1. 2004 Review of Personal Alarm Systems
2. 2005 Update on Wireless Vital Sign Monitoring Alarm Systems
3. 2006 Update on Wireless Vital Sign Monitoring Alarm Systems
4. Update to the 2006 update (January 2007)
5. December 2007 Update on Wireless Vital Sign Monitoring Alarm Systems

I. 2004 Review of Personal Alarm Systems

For many years I have been very concerned about elderly cryonicists who live alone. Too many have died and not been discovered for days, as recently happened to Cryonics Institute Member Hugh Hart. The degradation of brain tissue which occurs under these circumstances seriously undermines the prospects of future restoration of personal identity and memory. Daily checkup calls or e-mail messages are not without value, but still can mean up to a day or more before discovery. Even couples often spend hours apart engaged in solitary activities -- or could lie beside each other in bed for many hours without knowing their partner had deanimated.

Cryonicists have proposed systems that monitor activity in bed, either from bedsprings or from a mat placed under the sheets. Alcor Member Hara-Ra was working on a wristwatch-type pulse monitor eight years ago, but gave-up on the idea partly because he thought it would soon be commercially available for consumer use. When I was with CryoCare I tried to work with Billy Seidel to adapt the Polar Heart Rate Monitor (which transmits electrocardiogram information from a chest band to a wrist-watch) to cryonics use. But after a while Billy too gave-up on the project because of expectations of commercially-available systems becoming available soon (we are still waiting).

Billy Seidel also developed a Deanimation Alarm System that can call up to four phone numbers if a bed mat or bedroom motion detector senses no activity within an hour. The system also includes a pendant push-button device. The system is inexpensive, but could be tedious and technically challenging to obtain all the parts and self-assemble based on the specifications available on the web.

It does appear that commercial vital signs monitoring equipment may be on the market in 2005. The most promising candidate is the Life Shirt System, made by VivoMetrics. The Life Shirt can monitor respiration, EEG, blood pressure & other vital signs -- and wirelessly communicate this information. This system has been widely publicized for many years. There are no technical obstacles, the product has already been built and is in use by academics, the military and pharmaceutical companies doing clinical trials. Government regulators stand in the way of allowing use of the product by consumers. I have been told by a VivoMetric representative that the product will be available in 2005, by which time approval by US government regulators is expected.

I was also told 2005 by a representative of the Canadian company Medical Intelligence, which makes a wireless cardiac alert system linked to GPS. Once the product is approved by the Canadian government it is expected to sell for between Cdn$1,000 and Cdn$1,500.

Digital Angel is another widely publicized system for vital signs monitoring and wireless GPS emergency alert, but my efforts to contact them have been a failure. E-mail messages to their published e-mail address have been returned as undeliverable. I tracked-down the sales representative responsible for the product, Brent Ballard, but despite leaving several messages on his answering machine he never returned my call. Perhaps in 2005 ...

The simplest and most widely available personal emergency systems use bracelets or pendants with push-button devices that communicate wirelessly to a console attached to a telephone. When the button is pushed, a control system manned at all hours is contacted and personnel attempt to talk to the customer through a speaker on the console attached to the phone. If there is no response, emergency numbers previously supplied by the customer are called. I know a cryonicist who says that his grandmother's life has been saved more than once by such a system.

Robert Ettinger has kindly agreed to be a test subject for emergency response systems. The first system I obtained is the Pioneer Emergency Bodyguard. The service costs $34.95 per month and requires a 6-month initial contract. There is always a special offer giving the first month free if you apply before a certain date near the end of the month. They have a sleazy feature based on renewal in 6-month blocks and a 30-day notification required for cancellation. Robert wore his "panic button" (as he calls it) on a pendant around his neck. By pressing the button in an emergency the central station operator would call the CI facility, Robert's son David and perhaps his cardiologist or funeral director. If the button is pressed accidently the central station operators can be informed of the false alarm through the voice-box on the console. Robert has triggered a number of false alarms, which has made him conscious of how frequently he presses objects to his chest. He shortened the pendant so it was closer to his neck and he became more careful not to press objects against his chest. Although the pendant is waterproof, he did not wear it in the shower. We found the company unpleasant to deal-with and returned the device.

There are numerous comparable systems:

http://www.americanmedicalalarms.com/featuresnew3.htm

http://seniorsafety.com/faq.html

http://avitallink.com/cost.html

http://www.hometechsystems.com/index.cfm

http://www.nightems.com/

http://www.lifefone.com/how.html

A how to choose guide for this type of system is offered on the Lifestation website, which has a similar product.

A limitation to these systems is that they are only for home emergencies. To deal with away-from-home situations I got Robert the Magnavox MobilePal+GPS System. This system uses a walkie-talkie-like console that can be worn on the belt. If, for example, Robert was in an automobile accident he could press a button on the console. The central station operators could call 911 and direct emergency response personnel to the location indicated by the GPS locator on the console. A 95-decibel alarm on the console would sound to attract help. And the central station operators could also phone the CI facility and others. The company also permits casual use of the device. For example, if Robert was on his way to visit his son David, he could press the console button and tell the central station operator: "Call David and tell him I will be late because I am stuck in traffic ". The Magnavox MobilePal+GPS costs about $130 to purchase, plus $19.95 per month for central station support. The monthly billing can be done by automatic withdrawals from a bank account or credit card.

Robert Ettinger was using both the Magnavox and Pioneer systems, but he felt that a system that did not involve central station operators or a monthly fee would be more economical. I did manage to locate one such system, but it has proved to be a frustrating, time-consuming and expensive proposition -- and it is still not functional.

A Do-It-Yourself (DIY) system (aka Neamatt) seemed to be what I was looking for. It offered an option of a push-button wrist transmitter that connected to a console that would automatically dial a list of numbers and transmit a pre-recorded voice message to those numbers. A single purchase of $345.00 would be all that was necessary. The website, however, seemed to be permanently under construction. When I finally contacted the salesperson selling the product it took him over a month to sell it to me because he was trying to figure-out how the system works. Only after I got the product did I discover that it is preferable to buy it directly from the manufacturer rather than this broker.

The manufacturer is Linear Corporation. But even the website of Linear is insufficiently informative. The package of products I have now assembled associated with the PERS_2400A has cost $700 and it is still not working. If I can get it working it could be a good system. The console can receive signals not only from a "panic button ", but from a smoke detector and a motion detector. The motion detector can be used to detect unwanted motion (an intruder) or inactivity (optionally 8, 12 or 24 hours). Thus, if Robert Ettinger were not to cross the path of the motion detector placed in the bathroom for an 8-hour period, the console would automatically dial a list of pre-selected numbers which could include the CI facility and Andy Zawacki's pager. Keeping the bathroom door closed would prevent Robert's dog from triggering the device.

There are many pieces to this system. Getting the pieces and getting the pieces working together has been a challenge. A 40-page manual (which can be copied as a PDF file from the Linear website) describes how telephone numbers for the console can be programmed into your computer, which sends the programmed information via the Internet into your console through the telephone line. Once the console has the numbers they can be auto-dialed when the console is activated by the wrist transmitter, smoke detector or motion detector. I have not gotten that far.

A unit for programming numbers has lines with jacks of two different sizes -- and it seems that a voice-box attachment is needed to accommodate the smaller-size jack. I phoned Linear tech support and found the support person to be struggling to figure-out the system himself -- although he was very friendly and seemed quite motivated. He figured-out a method of splicing wires and connecting them to the leads of the console back-up battery, which he told me would eliminate the need to buy the voice-box. A back-up battery can assure that the unit still works during a power failure, but the proper battery was harder to locate that I had been told. A Radio Shack store manager could not find it in his catalog, nor could I find one at Circuit City or another electronics store. I had to order it from Linear.

I attempted the splicing and battery connections recommended by the tech-rep, but it did not work. We do not need a voice-box because we are opting for autodialing rather than the service of central station operators. However, the voice-box is the only way I can accommodate the smaller line jacks connected to the phone-programmer. When I ordered the voice-box from Linear it was out-of-stock. I ordered it, and it was shipped, but I became too frustrated with the company and their product to continue working on it.

What worked was the wrist transmitter which causes the console to make a high-pitched sound when it is pressed. Curtis Henderson came to live with Robert Ettinger. Curtis could wear the wrist transmitter and press the alarm should Curtis experience a cardiac emergency when he was watching TV while Robert is downstairs working on his computer.

What you are paying for with a monthly fee is a human operator to assist in an emergency, something that you cannot be sure of with any of the auto-dialer systems. This service is even more valuable for a GPS-based system, since no existing autodialer is likely able to leave location information. That is why I think that the Magnavox MobilePal+GPS at $19.95 per month (after $130 up-front) is the best of the products I reviewed.

After returning the Pioneer unit to the company, I ordered the Radio Shack Wireless Emergency Pendant (Catalog # 49-2559), which is a pendant-based system connected wirelessly to an autodialer console that will call up to four phone numbers and play a pre-recorded 15-second message three times if someone answers. If there is no answer -- or if there is an answering machine -- the autodialer goes on to the next phone number. If someone answers he/she can press any button on his/her phone and hear any sounds that can reach the microphone on the console (but cannot converse). This pendant panic-button seems less vulnerable to false alarms by accidental pressing than the Pioneer button.

The console emits a loud squealing sound while phoning the numbers and playing the message after the pendant button is pressed. (A stop button is below the "panic button" on the pendant.) It is possible to buy a powerhorn auxiliary that emits an even louder sound, but the console was ear-piercingly loud enough for our purposes. We did buy an auxiliary device that interfaces between a lamp plug and a wall socket to cause the lamp to blink on and off after the console is activated by the pendant panic-button. Another auxiliary device is available that can replace a wall switch to produce the same effect for wall-switch-controlled lighting. These would be helpful in alerting neighbors or others in distant parts of the house that the pendant-wearer is in trouble.

We programmed four numbers into the console:

(1) the Cryonics Institute Facility
(2) Robert Ettinger's son's house
(3) the Cryonics InstituteI Funeral Director
(4) my cell phone

My cell phone should never be called insofar as the Cryonics Institute Funeral Director has a 24/7 answering service and a human will always answer the phone. In the recorded message made by Robert Ettinger he identifies himself and states that he is in trouble and needs emergency assistance. No one at the above numbers should need further information, such as his address.

The list price for this product is $62.99, but with taxes and warrenty we paid $77.76. The warrenty is indespensible. The first unit I obtained from the Radio Shack store simply did not work -- it was burned-out. Someone had returned the item and Radio Shack had put it back on the shelf for resale. When I returned the unit I was sent to a nearby Radio Shack store for a replacement. The first unit I was to be given at the second store had also been used and returned. The second unit was apparently new, however. I tested it at the CI facility and it worked fine. But when I attempted to test it at Robert Ettinger's home, the unit would not record a message when the record button was pushed. When I returned this unit to the first Radio Shack store and demonstrated the problem to the manager, she told me she would get a replacement unit from a third Radio Shack store, which I could get the following day. But when I came for pick-up the manager informed me that the unit in the third store had also been used and returned. So she ordered me a new unit for delivery directly from the warehouse to the CI facility.

The new unit apparently works as advertised, but my experience with this product has not inspired a sense of security in what is intended to be used as a life-saving device. Fortunately, we are also using the Magnavox MobilPal+GPS system. Redundancy is probably a good idea anyway, in case of problems with one of the units or power failure or battery failure (the pendant battery is supposed to last 5 years).

If anything, I think that the monthly fees are more likely to decrease rather than increase because there are so many competitors in this field and the number of competitors is increasing. I have found a site that is collecting links to the competition, which can allow for easier comparison of products, prices and services for the shopper:

http://www.businessranks.com/medical-alarms.htm

A wide variety of automotive dashboard emergency road services are available from On Star -- including emergency medical services.

The technology continues to improve, but the technology as it exists is still useful enough to save the life or greatly improve response time for an elderly person living alone. I have been hearing the " wait for technology improvements" line for years and think it is a deadly trap -- a rationalization for doing nothing and in many cases the excuse of dreamers who will never do anything. For an elderly cryonicist living alone I would recommend immediately getting a personal alarm system. When the technology changes, a better system can be obtained.

The handling of false alarms is a major advantage of the operator-based systems over the autodialer based systems. As I mentioned, with the pendant device Robert Ettinger has set-off a number of false alarms by inadvertently pressing objects against his chest. The operator always attempts to confirm that there is no false alarm before contacting the emergency numbers. And Robert can initiate false-alarm notification from his console.

I have discovered a system that seems to combine both a pendant and GPS, which could be less bulky:

http://www.ciscor.com/sys/sys.html

But I'm not sure how effectivey it could disable false alarms -- the bulky Magnavox MobilePal+GPS reputedly allows for immediate conversational contact with the operator to clarify the situation. But when last tested we got an answering machine followed by music before getting an operator -- a delay of nearly a full minute.

I have sought to find companies in the United Kingdom (UK) offering services comparable to those available in the United States. This company offers caregivers in the UK a pendant-device that can keep them in constant communication with the person or persons in their care:

http://www.silent-alert.co.uk/care/index.htm

It could be of use for cryonicist couples as well, especially if one of them is medically at risk.

This UK ompany looks to be offering an inexpensive autodialer like the one I was looking for when I got entangled in the mess with the DIY/Linear products I described:

http://www.easylinkuk.co.uk/page38.html

I am not inclined to investigate right now, but it could be just what I was looking for in terms of a product without a monthly fee for operator support. Again, there is value to be gained from false-alarm handling and immediate guaranteed contact with a living operator -- a value that might easily be worth the monthly fee.

A UK product that might be offering operator support is:

http://www.tunstallgroup.com/4_1_5lifeline.htm

I don't see operator-support explicitly mentioned, but the products are such that it would be required, I think. Pendants/wrist-transmitters are not shown, however.

Arguably, in this age of cell telephones and personal GPS systems the added benefit of "panic button" systems is marginal. Many cell phones have pre-programmed numbers which can be dialed at the press of a button. Vital signs monitoring connected to GPS and autodialing would make a significant difference, however.

What happens when an alarm is activated? What should be done?

First, of course, it is valuable to try to determine if it is a genuine emergency. If, for example, Robert Ettinger's alarm was activated, and I was contacted, I would attempt to phone him if I hadn't been called already automatically. If I was unable to reach Mr. Ettinger by any means then I think that the best thing to do would be to (1) call 911 and (2) quickly try to drive to Robert Ettinger's house and/or get someone near Robert Ettinger's house to drive there.

An ambulance is probably the fastest way to get someone to a hospital. If Mr. Ettinger's heart is still functional, then a quick trip to the hospital may keep him alive. If Mr. Ettinger has deanimated then a quick trip to the hospital is the fastest way of getting him pronounced legally dead by a physician. By driving to Mr. Ettinger's house there is a chance of being there when the ambulance is there -- and of following the ambulance to the hospital. This would allow me to know which hospital Mr. Ettinger is at and may allow me to initiate or get help initiating administration of heparin, CPR and possibly even administration of ice -- while I contact others for assistance.

In the United States municipalities often pay much of the expense of an ambulance, but a user fee of several hundred dollars is required from those receiving the services (more for Advanced Life Support than for Basic Life Support). Some of the costs may be covered by health insurance if the call is proven to have been a genuine emergency. The costs are typically only incurred when the patient is transported -- application of a defibrillator in the home would not incur a charge in most cases, I believe.

For a narrative story about ambulance costs, see:

Ambulance Service.

The 911 universal emergency number service was begun by AT&T in the United States in 1968 and currently is available in some form for about 99% of the population. Different emergency numbers are used in different countries. Locals and travelers outside the United States would be advised to learn the relevant numbers for their current locations:

International "911" Emergency Numbers

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II. 2005 Update on Wireless Vital Sign Monitoring Alarm Systems

In Decemeber 2005 none of the companies that claimed in 2004 to have wireless vital sign monitoring alarm systems on the market have fulfilled that promise. But the promises do look better now than they did in 2004 -- although Digital Angel (http://www.digitalangelcorp.com/) appears to have abandoned ambitions along these lines in favor of tracking animals.

EKGuard (http://www.ekguard.com/) has a 3-electrode system that attaches to the body. EKGuard is not a wireless cardiac monitor, however. It is a hand-held EKG device. TO contact their Call Center you need access to a telephone. The system is already widely used in Israel, but is currently only available in 3 states: New York, New Jersey and Connecticut. It should be available throughout the United States some time in 2006. The device costs $499 and the monthly fee for Call Center support is $69. Call Center support for push-button alarm systems is currently one-quarter to one-half this price, partly because the EKGuard Call Center has a staff Cardiologist who is available to analyze data coming from the devices. This is of great advantage because it can warn of heart problems prior to cardiac arrest and allow for rapid intervention to prevent cardiac arrest. With greater volume of sales the Call Center support for EKGuard and comparable systems should be expected to drop. And the cost of the devices themselves should drop, much as has been the case with cell phones. But this will take a few years.

BodyMedia (http://www.bodymedia.com/products/biotransceiver.jsp) has a monitoring system that is worn on the arm like an arm-band. Currently the product is sold for athletes wanting to monitor their physiological performance, but the company is planning an emergency wireless alarm system for late 2006.

The Canadian company Medical Intelligence (http://www.medicalintelligence.ca/en/index.html) which was expecting a cardiac monitoring alarm system on the market in 2005 is now saying the system will be available in Canada and the US at the end of 2006. The VPS/W−ECG (Vital Positioning System/Wearable−ECG) device is worn around the waist like a belt, and it monitors the heart through electrodes that contact the skin. It will have GPS so the victim can be located if the heart stops. If the victim is able to speak, he or she can talk to the Call Center. The device is expected to cost about $750 and the monthly Call Center support is expected to cost $40−$45, but these figures are guesses.

Pulse oximetry is the measurement of SpO₂, Spot Oxygen saturation of the blood. Arterial blood is normally saturated to 95−100% of its maximum oxygen carrying capacity at sea level. A pulse oximeter detects pulse blood, ie, arterial blood, and measures the oxygen saturation by shining a bright red light through a finger-tip or ear-lobe, determining how much light is absorbed. Bright red oxygenated blood allows most of the red light to pass through the finger-tip or ear-lobe. A pulse oximeter can give warning when SpO₂ becomes critically low, as happens in cardiac conditions that develop more gradually than sudden cardiac arrest (including conditions of low oxygen, such as a gas leak or a high-altitude flight). Ideally, a pulse oximeter would be small enough to be worn as an ear-ring and have the capacity to wirelessly alert a Call Center if there is a problem. Unfortunately, the FDA requires that pulse oximeters can only obtained by prescription.

The biggest name manufacturer for pulse oximetry is Nonin (short for NON-INvasive, http://www.nonin.com/). Nonin has a series of pulse oximeters, including the Wrist Ox 3100 which can be connected by a short cord to a device capping a fingertip. Detailed information about Nonin products can be found on the Nonin website. Nonin does not sell directly to the public, but their products can be purchased online from AeromedixRX (http://www.aeromedixrx.com/). The WristOx starter kit costs $1,225. Prescriptions are required to purchase, but their staff physician will give you a prescription upon request during your on-line check-out. Some of their pulse oximeters have alarms, but none have a wireless connection to an emergency Call Center.

MedicTouch mPOD (http://www.medictouch.net/wearable.html) is a pulse-oximetry cell-telephone-like device. It is anticipated that it will soon be available for wireless connection to emergency Call Centers.

MDKeeper (http://www.tadlifecare.com/index.php?id=197 is worn like a watch and has biosensors to monitor ECG (one lead), SpO₂ and heart rate. The device can generate alarms in response to vital signs or in response to a push button -- and it supports voice communication with a Call Center. Release to market is expected in the first half of 2006.

LifeShirt (http://www.vivometrics.com/site/system.html -- described in my 2004 report) is also expected to become available in 2006, although this system is much more sophisticated than would be required for detecting the presence or absence of a few vital signs. This is also true for a number of systems being developed at universities, including CodeBlue (Harvard, http://www.eecs.harvard.edu/~mdw/proj/codeblue/), Lifeguard (Stanford, http://lifeguard.stanford.edu/) and MMST (University of California, San Diego, http://mmst.ucsd.edu/).

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III. 2005 Update on Wireless Vital Sign Monitoring Alarm Systems

The best "panic button" system that I had found was the Magnavox MobilePal+GPS System, formerly at http://www.remotemdx.com/MobilePal/MobilePalGPS.htm but the service was discontinued in the Fall of 2006 reputedly due to the phasing out of analog cellular communication towers in favor of digital ones. This system combined GPS tracking with a push-button walkie-talkie. Robert Ettinger was using the service, but was informed that it was being terminated. The company evidently has a replacement service:

http://www.remotemdx.com/senior-safety/mobile.html

but that was not mentioned in the letter to Mr. Ettinger reporting termination of the original service.

The LifeShirt system (http://www.vivometrics.com/site/system.html) which I described in my 2004 and 2005 reports was purportedly going to be available to consumers in 2006, but the company is still only advertising its availability for use by pharmaceutical companies. Smart Shirt (http://www.sensatex.com/) is available for health monitoring, but only in a clinical setting. The Body Media system (http://www.bodymedia.com/products/bodymedia.jsp) is also only intended for use by clinicians.

Medical Intelligence (http://en.medicalintelligence.ca/iiix/home/) which I also described in my 2004 and 2005 reports and which was purportedly going to be available to consumers in 2006 as a cardiac monitoring system with GPS and wireless alarm to call centers, is now mainly being offered as a portable telephone system with GPS for elderly people with cognitive problems -- and is only available in France.

EKGuard (http://www.ekguard.com/), which was beginning service in three states last year, no longer has a functioning website. The MedicTouch mPOD (http://www.medictouch.net/wearable.html) webiste says the product will be available "soon". The MDKeeper website (http://www.tadlifecare.com/index.php?id=197) states that the product "is currently undergoing clinical certification for FDA and CE approval". Lifeguard (http://lifeguard.stanford.edu/) is not an FDA approved product and is designed for development by NASA and others for use in "extreme environments".

At this date there are only two products on the market which might suit the needs of cryonicists for providing a wireless emergency alert of deanimation. The first of these is Vivago (http://www.istsec.fi/index.php?lang=eng), which is only available in Europe -- apparently including distributors in the United Kingdom (http://www.vivatec.co.uk/) and the Netherlands (http://www.isolectra.nl/), among others.

The most promising system of all, however, is EXMOCARE. On its website, Exmocare compares itself very favorably against Vivagio and Life Alert (http://www.lifealert.com/) — which is one of the more prestigious of the "panic button" systems:

http://www.exmocare.com/products.php?slide=4

The main shortcomings of Exmocare is (1) it is expensive and (2) the product is currently out-of-stock (not available):

https://www.exmocare.com/store/

I want to investigate Exmocare further when it becomes available. And I am still hopeful that this is a technology whose time will soon come and cannot be suppressed indefinitely, even by government regulators. I will try to keep myself informed and update this webpage with the latest developments.

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IV. Update to the 2006 update (January 2007)

http://www.exmocare.com/contact.php

(800) 259-9866

I get a recorded message that says

"This number is not in use."

An e-mail message sent to the Exmocare company produced the following reply:

"We no longer sell Exmocare for consumer applications, as we are currently starting production for the next generation wristwatch, which will be much less expensive to purchase and maintain.

"We do however sell corporate Evaluation Kits to companies interested in licensing or distributing our technology. Each Evaluation Kit includes 2 wristwatches, Clinical Edition software for research and Enterprise Reporter Edition software and unlimited server use for remote subject monitoring. These kits cost $5000, and there are no monthly service fees."

This is yet another frustration and defeat in my multi-year project to get some kind of vital sign monitoring alarm systems of value to cryonicists. For years I have been hearing that we are on the verge of availability. The failures for this to manifest seem almost diabolical.

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V. December 2007 Update on Wireless Vital Sign Monitoring Alarm Systems

For well over a decade it has seemed that a commercial vital signs monitoring system would soon be on the market which cryonicists could use to signal cardiac arrest. Too often cryonicists have been found in their residence many hours if not days after cardiac arrest. One would imagine that the technology for monitoring vital signs and signaling their absence would be simple to implement. It is easy to imagine that the Federal Drug Administration (FDA) is the major obstacle.

Judging from the scientific literature, the greatest source of interest in vital signs monitoring equipment in the medical community is based on the idea of using such devices for triage in disasters involving many casualties. This may be associated with anticipation of terrorist attacks. The Advanced Health and Disaster Aid Network (AID-N) uses low power sensors that can wirelessly monitor the vital signs and locations of a large number of patients, as reported in the proceedings of the American Medical Informatics Symposium [AMAI Annu Symp Proc; Massey,T; 544-548 and Gao,T; 284-288 (2006)]. The SMART system also integrates wireless vital signs monitoring (ECG,SpO₂) and GPS for disaster triage [JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION; Curtis,DW; 15:44-63 (2008)].

The word "Smart" is popular in vital signs monitoring. Aside from the SMART system, it is also applied to the Smart Shirt designed by Georgia Tech for use in the next generation of combat uniforms for soldiers. And "Smart" is used for the Smart Vest, which is designed to monitor the health status of active persons vulnerable to danger, such as firefighters, miners, deep sea divers and soldiers. Along with GPS it can provide information on ECG, body temperature, blood pressure, heart rate and galvanic skin response -- with sensors that do not require gels or electrodes [MEDICAL ENGINEERING & PHYSICS; Pandian,PS; 12 Sept 2007)].

Although my interest has been most urgently motivated by my concern about elderly cryonicists living alone, I also think that vital signs monitoring could be of value for detecting cardiac arrest during cryonics patient standby. This raises the question as to whether such wireless devices could be deployed in a hospital. Cell phone use is banned in airplanes and hospitals, but the enforcement in hospitals is very poor. The greatest interference with medical equipment comes from devices like the two-way radios used by emergency personnel. Cell phones, WiFi and Bluetooth do not interfere with medical equipment as long as they are at least two meters away [TELEMEDICINE AND E-HEALTH; Boyle,J; 12(3):373-382 (2006)].

We at the Cryonics Institute recently tested the Radio Shack autodialer alarm that Robert Ettinger is using, and it still works. It is a panic-button system worn as a necklace that phones a list of numbers when the button is pushed. CI Member Gunter Boden mailed (by slow boat) a hand-made pulse detector alarm with circuit diagrams. It could be a workable alarm for someone having people within hearing range, but my main interest has been in phone dialers for people living alone.

With the assistance of Member Nick Pavlica, who has both a personal and commercial interest in vital signs monitoring alarm systems, I have done some serious investigation of some of the most promising systems I have found. Medical Intelligence and Exmocare are among the vital signs monitoring systems that are still expected to be soon available on the general consumer market (rather than restricted to accredited research organizations). But there have been too many years of such expectations with little tangible result.

I was contacted by AWare Technologies (www.awaretechs.com) concerning the vital signs alarm systems page that I have on the Cryonics Institute website. AWare makes devices for the US Army that soldiers can wear:

www.awaretechs.com/MilitaryVitalSignsPrototype.html

The Army wants to know whether its soldiers in the field are dead or alive in order to determine the value and risk of rescue efforts. Not being a medical device it can avoid FDA regulation (which has been a huge cost/regulation barrier to such devices becoming available to consumers).

I did a considerable amount of negotiation with AWare, but it ended in frustration. The units were to be deployed for $999 initial payment per unit with monthly charges of $14.99, with a contract for guaranteed service use for five years. They wanted the Cryonics Institute to pay for it all rather than the individual CI Members, although they eventually suggested this could be negotiated further. The device could be worn on the wrist, belt or as a pendant. It was a pedometer-type motion detector rather than a vital signs monitor. It gathered data and sent the data through a phone line once per day, but could be altered to trigger a phone call to a pager or cell phone if there was more than fifteen minutes of inactivity. Samples were sent to the Cryonics Institute so that they could be put on display for the CI Open House, but the samples were incapable of actually dialing a phone number, so they were not very impressive.

MyPulse Monitor (www.mypulsemonitor.com/) is the closest I have come to getting a working vital signs alarm system. It has a 1,000-foot detection range (at most) and requires the use of a PC (Personal Computer) that can be connected to a phone line (modem,DSL,etc). The MyPulse system monitors heartbeats by a chest strap worn over the heart. A repeater relays the signal from the chest strap to a receiver connected to the computer by a USB port. Within 1,000 feet of the computer it can produce graphs of the heartbeat and trigger phone calls to one or more phone numbers if the heartbeat stops. The chest strap does not feel comfortable at first, but I have gotten used to wearing it on a continual basis. It is waterproof so it need not be removed during a shower, although this may not make for good cleaning. The repeater must be kept within three feet of the chest strap. Taking the repeater into the shower is strongly discouraged, so the chest strap should probably be removed during baths and showers.

The system is not plug-and-play, and could prove challenging for the typical elderly person who has not worked with computers. The user's manual must be studied thoroughly and there are many details about installation and use that are not obvious from the manual. The system had many bugs, which have been corrected through an ongoing dialog with the company and numerous versions of software updates that I have been sent. I have been able to make the telephone connection on the Cryonics Institute's desktop computer, but was unable to do so for Robert Ettinger's computer. I tried many combinations of COM ports and baud rates without success -- there seems to be a mismatch with Mr. Ettinger's DSL device. The company suggested that I could get another modem for Mr. Ettinger.

The repeater requires a great deal of attention. The repeater's battery should be recharged daily, taking an hour or two to recharge. The repeater can be used while recharging, but does not recharge as quickly -- and requires that the subject be tethered to the electrical cord on the charger. It has been recommended that the repeater be placed under the mattress for recharging during sleeping to avoid interrupting monitoring. But when I have done this the repeater becomes so hot that I fear it will be damaged. When I have tried placing the repeater in the pillow, the alarm generally sounds because the repeater is not close enough to the chest strap. I have tried wearing a shirt in bed with the repeater in the shirt pocket while connected to the charger. Even doing this, the repeater can become overheated. When overheated the repeater may cease to transmit, although I have been too concerned about damage by overheating to validate this belief properly. Many rude awakenings by the alarm were probably caused by my skin drying during sleep. By using electrolyte gel that I ordered online from MedSupply

www.medsupplystore.com/par11.html

and wearing the chest strap tightly I believe I have eliminated this problem.

The alarm provides for autodialing of many phone numbers and sending of an e-mail message when no heartrate is detected. I have not been able to get the e-mail alarm message sent, but I suspect this may be due to the weirdness of SBCGlobal username. The computer dials both my cell phone and the CI auxiliary phone during my testing. The phones ring, but no message is left. The recipient of the calls would need to note the caller ID phone number and realize the source and reason for the call.

Less complicated systems are expected to be on the market in 2008, but I won't believe it until I see it. I will report on what I see, however.

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