Clinical death

The life of the organism is impossible without oxygen, which we get through the respiratory and circulatory system. If we stop breathing or stop the blood circulation, we will perish. However, when the respiration is stopped and the heartbeat stops, a fatal outcome does not occur immediately. There is a kind of transitional stage, which can not be attributed to either life or death - this is a clinical death.

This condition lasts for several minutes from the moment when the breathing and palpitation stopped, the vital activity of the organism faded, but at the level of the tissues there were not yet irreversible disturbances. From such a state, it is still possible to return a person to life if emergency measures are taken to provide emergency care.

[1], [2], [3]

Causes of clinical death

The definition of a clinical death is reduced to the following: this is a state where only a few minutes remain before a real death of a person. In this short time you can still save and return the patient to life.

What is the potential cause of this condition?

One of the most common causes is stopping the heartbeat. This is a terrible factor when the heart stops unexpectedly, although nothing has foreshadowed trouble before. Most often this occurs when there are any abnormalities in the work of this organ, or when the coronary system is blocked by a thrombus.

Among other common reasons, we can distinguish the following:

• excessive physical or stressful overexertion, which adversely affects the heart's blood supply;
• loss of significant blood volume in injuries, injuries, etc .;
• shock state (including anaphylaxis - a consequence of a strong allergic response of the body);
• respiratory arrest, asphyxia;
• severe thermal, electrical or mechanical damage to tissues;
• toxic shock - the effects of toxic, chemical and toxic substances on the body.

The causes of clinical death include chronic prolonged diseases of the cardiovascular and respiratory systems, as well as situations of accidental or violent death (the presence of injuries incompatible with life, brain trauma, cardiac shaking, compression and bruising, embolism, aspiration of fluid or blood, reflex spasm of the coronary vessels and stopping of the heartbeat).

[4], [5], [6], [7], [8]

Signs of clinical death

Clinical death is usually determined by the following symptoms:

• the person lost consciousness. This condition usually occurs within 15 seconds after the blood circulation has stopped. Important: blood circulation can not stop if the person is conscious;
• It is impossible to determine the pulse in the carotid artery within 10 seconds. This sign indicates that the blood supply of the brain has stopped, and very soon the cells of the cerebral cortex will die. The carotid artery lies in a depression dividing the sternocleidomastoid muscle and trachea;
• the person ceased to breathe at all, or on the background of lack of breathing, the respiratory muscles periodically convulsively contract (this state of ingestion of the air is called atonal breath passing into apnea);
• the pupils dilate and stop responding to the light source. This sign is a consequence of the cessation of blood supply to the brain centers and the nerve responsible for eye movement. This is the latest symptom of clinical death, so it is not worth waiting for, it is necessary to take urgent medical measures in advance.

The first signs of clinical death are determined during the first seconds after cardiac arrest. Therefore, when providing care, you should not waste precious time on tonometry and the determination of the pulse at the periphery. The sooner the diagnosis of clinical death is diagnosed, the greater the likelihood of successful resuscitation.

Clinical death in children

There are many factors known to provoke the state of clinical death in childhood. These are respiratory pathologies (pneumonia, inhaling smoke, drowning, blockage of the respiratory system by a foreign body, suffocation), cardiopathology (heart defects, arrhythmia, severe sepsis, ischemia), CNS lesions (seizures, intracranial trauma and hematomas, malignant brain formation, meningitis) and other causes (anaphylactic reaction, poisoning).

Regardless of the factor that provoked clinical death, the symptomatology of the condition is unchanged: the baby experiences loss of consciousness, coma, lack of respiratory movements and pulse. You can define several convulsive surface breaths and one deeper: on this breath freezes.

The statement of clinical death in children should not take more than 10 seconds. The child's body is more vulnerable than adults, so the risk of death of a child's body is somewhat higher.

Resuscitative measures, pulmonary resuscitation in childhood practically does not differ from those conducted in adults.

[9], [10], [11], [12], [13]

Clinical death in drowning

Drowning happens when the person immerses completely in water, which causes difficulty or complete stopping of respiratory gas exchange. There are several reasons for this:

• inhalation of a person's respiratory tract;
• laryngospastic state due to ingress of water into the respiratory system;
• cardiac shock;
• convulsive seizure, heart attack, stroke.

In a state of clinical death, the visual picture is characterized by loss of consciousness of the victim, cyanotic skin, lack of respiratory movements and pulsations in the field of carotid arteries, dilated pupils and their lack of response to the light source.

The probability of successful recovery of a person in this state is minimal, since he has 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 a victim can directly depend on the length of time a person is in the water, his age, his health status, and the temperature of the water. By the way, at a low temperature of a reservoir the chance for survival of the victim is much higher.

[14], [15], [16], [17], [18], [19], [20], [21]

Feelings of people who survived a clinical death

What do people see when they die? Visions can be different, or they may not be at all. Some of them are explicable from the point of view of scientific medicine, while others continue to amaze and amaze people's imaginations.

Some of the victims who described their stay in the "paws of death" say they saw and met with some deceased relatives or friends. Sometimes visions are so realistic that it is difficult to believe in them.

Many visions are associated with a person's ability to fly over his own body. Sometimes reanimated patients describe in sufficient detail the appearance and actions of physicians who performed emergency measures. There is no scientific explanation for such phenomena.

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

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

[22], [23]

Artificial clinical death

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

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

Artificial to whom can be used instead of anesthesia in cases where there are several serious urgent surgical interventions, as well as in neurosurgery and in the treatment of epilepsy.

The patient's coma is injected with the help of medical narcotic drugs. The procedure is performed according to strict medical and vital indications. The danger of introducing a patient into a coma should be fully justified by the possible expected benefit from such a condition. A big plus of an artificial coma - this process is absolutely controlled by doctors. The dynamics of this state is often positive.

[24], [25], [26], [27], [28]

Stages of clinical death

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

There are two stages of clinical death:

• the first stage lasts about 3-5 minutes. During this time, parts of the brain that are responsible for the vital functions of the organism, still maintain their ability to live in normothermic and anoxic conditions. Almost all scientists agree that the prolongation of this period does not exclude the possibility of revitalization, but it can lead to irreversible consequences of the death of some or all parts of the brain;
• the second stage is able to occur under certain conditions, and can last several tens of minutes. Under certain conditions, understand situations that contribute to slowing down the degenerative processes of the brain. This is an artificial or natural cooling of the body, which happens when the person freezes, drowns and suffers electrical damage. In such situations, the duration of the clinical condition increases.

Coma after clinical death

Coma and the state of clinical death are separate concepts. The initial stage of coma can serve as one of the symptoms of clinical death. But the very state of clinical death, distinct from comatose state, does not consist only in the loss of consciousness, but also in the arrest of cardiac activity and respiratory functions.

Being in a coma, the patient along with the lack of consciousness is able to instinctively breathe, his heart activity does not stop, the pulse is determined.

Often at the exit from the state of clinical death after carrying out urgent measures, the reanimated patient falls into a coma of various depths. What to do in this situation? Expect. Expect the symptoms according to which you can determine whether the period of clinical death has affected the integrity and performance of the brain. If there are any brain problems, the patient passes into a deep stage of a coma.

In a state of coma, the functions of the cortex and subcortex of the brain are suppressed, metabolic processes and the CNS structure are disturbed. The duration and depth of this condition are determined by the course of the underlying pathology, which led to the development of coma.

[29], [30], [31], [32], [33]

Consequences of clinical death

The consequences of being in a state of clinical death are entirely dependent on how quickly the patient is resuscitated. The earlier a person returns to life, the more favorable forecast he expects. If after a cardiac arrest, less than three minutes have elapsed before it is resumed, the probability of brain degeneration is minimal, complications are unlikely.

In the case when the duration of resuscitation is delayed for some reason, the lack of oxygen in the brain can lead to irreversible complications, up to an absolute loss of vital body functions.

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

Life after a clinical death in most people acquires new colors: first of all, the worldview changes, views on their actions, life principles. Many gain extrasensory abilities, a gift of clairvoyance. What processes contribute to this, what new ways open up due to several minutes of clinical death, is still unknown.

[34], [35], [36]

Clinical and biological death

The state of clinical death, in the absence of emergency care, invariably passes into the next, final stage of life - biological death. Biological death occurs as a result of death of the brain - this is an irreversible condition, resuscitation at this stage is futile, inexpedient and does not bring positive results.

Lethal outcome usually occurs 5-6 minutes after the onset of clinical death, under conditions of the absence of resuscitation. Sometimes the time of clinical death can be somewhat prolonged, which depends mainly on the temperature of the environment: at low temperatures, the metabolism slows down, oxygen starvation of tissues is transferred easier, so the body can be in a state of hypoxia longer.

The following symptoms are considered signs of biological death:

• blurred vision, loss of gloss (drying out) of the cornea;
• "Cat's eye" - when the eyeball contracts, the pupil changes in shape and turns into a kind of "gap". If a person is alive, this procedure is impossible;
• a decrease in body temperature occurs about one degree per hour after death, so this symptom is not urgent;
• the appearance of cadaveric spots - bluish spots on the body;
• Muscle tightening.

It is established that with the onset of biological death, the cerebral cortex first dies, then the subcortical zone and the dorsal brain, after 4 hours - the bone marrow, and after that - the integuments, muscle and tendon fibers, bones within 24 hours.

[37], [38], [39], [40], [41], [42]

What to do in case of clinical death?

If you suspect a clinical death, you should make sure of this condition by taking the following actions:

• confirm the patient's absence of consciousness;
• confirm absence of respiratory movements;
• confirm absence of pulsation on the carotid artery, check pupillary response.

First aid for clinical death should be given immediately, within the first seconds after confirmation. This should be done by emergency doctors, resuscitation, or simply people who are nearby who can provide emergency help.

• Provide free passage of air through the respiratory tract (unbutton the shirt, remove the sunken tongue, pull out the foreign body from the pharynx). Resuscitation in clinical death in such cases provides for the aspiration of water from the trachea and bronchi, the introduction of an airway or a respiratory mask.
• Make a sharp blow to the heart (this is done only by the reanimator).
• Perform artificial ventilation of the lungs by injecting air into the mouth or nose of the victim.
• Conduct an indoor massage of the heart (adults - two palms, children - one palm or with the thumb).
• Alternate ventilation and compressive pressure - 2:15.

The methods of revitalization in clinical death in conditions of resuscitation include the following methods:

• conducting electrical defibrillation (on exhalation), alternating with closed heart massage until the presence of guaranteed symptoms of circulatory function;
• carrying out of medicinal defibrillation (use of solutions of adrenaline, atropine, naloxone, lidocaine by intravenous or endotracheal administration).
• conducting a catheterization of the main venous system, the introduction of gecodemia to support blood circulation;
• to introduce intravenously by drop method the preparations correcting the alkaline-acid state (xylate, sorbilact);
• conduct drip therapy to support capillary circulation (rheosorbylact).

If the resuscitation is successful, the patient is transferred to the general treatment department, where he is given further supervision and therapy.

The above measures are not carried out in cases where:

• clinical death occurred against the background of all necessary components of intensive treatment;
• the patient was in the final stage of an incurable disease;
• cardiac arrest occurred more than 25 minutes ago;
• if there is a certified patient's refusal to carry out emergency medical measures (if the patient is a child under the age of 14, the document must be signed by his parents or guardians).

It is said that patients who have learned about themselves what a clinical death is, then live a long time, and even very seldom get sick. Unfortunately, this condition has not been fully investigated by scientists, and there are many inexplicable facts. Perhaps, when science still will be able to uncover the secrets of clinical death, at the same time we learn the recipe for immortality.

Famous people who have passed through clinical death

Among the people who survived after the state of clinical death, there are many people known to us. What did they see on the other side of life?

Famous singer Irina Ponarovskaya survived a clinical death in 1979, when she visited the city of Kursk with tours. Being on the stage, during the solo performance, Irina felt bad. Hardly having reached the wings, she fell unconscious. Irina's heart stopped for a long 14 minutes: the doctors saved her life for two months, and, fortunately, successfully. As it turned out, the cause of the cardiac arrest was malnutrition, which provoked a sudden kidney failure. By the way, since then Irina has noticed in herself extrasensory abilities: she feels future events and warns her relatives and friends about possible troubles.

The most common type of surgical operations, resorted to by the stars of show business - is, undoubtedly, plastic surgery. The victim of this procedure was Boris Moiseyev: during the operation he had a cardiac arrest. Resuscitative measures lasted about 40 minutes. "I did not notice the light and the tunnel, I did not have any flights. I saw only the faces of my enemies, clicked on their nose and smiled, "Boris said. After all that happened, Moiseyev regularly visited churches, but he did not refuse further plastic operations: "Beauty requires sacrifice!".

A similar situation has developed with Alla Pugacheva: in the 90s, having decided to make the plastic of the breast, the facial area, and also liposuction, she turned to the specialists of the clinic in Zurich for help. Doctors feared that the simultaneous volume of operations is too large and can be dangerous. However, Alla Borisovna nevertheless took risks. Everything went well, but after surgery there was a rejection of the breast implant. Severe intoxication, loss of consciousness and clinical death. Fortunately, the medical workers of the Moscow city hospital rescued Pugachev. About her visions during her clinical death the singer did not spread.

The popular performer and songwriter Oleg Gazmanov once nearly became a victim of an accident on stage: during the concert, technicians forgot to ground the microphone wire. Oleg was knocked out by electric current. At that moment he did not see anything, but he heard an unfamiliar voice that calmed Gazmanov, saying that he could stay on this earth if he wanted to. The doctors successfully carried out resuscitation measures, subsequently noticing that often in such situations there is little chance of life.

[43], [44], [45]