The main signs and tragic consequences of clinical death. What is the difference between coma and clinical death? Why does coma occur after clinical death?

What is the difference between clinical death and coma

Clinical death is a transitional stage between life and biological death. In this case, the central nervous system does not function, but the metabolic process still occurs in the tissues. Sometimes clinical death is identified with another condition - coma.

Differences between coma and clinical death

Signs and stages of clinical death

Signs of clinical death are: absence of heartbeat, general pallor, respiratory arrest, lack of pupillary reaction to light. The central nervous system stops functioning, but metabolic processes continue to occur in tissues. Clinical death has three stages. The first is a preagonal state, a person feels general weakness, consciousness is confused, blueness is observed skin or their pallor, absence or weakness of pulse in the peripheral arteries, it becomes difficult to determine blood pressure. The second stage of clinical death is the agonal stage (agony). During this period, there is a sharp intensification of the activity of all parts of the body. A characteristic external sign of this stage is short, deep breathing accompanied by wheezing. Often there is no consciousness because the functioning of the central nervous system. In the third stage, the body gives up and turns off the “life support system.” In that short period Doctors have the opportunity to bring a person back to life; at this time, the accumulated supply of oxygen and necessary substances is consumed in the body’s cells. If blood flow stops suddenly, it may take up to 10 minutes to die.

If, during clinical death, resuscitation actions were not carried out, or they were ineffective, biological death, which is irreversible. Clinical death lasts 5-6 minutes following cardiac and respiratory arrest. After this time, it is no longer possible to restore vital functions.

What is the difference between fainting and loss of consciousness

Loss of consciousness is a fairly common phenomenon, and in the Middle Ages, young ladies fainted several times a day, and there were good reasons for this. How often do people equate the concepts of fainting and loss of consciousness. You can often hear “lost consciousness”, “fainted” when talking about the same case? Is this opinion really wrong, or are these really synonymous terms denoting the same condition? In order to answer these questions, it is necessary to understand the etymology, causes and manifestations of these conditions.

What is fainting

Fainting is a short-term disturbance or loss of consciousness. The condition itself does not pose a danger to human health, unless, of course, it becomes a habit. Because if fainting becomes a frequent and habitual occurrence, it may be a symptom of a neuralgic or psychiatric disorder or disease. A person may be in this state no more than 5 minutes.

Fainting is characterized by a lack of reaction to the surrounding reality. Before fainting, there may be a feeling of stupor, ringing in the ears, and nausea. The skin turns pale or red if the cause of fainting is overheating.


Basically, people faint due to a decrease in the concentration of oxygen in the blood or when the regulation of blood vessels in the brain is disrupted, for example, as a result of a sudden change in body position. This condition is also observed as a result of heart rhythm disturbances, myocardial infarction.

What is loss of consciousness

Loss of consciousness is a much broader and deeper concept than fainting. From the point of view of neuralgia and psychiatry, loss of consciousness is characterized as a state when a person lacks reaction and awareness of reality. Moreover, this condition can last from several seconds to several years.


There are different types of loss of consciousness, each of which has its own specific symptoms, causes and duration.

Stupor is a state of loss of consciousness when a person seems to fall into a stupor.. Freezing occurs for several seconds, and during this time there is no reaction to the speech of others and their attempts to “reach out” to the person. And after a short period of time, the person continues to do what he was doing before the stupor and does not remember what happened to him during these few seconds. It was as if they had disappeared for him.

Other types of loss of consciousness, such as coma, may persist for several years. In such conditions, a person is connected to artificial nutrition and respiration, since otherwise the body will die. The coma state puts the body into what is called deep dream when loss of consciousness leads to disruptions in the functioning of almost all human organ systems.

Fainting is also a type of loss of consciousness, his clinical picture was discussed earlier. In addition, it is worth mentioning here the state of confused consciousness, characterized by the “loss” of some mental processes. For example, a person’s speech processes may be disrupted - in this case, it becomes impossible to construct an adequate speech message, or the person’s memory is impaired - he begins to confuse events. A violation of the motor component is also possible - movements become either spontaneous and abrupt, or vice versa - passive and slow, not meeting the requirements of the surrounding reality.

Confused consciousness can be classified in psychiatry as independent disease, and be a symptom accompanying other neuralgic and psychiatric illnesses, such as manic syndrome or post-traumatic psychosis.

It is also worth noting such a phenomenon as sopor– a state of loss of consciousness, characterized, on the one hand, by a lack of reaction to the surrounding reality, on the other, by the preservation of reflexes. That is, reflex activity functions in response to external influence, pain, but this does not return the person to consciousness.

What is the difference between fainting and loss of consciousness?

Summarizing the above, we can say that loss of consciousness and fainting are different concepts. Fainting is a special case or type of loss of consciousness. The latter includes, in addition to it, a lot of other states of different etymologies.

Since the main cause of fainting is a decrease in the concentration of oxygen in the blood, it is important to be able to distinguish this condition from other types of loss of consciousness. Since incorrect first aid measures before the arrival of the medical team in other cases of loss of consciousness can lead to the death of the victim.

According to some classifications, fainting is not included in the categories of types of loss of consciousness, but is interpreted as a separate state of short-term loss of perception of the environment, since, unlike other types of loss of consciousness, in most cases it does not imply clinical disorders of the nervous system.

Fainting and loss of consciousness: what is the difference? Causes of fainting and loss of consciousness. First aid for fainting and loss of consciousness

People are often concerned about what fainting and loss of consciousness are, what the difference is between these terms, and how to provide proper first aid to an unconscious person.

Characteristics of loss of consciousness

Loss of consciousness is a condition in which the body does not respond to external stimuli and is not aware of the surrounding reality. There are several types unconsciousness:

Thus, it turns out that fainting is one of the types of loss of consciousness.

Causes of loss of consciousness

The main causes of loss of consciousness are:

• overwork;
• strong pain;
• stress and emotional turmoil;
• dehydration of the body;
• hypothermia or overheating of the body;
• lack of oxygen;
• nervous tension.

Knowing the reasons for fainting and loss of consciousness, what is the difference between these conditions, you can correctly provide first aid.

Brain damage that causes loss of consciousness can be caused by direct exposure (head trauma, poisoning, hemorrhage) or indirect (bleeding, fainting, states of shock, suffocation, metabolic disorders).

Types of loss of consciousness

There are several types of unconsciousness:

Any manifestations of disturbances in the functioning of body systems can include fainting and loss of consciousness. The severity of symptoms varies depending on the duration of unconsciousness and the presence of additional injuries.

Clinical picture of loss of consciousness

In an unconscious state, the victim has:

Knowing the symptoms of fainting and loss of consciousness, what is the difference between them and how to properly provide first aid, you can prevent the death of the victim, especially if he has no breathing or cardiac activity. Since timely cardiopulmonary resuscitation can restore the functioning of these systems and bring the person back to life.

First aid for loss of consciousness

First of all, you need to eliminate possible reasons loss of consciousness - take the person out into the fresh air if there is a smell of smoke or gas or electric current in the room. After this, you need to clear the airways. In some cases, it may be necessary to clean the mouth using a tissue.

If a person has no heartbeat or breathing, cardiopulmonary resuscitation must be started immediately. After the restoration of cardiac activity and breathing, the victim must be taken to a medical facility. When transporting the victim, there must be an accompanying person.

If there are no problems with breathing or heart function, you need to increase blood flow to the brain. To do this, the victim must be laid so that the head is slightly lower than the level of the body (if there is a head injury or nose bleed, this point cannot be fulfilled!).

You need to loosen your clothes (untie your tie, unbutton your shirt, unbutton your belt) and open the window to ensure air flow fresh air, this will increase the supply of oxygen. You can bring a cotton swab with ammonia to the victim’s nose, in most cases this helps to return him to a conscious state.

Important! If the duration of unconsciousness exceeds 5 minutes, urgent medical attention is needed.

Knowing the difference between fainting and loss of consciousness, you can provide the victim with the correct first aid.

Characteristics of fainting

Fainting is a short-term loss of consciousness caused by a lack of oxygen due to impaired blood supply to the brain. A short-term loss of consciousness does not pose a danger to human life and health and often does not require medical intervention. The duration of this state ranges from several seconds to several minutes. Fainting can be caused by the following pathological conditions of the body:

• violations nervous regulation vessels during a sudden change in position (transition from horizontal to vertical position) either when swallowing;
• with a decrease in cardiac output - stenosis pulmonary arteries or aorta, angina attacks, heart rhythm disturbances, myocardial infarction;
• when the concentration of oxygen in the blood decreases - anemia and hypoxia, especially when rising to a high altitude (where the air is rarefied) or staying in a stuffy room.

The causes of fainting and loss of consciousness must be known in order to be able to distinguish between these conditions and provide necessary for a person first aid.

Clinical picture of fainting

Fainting is characteristic manifestation some diseases. Therefore, if you experience frequent fainting, you must see a doctor and undergo an examination to identify pathological processes in the body.

Fainting is a short-term loss of consciousness caused by a lack of oxygen due to a disruption in the blood supply to the brain. The main symptoms of fainting are nausea and a feeling of stuffiness, ringing in the ears, darkening in the eyes. At the same time, the person begins to turn pale, his muscles weaken and his legs give way. Loss of consciousness is characterized by both increased heart rate and slower heart rate.

In a fainting state, a person’s heart sounds weaken, blood pressure drops, and all neurological reflexes weaken significantly, so convulsions or involuntary urination may occur. Loss of consciousness and fainting are mainly characterized by the victim’s lack of perception of the surrounding reality and what is happening to him.

First aid for fainting

When a person faints, the tongue may sink in as its muscles weaken. To prevent this, you need to turn the person on his side and call ambulance, since it is quite difficult to independently determine the cause of this condition.

First aid for fainting and loss of consciousness makes it possible to support the vital functions of the victim’s body before the ambulance arrives. In most cases, first aid can avoid death.

Without proper examination, identify exact reason fainting is impossible. Since it can be a consequence of a pathological process in the body, and ordinary fatigue or nervous tension.

Fainting and loss of consciousness. What is the difference between these concepts?

Having understood the features of the unconscious state of the body, we can conclude that loss of consciousness is general concept. It includes many various manifestations. Fainting is one of them and is a short-term loss of consciousness that occurs as a result of oxygen starvation of the brain.

Loss of consciousness. Causes, symptoms, clinical death

Initial examination

As a rule, loss of consciousness occurs when there is a lack of necessary for the body glucose and low oxygen supply to brain cells. Once you have confirmed the presence of accompanying symptoms, you can safely diagnose that a loss of consciousness has occurred. First aid should be provided immediately, as the onset of clinical death is dangerous. The victim must be examined for the main signs fainting. Do not listen to advice that suggests conducting a visual inspection - unnecessary loss of time can be critical for the victim, and a visual examination, in any case, cannot give a complete picture of the incident. Therefore, you should immediately check the pulse in the carotid artery. You also need to pay attention to whether the victim is breathing and whether the pupils react to light. If something is missing, then you should proceed to resuscitation measures.

Causes

A person may lose consciousness as a result of heart failure or other factors. The causes of loss of consciousness are quite varied. This could be heat stroke when a person is overheated in the sun, or a lack of necessary oxygen in a musty room. Problems with the heart and internal organs can lead to temporary brain shutdown. Also, loss of consciousness can be caused by a blow to the back of the head or painful shock from any impact, poisoning, diabetes mellitus or internal bleeding. The latter is extremely difficult to identify. If the patient cannot stand or sit normally and constantly “passes out”, and while lying down comes to his senses again, then this is one of the signs that the loss of consciousness is caused by hidden internal bleeding.

Rehabilitation

If everything is fine with the heartbeat and breathing, then a series of restorative procedures should be carried out for the victim. First, you should bring a cotton swab moistened with ammonia to your nose - this will return the patient to a conscious state. Also, if the patient is diagnosed with low glucose levels, it is necessary to administer intravenous injections of glucose 40%. But this is already a method of treatment in a hospital setting.

Clinical death

What to do if an ordinary loss of consciousness turns out to be clinical death? This diagnosis can be made when there is no breathing, no heartbeat, or when there is no reaction of the pupils to light. In this case, emergency resuscitation will have to be performed. It's about about chest compressions and artificial ventilation. This is a fairly simple procedure if you understand and remember what to do. First you need to deliver a precordial blow. If this does not help, then you need to find a point on the victim’s chest, 2-3 cm above the xiphoid process. Place your palms there with the direction thumb to the head or feet of the patient. In order for the required amount of blood to be pumped into the heart, fairly strong pressure should be applied at a frequency of 40-60 beats per minute for several hours. In the absence of breathing, artificial ventilation of the lungs should also be carried out, after clearing the patient’s mouth of foreign matter. It is necessary to take 2-3 breaths per 30 pressures.

Fainting

Fainting is a short absence of consciousness caused by a sudden disruption of blood circulation in the brain. This happens because the brain does not receive sufficient quantity oxygen and nutrients. Fainting differs from complete loss of consciousness in that it lasts on average no longer than five minutes. Impaired blood flow can be caused by many factors, including various disorders cardiovascular system, inflammatory or infectious processes. In addition, short-term loss of consciousness is often observed in girls during their first menstruation. According to statistics, half of the world's population has encountered such a disorder at least once in their life. Doctors say that less than half of all such cases are of unknown nature.

Before losing consciousness, many people experience malaise, severe dizziness, tinnitus, and increased sweating. Fainting can be avoided; you just need to sit down in time; if you don’t do this, you will fall. Usually a person quickly comes to his senses, often without the help of others. Quite often, fainting is accompanied by injuries that a person receives directly during a fall. Slightly less often, a person experiences short-term, moderate-intensity seizures or urinary incontinence.

Normal syncope should be distinguished from epileptic syncope, although it can also be caused by some factors related to short-term loss of consciousness, for example, menstruation in women or the sleep phase. During epileptic syncope, a person immediately experiences intense convulsions.

Etiology

There are several reasons why people faint, but despite this, in almost half of the cases it is not possible to determine the factor causing such a disorder. Sources of insufficient blood flow to the brain can be:

• disorders of the functioning of the autonomic nervous system;
• heart defects;
• a sharp increase in intracranial pressure;
• intoxication caused by gas poisoning, nicotine, alcoholic drinks, household chemicals, plant care products, etc.;
• strong emotional changes;
• sudden drop in blood pressure;
• lack of glucose in the body;
• insufficient amount of hemoglobin;
• air pollution;
• change of body position. Loss of consciousness occurs when suddenly rising to your feet from a lying or sitting position;
• specific effects on the human body, including prolonged exposure to hot temperatures or increased atmospheric pressure;
• age category - in adults, fainting can occur when urinating or diarrhea, in teenagers, in particular in girls, fainting occurs during menstruation, and in older people, loss of consciousness can occur during sleep.

According to statistics, it is women who often faint, since they are most susceptible to changes in temperature or atmospheric pressure. Very often, while watching their figure, female representatives observe strict diets or refuse to eat at all, which leads to hungry fainting.

The causes of fainting in children and adolescents occur in the following cases:

• from strong fear or anxiety, such as when speaking in front of a crowd or visiting the dentist;
• when overworked from physical exertion or mental activity;
• associated with injuries and, as a consequence, with severe pain. This mainly happens with fractures;
• at the first onset of menstruation, girls are often accompanied severe dizziness, lack of air leading to fainting;
• frequent extreme situations, which attract young girls and boys so much;
• from prolonged fasting or strict diets.

Suddenly fainting a few minutes after a night's sleep, this may be due to excessive consumption alcoholic drinks the day before, or because the brain is not fully awake. In addition, in women over fifty, fainting can be caused by a condition such as menopause, that is, the cessation of menstruation.

Varieties

Depending on the factors influencing the occurrence, there are the following types fainting:

• neurogenic in nature, which, in turn, are:
  • vasodepressor – arising against the background of emotional changes, stressful situations. Very often manifests itself at the sight of blood in particularly impressionable people;
  • orthostatic – expressed due to a sudden change in body position or taking certain medications. This group includes loss of consciousness from wearing tight or uncomfortable clothing, in particular tight collars of outerwear, as well as fainting in men and women who experience urinary incontinence during sleep, coughing, or when passing feces;
  • maladaptive – arise due to non-adaptation to conditions external environment, for example, in too hot or cold climates;
• hyperventilation direction– appear from severe fear or panic;
• somatogenic– the causes of which directly depend on functioning disorders internal organs, with the exception of the brain. There are cardiogenic fainting - occurring due to heart pathologies, anemic - developing due to reduced level hemoglobin and red blood cells, as well as hypoglycemic - associated with insufficiency of glucose in the blood;
• extreme nature, which are:
  • hypoxic, resulting from a lack of oxygen in the air;
  • hypovolemic – appearing as a result of heavy blood loss, menstruation, extensive burns;
  • intoxication – developing due to various poisonings;
  • medicinal – taking medications that lower blood pressure;
  • hyperbaric - the occurrence factor is increased atmospheric pressure.

Symptoms

The appearance of such a disturbance of consciousness is preceded by uncomfortable and unpleasant sensations. Thus, the symptoms of fainting are:

• sudden onset of weakness;
• noise in ears;
• strong pulsation in the temples;
• heaviness in the back of the head;
• decreased visual acuity;
• pale skin, often the appearance of a gray tint;
• the appearance of nausea;
• abdominal cramps precede loss of consciousness during menstruation;
• excessive sweating.

The pulse of a person who has fainted is palpable weakly, the pupils practically do not react to light.

This condition very rarely lasts more than five minutes, but in cases where it takes longer, fainting with convulsions and urinary incontinence are observed. Thus, a short-term loss of consciousness becomes a deep faint. Besides this, some people fall into quitrent with with open eyes, in this case, the best solution would be to cover them with your hand or cloth to prevent them from becoming dry. After fainting, a person feels drowsy, slightly dizzy and confused. Such sensations go away on their own, but the victim still needs to see a doctor, especially if he was injured during a fall.

Diagnostics

Despite the fact that fainting often goes away on its own, diagnosis and treatment are necessary, because this condition is often a symptom of various diseases that may threaten a person’s health and life. In addition, it is not always clear why fainting occurs, and diagnostics will help determine the causes of the occurrence.

The first stage of diagnosis consists of identifying possible pronounced causes of fainting, for example, menstruation, working conditions, sleep phase, poisoning or pollution environment. The doctor needs to find out whether the patient has taken any medications and whether an overdose has occurred.

Next, it is necessary to examine the patient, but symptoms will not always be identified. If a person is taken to a medical facility immediately after fainting, he will experience inhibition and slowness of reaction, as if after sleep, and answers to any questions will be delayed. In addition, the doctor cannot help but notice an increased heart rate and decreased blood pressure.

Then the patient needs to take a blood test, which will confirm or refute the deficiency of glucose, red blood cells and hemoglobin.

Hardware diagnostics consists of undergoing examinations of various internal organs, since it is not always clear why fainting occurs, and if the problem is hidden in the improper functioning of one or more internal organs, then radiography, ultrasound, ECG, MRI and other methods will help detect this.

In addition, additional consultations with a cardiologist may be necessary - if heart problems have been detected, a gynecologist - in case of loss of consciousness during menstruation, and a specialist such as a neurologist.

Treatment

Before contacting specialists who will provide proper therapy, the first step is to provide the victim with first aid. Therefore, a person who is nearby at such a moment should know what to do in case of fainting. First aid methods include the following activities:

• protect from injuries, especially pay attention to the head;
• lay the person on a flat and soft surface, try to make sure that the legs are slightly higher than the level of the body;
• remove tight or tight clothing;
• put the victim not on his back, but on his side, because relaxed tongue muscles can cause breathing problems;
• provide a flow of fresh air in the room where the victim is located;
• during menstruation, do not apply a heating pad to your stomach, because not everyone knows that this can cause bleeding;
• Call a medical team as quickly as possible, especially in cases where fainting lasts more than five minutes and is accompanied by convulsions and incontinence.

Treatment for fainting depends entirely on the causes of its occurrence. If such a disorder is accompanied by a disease, then therapy will be aimed at eliminating it. Very often, medications are prescribed to improve brain nutrition. Adaptogens help a person adapt to environmental conditions. In case of hungry fainting, it is necessary to restore normal food intake and abandon diets. If a girl or woman experiences loss of consciousness during menstruation, it is necessary to take medications that facilitate this process. If a person suffers from fainting due to urine incontinence during sleep, he should stop drinking liquids two hours before bedtime.

What is clinical death - signs, maximum duration and consequences for human health

A person is able to live without water and food for some time, but without access to oxygen, breathing will stop after 3 minutes. This process is called clinical death, when the brain is still alive, but the heart does not beat. A person can still be saved if you know the rules of emergency resuscitation. In this case, both doctors and those who are next to the victim can help. The main thing is not to get confused and act quickly. This requires knowledge of the signs of clinical death, its symptoms and the rules of resuscitation.

Symptoms of clinical death

Clinical death is a reversible state of dying in which the heart stops working and breathing stops. All external signs of vital activity disappear, and it may seem that the person is dead. This process is a transitional stage between life and biological death, after which it is impossible to survive. During clinical death (3-6 minutes), oxygen starvation has virtually no effect on the subsequent functioning of organs, general condition. If more than 6 minutes have passed, the person will be deprived of many vital important functions due to the death of brain cells.

To recognize in time this state, you need to know its symptoms. Signs of clinical death are:

• Coma - loss of consciousness, cardiac arrest with cessation of blood circulation, pupils do not react to light.
• Apnea is the absence of respiratory movements of the chest, but metabolism remains at the same level.
• Asystole - the pulse in both carotid arteries cannot be heard for more than 10 seconds, which indicates the beginning of destruction of the cerebral cortex.

Duration

Under conditions of hypoxia, the cerebral cortex and subcortex are able to remain viable for a certain time. Based on this, the duration of clinical death is determined by two stages. The first of them lasts about 3-5 minutes. During this period, provided that the body temperature is normal, there is no oxygen supply to all parts of the brain. Exceeding this time range increases the risk of irreversible conditions:

• decortication - destruction of the cerebral cortex;
• Decerebration – death of all parts of the brain.

The second stage of the state of reversible dying lasts 10 minutes or more. It is characteristic of an organism with a reduced temperature. This process can be natural (hypothermia, frostbite) and artificial (hypothermia). In a hospital setting, this state is achieved by several methods:

• hyperbaric oxygenation – saturation of the body with oxygen under pressure in a special chamber;
• hemosorption - blood purification by a device;
• drugs that sharply reduce metabolism and cause suspended animation;
• transfusion of fresh donor blood.

Causes of clinical death

The state between life and death occurs for several reasons. They can be caused by the following factors:

• heart failure;
• obstruction of the respiratory tract (lung disease, suffocation);
• anaphylactic shock – respiratory arrest due to the body’s rapid reaction to an allergen;
• large loss of blood due to injuries, wounds;
• electrical damage to tissues;
• extensive burns, wounds;
• toxic shock - poisoning with toxic substances;
• vasospasm;
• the body's reaction to stress;
• excessive physical activity;
• violent death.

Basic steps and first aid methods

Before taking first aid measures, you must be sure that a state of temporary death has occurred. If all of the following symptoms are present, it is necessary to proceed to treatment emergency assistance. You should make sure of the following:

• the victim is unconscious;
• the chest does not make inhalation-exhalation movements;
• there is no pulse, the pupils do not react to light.

If there are symptoms of clinical death, it is necessary to call an ambulance resuscitation team. Until the doctors arrive, it is necessary to maintain the victim’s vital functions as much as possible. To do this, apply a precordial blow to the chest with a fist in the area of ​​the heart. The procedure can be repeated 2-3 times. If the victim’s condition remains unchanged, then it is necessary to move on to artificial pulmonary ventilation (ALV) and cardiopulmonary resuscitation (CPR).

CPR is divided into two stages: basic and specialized. The first is performed by a person who is next to the victim. Second - trained medical workers on site or in a hospital. The algorithm for performing the first stage is as follows:

1. Lay the victim on a flat, hard surface.
2. Place your hand on his forehead, tilting his head back slightly. At the same time, the chin will move forward.
3. With one hand, pinch the victim’s nose, with the other, stretch out your tongue and try to blow air into your mouth. Frequency – about 12 breaths per minute.
4. Go to indirect cardiac massage.

To do this, use the palm of one hand to press on the area of ​​the lower third of the sternum, and place the second hand on top of the first. Indentation chest wall is performed to a depth of 3-5 cm, and the frequency should not exceed 100 contractions per minute. Pressure is performed without bending the elbows, i.e. straight position of the shoulders over the palms. You cannot inflate and compress the chest at the same time. You must make sure that your nose is pinched tightly, otherwise your lungs will not get required quantity oxygen. If the injection is done quickly, air will get in into the stomach, causing vomiting.

Resuscitation of a patient in a clinical setting

Resuscitation of a victim in a hospital setting is carried out according to a certain system. It consists of the following methods:

1. Electrical defibrillation - stimulation of breathing by exposure to electrodes with alternating current.
2. Medical resuscitation through intravenous or endotracheal administration of solutions (Adrenaline, Atropine, Naloxone).
3. Circulatory support by administering Gecodez through a central venous catheter.
4. Correction acid-base balance intravenously (Sorbilact, Xylate).
5. Restoration of capillary circulation by drip(Reosorbilact).

If resuscitation measures are successful, the patient is transferred to the ward intensive care, where further treatment and monitoring of the condition is carried out. Resuscitation is stopped in the following cases:

• Ineffective resuscitation measures within 30 minutes.
• Statement of the state of biological death of a person due to brain death.

Signs of biological death

Biological death is the final stage of clinical death if resuscitation measures are ineffective. Tissues and cells of the body do not die immediately; it all depends on the organ’s ability to survive hypoxia. Death is diagnosed based on certain signs. They are divided into reliable (early and late), and orienting - immobility of the body, absence of breathing, heartbeat, pulse.

Biological death can be distinguished from clinical death using early signs. They occur 60 minutes after death. These include:

• lack of pupillary response to light or pressure;
• the appearance of triangles of dried skin (Larchet spots);
• drying of the lips - they become wrinkled, dense, brown in color;
• symptom " cat eye“- the pupil becomes elongated due to the lack of eye and blood pressure;
• drying of the cornea - the iris becomes covered with a white film, the pupil becomes cloudy.

A day after dying, they appear late signs biological death. These include:

• the appearance of cadaveric spots - localized mainly on the arms and legs. The spots have a marbled color.
• rigor mortis is a condition of the body due to ongoing biochemical processes that disappears after 3 days.
• cadaveric cooling - states the completion of biological death when the body temperature drops to a minimum level (below 30 degrees).

Consequences of clinical death

After successful resuscitation measures, a person returns to life from a state of clinical death. This process may be accompanied by various violations. They may affect both physical development, and psychological state. Damage to health depends on the time of oxygen deprivation important organs. In other words, than formerly man will return to life after a short death, the fewer complications he will experience.

Based on the above, we can identify temporary factors that determine the degree of complications after clinical death. These include:

• 3 minutes or less – the risk of destruction of the cerebral cortex is minimal, as is the appearance of complications in the future.
• 3-6 minutes - minor damage to parts of the brain indicates that consequences may occur (speech impairment, motor function, coma state).
• More than 6 minutes - destruction of brain cells by 70-80%, which will lead to complete absence socialization (ability to think, understand).

At the level of the psychological state, certain changes are also observed. They are usually called transcendental experiences. Many people claim that while in a state of reversible death, they floated in the air and saw bright light, tunnel. Some accurately list the actions of doctors during resuscitation procedures. After this, a person’s life values ​​change dramatically, because he escaped death and received a second chance at life.

If a person can live without food for a month, without water for several days, then the interrupted access of oxygen will cause breathing to stop within 3-5 minutes. But it’s too early to talk about final death right away, because clinical death occurs. This condition occurs when blood circulation and oxygen transfer to tissues stop.

Up to a certain point, a person can still be brought back to life, because irreversible changes the organs have not yet been affected, and most importantly, the brain.

Manifestations

This medical term implies the simultaneous cessation respiratory function and blood circulation. According to the ICD, the condition was assigned code R 96 - death occurred suddenly for unknown reasons. You can recognize being on the verge of life by the following signs:

• There is a loss of consciousness, which entails a cessation of blood flow.
• There is no pulse for more than 10 seconds. This already indicates a violation of the blood supply to the brain.
• Stopping breathing.
• The pupils are dilated, but do not react to light.
• Metabolic processes continue to occur at the same level.

Back in the 19th century, the listed symptoms were quite enough to declare and issue a person’s death certificate. But now the possibilities of medicine are enormous and doctors, thanks to resuscitation measures, may well be able to bring him back to life.

Pathophysiological basis of CS

The duration of such clinical death is determined by the time period during which brain cells are able to remain viable. According to doctors, there are two terms:

1. The duration of the first stage is no longer than 5 minutes. During this period, the lack of oxygen supply to the brain does not yet lead to irreversible consequences. Body temperature is within normal limits.

The history and experience of doctors shows that it is possible to revive a person after a given time, but there is a high probability of the death of most of the brain cells.

1. The second stage can last a long time if the necessary conditions to slow down degeneration processes with impaired blood supply and oxygen supply. This stage is often observed when a person is in cold water for a long time or after an electric shock.

If in as soon as possible If no action is taken to bring the person back to life, then everything will end in biological care.

Causes of the pathological condition

This condition usually occurs when the heart stops. This can be caused by serious diseases, the formation of blood clots that clog important arteries. The reasons for the cessation of breathing and heartbeat may be as follows:

• Excessive physical activity.
• A nervous breakdown or the body's reaction to a stressful situation.
• Anaphylactic shock.
• Choking or obstruction of the airway.
• Electric shock.
• Violent death.
• Vasospasm.
• Serious illnesses affecting vessels or organs of the respiratory system.
• Toxic shock from exposure to poisons or chemicals.

No matter the cause of this condition, during this period resuscitation should be carried out immediately. Delay is fraught with serious complications.

Duration

If we consider the entire body as a whole, then the period of preservation of normal viability is different for all systems and organs. For example, those located below the heart muscle are able to continue normal functioning for another half hour after cardiac arrest. Tendons and skin have a maximum survival period; they can be resuscitated 8-10 hours after the death of the body.

The brain is most sensitive to oxygen deficiency, so it suffers first. A few minutes are enough for his final death. That is why resuscitators and those who happened to be close to the person at that moment have a minimum amount of time to determine clinical death - 10 minutes. But it is advisable to spend even less, then the health consequences will be insignificant.

Introduction to the CS state artificially

There is a misconception that an artificially induced coma is the same as clinical death. But this is far from true. According to WHO, euthanasia is prohibited in Russia, and this is artificially induced care.

Induction into a medically induced coma is practiced. Doctors resort to it to avoid disorders that can adversely affect the brain. In addition, a coma helps to spend several in a row urgent operations. Finds its application in neurosurgery and treatment of epilepsy.

Coma or drug-induced sleep is caused by the administration of medications only as indicated.

Artificial coma unlike clinical death, it is completely controlled by specialists and a person can be taken out of it at any time.

One of the symptoms is coma. But clinical and biological death are completely different concepts. Often, after being revived, a person falls into a coma. But doctors are confident that the body’s vital functions have been restored and recommend that relatives be patient.

How is it different from coma?

The comatose state has its own character traits, which fundamentally distinguish it from clinical death. The following distinctive features can be mentioned:

• During clinical death, the work of the heart muscle suddenly stops and breathing movements stop. Coma is simply a loss of consciousness.
• In a comatose state, a person continues to breathe instinctively; one can feel the pulse and listen to the heartbeat.
• The duration of the coma can vary, from several days to months, but the borderline vital state will turn into biological withdrawal in 5-10 minutes.
• According to the definition of coma, all vital functions are preserved, but may be suppressed or impaired. However, the outcome is the death of first the brain cells, and then the entire organism.

Whether a comatose state, as the initial stage of clinical death, will end in the complete death of a person or not depends on the speed of medical care.

Difference between biological and clinical death

If it so happens that at the moment of clinical death there is no one near the person who could take resuscitation measures, then the survival rate is practically zero. After 6, maximum 10 minutes comes complete destruction brain cells, any rescue measures are pointless.

The undeniable signs of final death are:

• Clouding of the pupil and loss of luster of the cornea.
• The eye shrinks and the eyeball loses its normal shape.
• Another difference between clinical and biological death is sharp decline body temperature.
• Muscles become dense after death.
• Corpse spots appear on the body.

If the duration of clinical death can still be discussed, then for biological death there is no such concept. After the irreversible death of the brain, the spinal cord begins to die, and after 4-5 hours the functioning of the muscles, skin, and tendons stops.

First aid in case of CS

Before starting resuscitation, it is important to make sure that the CS phenomenon is occurring. Seconds are allotted for the assessment.

The mechanism is as follows:

1. Make sure there is no consciousness.
2. Make sure the person is not breathing.
3. Check pupil reaction and pulse.

If you know the signs of clinical and biological death, then diagnose dangerous condition will not be difficult.

The further algorithm of actions is as follows:

1. To clear the airways, to do this, remove the tie or scarf, if any, unbutton the shirt and pull out the sunken tongue. In medical institutions, breathing masks are used at this stage of care.
2. Give a sharp blow to the heart area, but this action should only be performed by a competent resuscitator.
3. Conducted artificial respiration And indirect massage hearts. Fulfill cardiopulmonary resuscitation necessary before the ambulance arrives.

At such moments, a person realizes that life depends on competent actions.

Resuscitation in a clinical setting

After the ambulance arrives, doctors continue to bring the person back to life. Carrying out ventilation of the lungs, which is performed using breathing bags. The difference between this type of ventilation is the supply to lung tissue mixtures of gases with an oxygen content of 21%. At this time, the doctor may well perform other resuscitation actions.

Heart massage

Most often, simultaneously with ventilation of the lungs, indoor massage hearts. But during its implementation, it is important to correlate the force of pressure on the sternum with the age of the patient.

In children infancy The sternum should not move more than 1.5-2 centimeters during the massage. For children school age the depth can be 3-3.5 cm with a frequency of up to 85-90 per minute; for adults, these figures are 4-5 cm and 80 pressures, respectively.

There are situations when it is possible to perform an open massage of the heart muscle:

• If cardiac arrest occurs during surgery.
• Pulmonary embolism occurs.
• Fractures of the ribs or sternum are observed.
• Closed massage does not give results after 2-3 minutes.

If cardiac fibrillation is determined using a cardiogram, then doctors resort to another method of revival.

This procedure can be of different types, which differ in technique and implementation features:

1. Chemical. Potassium chloride is administered intravenously, which stops fibrillation of the heart muscle. Currently, the method is not popular due to high risk asystole.
2. Mechanical. It also has a second name: “reanimation strike.” A regular punch is made to the sternum area. Sometimes the procedure can give the desired effect.
3. Medical defibrillation. The victim is administered antiarrhythmic drugs.
4. Electric. Used to start the heart electricity. This method is used as soon as possible, which significantly increases the chances of life during resuscitation.

For successful defibrillation, it is important to correctly position the device on the chest and select the current strength depending on age.

First aid for clinical death, provided in a timely manner, will bring a person back to life.

The study of this condition continues to this day; there are many facts that even competent scientists cannot explain.

Consequences

Complications and consequences for a person will depend entirely on how quickly help was provided to him, how much effective measures resuscitations were used. The faster the victim can be brought back to life, the more favorable the prognosis for health and psyche will be.

If you managed to spend only 3-4 minutes on revival, then there is a high probability that there will be no negative manifestations. In the case of prolonged resuscitation, the lack of oxygen will have a detrimental effect on the condition of the brain tissue, up to their complete death. To slow down degenerative processes, pathophysiology recommends deliberately cooling the human body at the time of resuscitation in case of unforeseen delays.

Through the eyes of eyewitnesses

After a person returns to this sinful earth from a suspended state, it is always interesting what can be experienced. Those who survived talk about their feelings like this:

• They saw their body as if from the outside.
• Complete calm and tranquility ensues.
• Moments of life flash before your eyes, like stills from a movie.
• The feeling of being in another world.
• Encounters with unknown creatures.
• They remember that a tunnel has appeared that they need to go through.

Among those who experienced this borderline state many famous people, for example, Irina Panarovskaya, who became ill right at the concert. Oleg Gazmanov lost consciousness when he was electrocuted on stage. Andreichenko and Pugacheva also experienced this state. Unfortunately, the stories of people who experienced clinical death cannot be 100% verified. You can only take my word for it, especially since similar sensations are observed.

Scientific view

If lovers of esotericism see in stories a direct confirmation of the existence of life on the other side, then scientists try to give natural and logical explanations:

• Flickering lights and sounds appear at the very first moment the blood flow through the body stops.
• During clinical death, the concentration of serotonin rises sharply and causes peace.
• The lack of oxygen also affects the organ of vision, which is why hallucinations with lights and tunnels appear.

The diagnosis of CS is a phenomenon that is interesting to scientists, and only thanks to high level medicine managed to save thousands of lives and prevent them from crossing that line where there is no turning back.

The life of the body is impossible without oxygen, which we receive through the respiratory and circulatory systems. If we stop breathing or stop blood circulation, we will die. However, if breathing stops and heartbeat stops fatal outcome does not come immediately. There is a certain transitional stage that cannot be attributed to either life or death - this is clinical death.

This state lasts several minutes from the moment when breathing and heartbeat stop, the body’s vital activity has died down, but irreversible damage has not yet occurred at the tissue level. From such a state it is still possible to bring a person back to life if you take emergency measures to provide emergency care.

Causes of clinical death

The definition of clinical death comes down to the following - this is a state when only a few minutes remain before a person’s real death. For that a short time it is still possible to save and bring the patient back to life.

What is the potential cause of this condition?

One of the most common reasons– heartbeat stops. This is a terrible factor when the heart stops unexpectedly, although nothing previously foreshadowed trouble. Most often this occurs when there is any disruption in the functioning of this organ, or when the coronary system is blocked by a blood clot.

Other common reasons include the following:

• excessive physical or stressful overexertion, which negatively affects cardiac blood supply;
• loss of significant volumes of blood due to injuries, wounds, etc.;
• state of shock (including anaphylaxis - a consequence of a strong allergic response of the body);
• respiratory arrest, asphyxia;
• serious thermal, electrical or mechanical tissue damage;
• toxic shock - exposure to toxic, chemical and toxic substances on the body.

Causes of clinical death also include chronic long-term illnesses cardiovascular and respiratory systems, as well as situations of accidental or violent death (presence of injuries incompatible with life, brain injuries, cardiac concussions, compression and bruises, embolism, aspiration of fluid or blood, reflex spasm of the coronary vessels and cardiac arrest).

Signs of clinical death

Clinical death is usually determined by the following signs:

• the man lost consciousness. This condition usually occurs within 15 seconds after circulation has stopped. Important: blood circulation cannot stop if a person is conscious;
• it is impossible to determine the pulse in the area within 10 seconds carotid arteries. This sign indicates that the blood supply to the brain has stopped, and very soon the cells of the cerebral cortex will die. The carotid artery is located in the depression separating the sternocleidomastoid muscle and the trachea;
• the person stopped breathing at all, or due to lack of breathing respiratory muscles periodically contract convulsively (this state of swallowing air is called atonal breathing, turning into apnea);
• a person's pupils dilate and stop responding to the light source. This symptom is a consequence of the cessation of blood supply to the brain centers and the nerve responsible for eye movement. This is the most late symptom clinical death, so you should not wait for it, it is necessary to take emergency medical measures in advance.

Clinical death from drowning

Drowning occurs when a person is completely immersed in water, causing difficulty or complete stoppage. respiratory gas exchange. There are several reasons for this:

• inhalation of liquid respiratory tract person;
• laryngospastic condition due to water entering the respiratory system;
• shock cardiac arrest;
• seizure, heart attack, stroke.

In a state of clinical death, the visual picture is characterized by loss of consciousness of the victim, cyanosis of the skin, absence of respiratory movements and pulsation in the area of ​​the carotid arteries, dilation of the pupils and lack of their reaction to the light source.

The likelihood of successfully reviving a person in this state is minimal, since he spent large amounts of body energy in the struggle for life while in the water. The possibility of a positive outcome of resuscitation measures to save the victim may directly depend on the duration of a person’s stay in the water, his age, his state of health, and the temperature of the water. By the way, at a low temperature of the reservoir, the victim’s chance of survival is much higher.

Feelings of people who have experienced clinical death

What do people see during clinical death? Visions may be different, or they may not exist at all. Some of them are understandable from the point of view scientific medicine, some continue to surprise and amaze people.

Some victims who described their time in the “clutches of death” say that they saw and met some of their deceased relatives or friends. Sometimes visions are so realistic that it can be quite difficult not to believe in them.

Many visions are associated with a person’s ability to fly above his own body. Sometimes resuscitated patients describe in sufficient detail the appearance and actions of the doctors who carried out urgent measures. Scientific explanation there are no such phenomena.

Often victims report that during the resuscitation period they could penetrate through the wall into neighboring rooms: they describe in some detail the situation, people, procedures, everything that was happening at the same time in other wards and operating rooms.

Medicine tries to explain such phenomena by the characteristics of our subconscious: being in a state of clinical death, a person hears certain sounds, stored in brain memory, and at a subconscious level complements sound images with visual ones.

Artificial clinical death

The concept of artificial clinical death is often identified with the concept of induced coma, which is not entirely true. Medicine does not use the special introduction of a person into a state of death; euthanasia is prohibited in our country. But artificial coma is used for medicinal purposes, and even quite successfully.

Induction into an artificial coma is used to prevent disorders that can negatively affect the functions of the cerebral cortex, for example, hemorrhage, accompanied by pressure on areas of the brain and its swelling.

Induced coma may be used instead of anesthesia in cases where several serious emergencies await surgical interventions, as well as in neurosurgery and in the treatment of epilepsy.

The patient is put into a coma using medical narcotic drugs. The procedure is performed according to strict medical and life-saving indications. The risk of putting a patient into a coma must be fully justified by the possible expected benefit of such a state. A big plus of an artificial coma is that this process is absolutely controlled by doctors. The dynamics of this state are often positive.

Stages of clinical death

Clinical death lasts exactly as long as the brain in a hypoxic state can maintain its own viability.

There are two stages of clinical death:

• the first stage lasts about 3-5 minutes. During this time, the areas of the brain that are responsible for the vital functions of the body still retain their ability to live under normothermic and anoxic conditions. Almost all scientific experts agree that prolonging this period does not exclude the possibility of reviving a person, but it can lead to irreversible consequences of the death of some or all parts of the brain;
• the second stage can occur under certain conditions and can last several tens of minutes. Certain conditions refer to situations that help slow down the degenerative processes of the brain. This is artificial or natural cooling of the body, which occurs when a person freezes, drowns, or gets electrocuted. In such situations, the duration of the clinical condition increases.

Coma after clinical death

Consequences of clinical death

The consequences of being in a state of clinical death depend entirely on how quickly the patient is resuscitated. The sooner a person returns to life, the more favorable prognosis is waiting for him. If less than three minutes have passed after stopping cardiac activity before it resumes, then the likelihood of brain degeneration is minimal, and the occurrence of complications is unlikely.

If the duration of resuscitation measures is delayed for any reason, the lack of oxygen in the brain can lead to irreversible complications, including the complete loss of vital body functions.

During prolonged resuscitation, in order to prevent hypoxic brain disorders, a cooling technique is sometimes used to human body, which allows you to increase the period of reversibility of degenerative processes to several additional minutes.

Life after clinical death for most people takes on new colors: first of all, their worldview and views on their actions change, life principles. Many gain psychic abilities, the gift of clairvoyance. What processes contribute to this, what new pathways open as a result of several minutes of clinical death, is still unknown.

Clinical and biological death

The state of clinical death, if emergency assistance is not provided, invariably passes into the next, final stage of life - biological death. Biological death occurs as a result of brain death - this condition is irreversible; resuscitation measures at this stage are futile, impractical and do not bring positive results.

Death usually occurs 5-6 minutes after the onset of clinical death, in the absence of resuscitation measures. Sometimes the time of clinical death can be slightly prolonged, which depends mainly on the ambient temperature: at low temperatures, metabolism slows down, oxygen starvation of tissues is more easily tolerated, so the body can remain in a state of hypoxia longer.

The following symptoms are considered signs of biological death:

• clouding of the pupil, loss of shine (drying) of the cornea;
• “cat's eye” - when the eyeball is compressed, the pupil changes in shape and turns into a kind of “slit”. If the person is alive, this procedure is impossible;
• a decrease in body temperature occurs by approximately one degree for every hour after death, so this sign is not an emergency;
• the appearance of cadaveric spots - bluish spots on the body;
• muscle tightening.

It has been established that with the onset of biological death, the cerebral cortex dies first, then the subcortical zone and spinal cord, after 4 hours - the bone marrow, and after that - the skin, muscle and tendon fibers, and bones within 24 hours.

Third stage of death

Clinical death is a state of the human body when there are no primary signs life - breathing stops, the heart stops working, there are no visible signs of activity of the central nervous system (a person is unconscious). This condition may seem inexplicable, but only at first glance, if it is considered in isolation, on its own.

In reality, clinical death is the third, penultimate stage of the dying process, naturally connected with the previous and subsequent stages. The first stage is the preagonal state, when a person feels general weakness, his consciousness is confused, general behavior is sluggish, blueness of the skin (cyanosis) or pallor, difficulty determining blood pressure, weakness or absence of pulse in the peripheral arteries.

The second stage is the agonal stage, better known as agony. This is a period of sharp intensification of activity in almost all parts of the body, which mark its decisive attempt to return to normal condition. Most often, a characteristic external sign of agony is deep short breathing, often accompanied by wheezing. Usually consciousness is no longer present, since the functioning of the central nervous system is seriously impaired, but periods of return to a conscious state are possible.

Clinical death represents the third stage, when the body actually gives up and turns off its “life support system.” During this period, which on average does not exceed five minutes, doctors have the opportunity to bring a person back to life - during this time, the accumulated supply of necessary substances and, most importantly, oxygen in the cells of the human body is spent.

After these five minutes, the most “hungry” cells for oxygen, the brain cells, begin to collapse, after which human recovery is almost impossible. This means the onset of the fourth stage of dying, biological death, when there are no longer any options for returning to life.

How is clinical death different from coma?

Often one can observe the identification of clinical death with another condition human body, known as coma. These are similar in content, but still not identical concepts. Coma is, first of all, severe pathological condition, in which the main negative aspect is the progressive depression of the functions of the central nervous system, that is, a violation of a person’s reaction to external stimuli and loss of consciousness. In the future, the coma can develop into a deep coma, leading to brain damage.

Coma in its initial form can be one of the signs of clinical death. However, clinical death, unlike coma, is not only a loss of consciousness, but also a cessation of heart contractions and cessation of breathing.

In a coma, a person is unconscious, but retains the instinctive ability to breathe and his heart is beating, which is determined by the presence of a pulse in the main arteries. Often, in cases of clinical death after resuscitation, a person goes into a coma of varying degrees of depth. After this, all that remains is to wait for signs that can be used to determine whether the doctors managed to bring the patient out of the state of clinical death before he suffered brain damage or not. In the latter case, the person falls into a deep coma.

Intangible aspects of clinical death

But in our time, clinical death is no longer known because of its physiological significance, oddly enough, but in connection with psychological and ideological aspects. The fact is that the mental sensations experienced by certain part people who have experienced a state of clinical death, and which in the pseudo-scientific press are called near-death experiences.

Most often they come down to a standard set: a feeling of euphoria, lightness, relief from physical suffering, seeing a visual image of light at the end of a dark tunnel, seeing previously deceased loved ones or religious characters, seeing a picture of one’s body from the outside, and the like. For religious or mystical people, near-death experiences during clinical death are evidence of the existence of the other world and immortality of the soul.

Official science explains such experiences exclusively by physical reasons.

First of all, doctors pay attention to the fact that an insignificant part of those who have experienced clinical death remember some sensations in this state - about one person out of five hundred. However, given that in the United States alone several million people experience clinical death every year, the number of cases of near-death experiences much. This leads to the fact that in the public consciousness the set of what a person “should” see during clinical death is already well known, which leads to self-hypnosis and memories that did not actually exist. Finally, doctors say that near-death experiences are hallucinations caused by changes in the functioning of the brain during clinical death: for example, the famous image of a dark tunnel with light at its end is explained by a decrease in blood flow to the eyes and a state of “narrowing” of visual perception.

Clinical death is a transitional stage between life and biological death. In this case, the central nervous system does not function, but the metabolic process still occurs in the tissues. Sometimes clinical death is identified with another condition - coma.

Differences between coma and clinical death

Coma can progress to a deep coma, which causes brain damage.

Signs and stages of clinical death

If blood flow stops suddenly, it may take up to 10 minutes to die.

If during clinical death no resuscitation actions were carried out, or they were ineffective, biological death occurs, which is irreversible. Clinical death lasts 5-6 minutes following cardiac and respiratory arrest. After this time, it is no longer possible to restore vital functions.