This post will surely show my ignorance on such things...but I'm guessing I'm not the only one wondering these things. How long does it take you to die from this type of procedure? I imagine you just fall asleep and stop breathing...but I can't help but think this might have been an agonizing thing for her family to stand by and watch happen. (I know...either way, it was going to be agonizing for them.)
I was wondering that myself. How is this procedure different from how States administer the death penalty?
RIP Brittany - be at peace
Execution by lethal injection takes typically about 10 min from the start of intravenously administered meds (referred to as "chemicals" in state laws and prison policies). The person is unconscious within seconds if the IV line is functioning properly. This is the same as a general anesthetic in the OR-- the person loses consciousness within seconds of the induction meds administered IV (not to be confused with sedation), and is apneic (unable to take a breath) seconds past losing consciousness. Induction meds are usually a combination of benzodiazepine, opioid, and propofol, plus a paralyzing agent (short acting, usually.) In general anesthetics, typically we administer a paralyzing agent also, to facilitate endotracheal intubation. The most common paralyzing agent in the OR is rocuronium (Zemuron), which will paralyze skeletal muscles (breathing muscles as well as arms, legs, etc) for about 25-40 min. In the OR, of course, we take over the task of breathing for the patient, using the mask and circuit on the anesthesia "gas" machine. We support blood pressure and heart rate, and once intubated, we "turn on" the anesthetic agents ("gas" + oxygen, and sometimes nitrous oxide).
In a judicial execution, no one takes over the task of breathing for the inmate, once he/ she loses consciousness. Cardiac arrest follows respiratory arrest. Each state uses different meds, or a combination. The end result is the same. The process is not painful as long as the doses are administered properly, and in huge enough amounts to effect unconsciousness within seconds. Execution doses of anesthetic meds are typically 10 to 20 times what we would use for a "normal" anesthetic. (And they have back up syringes, usually, for a second dose if needed.) A few states have a protocol for intramuscular shots as a back up plan if the IV fails, etc, but I have a lot of issues about that. (I'll spare you the lecture!)
Now, in compassionate end of life overdose, the meds prescribed are oral meds. Could be pills, or more effectively would be liquids, to speed absorption and onset, and ward off vomiting. State laws, as I understand them, require the terminally ill person to take them unassisted. I don't know for sure exactly which meds would be prescribed, but an enormous dose of highly concentrated opioids like dilaudid is most likely.
** Edited to add-- I'm wrong here! Secobarbital is the most commonly prescribed. See post #19 below for links. (Paralyzing drugs as used in general anesthetics would not "work" if administered orally, and these would not be used.)
If taken on an empty stomach to facilitate rapid absorption and defer vomiting, I think it's reasonable to assume the person would become unconscious within something under 30 min, and possibly much faster, depending on their level of debilitation. There is typically no air hunger with an opioid overdose-- opioid overdose is usually quite comfortable and peaceful. No anxiety. (This is why we worry about pain meds in the hospital so much.)
The person gently loses consciousness, and breathing becomes more shallow, breaths further apart. They will make snoring sounds if their airway is obstructed, which can often be relieved in a thinner person by simply tipping their head back. Once respiratory arrest has occurred (no further attempts to breathe), the heart will begin to go into fatal rhythm patterns. This is not noticed or painful by the dying person. Depending on the level of debilitation of the patient, and the health of their heart, this shouldn't take long-- maybe another 4-10 min. From my knowledge of anesthesia and meds, I'd think the whole process would be maybe 30-45 min at the most, and possibly a lot less.
RIP Brittany. I'm glad she got to leave on her terms, in the arms of her loved ones.
