Main and secondary signs of clinical death. Clinical death: causes, main signs, assistance

Considered as the last stage terminal state, which begins from the moment the basic functions of the body’s vital functions cease (blood circulation, breathing) and continues until the onset of irreversible changes in the cerebral cortex. Able clinical death full restoration of a person’s life is possible. Its duration under normal conditions is about 3-4 minutes, so to save the victim it is necessary to begin resuscitation measures as early as possible.

The duration of clinical death depends on many factors, but the determining factor is the supply of glycogen in neurons, because it is glycogenolysis that is the only source energy in the absence of blood circulation. Because neurons are one of those cells that function quickly, they cannot contain a large supply of glycogen. Under normal conditions, it is enough for exactly 3-4 minutes of anaerobic metabolism. With absence resuscitation care or if it is carried out incorrectly, after a specified time, energy production in the cells completely stops. This leads to disruption of all energy-dependent processes and, above all, the maintenance of the integrity of intracellular and extracellular membranes.

Signs of clinical death

All symptoms that can be used to establish a diagnosis of clinical death are divided into basic and additional. The main signs are those that are determined during direct contact with the victim and allow one to reliably diagnose clinical death, the additional ones are those signs that indicate a critical condition and allow one to suspect the presence of clinical death even before contact with the patient. In many cases, this allows for a faster start. resuscitation measures and can save the patient's life.

The main signs of clinical death:

absence of pulse in the carotid arteries;
lack of spontaneous breathing;
dilation of the pupils - they dilate 40-60 seconds after blood circulation stops.

Additional signs of clinical death:

lack of consciousness;
pallor or cyanosis skin;
lack of independent movements (however, rare convulsive muscle contractions are possible during acute circulatory arrest);
unnatural position of the patient.

The diagnosis of clinical death should be established within 7-10 seconds. For the success of resuscitation measures, the time factor and technically correct implementation are crucial. To speed up the diagnosis of clinical death, checking the presence of a pulse and the condition of the pupils is carried out simultaneously: the pulse is determined with one hand, and the eyelids are raised with the other.

Cardiopulmonary and cerebral resuscitation

The complex of cardiopulmonary and cerebral resuscitation (CPCR), according to P. Safar, consists of 3 stages:

Stage I - basic life support
Purpose: emergency oxygenation.
Stages: 1) restoration of patency respiratory tract; 2) artificial ventilation; 3) indirect cardiac massage. Stage II - further life support
Goal: restoration of independent blood circulation.
Stages: 1) drug therapy; 2) diagnosis of the type of circulatory arrest; 3) defibrillation. Stage III- long-term life support
Goal: cerebral resuscitation.
Stages: 1) assessment of the patient’s condition and prognosis for the immediate future; 2) restoration of higher brain functions; 3) treatment of complications, rehabilitation therapy.

The first stage of resuscitation should be started immediately at the scene of the incident without delay by any person familiar with the elements of cardiopulmonary resuscitation. Its goal is to support artificial circulation and mechanical ventilation using elementary methods that ensure an extension of the period of reversible changes in vital organs until adequate spontaneous circulation is restored.

The indication for SLCR is the presence of even two main signs of clinical death. Begin resuscitation without checking the pulse carotid artery is unacceptable, since performing indirect cardiac massage during normal operation can cause circulatory arrest.

Clinical death, in which circulatory arrest occurs, is one of the main causes deaths among the population in conditions developed countries. Mostly clinical death, in which first aid allows you to save a person with timely and correctly performed actions, is caused by ventricular fibrillation, somewhat less often it occurs due to asystole (cessation of cardiac electrical activity).

Signs of clinical death

lack of consciousness in a person;
absent pulse in the area of the carotid arteries;
lack of breathing ( this sign several appear later signs listed above).

In addition, shortly before the onset of these symptoms, complaints of chest pain, dizziness, and shortness of breath are noted. Loss of consciousness is accompanied by the development of convulsions (which occurs approximately half a minute after this event), then the pupils dilate. As for breathing, it becomes rare and superficial, from the second minute of the state of clinical death and completely disappears.

First aid for clinical death: basic actions

Make sure that the patient is unconscious.
Make sure there is no pulse in the carotid artery area. In this case, it is checked for about 10 seconds from the anterior cervical surface, between the sternocleidomastoid muscle and the mandibular angle.
In a situation where it is impossible to determine the pulse and in the absence of consciousness, it is necessary to perform a precordial blow. To do this, you need to hit the sternum once with your fist. This measure, although in a few cases, makes it possible to stop the process of ventricular fibrillation.
Call " ambulance", explaining to the dispatcher the essence of the situation and the actions performed above, location. It is important to consider that the vast majority of cases indicate that the lack of specialized medical care reduces any efforts to save the patient’s life to “no”. The goal of the people who are nearby at this moment is to provide maximum support for the patient’s life until the ambulance arrives. Any resuscitation measures without an ambulance are practically meaningless in case of clinical death!
If there is no effect from a blow to the sternum and the signs characteristic of the condition in question persist, first aid in case of clinical death requires cardiopulmonary resuscitation.

Cardiopulmonary resuscitation: how is it performed?

The victim must be laid on a flat and hard surface (the floor will do). Note that a serious mistake when performing this action is to lay the person on a soft bed - remember that in such a situation, a soft surface only reduces the effectiveness of the result of the actions performed, therefore first aid in this regard may also be meaningless;
the victim’s lower jaw should be moved slightly forward, for which your palm is placed on his forehead, his head is thrown back, and his chin is raised accordingly;
eliminate removable dentures teeth of the person being resuscitated, if any, remove other foreign objects;
if the victim is unable to breathe, he needs to tightly pinch his nose while simultaneously blowing air from mouth to mouth, the frequency of actions should be about 12 inhalations/min. A certain effectiveness is noted when moving the cage pile, which rises during inhalation and falls during passive exhalation. The most common mistake at this stage comes down to blowing air into the victim too quickly, which causes it to enter his stomach, thereby provoking vomiting. Remember that not pinching a person’s nose tightly enough prevents air from entering his lungs;
then you need to go to private massage heart, for which one hand is placed in the area of the lower third of the sternum with the protrusion of the palm, the second is similarly placed on its dorsal surface. Pressure implies straight position shoulders above the palms, without bending the elbows. Indentation chest wall should be performed within 3-5 cm, at a frequency of up to 100 per minute. Please note that air injection cannot be performed simultaneously with compression. chest.

If resuscitation measures are carried out correctly, then there is an improvement in the patient’s condition, in which he begins to breathe on his own (heart massage must still be continued), his pupils also narrow and his skin turns pink.

We also note those situations in which resuscitation measures are not necessary:

the person is in a conscious state;
the person is fainting, but a pulse is present in the area of the carotid arteries, which indicates normal cardiac activity;
the person is in a state terminal stage currents incurable disease(oncology, etc.);
About half an hour has passed since the cessation of cardiac activity, or signs have appeared indicating biological death(cold skin, rigor mortis, cadaveric spots, dried out corneas).

To top it off, I would like to note that if you had to find yourself in a situation in which you had already provided first aid, during clinical death or in any other cases, but the actions were unsuccessful, there is no need to blame yourself for this!

Even with modern equipment, using best medicines and surrounded by excellent medical specialists, attempts to bring a person back to life do not always end in successful results. The result of successful resuscitation is always a small miracle, however, be that as it may, one should try to hope for it and do everything possible in any case.

Symptoms of clinical death

Clinical death is a reversible state of dying in which the heart stops working and breathing stops. All external signs vital functions disappear, 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 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 – absence breathing movements 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, subject to normal temperature body, 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, we need to provide maximum support vital signs victim. 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 we must proceed to artificial ventilation lungs (ventilator) 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:

Lay the victim on a flat, hard surface.
Place your hand on his forehead, tilting his head back slightly. At the same time, the chin will move forward.
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.
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. The chest wall is pressed 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:

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

If resuscitation measures are successful, the patient is transferred to the ward intensive care, where it is carried out further treatment and condition monitoring. 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, late signs of biological death appear. 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 various disorders. They may affect both physical development, and psychological state. Damage to health depends on time oxygen starvation important organs. In other words, than formerly man will return to life after a short death, so fewer complications he will be observed.

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 brain cells by 70-80%, which will lead to complete absence socialization (ability to think, understand).

At the level 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.

During clinical death, all processes necessary for life stop. Signs of clinical death are precisely the absence visible signs life.

As mentioned earlier, clinical death occurs due to inhibition of the heart. The reasons for the malfunction of this vital organ can be different:

too strong physical and emotional stress, which can disrupt blood circulation in the heart.
severe blood loss (if there were injuries or wounds);
state of shock, including allergic shock(anaphylaxis), toxic shock;
the presence of long-term chronic diseases of the heart and respiratory system;
severe injuries to the brain and significant organs.

Regardless of what causes the state of clinical death, its symptoms will be the same and medical assistance is required immediately.

Phases of clinical death

Since clinical death is borderline state, there are 2 ways out of it - either the person returns to life, or biological death occurs. Clinical death lasts as long as the human brain is able to maintain its viability without nutrition. Doctors distinguish two stages of clinical death:

The first stage is short, lasting up to 5 minutes. During this time, the body is still able to maintain its vital functions, but if during this time the person is not resuscitated, the risk of biological death is very high. If the functions were restored longer than 5 minutes, the person may remain disabled, because During a prolonged state of clinical death, irreversible processes begin in the brain and some parts of it die.
The second stage is longer, but does not always occur. In some cases, all processes in the body slow down, as well as the processes of tissue death. This happens, for example, with hypothermia. As a result of such a slowdown, clinical death can continue for another ten or several tens of minutes.

First aid measures in case of clinical death are aimed at establishing blood circulation and restoring respiratory function. It is better to carry out all resuscitation measures together, but if this is not possible, one person can handle it. Before providing first aid, you must call an ambulance.

To “start” contractions of the ventricles of the heart, you need to perform a precordial blow - this is a strong and sharp push with a fist into the sternum. If the effect does not occur, move on to the next steps.
Cardiopulmonary resuscitation is necessary. It consists of indirect cardiac massage, which alternates with artificial respiration using the “mouth to mouth” principle. During artificial respiration It is necessary that the air enters the lungs, and not the stomach. To do this, you should not inhale too often and pinch your nose very tightly. It’s good if a person’s chest rises during artificial inhalation. Indirect massage hearts are pushes with both hands into the sternum area. You need to alternate points and breaths according to the following scheme: 30 pushes - 2 blows. This must be repeated cyclically. After 5 cycles of CPR, the person's pulse and breathing should be checked.

In some situations, resuscitation is not necessary:

if the person is conscious;
if he showed signs of vital activity (the pupils narrowed, he began to breathe on his own, a pulse appeared);
if there are signs of biological death of the victim (rigor, cadaveric spots);
if before the onset of clinical death the person was already seriously ill with an incurable disease and was actually near death.

In some cases, it is possible to bring the victim out of a state of clinical death; the vital functions of his body are restored, but he does not regain consciousness. In this case, from a state of clinical death, he goes into a state of coma and can remain there for quite some time. for a long time. At the same time, his heart functions and he is able to breathe. Depth comatose state and forecasts for exiting it depend on how strong the brain damaged during clinical death.

This period when everyone's vitality has faded important processes the body is still reversible, called clinical death. Clinical death can be caused by heavy bleeding, electrical trauma, drowning, reflex cardiac arrest, acute poisoning etc.

Clinical death

Signs of clinical death:

1) absence of pulse in the carotid or femoral artery;
2) lack of breathing;
3) loss of consciousness;
4) wide pupils and their lack of reaction to light.

Therefore, first of all, it is necessary to determine the presence of blood circulation and breathing in the patient or victim.

Determination of signs of clinical death:

1. Absence of pulse in the carotid artery is the main sign of circulatory arrest;

2. Lack of breathing can be checked by visible movements of the chest when inhaling and exhaling, or by placing your ear to the chest, hearing the sound of breathing, feeling (the movement of air during exhalation is felt by the cheek), and also by bringing a mirror, glass or watch glass, as well as cotton wool or thread, holding them with tweezers. But it is precisely on the determination of this characteristic that one should not waste time, since the methods are not perfect and unreliable, and most importantly, they require a lot of precious time for their determination;

3. Signs of loss of consciousness are a lack of reaction to what is happening, to sound and pain stimuli;

4. Raises upper eyelid the victim and the size of the pupil is determined visually, the eyelid drops and immediately rises again. If the pupil remains wide and does not narrow after lifting the eyelid again, then we can assume that there is no reaction to light.

If one of the first two of the 4 signs of clinical death is determined, then you need to immediately begin resuscitation. Since only timely resuscitation (within 3–4 minutes after cardiac arrest) can bring the victim back to life. Resuscitation is not performed only in the case of biological (irreversible) death, when irreversible changes occur in the tissues of the brain and many organs.

Biological death

Signs of biological death:

1) drying of the cornea;
2) the “cat’s pupil” phenomenon;
3) decrease in temperature;.
4) body cadaveric spots;
5) rigor mortis

Determination of signs of biological death:

1. Signs of drying out of the cornea are the loss of the iris of its original color, the eye appears to be covered with a whitish film - a “herring shine”, and the pupil becomes cloudy.

2. Big and index fingers squeeze eyeball, if a person is dead, then his pupil will change shape and turn into a narrow slit - a “cat’s pupil”. This cannot be done in a living person. If these 2 signs appear, this means that the person died at least an hour ago.

3. Body temperature drops gradually, by about 1 degree Celsius every hour after death. Therefore, based on these signs, death can only be confirmed after 2–4 hours or later.

4. Cadaveric spots purple appear on the underlying parts of the corpse. If he lies on his back, then they are identified on the head behind the ears, on the back of the shoulders and hips, on the back and buttocks.

5. Rigor mortis - post-mortem contraction skeletal muscles“top to bottom”, i.e. face – neck – upper limbs– torso – lower limbs.

Full development of signs occurs within 24 hours after death.

Clinical death, in which circulatory arrest occurs, is one of the main causes of death among the population in developed countries. Mostly clinical death, in which first aid allows you to save a person with timely and correctly performed actions, is caused by ventricular fibrillation, somewhat less often it occurs due to asystole (cessation of cardiac electrical activity).

Signs of clinical death

lack of consciousness in a person;
absent pulse in the area of the carotid arteries;
absent breathing (this symptom appears somewhat later than the symptoms listed above).

First aid for clinical death: basic actions

Cardiopulmonary resuscitation: how is it performed?

The victim must be laid on a flat and hard surface (the floor will do). Note that a serious mistake when performing this action is to lay the person on a soft bed - remember that in such a situation, a soft surface only reduces the effectiveness of the result of the actions performed, therefore first aid in this regard may also be meaningless;
the victim’s lower jaw should be moved slightly forward, for which your palm is placed on his forehead, his head is thrown back, and his chin is raised accordingly;
remove the removable dentures of the patient’s teeth, if any, remove other foreign objects;
if the victim is unable to breathe, he needs to tightly pinch his nose while simultaneously blowing air from mouth to mouth, the frequency of actions should be about 12 inhalations/min. A certain effectiveness is noted when moving the cage pile, which rises during inhalation and falls during passive exhalation. The most common mistake at this stage comes down to blowing air into the victim too quickly, which causes it to enter his stomach, thereby provoking vomiting. Remember that not pinching a person’s nose tightly enough prevents air from entering his lungs;
Next, you need to move on to closed heart massage, for which one hand is placed in the area of the lower third of the sternum with the protrusion of the palm, the second is similarly placed on its dorsal surface. Pressing involves straight shoulders over your palms, without bending your elbows. Indentation of the chest wall should be done within 3-5 cm, at a frequency of up to 100 per minute. Please note that air injection cannot be performed simultaneously with chest compressions.

We also note those situations in which resuscitation measures are not necessary:

the person is in a conscious state;
the person is fainting, but a pulse is present in the area of the carotid arteries, which indicates normal cardiac activity;
the person is in the terminal stage of an incurable disease (oncology, etc.);
About half an hour has passed since the cessation of cardiac activity, or signs indicating biological death have appeared (coldness of the skin, rigor mortis, cadaveric spots, dried out corneas of the eyes).

Even with modern equipment, using the best medicines and surrounded by excellent medical specialists, attempts to bring a person back to life do not always result in successful results. The result of successful resuscitation is always a small miracle, however, be that as it may, one should try to hope for it and do everything possible in any case.

A living organism does not die simultaneously with the cessation of breathing and cessation of cardiac activity, therefore, even after they stop, the body continues to live for some time. This time is determined by the brain’s ability to survive without oxygen supplied to it; it lasts 4–6 minutes, on average 5 minutes. This period, when all the extinct vital processes of the body are still reversible, is called clinical death. Clinical death can be caused heavy bleeding,electrical trauma, drowning, reflex cardiac arrest, acute poisoning, etc.

Signs of clinical death:

1) absence of pulse in the carotid or femoral artery; 2) lack of breathing; 3) loss of consciousness; 4) wide pupils and their lack of reaction to light.

Therefore, first of all, it is necessary to determine the presence of blood circulation and breathing in the patient or victim.

Definition of signs clinical death:

1. Absence of pulse in the carotid artery is the main sign of circulatory arrest;

2. Lack of breathing can be checked by visible movements of the chest during inhalation and exhalation, or by placing your ear to the chest, hearing the sound of breathing, feeling (the movement of air during exhalation is felt by the cheek), and also by bringing a mirror, a piece of glass or a watch glass, or a cotton swab to your lips or thread, holding them with tweezers. But it is precisely on the determination of this characteristic that one should not waste time, since the methods are not perfect and unreliable, and most importantly, they require a lot of precious time for their determination;

3. Signs of loss of consciousness are a lack of reaction to what is happening, to sound and pain stimuli;

4. The victim’s upper eyelid is raised and the size of the pupil is determined visually, the eyelid lowers and immediately rises again. If the pupil remains wide and does not narrow after lifting the eyelid again, then we can assume that there is no reaction to light.

If one of the first two of the 4 signs of clinical death is determined, then resuscitation must be started immediately. Since only timely resuscitation (within 3–4 minutes after cardiac arrest) can bring the victim back to life. Resuscitation is not performed only in the case of biological (irreversible) death, when irreversible changes occur in the tissues of the brain and many organs.

Signs of biological death :

1) drying of the cornea; 2) the “cat’s pupil” phenomenon; 3) decrease in temperature;. 4) body cadaveric spots; 5) rigor mortis

Definition of signs biological death:

1. Signs of drying out of the cornea are the loss of the iris of its original color, the eye appears to be covered with a whitish film - a “herring shine”, and the pupil becomes cloudy.

2. The thumb and forefinger squeeze the eyeball; if the person is dead, then his pupil will change shape and turn into a narrow slit - a “cat’s pupil.” This cannot be done in a living person. If these 2 signs appear, this means that the person died at least an hour ago.

3. Body temperature drops gradually, by about 1 degree Celsius every hour after death. Therefore, based on these signs, death can only be confirmed after 2–4 hours or later.

4. Purple cadaveric spots appear on the underlying parts of the corpse. If he lies on his back, then they are identified on the head behind the ears, on the back of the shoulders and hips, on the back and buttocks.

5. Rigor mortis is a post-mortem contraction of skeletal muscles “from top to bottom,” i.e. face – neck – upper limbs – torso – lower limbs.

Full development of signs occurs within 24 hours after death. Before you begin to revive the victim, you must first establish the presence of clinical death.

! They begin resuscitation only if there is no pulse (in the carotid artery) or breathing.

! Revitalization efforts must begin without delay. The sooner resuscitation measures are started, the more likely a favorable outcome is.

Resuscitation measures directed to restore the vital functions of the body, primarily blood circulation and breathing. This is, first of all, artificial maintenance of blood circulation in the brain and forced enrichment of the blood with oxygen.

TO events cardiopulmonary resuscitation relate: precordial stroke , indirect cardiac massage And artificial ventilation (ventilation) using the mouth-to-mouth method.

Cardiopulmonary resuscitation consists of sequential stages: precordial stroke; artificial maintenance of blood circulation (external cardiac massage); restoration of airway patency; artificial pulmonary ventilation (ALV);

Preparing the victim for resuscitation

The victim must lie down on your back, on a hard surface. If it was lying on the bed or on the sofa, then it must be moved to the floor.

Expose your chest the victim, since under his clothes on the sternum there may be pectoral cross, medallion, buttons, etc., which may cause additional injury, as well as unfasten the waist belt.

For ensuring airway patency necessary: 1) clean oral cavity from mucus, vomit with a cloth wrapped around the index finger. 2) eliminate tongue retraction in two ways: by throwing back the head or extending it lower jaw.

throw back your head the victim needs to ensure that the back wall of the pharynx moves away from the root of the sunken tongue, and air can freely pass into the lungs. This can be done by placing a cushion of clothing either under the neck or under the shoulder blades. (Attention! ), but not to the back of the head!

Forbidden! Place hard objects under your neck or back: a backpack, a brick, a board, a stone. In this case, during chest compressions, the spine can be broken.

If there is a suspicion of a fracture of the cervical vertebrae, you can, without bending your neck, extend only the lower jaw. To do this, place your index fingers on the corners of the lower jaw under the left and right earlobes, push the jaw forward and secure it in this position with your thumb right hand. The left hand is freed, so it is necessary to pinch the victim’s nose with it (thumb and forefinger). This way the victim is prepared for artificial pulmonary ventilation (ALV).