Code here relates to "calling a code" as described here when someone is imminently dying.

I talk to a 96 year old about end of life and a POLST form.

The first question on the Washington State POLST is if found not breathing and with no pulse, do you want an attempt at resuscitation or no resuscitation (Natural Death). I reframe that as "not breathing and no pulse, that is, dead."

Most 96 year olds do not want to be resuscitated if they are dead. Most people over 80 don't want to be resuscitated and it would be very unlikely to be successful and even if we got them back, it's like a stroke. No blood flow to the brain is bad and there are 6-8 minutes to brain death.

Patients say, "Only bring me back if I am ok." My response is "We do not come with the little turkey pop up that says too late." But... we could build that.

Which leads to the app. There is now a $100 ECG attachment for smart phones. Lots of people are wearing Fitbits and hello, the smart phones and the Fitbit and lots of other things can measure pulse. Also the lack of a pulse. When will someone build a heart alarm monitor to wear that times how long the heart has stopped? I joke to patients that if they want to be revived, it's best to die right in the emergency room with all the equipment and the ER doctor present, or possibly in Las Vegas, where all the security guards have used AEDs.

Build an app that tells us when someone is brain dead, when it is too late. Also that calls an ambulance. Of course then there is potential for error or abuse. Do not attach it to your cat. What if it malfunctions? Horrors, what if it is wrong? Would it catch murderers in the act?

Would it sell? I am curious. I think that my over 80 crowd might be interested....

Iron Noder: Tokyo drift 26

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