 minutes Point to Note While death from an Exit bag combined wit h sleeping tablets is peaceful and reliable, technique remains very importa nt. A person needs a high degree of co ntrol and the ability to coordinate arm movements. For this reason, the method may not be suitable for people with specific medical conditions. Neurological conditions such as multiple sclerosis or Parkinsons disease are exampl es. If the technique is not followed closely there is the chance that the Exit bag will not be correctly positioned around the neck when sleep ensues. Clearly a witnes s can ensure that this doesn't hap pen but that woul d be assisting a suicide, and the law would be broken. Remember that the process that leads to t he hypoxic death does not commence until the person's arms relax and the bag takes up its position around the neck. While the person is awake their fingers keep the neck elastic stretched allowing plenty of air to circulate. If one doesn't sleep, one will not die.. Joanna's Story (as told by her husband Stephen) Joanna Cataldi (not her real nam e) joined Exit in 2003 after the development of cardiac failure following a heart attack the previous year. Joanna's prognosis was not immediately apparent. The initial heart attack had left her with significant ca rdiac damage but her doctors were unsure of just how much this would effect her life. While pleased to have survived the initial attack, Joanna soon found that her cond ition was deteriorating. She said it was this uncertainty that led her to make contact, firs t with her local VE Society and then with Exit. At the time of joining, Joanna and Stephen were living in their own home in outer Sydney. Stephen writes: Joanna had heard about the possible use of a plastic Exit Bag with helium gas as a quick and reliable way of obtaining a peaceful death. Back then, disposable helium canisters were not available in Australia, although she had read about their availability in the US. In early 2005, these helium canister s started to be marketed in Australia and Joanna set about obtaining the equipment sh e would need. Joanna knew that the presence of helium in an Exit Bag would dramatically speed the process. When the bag is pulled down over one's head and a deep breath taken, she knew that there would be almost no oxygen in that breath. This lack of oxygen in the inhaled gas would ca use her blood oxygen levels to plummet, and she would lose consciousness almost immediately. Joanna knew her death would be very similar to that which occurs when an aircraft rapidly depressurizes. The helium that fills the bag displaces any oxygen and flushes away the exhaled carbon dioxide. One does not need to wait for the oxygen level inside the bag to fall, and there is no associated build up of carbon dioxide. Authors Note With helium in the bag instead of air, one doesn't have to 'breath down' the oxygen in the bag from an initial 21% to < 5%. Helium in the Exit Bag displaces the air (and oxygen). It is important to note that the helium, itself, does not interact with the body. Helium has no taste or smell and quickly dissipates after death. There is no test that can reveal its use. Helium is not the only gas that could be used .. There is nothing particularly special about helium, i ndeed any gas that does not react with the body, is odourless and available in a compressed form would do. Other inert gases that could be used include: argon, neon, even nitr ogen the gas which makes up 80 % of the air we breath. The important thing is the intr oduction into the bag of a flow of an odourless gas that will displace the oxygen and flush away exhaled carbon dioxide. Many compressed gases are only available in high pressure cylinders which are rented from gas supply companies (like BOC Gases). For many years, helium has only been available in this form. These cylinders are available for lease, either short term or for an annual fee. The drawback with accessing helium this way is the paper trail that is generated. There is no anonymity. A second issue of concern is the size of these commercia l cylinders. Commercial helium cylinders are large, heavy and difficult to transport. High pre ssure gas also needs to be controlled with a regulat or in order for a usable stream of gas to be produced. Suspicion might arise if an elderly or very sick person is seen leas ing a cylinder from their local BOC gas outlet. If someone else were to collect the cylinder for them , this other person may well become legally implicated in assisting in a suicide. These concerns turned many people away from using high pressure co mpressed inert gas with an Exit bag. The introduction of low pressure disposable cylinders has meant that helium has become a viable gas for use with an Exit Bag and dramatic ally increased the popularity of the method. The compressed helium co mes as part of a Balloon Kit manufactured in the US. These kits are designed to provide an instant system to fill helium party balloons and contain a light weight cylinder of helium, a packet of party balloons (30 or 50 depending upon the size cylinder) and tie ribbon. Joanna purchased the kit outr ight, paid cash and left no paper trail. Stephen continues: Of the two sizes of cylinder available, she purchased the la rger cylinder which contained 420 litres (14.9 cubic feet) of compressed helium at a pressure of ~1500 kPa. (Fig 5.2) She knew this would produce a usable stream of gas which would run for approximately 20 minutes, more than enough time for a peaceful death to occu r. Joanna adopted the following technique: 1. She introduced a controlled stream of helium into the Exit Ba g through a plastic tube. The tube was fed into the Exit Bag through the neck opening and secured to a tie held by adhesive tape inside the bag. 2. She adjusted the neck of the Exit bag to obtain a snug (not tight) fit around her neck. The Bag was positione d on her head like a hair net at her forehead at the front and down towards her lower head, upper neck at the back and above the ears at the side. Joanna' s face was fully exposed (Fig 5.3a). Fig 5.3: Positioning, inflating & Using the Exit Bag with Helium 3. The tap on the cylinder was then turned fully on. With a regul ating jet in place the initial flow of gas at full cylinde r pressure was aroun d 15 liters/min. Th e average Exit bag is around 15 litres in capacity so in about a minute, most of the air (and oxygen) in the bag was displaced. The bag remain ed over the hair and inflated and excess gas leaked from around the elastic (Fig 5.3b). 4. When the bag was fully inflated, Joanna exhaled completely, and pulled the bag down over her face until the neck band was positioned comfortably around the neck. She then took a full, deep breath of helium (Fig 5.3c). 5. The single breath of helium caused a sudden and precipitous fall in the oxygen level of the blood going to her brain. An automatic r eaction was to take a further deep gasp for air, but consciousness was rapidly lost. A peaceful death follow ed a few minutes later. When Joanna had stopped breathing, I removed and disposed of th e Exit Bag and threw away the empty helium cylinder. We had previously discussed in detail how Joanna's death should be dealt with. She did not want to be known as th e grandmother who suicided. To hide the true cause of her death, I removed all of the equipment used and concealed any evidence of her suicide. I hoped that the doctor would assu me it was a consequence of her cardiac disease. I knew though that if t he doctor was uncomfortable and the police became involved, I would have to lie and say that I had no idea how my beloved wife had died. I knew that a hypoxic death is undetectable, but luckily it never got to that point. The Use of Helium In planning the end of her life, Joanna had obtained a number of pieces of equipment. She made an Exit Bag and secured a means to control the gas flow. She also wanted to be sure that the cylinder was full before using it. Joanna made the Exit bag and the control kit herself. While I was willing to remove the equipm ent I did not want to be accused of helping her with her death. Her other equipment included: 1. Plastic tubing (standard 2.1m oxygen tubing with soft connectors). 2. Quick release (Jamec) air line fitting that attaches to helium cylinder. 3. Gas jet regulator this is a small, custom made jet that fits inside the air line fitting. 4. A pressure gauge for testing the cylinder. 5. A plastic Exit bag. Authors Note It is important to check if the cylinder is full as some newly purchased cylinders have been found to be nearly empty presumably be cause the cylinder tap was leaking. Helium Canister Testing At an Exit workshop a year earlier we had learned that occasionally, newly purchased helium cylinders do not co ntain the full 420 litr es of helium. Cylinder s occasionally have a faulty tap and when kept in stor age for a long period there is the possibility that the gas will have leaked from the cylinder. The easiest way to ensure that a cylinder is full is to check the pressure. Joanna had checked her cylinder on purchase and did so again two days before she planned to use it. Her full canister of helium show ed a pressure of 1500kPa (or 220 psi). She used a pressure gauge fitted with a Jamec coupling th at allowed quick testing of pressure, with no gas loss. She borrowed this gauge from our local Exit Chapter (Fig 5.4). Fig 5.4: Cylinder pressure test gauge Helium Gas Flow Control Joanna and I both knew that it would be important when using an Exit Bag with helium to ensure that the stream of helium into the Bag would be adequate and steady. Exit told us that a 420 litre cylinder could provide around 20 minutes of useful gas flow, long in excess of the few minutes that it takes for a peaceful death. We knew that to ensure this steady flow of gas, some met hod of gas regulation would be required. While it is possible to use the tap on th e cylinder to adjust the flow, there is difficulty and risk with this as the tap on the heliu m cylinder is designed to simply switch the gas on and off, not to control the flow. Small tap adjustments can great ly affect the gas flow. If they are opened too wide, the gas will exhaust too quickly. If the tap opening is too small, an insufficient gas stream will result. We knew that control of the gas flow would be particularly important if a small (250 litre) helium cylinde r was to be used. Authors note Exit International has investigated several methods of controlling the gas flow from helium cylinders and developed a gas jet that neatly fits the Jamec cylinder head coupling. Once the jet is clippe d into position and the tap on the cylinder switchedfull on, the gas flows at a rate of 15 l/min at full cylinder pressure. This flow decreases as the pressure falls, which is exactly what is requir ed. At the start of the process, as the bag is filling and prior to the first br eath, the flow rates are highest. The original fitting that comes with the cylinder on purchase, the modified fitting and the control jet to provide the initial 15 l/min flow are s hown in Fig 5.6. Cons truction details are described later in this chapter. Fig 5.6: Modified cyl inder fitting and Jet Large He Cylinder (420 litre) Small He Cylinder(250 litre) Fig 5.7: Flow Rate, Pressure and Volume changes with Time A graph of flow rate, pressure and volume of gas with time is shown for the two available cylinder sizes is shown in Fig 5.7. NOTE: Useful flow rates are obtained from either cylinder (>5 litres/min for 15 minutes with the small cylinde r, and 25 minutes with the larger). Purchasing Helium We purchased our first helium cylinder from a local party shop. We ordered a second cylinder just in case by ma il order. In Australia, dis posable helium canisters can be purchased online or ordered by phone. The telephone number for mail order delivery is: 1300 650 823. Most Spotlight stores also stock the helium canisters. In the US and Canada, major department chains are a good source of supply. In the UK, the larger supermarket chains also stock the cylinders. At our local shop, we t ook the advice of other Exit supporters, telling the sales staff that we wanted the canister on stand by for when the grandchildren visited at weekends and school holidays. Others had told us that it's true, their grandchildren do love filling party balloons with helium. This is why it might be wise to purchase more than one cylinder! Although available in two sizes, we initially purchased the smaller, 250 litre cylinder of compressed helium that is sold in a green bo x. Later we purchas ed by phone the larger 420 litre blue boxed cylinder which cost ~A$70. Disposable he lium cylinders are light and easily moved and stored (preferably in a cool place), an d, as long as ther e is no fault in the cylinder or tap, the gas will keep indefinitely. Authors note While there is enough helium in a smal l cylinder for a peac eful death, close control of the gas flow rate in the small cylinders is essentia l. The larger 420 litre cylinders give greater margin fo r error and are pr eferred for this reason.. Pressure should ALWAYS be checked prior to use to ensure the cylinder is full. Helium Purity In 2006 Exit received th e first reports of failures by people using Exit bags with helium. Although this information has been sketchy, the descriptions sugges t that there has been some unexpected contamination of the helium in the cylinder. The reports have been of people breathing the gas insi de the bag for some minutes but with no loss of consciousness. The only possible contamination that could produce this result would be the addition of a significant quantity of oxygen to the helium. This has long been postulated as a possible means of frustrating the use of disposable helium cylinders by those wanting a peaceful death. The introduction of 10% of oxygen would have no effect on the marketed use of the gas balloons filled with this mixture would float but the gas would be of no use in an Exit bag. In mid 2006, Exit undertook extensive testing. The results of these tests were reassuring. No significant contamination of the cylinders tested was found. The results were: Oxygen 0.4%, Carbon Dioxide <0.01 %, Carbon Monoxide <0.1 ppm, Hydrocarbons ~40ppm. The gas from cylinders used in the failed attempts was not tested. This needs to be carried out. Cylinder gas testing for contam inants is quick but one needs reliable test equipment. Exit offers this service. Comparing Methods There is little doubt that the use of helium has greatly improved the acceptance of the Exit Bag. Looking at the RP Test scores for each approach shows why (see below). The helium method used by Joanna was quick. According to her husband, Stephen, Joanna lost consciousness almost immediately. Nevertheless with this method, the person does not die in their sleep and there is some (short lived) al arm and anxiety with the first breath. On the other hand, the use of an Ex it bag with sleeping tablets by Brian meant that there was a period of more than 15 minutes when he sat anxiously with the bag half on his head and with his arms outstretched, waiting for the tablets to take effect. His anxiety almost certainly prolonged this period. More import antly, the whole process Brian used is much slower than with helium and the risk of discovery with possible intervention and resuscitation is much gr eater. For some people, though, the increase d need for associated equipment when helium is used gas cylinder, tubing, regulating jet etc is a significant disincentive.. Note: The helium method produces no changes in the body that can be seen or found on inspection, or discovered at autopsy. If there is no evidence of an Exit bag or cylinder being used, the doctor will likely certify the death as natural, assuming that the person died from their underlying illness. The Exit Bag is the only method that allows this possibility. If sleeping ta blets are used these will be detected at autopsy, although they wo uld probably be at levels unlikely to explain the death. All other approaches described in this book are detectable upon examination or autopsy. Exit Bags While different people make slightly different bags, Brian and Joanna both followed a standard Exit Bag manu facturing outline. Both of their bags were: • a reasonable size • a suitable soft plastic • a neck band of elasti c that allows the bag to make a snug fit around a person's neck In the past, Exit Bags have been able to be purchased from organiza tions such as Right to Die Canada. As the original inventors of the Bag, Right to Die Canada were active for many years in their manufacture and sale and for a while provided a mail order service for their members. For a short period in 2001, Exit International also made bags av ailable to supporters of the organization. However, with the experience of Canadian VE activist, Evelyn Martyns, fresh in our minds, (see Killing Me Softly: VE and the Road to the Peaceful Pill), the organization was forced to revise its position. Recent changes to t he Australian Customs Act have increased the risks associated with distri bution and Exit has now abandoned the manufacture of bags. Exit now concentrates on developing strategies that enable people to construct their own bags and associated equipment. Exit bags vary in size, depending upon whether sleeping tablets or he lium is to be used. Because he was intending to use sleeping pills Brian's bag was quite large. He knew he would need to spend some time with the bag half over hi s head and with his arms holding open the bag's neck before he fell asleep. A smaller bag would have been less comfortable and more likely to bring on a feeling of claustrophobia. For Joanna who used helium, the bag was smaller a nd made of lighter weight plastic. Stephen said that Joanna used a commercial polyester oven bag. Experience has shown that this smaller type of bag can be easily and quickly filled with the helium gas. With helium, the time before loss of consciousness is short, so claustrophobia is less of an issue. In both methods though, the plastic of the bag was thick enough to ens ure that there would be no chance of the plastic obstructing the mouth and nose during deep inspiration (breathing in). Exit Bag Manufacture The following items are needed (see Fig 5.9): • Plastic bag polyester' oven bag' available in superma rkets is a good size (Large 35cm x 48cm) 'A & B' • 1 metre of 10 mm wide elastic, 'D' • 1 toggle to adjust elastic length • 1 roll of 20mm transp arent sticky tape 'C • 1 small roll of ~3 5 mm plastic duct tape • Pair of sharp scissors Fig 5.9: Items used to construct an Exit Bag Construction (See Fig 5.10) Stephen describes how Joanna made her bag (Fig 5.10) 1. She lay the bag out on a flat surface and folded bac k ~25mm (1") around the open end (A B) 2. She made a 25mm cut in the folded polyester 3. She lay the elastic (C) inside the fold a nd had the two ends exit through this cut 4. She taped completely along the folded edge of the plastic with the sticky tape 5. She placed a cut in a ~60mm piece of duct tape and folded this over the exiting elastic to strengthen this part of the bag 6. She threaded a small wire tie through two cuts in another piece (~50mm) of duct tape and stuck this to the inside of the bag ~15cm up from the elastic (E). This was used to secure the plastic helium hose inside the bag. 7. The toggle was then threaded onto the tw o ends of the elastic to complete the bag (D) Fig 5.10: Exit Bag Manufacture Authors 'note the bag should be tested before use. See Point 2 of Brian's story. Fig 5.11: The completed Exit Bag Concluding Comments For seriously ill people who wish to have the option of accessing a peaceful death at a time of their choosing , Exit bags with sleeping tablets or helium provide some options. The method is reliable, simple and does not involve difficult to obtain drugs or equipment. Nevertheless, for the successful use of either of these method s, substantial preparation is required. If sedation is used, sleeping pills (only available up on prescription) will also be needed.. If helium is to be used, a disposable cylinder ne eds to be purchased, along with the requisite connections and tubing. For both methods, a plastic Exit Bag is needed. For each approach, technique is important and a certain degree of physical dexterity required. The need for so much equipment and the unaesthetic nature of placing a bag over one's head prevents many people from even consi dering these methods. Exit Helium Flow Control kit The flow control is a simple device for regulating the gas flow from the helium cylinder. The Kit used by Joanna consisted of two parts: 1. A nylon/brass fitting made from the nylon balloon valve that comes with the cylinder and a 1 /4" BSP female Ja mec Pem compressed air coupling (Part No: 13.0980) 2. A control jet (Primus PCS 8925 or equivalent) threaded into Jamec Pem 1/4" hose tail (part No: 31 1117) Fig 5.12: Making t he cylinder fitting The Construction of the Cylinder Fitting (Instruc tions courtesy of Joanna and Stephen Cataldi) 1. Remove the black rubber fr om the nylon of the balloon filler valve that came with the helium cylinder (Fig 5.12, A) 2. Remove the central brass pin using a light blow with a hammer. Retain the brass washer and rubber seal (B) 3. Replace the washer and rubber seal into the nylon fitting 4. Using a 1 /4" BSP die (F) cut a thread on to the shoulder of the nylon. As the shoulder is only 8mm in length a lathe is useful for this step or one can make use of the purpose made jig provided for loan at all Exit Chapters (Fig 5.13) 5. Using Teflon tape on the thread, fit the nylon to the 1/4" female Jamec Pem compressed air coupling (E). 5. Test the fitting by screwin g the nylon onto the Balloon time cy linder and opening the valve. There should be no leak of helium. Test this using soapy water . Fig 5.13 Jig for cu tting nylon thread The Construction of the Jet Fitting (Instructions courtesy of John Edge) 1. Using a 4.5mm metric fine taper tap (E) cut an internal thread into the Jamec Pem 1/4" hose tail (A, the non hose tail end). Th read a Primus jet (B ,C) into the threaded end of the hose tail and tighten with a spanner. 2. Test to see that the hose tail clips neatly into the brass cylin der fitting. Now when the cylinder is turned on the hiss of gas leaking through the jet at ~15 l/min will be heard. Testing the Pressure To test the pressure, obtain a pressure gauge with range up to 2500 kPa (350 psi) and fit to this a female 1/4" Jamec Pem couplin g (Part No 31.1111). (Fig 5.4 & 5.14) Remove the jet assembly from the cylinder fitting. The gauge ca n be fitted and will immediately provide the cylinder pressure. A full cylinder should have a pressure of >1700 kPa (250 psi) Fig 5.14 Checking to s ee the cylinder is full THE RP TEST SCORE Exit Bag + Sleeping Pills Reliability (R = 6/10) Much more dependent on technique Peacefulness (P = 5/10) Depends on the efficacy of the sleeping tablets used Availability (A = 4/5) Requires prescription drugs Preparation (Pr = 2/5) Taking of tablets and positioning of bag requires skill Undetectability (U = 4/5) Undetectable if equipment removed. Sleeping drugs will be found at autopsy Speed (Sp = 1/5) Slow, depends on action of drugs and "breathing down" oxygen level Safety (Sa = 5/5) Presents no risk to others Storage (St = 4/5) Sedative expiry dates must be noted Total RP Score 31/50 (62%) THE RP TEST SCORE Exit Bag + Helium Reliability (R = 8/10) The method is reliable but technique is important and a degree of coordination and dexterity is required Peacefulness (P=7/10) Considered "peaceful" partly because the loss of consciousness comes quickly. There is the sensation of "air hunger" and alarm Availability (A = 5/5) All components are readily available Preparation (Pr=l/5) Considerable assembly and "setting up" of equipment Undetectability (U = 5/5) If equipment is removed there is no way of establishing the method used even at autopsy Speed (Sp = 5/5) Loss of consciousness comes quickly Safety (Sa = 5/5) The method presents no danger to others Storage (St = 5/5) Components do not deteriorate with time. Gas pressure test can readily establish helium cylinder is full Total RP Score 41/50 (82%) THE RP TEST SCORE Exit Bag + Sleeping Pills Criteria Score Reliability 6/10 Peacefulness 5/10 Availability 4/5 Preparation 2/5 Undetectability 4/5 Speed 1/5 Safety 5/5 Storage 4/5 Total 31 (62%) THE RP TEST SCORE Exit Bag + Helium Criteria Score Reliability 8/10 Peacefulness 7/10 Availability 5/5 Preparation 1/5 Undetectability 5/5 Speed 5/5 Safety 5/5 Storage 5/5 Total 41 (82%)

Contents [hide] 1 Introduction 2 How is inert gas asphyxia different from smothering? 2.1 Feeling of suffocation: not enough air or too much CO2? 2.2 Helium and other inert gases: free breathing, no oxygen 2.3 Data and differences between the inert gases (pros and cons) 2.4 Where can you get inert gases? 2.5 How to generally use it (specific instructions are given later on) 2.6 The exit bag 2.7 Risk of brain damage if rescued 2.8 Experiment with animals 2.9 Helium 2.10 Cause of death 2.11 Advantages of using an inert gas 3 THE METHOD 3.1 Equipment 3.2 Lethal dose 3.3 Sleeping pill 3.4 How to adjust the hose to the tank and "make the set" 3.5 What if you buy the tank from other sources? 3.6 The stepwise guide 3.7 Statistics and case reports 4 If using a T-connector instead of a flow regulator 5 Time of death info 6 Reports of failures:analysis of the causes,and insights of how to avoid it 6.1 Report on failure - #1 6.2 Report of a failure - #2 6.3 Report of a failure - #3 6.4 Report of a failure - #4 6.5 Report of a failure - #5 6.6 Report of a failure - #6 7 FAQ and common discussions 7.1 Calculations 7.2 Which purity of helium is needed? 7.3 But if the helium runs out wouldn't I suffocate? 7.4 Q: How is removing CO2 going to kill you? 7.5 Q: What final exit says and what's missing there? 7.6 Q: Some issues which may arise when buying the balloon kit tank? 7.7 Q: what is most important to take care of before pulling the bag over the head? 8 References [edit] Introduction The helium method became widely used few years ago and is now in use by reputable organisations like Dignitas. It is based on the fact that breathing inert gas like helium does not produce any feeling of suffocation but depletes the body of oxygen, leading to loss of consciousness and death. Compared to other methods: All parts (helium tank, plastic tubing etc) can be legally bought and possessed. Can be done at home,in one's own convenience. Does not put others at risk. Complete setup requires significant amount of handwork. Some people find having plastic bags over their heads disgusting. One must be very accurate in technically applying the method in order to succeed. [edit] How is inert gas asphyxia different from smothering? Often, people confuse inert gas asphyxia with smothering (which is not peaceful at all). [edit] Feeling of suffocation: not enough air or too much CO2? Everyone knows the unpleasant sensation when holding a breath for a long time. However, this sensation is not caused by lack of oxygen; the main factor is build-up of CO2 in blood. Even if our body constantly needs oxygen, it (surprisingly) does not have a mechanism to measure oxygen levels; instead, it relies on CO2 reflex to avoid asphyxia. Under normal conditions, this reflex works reliably to protect us from high CO2 levels and from lack of oxygen at the same time: our body constantly produces CO2, so if we are unable to breath or are in area with not enough ventilation, CO2 levels rise causing unpleasant sensation. This is the sensation that forces you to grasp for air when diving in a swimming pool. There is one special situation though: when we are able to freely breathe and exhale CO2, but there is no or not enough oxygen in the mix we inhale. Our body is not built to handle this situation well. When does this situation happen ?: breathing at a high altitude, where air pressure is low. One exhales CO2 freely but the body does not recieve enough oxygen. Because CO2 can be exhaled, CO2 reflex is not triggered, there is no suffocation feeling; often, consciousness is lost without any advance warning. Pilots are likely to face this situation in case of aircraft depressurization. Lack of warning before unconsciousness is so dangerous that US Air Force trains crews to recognize signs of approaching hypoxia.[1] breathing a gas mix with low oxygen. In the next chapter, we focus on this case. [edit] Helium and other inert gases: free breathing, no oxygen Many gases that are more or less nontoxic can cause asphyxia by replacing oxygen from the breathing mixture. as a result, they are dangerous in enclosed areas, but not otherwise. People start showing signs of asphyxia when the concentration of these gases is around 30 percent; severe symptoms at around 50 percent; death at around 75 percent. Argon, helium, and nitrogen - are your best bets in this category. They are all tasteless, odorless, nonirritating, and under these conditions, chemically and physiologically inert. In fact, nitrogen comprises about 78 percent of the air we breathe. Since these inert gases are not poisonous and your lungs have something to inhale, such asphyxia will be minimally traumatic. That is, they will not cause feelings of suffocation (which are due to carbon dioxide buildup, not the lack of oxygen) or haemorrhages (caused by high blood pressure from blocked jugular vein or struggling to breathe against a closed airway). Most medical use of inert gases is for animal euthanasia; however there have been human fatalities from them, too. For example, airline face masks were mistakenly hooked up to inert gas cylinders instead of to oxygen at least ten times during the 1980s in the United States. The fact that these people died without attracting attention is consistent with no traumatic death. [edit] Data and differences between the inert gases (pros and cons) Helium (He) - The density of is 0.14 of the weight of the air we breath, which says it is just about 1/7 of the weight of the air we breath. That's why helium rises. Advantages: quite easy to get [will be discussed later], have been supported by most euthanasia books, and have many case reports to show success. Disadvantages: There were cases of failing the method [which we will discuss later]. Though most failures were due to crucial mistakes, yet it needed to take it into account. Another point = 96 the weight of helium and its inclination to rise, makes it crucial to plan your posture and position well when using it. Nitrogen (N2) - a colourless, odourless and tasteless gas that makes up 78.09% (by volume) of the air we breathe. The weight of nitrogen is 0.97 of the weight of the air we breathe, which says it is just slightly lighter than air. Advantages: since nitrogen is 78% of the air we breathe, breathing this gas should be almost similar to breathing air, in terms of sense. Moreover, its weight being almost similar to the air, dispense of the need to address the possibility of this gas sinking down or rising up when we are unconscious. Disadvantages: Poor documented case reports. While this fact by itself does not say it will not be efficient, however, having case reports available may increase our sense of certainty. Argon (Ar) - its specific weight is 1.39 times of the air's weight. Advantages: the gas is way heavier than the air so it sinks to the bottom of the chamber you use, so lying down when performing your attempt is a possibility. Disadvantages: poor case reports about it. the same statement about nitrogen is valid here too, that is, it says nothing about the method reliability. [edit] Where can you get inert gases? Argon is commonly used for inert gas electric welding and helium for balloons. Nitrogen has a variety of uses and may be purchased either as a gas or as a cold (-196 degrees C or -321 degrees F) liquid. All of these are available from industrial gas suppliers. Helium can also be found at party-supply stores. Argon and nitrogen can be found at welding suppliers, or Heating, Ventilating, and Air Conditioning (HVAC) suppliers. None of these gases are dangerous unless they displace oxygen from the breathing mixture. [edit] How to generally use it (specific instructions are given later on) Probably the easiest way to use inert gases for suicide is to enter a tube tent with a gas cylinder, flush the tent with any of the three gases, and seal the ends of the tube. The volume of a tent is such that you won't produce enough carbon dioxide to stimulate breathing reflexes before dying. Since there's little or no residual oxygen in the breathing mixture, minimal amounts of carbon dioxide ought to be exhaled, suggesting that a large inert gas-filled plastic bag over the head should work as well as the tube tent. [edit] The exit bag Another variation of helium method uses an "exit bag", a plastic bag with attached hose. You can either order ready exit bag by post, or make your own one. There is a video demonstrating how to make an exit bag, available by purchasing the e-version of The Peaceful Pill Handbook. Use of exit bag (from Final Exit by Derek Humphry): Important note: in this image, the angle in which the person lies is not the recommended one by most known books (Dr. Nitschke, Dr. Admiraal). You would need to lie half sitting half lying. [edit] Risk of brain damage if rescued The main hazard of this (and all) asphyxia is the possibility of brain damage if the process is interrupted due to intervention, running out of gas, or tearing or removing the gas mask, plastic bag, or tube tent while unconscious. Using a high concentration can minimize this of the anoxic gas, which causes most rapid loss of consciousness. These gases are not a danger to others in anything but a small, sealed space; however it's important that a gas cylinder not be mislabelled, lest it imperil subsequent users. [edit] Experiment with animals In experiments, animals (dogs, cats, rabbits, mink, chickens) show little or no evidence of distress from inert gas asphyxia, become unconscious after one to two minutes, and die after about three to five minutes. Thus, use of any of these three gases, combined with a plastic bag, should be less traumatic than plastic bag asphyxia alone, since there will be little discomfort from carbon dioxide buildup and unconsciousness will be swift. [edit] Helium The following chapter is dealing mainly with helium due to extensive available track record with this inert gas; however, following this chapter, there is a section which makes adjustments regarding other inert gases. [edit] Cause of death Inhalation of 100% pure helium (which is not mixed with oxygen) causes rapid death due to oxygen deprivation (since the helium displace the oxygen).when breathing pure helium inside a plastic bag, unconsciousness follows after about 5 breaths. In 62 cases where "time to unconsciousness" was reported, the average was 35 seconds (range 10-120 seconds). Death will often follow in about 10 minutes, sometimes as quickly as 5 minutes. Elapsed "time to death" was reported in 108 cases. The average was 13 minutes (range was 2 to 40 minutes). [edit] Advantages of using an inert gas While breathing pure helium there is no feeling of suffocation or choking. This is because the breathing of helium permits the lungs to continue exhaling carbon dioxide (see remark 1).the brain never receives any warning signal of suffocation when breathing helium (or any other inert gas).[The Article: "analytical investigation in a death case by suffocation in an Argon atmosphere", in the magazine: Forensic science International. 2004]. Death by inhalation of Inert gas is not detectable through any known toxicity test. Only a witness or materials left in the scene can confirm helium inhalation as a cause of death. That's because helium rapidly dissipates into the surrounding air and does not remain in the body tissues or blood cells. [edit] THE METHOD [edit] Equipment At least one organization sells a helium suicide kit. Tanks of helium can be purchased from toy stores. [edit] Lethal dose According to the book Guide to a Humane Self-Chosen Death written by Dr. Pieter Admiraal and a committee of medical professionals, nearly in all 119 reported cases used non-refillable party balloon kits. A small tank [4.5 cu ft] is sufficient to bring about death if breathed in a plastic bag. To be sure, I would go for 8.9 cu ft [the following size].the assumptions are that the tank is new and full, and that there are no leaks in the bag. [edit] Sleeping pill The book Final exit recommended taking few Valiums to contract convulsions and so; however, Dr. Admiraal from the Dutch euthanasia group says in his book that: "to be sure that one does not make any errors in the procedure, pills are not recommended". I tend to agree here with the Dutch booklet, since, falling into any sleep, may indeed cause you to act out of shallow or deep sleep, while you may take off the bag or miss some details. Case Reports regarding sleeping pills with helium in 31 reported cases, the patient took no meds at all. no complications were reported and time to death was not influenced. The needed items: Helium tank.8.9 cu ft or more Oven roasting bag (19x24 Inch =45x60cm) Soft plastic hose/tubing 3 meters. The tubing must fit snugly over the tank nozzle. For most party balloon kits it requires tubing with an inner diameter of 3/8 or 5/16 inch A rubber band such as of tennis players [edit] How to adjust the hose to the tank and "make the set" 1. Take off the plastic nozzle of the tank. (Use any pillar for this) (You can also do it carefully with a carpet knife if you have trouble finding out what a pillar is) 2. Put the edge of the plastic pipe in warm water for some minutes to make it softer. 3. Connect the hose to the tank and make sure it is very well adjusted. use a half inch hose clamp (you can get it in hardware stores) and adjust it with a screwdriver. If you're using a "Y"-tube for two tanks, remember to take the tube through the clamp before fitting the tube to the tank (if the clamp can't be opened). 4. Check the bag for holes or leaks. If you blow it with air you would be able to check in case it leaks. [edit] What if you buy the tank from other sources? If you buy directly form a helium supplier, you should buy a regulator from them as well in order to control the gas flow. Never buy other than a new tank of helium, since you can never know otherwise if the tank is full. It is advisable by the Dutch euthanasia group to practice the procedure without helium so that you make sure you know exactly how to do it. Note that testing is problematic; if you get one of the consumer helium tanks, you will most likely have a nozzle that won't shut completely, so if you perform a test of helium output with such a tank, you might eventually lose all of the helium before your actual exit date. However, a helium tank from a commercial helium supplier should not have this problem. [edit] The stepwise guide 1. The position: you have to sit or lean, such that your body is vertical, since the helium tends to rise. 2. Open the valve and close it immediately. that's for the first opening of the tank. 3. Place the bag on your head such that the margins of the bag cover only the ears and your forehead. 4. Now, the most important thing is to get the air out of the bag. If you have air there, you won't lose consciousness quickly. Most literature recommends doing it by squeezing the bag with both hands on your head to deplete the air. However, I suggest that this way there is a good option that air would be present. Alternatively, you can simply put the bag on a flat surface, roll it back and forth to get all the air out and then you may close it tight, while leaving long enough margins (after the place where you close the bag with your hand tight), for placing the bag with the band,back on your forehead and ears. By doing so, you are more likely to get rid of all the air. 5. Now, open the valve and let the bag inflate with helium. You should now be prepared to pull the margins of the bag with the band over your head. The rubber should not be too tight since you need to leave some room for the CO2 you exhale, to get out of the bag through the bottom. 6. Now,VERY IMPORTANT: the Dutch group recommend here, to exhale all the air in your lungs BEFORE pulling the bag over you head. There is logic here, since you need to get rid of all CO2 in your lungs. So you need now to make a big exhale, then hold your breath, pull the inflated bag over your head with the band, and now, you should take a very deep breath(of the Helium in this inflated bag), when inside the bag. 7. Continue to breathe normally, unconsciousness should follow quite quickly. [edit] Statistics and case reports According to Pieter Admiraal's book, in 119 reported successful cases using helium and a plastic bag: Nearly all cases used a non-refillable balloon kit, although, it is less reliable than any industrial size tank. In 62 cases where "time to unconsciousness" was measured and reported by an eyewitness, the average was 35 seconds [10-120 range] in cases where it took longer than average, it was reported that there were difficulties with gas flow, Leaking tube/nozzle connections, or improper seal between the neck and the bag. That's why a good preparation is needed, says the Dutch group. [edit]If using a T-connector instead of a flow regulator If using a T-shaped connector to join the flow of two disposable helium tanks, make sure to use one made of PLASTIC or VINYL. A T-connector is often sold as a "hose barb" or a "garden hose tee". The right size (if using tubing of 1/2" OD and 1/8" ID) is 1/8" OD so the tubing will fit OVER the T-connector perfectly. T-connectors look something like this: http://i.imgur.com/piqQo.jpg. Often sold in the PVC isle of a hardware store. [edit]Time of death info Time to death was reported in 108 cases --- the average was 13 minutes [range 2-40 minutes]. Muscle contractions were reported in half the case reports. it happened between 2 to 8 minutes into the procedure. Arms and legs will tighten and relax few times for about 10seconds to 2 minutes duration. It is not should be interpreted as an attempt to remove the bag. Those contractions are common in anesthesia in surgery settings. Witnesses of several cases with helium said that they have never seen a case in which the hands reached the plastic bag. Patient is unconscious in this stage. Deep gasps are common in the unconscious stage. In 31 cases in which no meds were in used it was found that there is no correlation between meds and contractions. In 11 cases contraction have been present while in 7 non were present. [edit] Reports of failures:analysis of the causes,and insights of how to avoid it [edit] Report on failure - #1 Source: this ASM thread "Speaking from experience, I can say that helium is not as comfortable as it sounds. Breathing it was not a problem. However, moments after beginning, my whole body started feeling all tingly (like a foot that has fallen asleep or something). After that, body started having uncontrollable convulsions. Finally reached up and removed the plastic bag. I was a bright shade of pink for a while after the experience, which I found out later, was a symptom of oxygen deprivation. Was no pain, just a very uncomfortable feeling " Explanations: What might have happened? The man describes what he has done: "What I had done, was place the bag over my whole head/face, ran the hoses up into it, pulled the rubber band down around my neck, and held the rubber bands away from my neck to continue breathing air until I was ready." Mistakes done: That means he had a good breath of air in his lungs when went went in (as he DID NOT exhale first as he should, in order to deplete the lungs from CO2). Moreover -- there was probably quite a bit of oxygen in the bag as well, since the man did not emptied the bag BEFORE streaming helium in. General inferences, following that case: The main goal when using an inert gas, is to have a sudden and intense exposure to the gas. You need to make the best you can to make sure that no oxygen or carbon dioxide is in there to contaminate the helium, with your first few intakes of breath you will be inhaling nearly-pure helium. This is what is required for a quick loss of consciousness. if you proceed by piping helium into a bag (or tent) which currently contains air, that would be quite disastrous -- for a long time there would be enough oxygen to support consciousness, and that consciousness would become very unpleasant before it vanished. [edit] Report of a failure - #2 Quote: "I really tried the helium method as described in the Dutch booklet, and really wanted to go. Before dragging the bag on my head I was even excited and happy that finally all my misery and illness will be history. So with the full of helium bag on my head I started to breathe normally waiting to lose consciousness in 2-5 breaths. Instead of that, after some 15 deep breaths of helium all I felt was pain in my chest, my heart pounding like hell and a HUGE panic. It was everything but pleasant or peaceful. So, I couldn't resist that overwhelming feelings and took the thing of. It took some 10 min. to get back completely. I felt dizzy and had a light headache. I was hoping I didn't damage my brain. What I want to emphasize for you is that this method is not so peaceful as I would have thought." Explanations: What might have happened? I knew of one other person who did not lose consciousness quickly and who felt significant panic (enough to make her stop). In her case I think it may have been because the helium was contaminated with oxygen-containing room air. She wanted to use 3 tanks, to be sure that the helium would not run out too soon, but she joined the various tubing pieces with T- connectors intended for use with copper plumbing pipe. These connectors went on the outside of the tubing rather than on the inside (she had not managed to find the kind that goes inside the tubing, and the hardware- store person told her that the plumbing connectors would be just as good). She put lots of tape over each place where a connector lay over the tubing, but she used electrical tape, which does not have a high degree of stickiness (not as high as duct tape, for instance). There were quite a few of these possibly-leaky connections, and I think that perhaps wherever the helium flowed past a connection it entrained (pulled in) some room air. Also, this above person may have skipped thoroughly forcing all room air out of the bag before filling it with helium, and thoroughly evacuate the lungs by doing a big "Whoof!" immediately before pulling the bag down. If the first thing is not done, there can be quite a bit of oxygen in the bag, and if the second thing is not done, there can be quite a bit of carbon dioxide; breathing carbon dioxide causes panic. However, panic can accompany rapid loss of consciousness even in the (relative) absence of carbon dioxide (I felt it when I passed out from ether, though only for a couple of seconds). [edit] Report of a failure - #3 Source: | this message 11-8-2006 "I recently tried the helium + plastic bag, and I failed. I bought a 20 l helium tank and some big plastic trash bags. The first problem I experienced was that the tank was huge. And I didn't have any tube to connect it to the bag. So I tried a few methods. I first tried lying in bed (slightly upwards so that the helium would concentrate at the top) and had the top part of the tank inside the bag along with my upper body. I closed the bottom part of the bag pretty well to prevent leakage. I had the helium tank running for a little while and my head started to get dizzy, but quickly panic stepped in. I tried to wait it out, but in the end I just couldn't. Anyway, I thought maybe the bag was too contaminated with oxygen, and that's why I kept getting the panic attacks (quick heartbeat etc). So I tried to fill the bag with helium before I actually put it over my head. Then I put it over my head ... same result, although, it lasted longer in that attempt, probably because there was less helium in the bag. I tried a few different postures with the bag over my head and the tank inside, but nothing seemed to work. At the end I was feeling very dizzy, but I just couldn't go through with it. Could anyone give me some advice? I thought this method was supposed to be foolproof and painless, but it just wasn't for me. I felt the same way that I feel when I put a plastic bag over my head and no helium, the panic and increased heart rate steps in pretty quick." Explanations: What might have happened? When somebody does not lose conscious shortly, it is due to excess of oxygen in the bag. It usually happen when the bag is not previously completely depleted out of all the air. That should be done before any helium is blown into the bag. Residual oxygen will make you experience the side effects. Now, as to the panic itself, I would attribute it to a CO2 build up. One should not complexly close the marginal of the bag, and only use a slightly tightened band, to let the CO2 escape form the bottom. During the first attempt, this guy got into a kind of a "tent". This imposes a problem since you have large amount of oxygen there, and you need to either deplete it first, or to create a very strong and steady stream for that. [edit] Report of a failure - #4 Source: An ASM message in this thread Oct. 2004 "I tried this recently. I panicked while nearly passed out and took the bag off, although I only vaguely remember doing it. I used a tank with 15 cubic feet of helium. In the U.S. (at least here in California) you can get these at Party stores. So be sure you take something to relax you or make you sleepy, and be sure that the helium is turned up high enough to keep the bag from getting warm and moist and hitting your face, which is what caused my state of panic. You will start breathing heavily as your body starves for oxygen. I suspect if I'd been in there another 15 seconds I would not have been able to undo it." Explanations: What might have happened? 14.9 cu ft of helium should be well sufficient for succeeding. While Final Exit recommends 1-2 tanks of 9 cu. feet, it was proven that even 4.9 cu ft should be enough. moreover, the Dutch euthanasia group, recommended, following more than 120 case reports, to avoid using more than one tank, since there is a great chance that the connectors would create a leak, if you use more than one tank. It is indeed recommended to make sure the regulator of the tank is at least turned to a one third [full guide is given] to allow sufficient flow of helium. However, using sedatives is not recommended in this method as it may increase the chances to fail, as you are likely to miss some of the accurate instructions if so. The moist and heat in the bag should be prevented once you open the valve sufficiently as instructed. [edit] Report of a failure - #5 July 2007, a report of M.D. : "In the one case of which I have knowledge, there were many difficulties. The size of the tube that was given did not fit the fixture and, at the last moment, had to be reamed out with a makeshift tool. The valve was very hard to open and knuckles were slashed on the sharp handle of the tank as the struggle to open it ensued. "The patient appeared to fall asleep readily and in seconds, but after about a minute eyes opened and the patient sat up slightly and breathed shallowly and extremely rapidly (over 200/minute) for ten to fifteen seconds. This occurred three times. After that, both upper and lower extremities flailed about for fifteen seconds or so. Then, after a few minutes pause, this happened again. Then once again, the movements did not conform to any pattern. The eyes were partially open and it could not be determined if there was any consciousness. "The whole process took about fifteen minutes and was horrifying to the onlooker. The person who had given the verbal instructions for the procedure thought it might be due to the fact that the patient was, due to chronic respiratory difficulty, unable to take a deep breath and exhale at the right moment, but subsequent discussions with anesthesiologists cast great doubt on this notion as total anoxia must have occurred long before much of the seizure like behavior even if not quite as quickly as with a good exhalation. Also, the question was raised if the pacemaker- defibrillator had produced some of the effects, but discussions with cardiologists tended to rule that out as the amount of current was deemed to be too low to produce seizure. Apparently, from some of the current mailings, the helium Method is not the ideal exit that it's touted to be. Norman J Ackerman, M.D." Explanations: What might have happened? The first part can easily be dismissed as not ensuring everything would go off without a hitch, but the actual account of it seems disturbing. I know, I shouldn't be surprised it's not a party, but still. I might be wrong, but this seems to lead to only one conclusion, that oxygen was leaping in from somewhere. That seizures during the process are likely to occur seems to be inevitable, the question is, is the person aware of them or in any pain, when it happens (patient should be unconscious in that point)? If a mask has been used it tends to be less effective in this method. The origin of the helium is another factor which may be missing. [edit] Report of a failure - #6 Source: | ASM message "I failed with helium today. I never passed out; I just got light headed and experienced tingling and numbness in my hands/arms. What I used: 99% Pure helium 14.9 cubic feet tank > tube > plastic bag 2ft x 7 ft non- rebreathable medical mask > tube ----------^ "I should have had enough helium pumping into that bag to do the job but I am still here and I never passed out so something went wrong. My best guess is either (despite the amount of tape I used) there was a leak somewhere on the bag (does helium escape particularly easily?), or the mask wasn't doing its job properly and letting air in. Can anyone help me out with ideas of how to make this work? I have thought about a small tent but after this failed attempt I have a feeling the helium would escape extremely easily. I can't just do it straight from the tank to a mask because there isn't enough helium, I need to contain the helium in something and make sure I waste as little of it as possible. A regular plastic bag over my head wouldn't hold enough either." Explanations: What might have happened? Indeed, helium "escapes" quite quickly in any open space or such as not sealed well enough. Thus any possible leak, either in the tube or in any mask or so, may be a reason for such a failure. In addition, again, the man has not lost conscious, probably due to remnants of oxygen penetrating to the mask. That's why I would say a closed chamber would be better. [for this term, a plastic bag would be considered as a chamber of course] Suggestion: I've heard people purchased the party balloon tanks only to find out when they got them home that the package had already been opened, and when used, found it to be empty. The problem here maybe returned tanks going back on the shelves. So check the package to see its been opened before, make sure its in a sealed box! You could also do a one balloon test. Tell the store you are purchasing it but want to make sure its not leaking, with permission open the valve, blow up one baloon.. if it fills quickly its working the way it should, tanks with leaks would fill a balloon slowly. Tighten the valve very tight once you are through. [edit] FAQ and common discussions [edit] Calculations An average person will breathe in and out about 12 to 20 times a minute [2]. People who are tall and/or overweight will breathe more than someone who is short and/or thin (based on Body Surface Area, BSA). Each inhalation brings in about 500 ml of air, corresponding to 6 to 10 litres of air per minute, together with any contaminants that the air contains. Please note that people who smoke, and/or have pulmonary sickness will breathe almost 2-3 times more air than an average person[3]. In an average person, the respiratory rate in cubic feet per minute is (worst-case): For a helium tank containing 14.9 cubic feet of helium, the tank should last: For someone with asthma, or heart disease: Making the 14.8 cu ft helium tank last: [edit] Which purity of helium is needed? Q: How important is the purity of the helium, and what's acceptable? A: In general terms, balloon-grade helium is sufficient to cause death if it is the only gas an individual is breathing. Any gas that contains no oxygen will kill you if it's all you're breathing, but some gasses trigger unpleasant responses What is the concern about CO2 in this method? While it's true that any gas mixture without oxygen will black you out pretty quick, I need to add a minor correction about CO2: At concentrations > 30%, CO2 will drop you with little or no warning, even with 'normal' levels of oxygen. At higher concentrations, CO2 acts like an anesthetic and then kills rapidly. The 'unpleasant' effects all come from lower concentrations of CO2. CO2 kills unwary people all the time, including people who deliver it for soft drink fountains, people who hang out in low places near volcanic activity, people who work with agricultural waste, people who work in grain silos, people in coal mines, and people unfortunate enough to be near places like Lake Nyos when it gassed over. In most such cases, they were 'fine' one moment, and unconscious the next. http://www.emedmag.com/html/pre/tox/0500.asp http://www.snopes.com/horrors/freakish/smother.asp [edit] But if the helium runs out wouldn't I suffocate? A: In a sealed-in area, yes you would, eventually. But you'd be more likely to suffocate from CO2 instead of helium, and CO2 suffocation - at least at a slower rates of air infusion - can be very unpleasant. The body's evolved some rather nasty responses to CO2 poisoning because it's a kind of poisoning virtually all oxygen-breathing mammals are prone to - choking, suffocation, etc.... The body has learned when CO2 levels increase, it needs to do whatever it can to make you breathe harder or clear your breathing passages, and so you convulse and cramp in all sorts of nasty, painful ways, Unless of course you can get just about immediately into a very high- concentration of CO2 quickly, where it can drop you pretty fast. But bags over the head relying on CO2 to do the job don't tend to work that well. The body has learned no such response to helium, and while in the early stages of helium, the body can still release CO2 for a time. More so than to acquire oxygen, the primary functions of breathing is to release CO2 from the body. It's the pressure to release CO2 that causes that "I thought my chest was going to explode" feeling in near-drowning victims. Acquiring oxygen is a secondary function of breathing - just as vital, but as strange as it may sound, you can survive longer without oxygen coming into your body than you can without being able to release CO2 (which you can't do if CO2 is what you're breathing - at best, you're shuffling individual CO2 molecules around, and the body doesn't know the difference between one that's already been through and one that's just arriving). Both functions are vital, of course, and we'd die in fairly short-order without the ability to do either one. But CO2 poisoning is the more critical issue to the body, which is why the body reacts to CO2 gas but not to certain other kinds of gas. Other inert, non-irritating gasses allow the continued release of CO2 for a time, which keeps the body off- guard for awhile. With those types of gasses, it's too late for the body to react by the time it realizes it's not receiving any more oxygen. [edit] Q: How is removing CO2 going to kill you? A: If you mean tanks that aren't filled O2, but rather nitrous oxide or helium, then there's no need for scrubbing out CO2. Helium doesn't become CHe when inhaled, it stays helium. Same with nitrous oxide. Your body doesn't convert the gas at all. The same breath of helium can be used over and over until you're dead. >> How to overcome some problems with the hose and >> connecting it to the tank? As far as how to hook >> the hoses etc., that was the most pleasant of the >> whole deal. Since I got my tanks (got 2 just to >> make darn sure) at a party store, they came with a >> regulator and a rubber fitting designed for >> inflating balloons. I took the regulator to the >> local Home Depot and explained that I was doing a >> science project with my kid and that we needed to >> fill several large trash bags with the gas and that >> the rubber valve just wouldn't be practical for that >> purpose. I got the best service I had ever received >> at Home Depot that day!!! The employee walked me >> over to where he had fittings that would screw into >> the regulator to replace the rubber valve with, >> which were designed for a hose to go onto. He then >> walked me over and made recommendations as to which >> fastener would be best for holding the hose onto the >> fitting. He then walked me over to where they had a >> nice selection of hoses that would fit onto the >> fitting he had gotten for me. And finally, he >> walked me over to the plumbing area to get some >> thread sealer so that there would be no leaks. He >> even reminded me before I left to be sure and do the >> experiment in a ventilated area so that no one would >> get hurt by inhaling too much. Ha. I can't say it >> enough that was the best service I had ever gotten >> in a Home Depot. [edit] Q: What final exit says and what's missing there? A: The book (I sprung for it finally after failing) suggests running a tube from the helium tank to a plastic bag which is positioned on top of your head with a rubber band or such around your forehead to hold the bag in place. Let the bag fill with helium, EXHALE, and then pull the bag down over your face positioning the rubber band around your neck to hold it in place. [edit] Q: Some issues which may arise when buying the balloon kit tank? A: The gas tanks that are supplied for filling balloons have an unusual outlet. It consists of a spring-loaded nozzle, which when bent, opens a valve to allow the gas out. Filling the balloon in a matter of seconds. When the nozzle is released, the spring forces the nozzle back to the horizontal position and the metal plunger slides back against a stop, cutting off the gas flow. There is a master valve on the top of the cylinder too, but it doesn't allow for much flow regulation. In that case we recommend on getting a proper gas regulator valve, to replace the one on the cylinder. This is one of the reasons I prefer obtaining a proper helium gas directly from the helium supplier (all gas agencies would sell it to you).if they ask you why do you need it, you can obviously say you are starting maybe a party line, and you'd like to first buy a small tank [14.9 cu ft or so]to test is in a private party, "to see how it goes". Most suppliers will offer the regulator immediately, thus preventing the extra hassle of taking care of it. [edit] Q: what is most important to take care of before pulling the bag over the head? A: It is important to make sure there's no air in the bag or in your lungs before starting. having air in the bag would interfere with losing conscious while having air in your lungs would cause panic attack due to CO2 build up. [edit] References ↑ There apparently was a reference link given for this statement, but it was not present in this article when it was first uploaded to the wiki. ↑ Wikipedia article on Respiratory Rate ↑ Wikipedia article on breathing page discussion edit history Log in / create account navigation Main page Community portal Current events Recent changes Random page Help Create Your Wiki search toolbox What links here Related changes Special pages Printable version Permanent link This page was last modified on 22 October 2012, at 01:27. This page has been accessed 20,461 times. Content is available under GNU Free Documentation License 1.2. Privacy policy About ASH Disclaimers