Conditions that increase the time of clinical death. Clinical death: causes, main signs, assistance

Every body needs a sufficient amount of oxygen, it comes from the circulatory and respiratory systems. If blood circulation stops, breathing is blocked, the person dies. We draw your attention to when the heart does not beat, breathing stops, the person does not die immediately. This transitional stage is called clinical death. Why does clinical death occur? Is it possible to help a person?

Causes of clinical death

It is important to understand that in this case a person can be saved, it takes a few minutes. Most often, clinical death occurs when the heart stops. As a rule, such a violation is provoked by cardiac pathologies, as well as blockage of blood clots.

The main causes of pathology include:

• strong stress, physical activity- all this negatively affects the blood supply to the heart.
• Blood loss due to injury, trauma.
• State of shock (most often clinical death occurs in case of anaphylactic shock after a severe allergic reaction).
• Asphyxia, respiratory arrest.
• Serious mechanical, thermal, electrical tissue damage.
• as a result of exposure to a chemical, poisonous and toxic substance on the body.
• Serious respiratory disease of cardio-vascular system.
• Violent death, in which serious injuries were inflicted, as well as aspiration of blood, fluid, embolism, spasm in the coronary vessels.

Main symptoms

• The person loses consciousness after circulatory arrest (within a few seconds). Please note that blood circulation never stops if a person is conscious.
• No pulse for 10 seconds. It's quite danger sign, because it indicates the cessation of the blood supply to the brain. With untimely assistance, brain cells can die.
• The person stops breathing.
• Pupil dilation and no reaction to light. This sign indicates the cessation of blood supply in the nerve, which is responsible for motor activity eye.

The specialist can determine the first symptoms of clinical death already within a few seconds after the heart stops. In this case, it is important to provide first aid, to carry out all resuscitation measures, otherwise everything can end in serious consequences.

How does clinical death proceed?

First stage(lasts no more than 5 minutes). Some areas of the brain that are responsible for the vital activity of the body are still in normal condition. In this case, everything can end with the following consequences: man will come into itself or, conversely, the situation will worsen - all parts of the brain will die at once.

Second stage occurs when the degenerative process in the brain slows down. Most often, this stage is characteristic of a person who has become cold, long time arrived under water, as well as after an electric shock.

Features of clinical death in children

It should be noted that there are many different pathologies and factors that can lead to such a dangerous condition in a child:

• Problems with respiratory system- pneumonia, inhalation a large number smoke, suffocation, drowning, blockage of the respiratory organs.
• Cardiac pathologies - arrhythmia, heart disease, ischemia, sepsis.
• Serious damage to the central nervous system- meningitis, hematomas, convulsions, intracranial trauma, malignancy brain.
• poisoning, .

Despite the causes of clinical death, the child loses consciousness, falls into a coma, he has no respiratory movements, pulse. Ascertain clinical death within 10 seconds. It is important to remember that the child's body is sensitive, so if you do not take action, everything can end in death.

How to distinguish clinical death from biological?

In the case of untimely assistance, everything ends with biological death. It comes because the brain is completely dying. The condition is irreversible, all resuscitation procedures are inappropriate.

As a rule, biological death occurs 6 minutes after clinical death. In some situations, the time of clinical death is significantly lengthened. It all depends on the ambient temperature. If she's low metabolic processes slow down in the body oxygen starvation much better tolerated.

The main signs of biological death include the following symptoms:

• The pupil becomes cloudy, the shine in the cornea is lost.
• Observed " cat eye". When eyeball shrinks, it loses its normal shape.
• The body temperature drops sharply.
• Bluish spots appear on the body.
• Muscles are tightened.

It has been proven that when attacked, the cerebral cortex dies first, after that spinal cord and subcortical region. Stops working after 4 hours Bone marrow, tendon, muscle, skin. During the day, the bones are destroyed.

What does the person feel?

The patient may have different visions, in some situations they do not exist at all. Many victims who had to endure clinical death said that they communicated with their close deceased relatives. Quite often, visions are quite real. In some visions, it seemed to the person that he was flying over his body. Other patients saw and remembered the appearance of doctors conducting resuscitation procedures.

So, medicine is still carefully studying the features of clinical death. You can save a person by providing first aid in the first seconds of clinical death. In this situation, the resuscitator can hit the heart area sharply, and artificial look ventilation to the mouth or nose. Remember, you can save a person by taking timely action!

- This is a reversible stage of dying, occurring at the moment of cessation of cardiac and respiratory activity. Characterized by the absence of consciousness, pulse on the central arteries and excursions chest, dilated pupils. It is diagnosed according to the data obtained during the examination, palpation of the carotid artery, listening to heart sounds and pulmonary murmurs. An objective sign of cardiac arrest is small-wave atrial fibrillation or isoline on the ECG. Specific treatment- activities of the primary cardiopulmonary resuscitation, transfer of the patient to a ventilator, hospitalization in the ICU.

ICD-10

R96 I46

General information

Clinical death (CS) - First stage death of the body, lasting for 5-6 minutes. During this period, metabolic processes in tissues slow down sharply, but do not stop completely due to anaerobic glycolysis. Then irreversible changes occur in the cerebral cortex and internal organs, making it impossible to revive the victim. The duration of the condition depends on a number of factors. At low ambient temperatures, it increases, at high temperatures, it decreases. How the patient died also matters. Sudden death against the background of relative stability, it lengthens the reversible period, the slow depletion of the body in incurable diseases reduces it.

Causes

The factors that cause CS include all diseases and injuries that lead to the death of the patient. This list does not include accidents in which the body of the victim receives significant damage incompatible with life (crushing of the head, burning in a fire, decapitation, etc.). It is generally accepted to divide the causes into two large groups- associated and not associated with direct damage to the heart muscle:

• Cardiac. Primary disorders of myocardial contractility caused by acute coronary pathology or exposure to cardiotoxic substances. provoke mechanical damage cardiac muscle layers, tamponade, disturbances in the conduction system and the sinoatrial node. Circulatory arrest can occur against the background of acute myocardial infarction, electrolyte imbalance, arrhythmias, endocarditis, aortic aneurysm rupture, coronary disease.
• non-cardiac. This group includes conditions accompanied by the development of severe hypoxia: drowning, suffocation, obstruction respiratory tract and acute respiratory failure, shocks of any origin, embolisms, reflex reactions, electric shocks, poisoning with cardiotoxic poisons and endotoxins. Fibrillation followed by cardiac arrest may occur with improper administration of cardiac glycosides, potassium preparations, antiarrhythmics, barbiturates. A high risk is noted in patients with organophosphate poisoning.

Pathogenesis

After stopping breathing and blood circulation, destructive processes begin to develop rapidly in the body. All tissues experience oxygen starvation, which leads to their destruction. The most sensitive to hypoxia are the cells of the cerebral cortex, which die after several tens of seconds from the moment the blood flow stops. In the case of decortication and brain death, even successful resuscitation does not lead to full recovery. The body continues to live, however brain activity is absent.

When the blood flow stops, the blood coagulation system is activated, microthrombi are formed in the vessels. Toxic decay products of tissues are released into the blood, metabolic acidosis develops. pH internal environment drops to 7 or below. Prolonged absence blood circulation causes irreversible changes and biological death. Successful resuscitation ends with the restoration of cardiac activity, a metabolic storm, and the occurrence of post-resuscitation disease. The latter is formed due to ischemia, thrombosis of the capillary network internal organs, significant homeostatic shifts.

Symptoms of clinical death

It is characterized by three main features: the absence of effective heart contractions, breathing and consciousness. An undoubted symptom is all three signs that are present in the patient at the same time. CS against the background of preserved consciousness or heartbeat is not diagnosed. Spontaneous residual breathing (gasping) can persist for up to 30 seconds after blood flow stops. In the first minutes, individual ineffective contractions of the myocardium are possible, which lead to the appearance of weak pulse shocks. Their frequency usually does not exceed 2-5 times per minute.

Among the secondary signs include the lack of muscle tone, reflexes, movements, unnatural position of the body of the victim. The skin is pale, earthy. Arterial pressure is not determined. After 90 seconds, pupil dilation occurs to a diameter of more than 5 mm without reaction to light. Facial features are pointed (Hippocratic mask). Such a clinical picture does not have a special diagnostic value in the presence of the main signs, therefore, the examination is carried out in the process of resuscitation, and not before they begin.

Complications

The main complication is the transition of clinical death to biological. This finally occurs 10-12 minutes after cardiac arrest. If it was possible to restore blood circulation and respiration, but clinical death before the start of treatment lasted more than 5-7 minutes, brain death or partial impairment of its functions is possible. The latter manifests itself in the form of neurological disorders, posthypoxic encephalopathy. In the early period, the patient develops postresuscitation disease, which can lead to multiple organ failure, endotoxicosis and secondary asystole. The risk of complications increases in proportion to the time spent in conditions of circulatory arrest.

Diagnostics

Clinical death is easily determined by external symptoms. If the pathology develops in conditions medical institution, apply additional hardware and laboratory methods. This is necessary to determine the effectiveness of ongoing resuscitation measures, to assess the severity of hypoxia and acid-base balance disorders. All diagnostic manipulations are carried out in parallel with the restoration work. heart rate. To confirm the diagnosis and monitor the effectiveness of the measures taken, use the following types research:

• physical. are the main method. On examination, they find characteristics KS. During auscultation, coronary tones are not auscultated, there are no respiratory sounds in the lungs. The presence of a pulse outside the ICU is determined by pressing on the projection area of ​​the carotid artery. Probing shocks on peripheral vessels has no diagnostic value, since with agonal and shock states they can disappear long before the cessation of cardiac activity. The presence or absence of breathing is assessed visually, by the movements of the chest. The test with a mirror or a suspended thread is not advisable, as it requires additional time. BP is not determined. Tonometry outside the ICU is carried out only in the presence of two or more resuscitators.
• Instrumental. Basic way instrumental diagnostics- electrocardiography. It should be taken into account that the isoline corresponding to complete cardiac arrest is not always recorded. In many cases, individual fibers continue to contract randomly without providing blood flow. On the ECG, such phenomena are expressed in fine waviness (amplitude less than 0.25 mV). There are no clear ventricular complexes on the film.
• Laboratory. Appointed only with successful resuscitation. The main studies are considered acid-base balance, electrolyte balance, biochemical parameters. Metabolic acidosis, increased content of sodium, potassium, proteins and tissue breakdown products are found in the blood. The concentration of platelets and coagulation factors is reduced, there are phenomena of hypocoagulation.

Urgent care

The restoration of the vital functions of the patient is carried out with the help of basic and specialized resuscitation measures. They should be started as early as possible, ideally within 15 seconds of circulatory arrest. This helps to prevent decortication and neurological pathology, to reduce the severity of post-resuscitation disease. Measures are considered unsuccessful if they did not lead to the restoration of the rhythm within 40 minutes from the last electrical activity. Resuscitation is not indicated for patients who die due to documented, long-term incurable disease(oncology). The list of measures aimed at resuming heart contractions and breathing includes:

• Base complex. Usually implemented outside the hospital. The victim is laid on a hard, flat surface, his head is thrown back, a roller made from improvised material (bag, jacket) is placed under his shoulders. lower jaw push forward, with fingers wrapped in cloth, clear the airways of mucus, vomit, remove existing foreign bodies, false jaws. An indirect heart massage is performed in combination with mouth-to-mouth artificial respiration. The ratio of compressions and breaths should be 15:2, respectively, regardless of the number of rescuers. Massage speed - 100-120 strokes / minute. After restoring the pulse, the patient is laid on his side, his condition is monitored until the arrival of doctors. Clinical death may recur.
• Specialized complex. It is carried out in the conditions of the ICU or the SMP machine. To ensure lung excursion, the patient is intubated and connected to the ventilator. Alternative option– use of the Ambu bag. A laryngeal or face mask for non-invasive ventilation may be used. If the cause is an unrepairable airway obstruction, a conicotomy or tracheostomy with a hollow tube is indicated. Indirect massage is performed manually or with a cardio pump. The latter facilitates the work of specialists and makes the event more efficient. In the presence of fibrillation, the rhythm is restored using a defibrillator (electropulse therapy). Discharges with a power of 150, 200, 360 J. are used on bipolar devices.
• Medical allowance. During resuscitation, the patient is given intravenous administration adrenaline, mezaton, atropine, calcium chloride. To maintain blood pressure after the rhythm is restored, pressor amines are administered through a syringe pump. To correct metabolic acidosis, sodium bicarbonate is used as an infusion. An increase in BCC is achieved through colloidal solutions - rheopolyglucin, etc. Correction of the electrolyte balance is implemented taking into account the information obtained during laboratory research. Can be assigned saline solutions: acesol, trisol, disol, saline sodium chloride. Immediately after the restoration of the work of the heart, antiarrhythmic drugs, antioxidants, antihypoxants, agents that improve microcirculation.

Measures are considered effective, during which the patient has restored sinus rhythm, systolic blood pressure was established at the level of 70 mm Hg. Art. or higher, heart rate is kept within 60-110 beats. Clinical picture indicates the resumption of blood supply to tissues. There is a narrowing of the pupils, the restoration of their reaction to a light stimulus. Skin color returns to normal. Spontaneous breathing or an immediate return of consciousness immediately after resuscitation is rare.

Forecast and prevention

Clinical death has a poor prognosis. Even with a short period of absent blood circulation, the risk of damage to the central nervous system is high. The severity of the consequences increases in proportion to the time elapsed from the moment the pathology developed to the start of the work of resuscitators. If this period was more than 5 minutes, the possibility of decortication and posthypoxic encephalopathy increases many times over. With asystole for more than 10-15 minutes, the chances of resuming myocardial work are sharply reduced. The cerebral cortex is guaranteed to be damaged.

Among the specific preventive measures hospitalization and constant monitoring of patients with high risk cardiac death. At the same time, therapy is carried out aimed at restoring normal operation of cardio-vascular system. Specialists working in healthcare facilities must carefully observe the dosages and rules for the administration of cardiotoxic drugs. A non-specific preventive measure is the observance of safety precautions in all areas of life, which reduces the risk of drowning, trauma, asphyxia resulting from an accident.

"Man is mortal, but his main trouble is that he is suddenly mortal," these words, put into Woland's mouth by Bulgakov, perfectly describe the feelings of most people. Probably, there is no person who would not be afraid of death. But along with the big death, there is a small death - clinical. What is it, why people who have experienced clinical death often see the divine light, and is it not a delayed path to paradise - in the material of the site.

Clinical death from the point of view of medicine

The problems of studying clinical death as a borderline state between life and death remain one of the most important in modern medicine. Unraveling many of its mysteries is also difficult because many people who have experienced clinical death do not fully recover, and more than half of patients with a similar condition cannot be resuscitated, and they die for real - biologically.

So, clinical death is a condition accompanied by cardiac arrest, or asystole (a condition in which various parts of the heart stop contracting first, and then cardiac arrest occurs), respiratory arrest and deep, or beyond, cerebral coma. With the first two points, everything is clear, but about whom it is worth explaining in more detail. Usually doctors in Russia use the so-called Glasgow scale. According to the 15-point system, the reaction of opening the eyes, as well as motor and speech reactions, is evaluated. 15 points on this scale correspond to clear consciousness, and the minimum score is 3, when the brain does not respond to any kind of external influence, corresponds to transcendental coma.

After stopping breathing and cardiac activity, a person does not die immediately. Almost instantly, consciousness is turned off, because the brain does not receive oxygen and its oxygen starvation sets in. But nevertheless in short period time, three to six minutes, he can still be saved. Approximately three minutes after breathing stops, cell death begins in the cerebral cortex, the so-called decortication. The cerebral cortex is responsible for the higher nervous activity and after decortication, although resuscitation may be successful, a person may be doomed to a vegetative existence.

After a few minutes, cells of other parts of the brain begin to die - in the thalamus, hippocampus, hemispheres brain. The state in which all parts of the brain have lost functional neurons is called decerebration and actually corresponds to the concept of biological death. That is, the revival of people after decerebration is in principle possible, but a person will be doomed to stay on artificial ventilation lung and other life-sustaining procedures.

The fact is that the vital (vital - site) centers are located in the medulla oblongata, which regulates breathing, heartbeat, cardiovascular tone, as well as unconditioned reflexes like sneezing. With oxygen starvation, the medulla oblongata, which is actually a continuation of the spinal cord, dies one of the last sections of the brain. However, although the vital centers may not be damaged, by then decortication will have set in, making it impossible to return to normal life.

Other human organs, such as the heart, lungs, liver, and kidneys, can go much longer without oxygen. Therefore, one should not be surprised at the transplantation, for example, of kidneys taken from a patient with an already brain dead. Despite the death of the brain, the kidneys are still in working condition for some time. And the muscles and cells of the intestine live without oxygen for six hours.

Currently, methods have been developed that allow increasing the duration of clinical death up to two hours. This effect is achieved with the help of hypothermia, that is, artificial cooling of the body.

As a rule (unless, of course, it happens in a clinic under the supervision of doctors), it is quite difficult to determine exactly when the cardiac arrest occurred. According to current regulations, doctors are required to carry out resuscitation measures: heart massage, artificial respiration within 30 minutes from start. If during this time it was not possible to resuscitate the patient, then biological death is stated.

However, there are several signs of biological death that appear as early as 10–15 minutes after brain death. First, Beloglazov's symptom appears (when pressing on the eyeball, the pupil becomes similar to a cat's), and then the cornea of ​​​​the eyes dries up. If these symptoms are present, resuscitation is not carried out.

How many people safely survive clinical death

It may seem that most people who find themselves in a state of clinical death come out of it safely. However, this is not the case, only three to four percent of patients can be resuscitated, after which they return to normal life and do not suffer from any mental disorders or loss of body functions.

Another six to seven percent of patients, being resuscitated, nevertheless do not recover to the end, suffer from various brain lesions. The vast majority of patients die.

Such sad statistics largely due to two reasons. The first of them - clinical death can occur not under the supervision of doctors, but, for example, in the country, from where the nearest hospital is at least half an hour away. In this case, the doctors will come when it will be impossible to save the person. Sometimes it is impossible to timely defibrillate when ventricular fibrillation occurs.

The second reason is the nature of body lesions in clinical death. If a we are talking about massive blood loss, resuscitation measures are almost always unsuccessful. The same applies to critical myocardial damage in a heart attack.

For example, if a person has a blockage in one of coronary arteries more than 40 percent of the myocardium is affected, death is inevitable, because the body does not live without heart muscles, no matter what resuscitation measures are carried out.

Thus, it is possible to increase the survival rate in case of clinical death mainly by equipping crowded places with defibrillators, as well as by organizing flying ambulance crews in hard-to-reach areas.

Clinical death for patients

If clinical death for doctors is an urgent condition in which it is necessary to urgently resort to resuscitation, then for patients it often seems like a road to the bright world. Many near-death survivors have reported seeing light at the end of a tunnel, some meeting their long-dead relatives, others looking at the earth from a bird's eye view.

“I had a light (yes, I know how it sounds), and I seemed to see everything from the outside. It was bliss, or something. No pain for the first time in so much time. someone else's life and now I just slide back into my skin, my life - the only one that I feel comfortable in. It is a little tight, but it is a pleasant tightness, like a worn pair of jeans that you have been wearing for years, "says Lydia, one of the patients who underwent clinical death.

It is this feature of clinical death, its ability to evoke vivid images, that is still the subject of much controversy. From a purely scientific point of view, what is happening is described quite simply: brain hypoxia occurs, which leads to hallucinations in the actual absence of consciousness. What kind of images arise in a person in this state is a strictly individual question. The mechanism for the occurrence of hallucinations has not yet been fully elucidated.

At one time, the endorphin theory was very popular. According to her, much of what people experience near death can be attributed to the release of endorphins due to extreme stress. Since endorphins are responsible for obtaining pleasure, and in particular even for orgasm, it is easy to guess that many people who survived clinical death considered ordinary life after it to be only a burdensome routine. However, in recent years, this theory has been debunked because researchers have found no evidence that endorphins are released during clinical death.

There is also a religious point of view. As, however, in any cases that are inexplicable from the standpoint of modern science. Many people (there are scientists among them) tend to believe that after death a person goes to heaven or hell, and the hallucinations that survivors of near-death experience saw are only proof that hell or heaven exists, like the afterlife in general. It is extremely difficult to give any assessment to these views.

Nevertheless, not all people experienced heavenly bliss during clinical death.

“I suffered clinical death twice in less than one month. I didn’t see anything. When they returned, I realized that I was nowhere, in oblivion. I didn’t have anything there. I concluded that you get rid of everything there by completely losing yourself, probably , along with the soul. Now death does not really bother me, but I enjoy life, "accountant Andrey cites his experience.

In general, studies have shown that at the time of human death, the body loses little in weight (literally a few grams). Adherents of religions hastened to assure mankind that at this moment from human body the soul separates. However, the scientific approach says that the weight of the human body changes due to chemical processes occurring in the brain at the time of death.

Doctor's opinion

Current standards dictate resuscitation within 30 minutes of the last heartbeat. Resuscitation stops when the human brain dies, namely on registration on the EEG. I have personally resuscitated a patient once who went into cardiac arrest. In my opinion, the stories of people who have experienced clinical death are, in most cases, a myth or fiction. I have never heard such stories from patients of our medical institution. As well as there were no such stories from colleagues.

Moreover, people tend to call clinical death completely different conditions. It is possible that the people who allegedly had it did not actually die, they just had a syncopal state, that is, fainting.

Cardiovascular diseases remain the main cause that leads to clinical death (as well as, in fact, to death in general). Generally speaking, such statistics are not kept, but it must be clearly understood that clinical death occurs first, and then biological. Since the first place in mortality in Russia is occupied by diseases of the heart and blood vessels, it is logical to assume that they most often lead to clinical death.

Dmitry Yeletskov

anesthesiologist-resuscitator, Volgograd

One way or another, the phenomenon of near-death experiences deserves careful study. And it is quite difficult for scientists, because in addition to the fact that it is necessary to establish which chemical processes in the brain lead to the appearance of certain hallucinations, it is also necessary to distinguish truth from fiction.

clinical death

clinical death- reversible stage of dying, a transitional period between life and death. On the this stage activity of the heart and respiration ceases, all external signs the vital activity of the organism. At the same time, hypoxia (oxygen starvation) does not cause irreversible changes in the organs and systems most sensitive to it. This period terminal state, with the exception of rare and casuistic cases, on average lasts no more than 3-4 minutes, a maximum of 5-6 minutes (with an initially reduced or normal temperature bodies).

Signs of clinical death

Signs of clinical death include: coma, apnea, asystole. This triad concerns early period clinical death (when several minutes have passed since asystole), and does not apply to cases where there are already clear signs of biological death. The shorter the period between the statement of clinical death and the start of resuscitation, the greater the chances of life for the patient, so diagnosis and treatment are carried out in parallel.

Treatment

The main problem is that the brain almost completely stops its work soon after cardiac arrest. It follows that in a state of clinical death, a person, in principle, cannot feel or experience anything.

There are two ways to explain this problem. According to the first, human consciousness can exist independently of the human brain. And near-death experiences could well serve as confirmation of the existence of the afterlife. However, this view is not a scientific hypothesis.

Most scientists consider such experiences to be hallucinations caused by brain hypoxia. According to this view, near-death experiences are experienced by people not in a state of near-death experience, but more early stages dying of the brain during the preagonal state or agony, as well as during the period of coma, after the patient was resuscitated.

From the point of view of pathological physiology, these sensations are quite naturally conditioned. As a result of hypoxia, the work of the brain is inhibited from top to bottom from the neocortex to the archeocortex.

Notes

see also

Literature

• Sumin S.A. Emergency conditions. - Medical Information Agency, 2006. - 800 p. - 4000 copies. - ISBN 5-89481-337-8

Wikimedia Foundation. 2010 .

See what "clinical death" is in other dictionaries:

See Death Glossary of business terms. Akademik.ru. 2001 ... Glossary of business terms

Profound but reversible (provided medical care within a few minutes) depression of vital functions up to respiratory and circulatory arrest ... Law Dictionary

Modern Encyclopedia

terminal state in which there are no visible signs life (cardiac activity, respiration), the functions of the central nervous system fade away, but metabolic processes in the tissues remain. Lasts a few minutes, is replaced by biological ... ... Big Encyclopedic Dictionary

clinical death- CLINICAL DEATH, a terminal condition in which there are no visible signs of life (cardiac activity, respiration), the functions of the central nervous system fade away, but metabolic processes in tissues remain. Lasts a few minutes... Illustrated Encyclopedic Dictionary

The terminal state (borderline between life and death), in which there are no visible signs of life (cardiac activity, respiration), the functions of the central nervous system fade away, but unlike biological death, in which ... ... encyclopedic Dictionary

The state of the body, characterized by the absence of external signs of life (cardiac activity and respiration). During To. the functions of the central nervous system fade away, however, metabolic processes are still preserved in the tissues. K. s. ... ... Great Soviet Encyclopedia

The terminal state (borderline between life and death), when there are no visible signs of life (cardiac activity, respiration), the functions of the center fade away. nerve. systems, but unlike biol. death, with a swarm of restoration of life ... ... Natural science. encyclopedic Dictionary

clinical death- a borderline state between life and death, with no visible signs of life (cardiac activity, respiration), the functions of the central nervous system fade away, but metabolic processes in the tissues remain. Lasts a few minutes... Forensic Encyclopedia

The word "death" seems to have only one meaning, but in medical field exist different classifications for that term, most of them are irreversible, but there is one that is not.

What is clinical death?

Clinical death (or apparent death) is the cessation of heartbeat and breathing without damaging brain cells. With clinical point of view, death is the interruption of the organic functions of any living being, which is most of the time preceded by an agonizing stage, which includes a series of clinical manifestations who prescribe it.

The agony may be short or may last up to a month before death. In some special cases, the agony phase lasts for years, and suddenly there is an inexplicable improvement. In the case of clinical death, all external signs of life disappear, such as consciousness, pulse and breathing. In these cases, biological death occurs unless steps are taken to change the situation. On the other hand, biological death cannot be changed because it is physically irreversible.

In the event of clinical death, the state in which a person remains is highly dependent on the time required for the resumption of breathing and cardiac function. Moreover, the organs begin to be damaged due to lack of oxygen, and the same thing happens with the brain.

Every hospital has a protocol for when to stop trying to resuscitate, be it heart massage, assisted breathing, or electrical defibrillation, as deep brain damage or failure to recover can occur.

Signs of clinical death

• Absence of pulse, it can be determined only on the carotid artery or femoral artery, the heartbeat can be heard by putting your ear to the heart area;
• Circulatory arrest;
• Complete loss of consciousness;
• Lack of reflexes;
• Very weak breathing, which is checked by the movements of the chest when inhaling or exhaling;
• Cyanosis of the skin, pallor of the skin;
• Pupil dilation and lack of reaction to light;

Timely rendered first first aid the patient, is able to save a person's life: artificial respiration, heart massage, which must be carried out before the arrival of an ambulance. When patients return to life, most of them change their outlook on life and look at everything that happens in a completely different way. Very often, such people become detached from loved ones and live in their own world, some acquire supernatural abilities and begin to help other people.

What types of death are there?

Because on medical level there is a term called near-death for those who respond to reversible cardiorespiratory arrest, and there are others that have the peculiarity of being irreversible.

Of course, you have heard of brain death, the brain dead patient suffers this level of damage in his brain, losing all functions beyond those automatic ones for which he needs the help of a respirator and other artificial machines.

To determine brain death, various tests are performed to determine the activity of neurons, which are reviewed by several doctors. If brain death is established, the person is a candidate donor unless there is some level of deterioration.

It is important to note that brain death and other conditions such as coma or vegetative state, do not match, since in the second and third cases recovery can occur, which is impossible in the first.

Finally, we have biological death, absolute and irreversible death, because not only the organs stop working, but the brain also loses all activity, this is a classic type of death.

Causes of clinical death

The cause of clinical death is trauma, disease, or a combination of both responsible for initiating a series of pathophysiological disorders. The cause of death is unique (immediate and fundamental) when an injury or illness results in death so quickly that there are no complications. When there is a delay between the onset of an illness or injury and final death, one can distinguish between an immediate or final cause (the one that caused direct death) and another fundamental, initial, or underlying cause.