Death by nitrogen hypoxia

[Agast]

Anyone read about Alabama’s planned execution next week with nitrogen gas?

Alabama execution using nitrogen gas could "amount to torture" and violate human rights treaties, U.N. warns

The inmate, Kenneth Eugene Smith, already survived a botched execution attempt by lethal injection in 2022.

www.cbsnews.com

Apparently they couldn’t do the lethal injection because they couldn’t establish an IV. They will fit a mask over his face and then pump in nitrogen gas for 15 minutes or 5 minutes post EKG flat line. I’m wondering who came up with that protocol. It would be morbidly funny if the mask leaked and he didn’t die.

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[Dr. Rude]

Executions in the US have become Rube Goldberg machines.

 

[Pharmado]

I guess an IO catheter would be considered cruel and unusual punishment?

 

[coffeebythelake]

Carbon monoxide would work just fine.
Or helium. Or nitrous.

 

[pgg]

Xenon!

 

[Ezekiel2517]

I feel like just finding someone who is better at obtaining IV access would be a much simpler solution. I'm pretty sure he has veins in there

 

[Agast]

Carbon monoxide would work just fine.
Or helium. Or nitrous.

Just book each execution with the next big kid’s birthday party!

 

[nimbus]

Anyone read about Alabama’s planned execution next week with nitrogen gas?

Alabama execution using nitrogen gas could "amount to torture" and violate human rights treaties, U.N. warns

The inmate, Kenneth Eugene Smith, already survived a botched execution attempt by lethal injection in 2022.

www.cbsnews.com

Apparently they couldn’t do the lethal injection because they couldn’t establish an IV. They will fit a mask over his face and then pump in nitrogen gas for 15 minutes or 5 minutes post EKG flat line. I’m wondering who came up with that protocol. It would be morbidly funny if the mask leaked and he didn’t die.

I don’t know if the mask will be strapped to his face or if someone will hold the mask. In either case, he should flail his head around.

If they botch it twice, does he get to go home?

 

[nimbus]

I feel like just finding someone who is better at obtaining IV access would be a much simpler solution. I'm pretty sure he has veins in there

Maybe former paramedic/prison guard.

 

[Iso4ane]

I don’t know if the mask will be strapped to his face or if someone will hold the mask. In either case, he should flail his head around.

If they botch it twice, does he get to go home?

I believe people who get hypoxic, but are still ventilating usually lose consciousness/awareness, before the body starts to ‘freak out’. Think carbon monoxide poisoning, or there are videos of pilots undergoing high altitude training who get real confused (but remain calm).

 

[nimbus]

I believe people who get hypoxic, but are still ventilating usually lose consciousness/awareness, before the body starts to ‘freak out’. Think carbon monoxide poisoning, or there are videos of pilots undergoing high altitude training who get real confused (but remain calm).

I mean he should intentionally flail his head around from the beginning to break the mask seal so he doesn’t become hypoxic or narcotized. If he doesn’t want to die.

 

[woopedazz]

I believe people who get hypoxic, but are still ventilating usually lose consciousness/awareness, before the body starts to ‘freak out’. Think carbon monoxide poisoning, or there are videos of pilots undergoing high altitude training who get real confused (but remain calm).

The suffocation sensation gets negative feedback from some mechanoreceptors in the lungs... J-receptors or something? Can't remember from exams. Means they never really feel like they're dying.

 

[Agast]

I don’t know if the mask will be strapped to his face or if someone will hold the mask. In either case, he should flail his head around.

If they botch it twice, does he get to go home?

I read the document that was attached to the article. They strap it on and leave him in there and basically flip the switch from O2 to nitrogen. I suspect it’s not a custom designed mask either. I’m assuming it is a Venturi type mask and not the anesthesia mask they’re talking about.

welp, one day the AI sexbot will become a thing and then you can choose death by snu snu…

 

[GassYous]

I read the document that was attached to the article. They strap it on and leave him in there and basically flip the switch from O2 to nitrogen. I suspect it’s not a custom designed mask either. I’m assuming it is a Venturi type mask and not the anesthesia mask they’re talking about.

welp, one day the AI sexbot will become a thing and then you can choose death by snu snu…

It's actually a thing already

 

[Agast]

It's actually a thing already

…the mask or the death by snu snu?

 

[abolt18]

I mean he should intentionally flail his head around from the beginning to break the mask seal so he doesn’t become hypoxic or narcotized. If he doesn’t want to die.

Looks like they need one of these puppies.

 

[Dr. Rude]

I mean he should intentionally flail his head around from the beginning to break the mask seal so he doesn’t become hypoxic or narcotized. If he doesn’t want to die.

Or to make a statement about the cruelty of this form of capital punishment.

 

[nimbus]

I read the document that was attached to the article. They strap it on and leave him in there and basically flip the switch from O2 to nitrogen. I suspect it’s not a custom designed mask either. I’m assuming it is a Venturi type mask and not the anesthesia mask they’re talking about.

welp, one day the AI sexbot will become a thing and then you can choose death by snu snu…

https://dpic-cdn.org/production/documents/Al_Lethal_Gas_Execution_Protocol_2023_08.pdf?dm=1693938490

It’s interesting the document mentions pressure but not flow. If the system is not sealed and he can maintain MV>>>flow, he could entrain a lot of room air and not become hypoxic.

 

[pgg]

https://dpic-cdn.org/production/documents/Al_Lethal_Gas_Execution_Protocol_2023_08.pdf?dm=1693938490

It’s interesting the document mentions pressure but not flow. If the system is not sealed and he can maintain MV>>>flow, he could entrain a lot of room air and not become hypoxic.

There's an awful lot of material redacted in that document. It's hard to really assess how competent or incompetent they are without being able to read it all.

Maybe flow minimums are specified in one of the thousand or so redacted segments. I lean toward assuming they'll be as incompetent at this as they have been with their lethal injections, though I do remember their drug doses were absolutely MASSIVE so it wouldn't surprise me if they specify similarly enormous, to the point of absurdity, gas flows.


Edit - lethal injection doses were on page 27: 500 mg midazolam, 600 mg rocuronium, 240 mEq KCl

 

[psychbender]

Why strap a mask, when they can just stick him in an airtight room/chamber (like hyperbaric chamber), and change the gas mixture from the outside? Yes, I know a mask is cheaper, but the room is more foolproof.

 

[Dr. Rude]

Looks like they need one of these puppies.View attachment 381340

Where they got the idea from:

 

[pgg]

Why strap a mask, when they can just stick him in an airtight room/chamber (like hyperbaric chamber), and change the gas mixture from the outside? Yes, I know a mask is cheaper, but the room is more foolproof.

Judging by the issues they've had in the past, there's an awful lot of fool to overcome.

All of their previous problems have arisen from the simple fact that nobody capable of carrying out the task with competence is willing to take the job. Paradoxically, as they try harder and harder to be more humane about it the methods get more and more complicated with more and more failure modes, with fewer and fewer actual experts on staff to make it happen.

Seal the room ... they'd probably send the warden's nephew to Home Depot with instructions to pick up a bucket of drywall spackle.

 

[nimbus]

I don’t know how airtight these tents are but Alabama could test one of these tents attached to their nitrogen tanks before the fateful day.

Altitude generators, tents, and training masks by Higher Peak

Higher Peak, the top-selling personal athletic altitude training system, builds speed and endurance with low-oxygen training masks and altitude tents.

www.higherpeak.com

 

[chessknt]

CO makes the most sense honestly. Exact same mechanism but doesn't care about flow rates or mask leak since it kicks all off all the oxygen off the Hb. It won't be pretty to watch though, bad headache followed by coma then hypoxic seizures though I imagine it would be humane since his brain won't be working while that is happening.

The nitrogen asphyxiation strategy sounds really likely to fail.

 

[JiPo]

Where do we draw the line on “cruel and unusual punishment”?

These people on the death row must have done something treacherous to get there. Is I/O, EJ, or central line really cruel and inhumane?

If multiple attempts of establishing access is considered cruel, ketamine dart them and then attempt. Or use massive dose of IM anesthetics.

 

[nimbus]

I don’t know why execution has been medicalized in the US.

 

[pgg]

I don’t know why execution has been medicalized in the US.

It's because we (collectively) are stupid. Execution itself is dumb. Capital trials and sentencing and appeals cost far more than life imprisonment; wrongful convictions, whether because of incompetence or more sinister reasons are probably at least in the ~5% range; it's irreversible; prosecution and sentencing is not uniformly applied to all defendants.

If it's punishment that is desired, life in a small concrete box is a far more severe sentence than the sweet release of death.

The method of execution and the mental gymnastics some people do to make them more pleasant for the condemned and lay observers are a red herring. The actual problem is that we shouldn't be executing people at all.

 

[Dr. Rude]

I don’t know why execution has been medicalized in the US.

To make it more humane. (Chortle)

 

[drmwvr]

I don’t know why execution has been medicalized in the US.

Suicide has...kind of a no brainer...

 

[Agast]

The death penalty actually is way more expensive than lifetime imprisonment. Alabama has probably blown a lot of money trying to kill this guy more than once.

https://www.leg.state.nv.us/App/NELIS/REL/76th2011/ExhibitDocument/OpenExhibitDocument?exhibitId=17686&fileDownloadName=h041211ab501_pescetta.pdf

 

[Iso4ane]

The death penalty actually is way more expensive than lifetime imprisonment. Alabama has probably blown a lot of money trying to kill this guy more than once.

https://www.leg.state.nv.us/App/NELIS/REL/76th2011/ExhibitDocument/OpenExhibitDocument?exhibitId=17686&fileDownloadName=h041211ab501_pescetta.pdf

That link doesn't have Alabama, buuut it did have Maryland spending $37.2 mil for an execution. I think I can save them like $30mil. Personal fee of 7mil and 200K for equipment.

 

[Agast]

I mean, the actual guy on death row was paid $1000 to whack a pastor’s wife. Adjust for inflation but still a big cost savings /s

 

[nimbus]

“There are few people who have intimate knowledge of what an execution by nitrogen hypoxia might look like. However, one of them is Dr. Philip Nitschke, a pioneer in assisted suicide who recently invented a pod that fills with nitrogen as a way for people to end their lives.


Dr. Nitschke estimates he has witnessed at least 50 deaths by nitrogen hypoxia. He was called to testify by Mr. Smith’s lawyers in December during their effort to block the execution, and he met with Mr. Smith. After visiting the Alabama execution chamber and examining the mask that will be used by the state for Mr. Smith’s death, Dr. Nitschke said in an interview that he could imagine scenarios ranging from a quick and painless death to one involving substantial suffering if things were to go wrong.
He said that the big difference between Alabama’s protocols and those of his assisted suicide work in Europe and Australia lies in Alabama’s plan to use a mask. He said it would create a higher chance of there being a leak — allowing oxygen in and prolonging the process — than a room, pod or a plastic bag would.
“I feel anxious about Kenny, and I just don’t know which way things are going to go,” Dr. Nitschke said of Mr. Smith, whom he said seemed very nervous when the two met.
“What he would’ve liked to hear from me,” Dr. Nitschke said, “was that this was going to work well.” But, he said, he did not feel that he could promise Mr. Smith as much, instead viewing Alabama’s protocols as a “quick and nasty” attempt at nitrogen hypoxia that ignores the potential dangers of vomiting and air leakage.“

After a Botched Execution, Alabama Is Trying an Untested Method (Published 2024)

The state plans to carry out the first U.S. execution via nitrogen hypoxia with Kenneth Smith, who survived an earlier attempt to execute him by lethal injection.

www.nytimes.com

 

[Drwine]

I feel like just finding someone who is better at obtaining IV access would be a much simpler solution. I'm pretty sure he has veins in there

Hire a PICC line nurse.

 

[coffeebythelake]

Judging by the issues they've had in the past, there's an awful lot of fool to overcome.

All of their previous problems have arisen from the simple fact that nobody capable of carrying out the task with competence is willing to take the job. Paradoxically, as they try harder and harder to be more humane about it the methods get more and more complicated with more and more failure modes, with fewer and fewer actual experts on staff to make it happen.

Seal the room ... they'd probably send the warden's nephew to Home Depot with instructions to pick up a bucket of drywall spackle.

The inventor of the guillotine was a physician who wanted to make execution more humane. Look what happened

 

[coffeebythelake]

Where do we draw the line on “cruel and unusual punishment”?

These people on the death row must have done something treacherous to get there. Is I/O, EJ, or central line really cruel and inhumane?

If multiple attempts of establishing access is considered cruel, ketamine dart them and then attempt. Or use massive dose of IM anesthetics.

We do these things to patients all the time. The argument is that it is needed to take care of the patient and ultimately to improve their care and well being. I suppose you could make a similar argument about improving the execution experience for a condemned person..

 

[Angus Avagadro]

Very interesting conversation. Over 60,000 fentanyl deaths in 2021. Maybe oral fentanyl? Why make this hard? I believe they thwarted, not very successfully, the Russian Opera House hostage crisis in the early 2000's with aerosolized narcotics.

 

[Agast]

The inventor of the guillotine was a physician who wanted to make execution more humane. Look what happened

More humane than having a guy swing at you with an axe and miss grotesquely, he wasn’t wrong on that front

 

[coffeebythelake]

More humane than having a guy swing at you with an axe and miss grotesquely, he wasn’t wrong on that front

Yes that's true. But unintended consequences it became a symbol of terror during the French revolution

 

[GaseousClay]

Where do we draw the line on “cruel and unusual punishment”?

These people on the death row must have done something treacherous to get there. Is I/O, EJ, or central line really cruel and inhumane?

If multiple attempts of establishing access is considered cruel, ketamine dart them and then attempt. Or use massive dose of IM anesthetics.

apparently they are supposed to instantly go unconscious, secondly this killer demands this method. seems less cruel than anything if this is the case.

 

[Gern Blansten]

This seemed to work well.

 

[nimbus]

Very interesting conversation. Over 60,000 fentanyl deaths in 2021. Maybe oral fentanyl? Why make this hard? I believe they thwarted, not very successfully, the Russian Opera House hostage crisis in the early 2000's with aerosolized narcotics.

I think the man is contesting his sentence. In order to administer oral fentanyl he needs to swallow it.

The other thing about this case is that the jury sentenced him to life imprisonment. The judge presiding over the case decided that he should be executed by electrocution instead.

Everything you need to know about Alabama's nitrogen hypoxia execution of Kenneth Eugene Smith

After more than two decades on death row, contract killer and Alabama native Kenneth Smith died by nitrogen hypoxia on Thursday, the first execution of its kind.

www.wvtm13.com

 

[Angus Avagadro]

I think the man is contesting his sentence. In order to administer oral fentanyl he needs to swallow it.

The other thing about this case is that the jury sentenced him to life imprisonment. The judge presiding over the case decided that he should be executed by execution instead.

Everything you need to know about Alabama's nitrogen hypoxia execution of Kenneth Eugene Smith

After more than two decades on death row, contract killer and Alabama native Kenneth Smith died by nitrogen hypoxia on Thursday, the first execution of its kind.

www.wvtm13.com

Oh, I agree with you. He would not swallow it. I was spitballing, but there are several routes fentanyl can be administered, oral, patches, IM, nasal spray, NG tube, PR, aerosolized etc.. Slap a dozen patches on him to take the lead out of his pencil, and give him a shot. That should work. We give newborns IM injections, hardly cruel and unusual. We are only limited by our creativity. We sadly know how to kill people by other means and I can understand why it has come to this.

 

[Agast]

Apparently it’s happening right about now, and his minister is by his side as it’s done. Had to sign a waiver acknowledging the mask could leak.

https://www.reuters.com/legal/alabama-prepares-carry-out-first-execution-by-nitrogen-asphyxiation-2024-01-25/

 

[gcc322]

I read they made him NPO after 10am…at least they were smart enough to do that. Can you imagine the sight of someone vomiting into that respirator and aspirating?

 

[dozitgetchahi]

Why strap a mask, when they can just stick him in an airtight room/chamber (like hyperbaric chamber), and change the gas mixture from the outside? Yes, I know a mask is cheaper, but the room is more foolproof.

As I understand it, this is basically the method used at dog pounds/“kill shelters”…place the animals in room, and then either pump in other gasses or reduce the pressure etc etc…

 

[dozitgetchahi]

It's because we (collectively) are stupid. Execution itself is dumb. Capital trials and sentencing and appeals cost far more than life imprisonment; wrongful convictions, whether because of incompetence or more sinister reasons are probably at least in the ~5% range; it's irreversible; prosecution and sentencing is not uniformly applied to all defendants.

If it's punishment that is desired, life in a small concrete box is a far more severe sentence than the sweet release of death.

The method of execution and the mental gymnastics some people do to make them more pleasant for the condemned and lay observers are a red herring. The actual problem is that we shouldn't be executing people at all.

And not just for these reasons…my personal belief is that governments should not be in the business of killing their own citizens, for any reason. Lifetime imprisonment? Fine, fitting punishment indeed.

 

[ProPropofol]

Whenever they have difficulty getting IV access for these executions, I always wonder about how much they try to get access. Did they use a vein finder? Ultrasound? Attempt a central line? How about IO access? Even in bad traumas, I may have struggled to get access but I always got something eventually. It really makes me wonder who is in charge of getting the IV.

 

[ProPropofol]

You probably have amateurs doing all of that during these executions. You think they care about the humanity of the condemned?

I thought they would at least care about the efficiency and proficiency of the tasks involved with carrying out a sentencing... It's probably not cheap to carry out the same execution multiple times because of a failed IV.

 

[mdo1738]

Should have got the chair