Sudden cardiac arrest causes and symptoms. Signs and causes of sudden cardiac arrest

Date: 19.07.2019

Today, cardiac arrest is considered, unfortunately, a very common cause of death. And this despite being on time Taken measures can save many lives. This type of pathology occurs suddenly, often in a dream, and affects not only people with diseases of cardio-vascular system but also a healthy person. Being near a victim who has a cardiac arrest, you need to be sure what kind of situation people are facing and what can be done.

How to detect that the heart has stopped

Doctors know certain basic indicators, knowing which, it is possible to determine whether a cardiac arrest has really occurred, and what measures can be taken to save the victim.

One of the first indicators is the absence of a pulse (it is not palpable in the region of large arteries). To accurately determine the absence / presence of a pulse, you need an average and index fingers attach to area carotid artery, if it is not palpable, it is necessary to immediately begin resuscitation, without waiting for the arrival of emergency assistance (having previously called the brigade).
The symptoms also include an unusually audible sound of a heartbeat.
Very important sign doctors call the cessation of respiratory activity. Determine presence/absence respiratory function it is possible with the help of any mirror surface that is at hand (pocket mirror) - it is brought to the mouth or nose, and, in addition, visually - by the presence or absence of respiratory movements in the chest area.
Dilated pupils that do not respond to light rays- is also one of the signs. To identify this, it is best to direct the light of a flashlight, a lighter into the eyes, and in the absence of a reaction (no pupillary constriction was detected), we can conclude that the myocardium is not functioning.
A change in the natural complexion is evidence of a clear violation of the circulatory system. As a rule, the face acquires a bluish or gray tint.
Loss of consciousness lasting 10 to 20 seconds or more is one of the symptoms of cardiac arrest. This usually indicates violations in the functioning of ventricular fibrillation or the onset of asystole. You can identify such a condition by patting gently on the face, or by creating noise (clapping, loud noises, screaming).

Is it possible to save a person, and how much time is there for this

Being close to the victim, who had a pathological cardiac arrest, the main thing on the part of others is not to hesitate, and to understand that competent first aid in case of cardiac arrest is the only chance for salvation. Doctors believe that there are only seven minutes to save a life, and in such a way that in the future it will do without serious consequences.

Execution technique indirect massage hearts

In a situation where it is possible to save a person's life in only 7-10 minutes, the victim increases the threat of mental and neurological pathologies in future. Late, or ineptly rendered assistance, as a rule, leads to the disability of the victim, and even to complete incapacity, that is, the consequences can be very severe and unpredictable.

The main focus of assistance is the restoration of respiratory activity, the rhythm of the heartbeat, as well as the launch of the blood flow system. This is extremely necessary, since the blood flow provides cells and tissues with oxygen, in the absence of which the functioning of organs, especially the brain, and hence the actual life of a person, is impossible. So with a short-term cardiac arrest, everything depends only on the speed of the actions of the surrounding people or doctors.

It is important to take into account that urgent care is possible only after the people who provide it are sure that the victim is unconscious.

To make sure of this, you need to gently shake the victim, call him loudly several times. As soon as signs of cardiac arrest (one or more) are detected, resuscitation should be started immediately. Help consists of several stages.

First of all, the victim must be carefully placed on a flat and hard surface, and then his head should be thrown back.
Release if possible Airways from accumulated mucus (before the arrival of doctors, only the nasal passages and oral cavity are cleaned).
At the next stage, it is necessary to carry out artificial ventilation of the lungs (the so-called mouth-to-mouth or nose breathing).

In case of sudden cardiac arrest, doctors also recommend an external (so-called indirect) massage. But, before that, you need to carry out a “precordial blow”. This is a punch exactly in the middle region of the sternum. At the same time, it is important to hit in such a way that the blow is not directed directly to the heart area, otherwise the position of the victim may be seriously aggravated. Despite the fact that doctors call this a preparatory measure, in some cases such a blow can resuscitate the victim without the use of other measures.

In any case, it maximizes the result of the massage. If this event did not help to resuscitate the victim, and the ambulance has not yet arrived, you need to perform an external massage. It is necessary to act quickly and clearly, since the resuscitators believe that it is the help in case of cardiac arrest, provided on time, that is the hope for a person to get out of this state and reduce the negative consequences.

Basic measures and treatment

When providing assistance, it is imperative to check the main indicators of the victim's condition every 2-3 minutes - to feel the pulse, check the presence / absence of respiratory activity, the reaction of the pupils to light. Doctors warn that resuscitation measures can be stopped if respiratory activity is restored, but in no case should be completed when the pulse has just recovered. In this case, you need to continue ventilation artificial method. External type massage is performed until the skin color becomes natural.

It is also necessary to know that in the event that no measures lead to saving a life, then resuscitation can be completed only after the arrival of a doctor who has the right to allow resuscitation to be stopped. Of course, the above measures are only the initial stage of saving the life of the victim, which is provided to him by the people around him, without waiting for an emergency resuscitation team. Professional resuscitation is much more serious.

Resuscitation of the patient with a defibrillator

In order to bring the victim out of this pathological condition, and with the least losses and consequences, emergency doctors use special methods for sudden cardiac arrest. But the main task of resuscitators also remains the restoration of the patient's respiratory function. For this apply:

ventilation with a special mask;
in those situations where this does not bring results, or it is not possible to use a mask, then tracheal incubation is indicated. This method is the most effective, as it ensures the release of the airways, and the restoration of respiratory function. But only a specialist doctor should install the incubation tube.

To start the heart by professional resuscitators, a defibrillator is used as an urgent measure - a device that acts on the heart muscle with an electric current. In addition to such measures, resuscitators use special medications(for specific cases - your drug). Among the most effective are:

atropine is recommended for asystole;
to enhance and increase the frequency of contractions of the heart muscle, adrenaline (epinephrine) is prescribed;
several drugs are used as antiarrhythmic drugs - amiodarone, bretylium tosylate, lidocaine;
to stabilize cardiac activity, stimulate the functioning of cells, sodium sulfate is recommended;
in the presence of hyperkalemia, calcium is effective.

Possible reasons for the occurrence of pathology

The main causes of cardiac arrest are not very diverse. First place medical practice displays a violation of ventricular fibrillation - these cases occupy from 70% to 90%. This is due to a sudden contraction of the muscle fibers of the ventricles of a chaotic nature. This pathology causes interruptions in blood flow to tissues and organs.

In second place in terms of the occurrence of pathology according to statistics is the absolute stop of cardiac activity (bioelectrical activity of the myocardium) - asystole. This reason occupies from 5% to 10% of the occurrence of pathology.

Other causes include types of cardiac arrest that also require resuscitation in cardiac arrests, such as:

paroxysmal tachycardia ventricular - in the absence of large vessels pulse;
bioelectric activity in the absence of ventricular contractions - electromechanical dissociation;
genetic predisposition - inherited Romano-Ward disease.

In addition, reflex cardiac arrest occurs in completely healthy people, and there is also a predisposition or relevant factors for this:

Sudden hypothermia (decrease in temperature less than 28 ° C).
electrical injury.
The misuse of these medicines, as glycosides, analgesics, adrenoblockers, as well as drugs for anesthesia that are not suitable for individual reasons (pathology can occur in a dream).
Lack of oxygen, such as from drowning or suffocation.
Diagnosed ischemic disease (at the same time, people with such a diagnosis, constantly drinking alcoholic drinks, are at high risk of death from such a pathology - 30% of cases).
Abuse of tobacco products.
atherosclerosis disease, arterial hypertension or diagnosed with left ventricular hypertrophy.
Age changes

Possible results of pathology

As a rule, the consequences of this pathology largely depend on the speed of providing assistance to the patient. The later he is brought back to life, the more the risk of serious pathologies in the future increases. This is due to oxygen starvation for a long time. As a result, in such patients, disorders of the brain activity are observed in the future, various diseases kidneys, liver.

In addition, pneumothorax and rib fractures can be side effects of massage. According to statistics, 30% of victims return to life after this pathology, and full life Unfortunately, no more than 5% of patients can return without serious illnesses

Cardiac arrest poses a serious threat to human life. When the heart stops beating, the pulse stops and death occurs within minutes. During cardiac arrest, every minute is important for a person, which takes about 10% of his life. If sudden cardiac arrest occurs and proper care is provided within the first minute, the survival rate is about 90%. When providing assistance after 9 minutes, less than 10% of people survive, after 10 minutes the percentage of survival is zero. It is impossible to save a person after this time.

According to statistics, every day from cardiac arrest dies more people than due to oncological diseases, traffic accidents, etc. This is because many do not know how to help a person who has a sudden cardiac arrest. People nearby call ambulance, which, unfortunately, is unlikely to have time to arrive in the short amount of time when it is still possible to save the patient. People's hearts can stop different ages- newborns, young and old people.

Causes

The main causes of cardiac arrest are disorders of the heart muscle caused by a number of factors. In particular, the following types of cardiac arrest are distinguished:

Ventricular fibrillation. In most cases it is this pathology causes cardiac arrest. Ventricular fibrillation is an irregular and ineffective contraction of muscle fibers, in which the pumping work of the heart is disturbed.
Ventricular asystole is ranked second in cardiac arrest. During this violation the electrical activity of the heart muscle stops completely.
Ventricular paroxysmal tachycardia is characterized by the absence of a pulse in large arteries.
As a result of electromechanical dissociation, cardiac arrest can also occur: due to the lack of mechanical activity of the organ, while maintaining electrical activity.

The heart can also stop due to a genetic predisposition - Romano-Ward syndrome. There are other factors that can cause a malfunction of the heart muscle and lead to the development of extremely adverse consequences.

The heart can stop on the background of:

hypothermia of the body, as a result of vasospasm;
electrical injury;
misuse medical preparations- cardiac glycosides, adrenoblockers, analgesics and drugs used in anesthesia;
stops breathing when immersed in water;
lack of air, asphyxia;
coronary disease hearts;
atherosclerosis;
high blood pressure, left ventricular hypertrophy;
anaphylactic and hemorrhagic shock;
smoking (an indirect factor that negatively affects cardiovascular activity);
due to advanced age.

Certain medications for arrhythmias can cause cardiac arrest, antibacterial drugs, remedies for schizophrenia. alcohol poisoning or intoxication of the body against the background of an overdose of drugs can provoke an onset clinical death.

If there are predisposing factors for the development of sudden cardiac arrest, then you must carefully take care of your body, refuse bad habits and get regular check-ups with your doctor. Control over your body is carried out with the help of a cardiovisor - a device that you can independently fix on your legs and arms and find out your electrocardiogram.

Symptoms

Signs of cardiac arrest will make it possible to distinguish the violation from other pathologies in which it is forbidden to use some manipulations to restore the functioning of the heart muscle. There are some signs that may suggest cardiac arrest. The first is loss of consciousness. A person passes out a few seconds after cardiac arrest, making convulsive twitches for 20 seconds.

The skin turns pale, and the lips, tip of the nose and earlobes acquire a blue tint. Breathing slows down, it is almost inaudible. After 2 minutes, it completely stops. There is no pulse on palpation in the area of the wrist and neck. main feature- Absence of heartbeat behind the sternum. Pupils during cardiac arrest dilated, without the slightest reaction to light.

2-3 minutes after the main organ stops, a person experiences clinical death, after which organs and tissues undergo irreversible hypoxic changes. If the correct resuscitation actions are not performed in time, clinical death will turn into biological.

After the heart has stopped, the brain continues to live for another 9 minutes. The death of brain cells occurs from 7 minutes, if you have time to resuscitate the heart after this time, a person may remain incapacitated for life. It is possible to save the health of the victim only in the first 2-5 minutes from the onset of the development of clinical death.

A person with cardiac arrest may have no symptoms. More precisely, he will not be able to perceive them because of the suddenly developing clinical situation. Some note a strong unbearable pain behind the chest. Cardiac arrest can occur so suddenly that others simply do not notice it. It is especially dangerous when this happens in a dream, and then for a long time everyone will think that the person is just sleeping. Cardiac arrest in children infancy this is what happens - abruptly, suddenly, and only a timely reaction can bring the baby back to life.

Diagnostics and first aid

Cardiac arrest must be diagnosed very quickly, according to outward signs and during the inspection. In this case, the patient is not prescribed an ECG and other procedures, since every minute is important in the case of his resuscitation. First of all, the doctor feels the pulse, listens to breathing, looks at the pupils (in the process of resuscitation).

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If suddenly a trouble occurs with a loved one or a passerby, it is urgent to call an ambulance and try to resuscitate the patient on your own. To do this, you need to lay it on a flat and hard surface, unbutton the shirt collar or free your neck from other clothes, check oral cavity for the possible presence of vomit or a sunken tongue and proceed with a heart massage. The heart massage itself may well be performed by an unprepared person, without a special medical education.

It is necessary to press the heart area with two straightened hands, alternating heart massage with artificial respiration.

You need to perform this resuscitation procedure within 30 minutes. If the chest begins to rise, this means that the lungs are filled with air and life returns to the person. Upon arrival, the doctor can inject adrenaline into the heart and continue the resuscitation procedure.

Further treatment will be prescribed after the patient's hospitalization, depending on the cause that provoked the cardiac arrest and the changes in the body that occurred after the attack.
Sometimes besides medications required surgical intervention which can increase the patient's chances of survival. Very rarely, after returning to life, the patient manages to avoid serious consequences, and as a result, it is necessary to undergo therapy in stationary conditions for a long time.

Sudden cardiac arrest is a condition in which the heart muscle suddenly stops contracting, which causes a violation of blood circulation, and blood does not flow to the brain and other organs. This condition, as a rule, leads to death if the patient is not treated within a few minutes after the incident.

About what causes cardiac arrest, what are the reasons for the cessation of his activity, and also about how to provide first aid to a person in order to prevent his final death, we will talk in this article.

Causes of sudden cardiac arrest

An acute cessation of blood circulation, leading to a state of clinical death and threatening a person’s life, is caused not only by mechanical complete cardiac arrest - its causes may also lie in cases of such a type of cardiac activity that cannot provide a minimum level of blood circulation.

This condition develops with different dangerous violations heart rhythm: fibrillation (flutter) of the ventricles, impaired atrioventricular conduction (blockade that prevents the conduct of an electrical impulse from the atria to the ventricles), paroxysmal ventricular tachycardia, etc.

Circulatory arrest caused by cardiogenic causes

The reasons that caused cardiac and circulatory arrest, from the point of view of medicine, are divided into 2 groups - those of a cardiogenic and non-cardiogenic nature.

The former include conditions that lead to a weakening of the pumping function of the heart and to a disorder coronary circulation. The most common cause of this is myocardial infarction.

By the way, almost every fifth patient with this diagnosis dies within 6 hours from the onset of an attack. And most often this happens in the morning (before 7 o'clock in the morning).

Cardiac arrest can be triggered by: ischemic disease, angina pectoris, arrhythmia (cardiac arrhythmia), damage to its valves, inflammatory processes in the lining of the heart (myocarditis or endocarditis), as well as a change in the shape of the heart and myocardial functions (cardiomyopathy). No less dangerous in this sense can be cardiac tamponade (a disease in which it, simply put, “chokes” with its blood), as well as an aortic aneurysm leading to its rupture, or pulmonary embolism.

Non-cardiogenic causes of cardiac arrest

If non-cardiogenic cardiac arrest is meant, the reasons for this may lie in the violation of the functions of other systems, which are manifested, for example, by the development of any type of acute respiratory failure or a disorder in the central regulation of blood circulation.

Situations with airway obstruction (hit foreign body into the trachea, bronchi, or even just into the mouth), state of shock any genesis ( allergic reaction, pain, bleeding), overdose of drugs, alcohol or drugs, severe chemical intoxication, injury, injury, electric shock, drowning.

Signs of cardiac arrest

Despite the many reasons that lead to the cessation of blood circulation, its Clinical signs are the same in all patients.

Sudden cardiac arrest is characterized by the following external signs:

loss of consciousness;
lack of heart sounds and pulse on the carotid and femoral arteries;
cessation of breathing or its appearance according to the agonal type;
pupil dilation;
cyanotic or gray skin tone.

By the way, it should be noted that cardiac arrest can also be confirmed on the basis of the first three of the listed signs.

At this time, it is especially important to do everything as quickly as possible. In order not to delay the determination of the presence of a pulse, you should place the index and middle fingers on the larynx of the victim, and then, without pressing hard, feel the lateral surfaces of the neck.

In the absence of a pulse, do not waste time listening to heart sounds or measuring arterial pressure- the absence of a pulse indicates an undoubted cessation of the heartbeat.

What are other signs of cardiac arrest?

Dilated pupils, as well as altered skin color, cannot always serve as an absolute guide to confirm cardiac arrest.

Firstly, dilated pupils are, as a rule, a sign of oxygen starvation in the cerebral cortex, which manifests itself at a rather late date - from 30 to 60 seconds after cardiac arrest.

Secondly, some medications can also affect the size of the pupil (for example, atropine, which dilates the pupils or drugs that narrow them).

Skin color also depends on the level of hemoglobin in the blood (with severe blood loss, there may not be cyanosis), and also whether there is a certain chemical effect on the victim (during poisoning carbon monoxide or cyanide persists pink shade skin).

Cardiac arrest: first aid

When assisting victims of cardiac arrest, it must be remembered that in most cases of sudden death, in practically healthy people, the experience of a complete cessation of the blood circulation process is on average 5 minutes, after which irreversible changes in the central nervous system appear. If the stop was preceded serious illness heart, lung or progressive hypoxia, the named time is sharply reduced.

Based on this, assistance in case of cardiac arrest should begin immediately, since it is important not only to restore blood circulation and breathing in the patient, but also to bring him back to life as a full-fledged person.

How to Diagnose Cardiac Arrest

So, in order not to cause damage to the victim, cardiac arrest must be diagnosed in the first 15 seconds!

To do this, you need to look for a pulse on the carotid artery, listen to breathing (it stops in the first minute sudden death). Raise the eyelids of the victim and if you find that the pupils have dilated and do not react to light in any way, then respiratory and cardiac arrest can be considered confirmed.

Remember that resuscitation in the form of a heart massage, as well as artificial respiration, cannot be performed if the victim has an open chest injury or broken ribs. In this case, internal bleeding can be provoked.

How to start resuscitation in cardiac arrest

Immediately after ascertaining clinical death, it is necessary to begin resuscitation measures - to restore breathing, blood circulation and consciousness in the victim.

First aid for cardiac arrest begins as soon as clinical death has been established. Before starting an indirect heart massage, a so-called mechanical defibrillation is performed. To do this, you need to hit with your fist in the middle part of the victim's sternum. But in any case, do not beat in the area of \u200b\u200bthe heart!

The proposed punch is needed to shake the heart, by the way, this sometimes turns out to be enough for the patient to come to his senses. But most often this procedure increases the effectiveness of subsequent resuscitation.

First aid for cardiac arrest: artificial respiration

Doing everything necessary, it should be remembered that the described assistance for cardiac arrest is effective under the condition of sudden death, but if a person is sick for a long time, exhausted, fading away, then resuscitation, as a rule, has no prospects.

The first step is to restore patency in the airways. For this, the patient is placed on a hard, flat surface (a soft surface will greatly reduce the effect of the actions being taken) and, placing folded clothes under his shoulders, throw his head back. Then the victim's mouth is opened, pushing forward the lower jaw.

After removing vomit, blood or dentures (if any) from the mouth with gauze or a handkerchief, the patient's tongue is taken out so that it does not block the airways. And then they do artificial respiration.

To do this, take a strong breath and, holding the nose of the victim, blow air into his mouth. If possible, this can be done using a special mask.

How is circulation restored?

First aid for cardiac arrest requires a closed massage to restore blood circulation.

The hands of a rescuer who has become left side from the patient, should be located with the base of the palm on the sternum (the so-called hard bone of the chest), one on the other. The rescuer, making rhythmic translational movements with them (one press every 2 seconds), accelerates blood from the heart muscle into the blood vessels.

By the way, when assisting with cardiac arrest, remember that too vigorous pressure can cause fracture of the ribs, which, in turn, will lead to a puncture of the cavity of the heart or lung.

In the case when one person acts as a rescuer, he must, after every two breaths, press the victim on the chest 15 times. If two rescuers are doing this, then after each breath, with the help of one of them, the second presses five times on the chest.

Some more information

It is very important to remember that it is necessary to fix the time of resuscitation. If the rescuer is alone, then having made two cycles of heart massage, he should call the ambulance, and then continue his actions.

Do not forget to check the patient's pulse on the carotid artery and the state of his pupils every 3 minutes during the heart massage.

If it is found that the pulse has recovered, but there is still no breathing, you need to continue artificial ventilation of the lungs. As soon as breathing is restored, all other functions will resume on their own, since the brain, which has received oxygen, will immediately give a command to restore blood circulation.

If neither pulse nor breathing is restored, continue to do resuscitation until the ambulance arrives.

What is sudden cardiac arrest and why does it happen? What help can each of us give to a person whose heart has suddenly stopped? The editors of Vesti.Medicina talked about this with cardioblogger Alexei Utin.

Alexey Utin

What is sudden cardiac arrest? How often does it happen?

Sudden cardiac arrest (SCA) is a sudden and complete cessation of the effective activity of the heart with or without bioelectrical activity. According to the World Health Organization, around the world, 7 million people die from VOS annually, in Russia - about 300 thousand people. One of the main factors of cardiac arrest is ventricular fibrillation - a dangerous chaotic contraction of myocardial fibers and the lack of coordinated contraction of the ventricles. In this state, the heart ceases to perform its pumping functions, and the blood supply to the entire body, including the brain, is cut off. If a person in such a situation is not helped within 7-10 minutes, then the person will die. It is important to note that in most cases, the correct functioning of the heart can be restored with a defibrillator discharge. Cardiopulmonary resuscitation and indirect heart massage are done in order to maintain blood circulation in the main organs and wait for the arrival of an ambulance, which has this device at its disposal.

Are there any statistics: who develops this condition more often - gender, age, concomitant diseases, other factors?

Referring to the statistics of cases of sudden cardiac arrest, two risk groups are usually divided: people under 35 years old, and people over 35 years old. In the first group, the main factors are congenital heart pathologies (hypertrophic cardiomyopathy, Burgada's syndrome, long QT syndrome, etc.). They can be diagnosed by doing ECG studies, Echocardiography of the heart. Plays an important role hereditary factor: for example, if one of the parents or close relatives had a sudden cardiac arrest.

After 35 years, these are the same factors that provoke myocardial infarction - smoking, high pressure, high level cholesterol and blood sugar overweight and a sedentary lifestyle, as well as male gender, strokes, heart attacks and sudden death in relatives under 60 years of age. In more than half of the cases, SCA has no symptoms or precursors, and it develops really suddenly. Therefore, it is so important to undergo regular medical examinations to identify risk factors.

What do Russians generally know about first aid, do they know how to provide it? How are things in other countries?

Unfortunately, Russians are not very knowledgeable about first aid skills. This is partly due to the lack of qualified personnel who could intelligibly and professionally train citizens in first aid skills according to protocols that are updated every 5 years. In theory, these skills should be taught in driving courses, but this is far from being observed everywhere. Of course, some people take various courses, but, in my opinion, such important skills should be taught at school in life safety lessons. And of course, the absence of a high mortality rate from SCA is also affected, because without these devices we lose precious minutes waiting for an ambulance. And our skills in cardiopulmonary resuscitation (CPR) may not be enough to maintain an adequate blood supply to the brain and heart.

What should I do if there is a sudden cardiac arrest and there is no defibrillator? How to act?

In this case, it is necessary to immediately call an ambulance and proceed with cardiopulmonary resuscitation according to the first aid protocol for SCA. First of all, you need to determine whether the victim is conscious. To do this, you need to pat him or shake him by the shoulder and call out loudly. Next, check his breathing, pulse, conduct an external examination. After that, it is necessary to put the person on his back, check the oral cavity: in the mouth of the victim during resuscitation should not be foreign objects.

Before performing CPR, mentally put in front of you three main tasks:

open the airways;
restore breathing;
restore circulation.

Opening of the airways

Lay the victim on their back on a hard surface.
Kneel on the side of the victim's neck and shoulders.
Open the victim's airway using the head tilt with chin lift technique. Place your palm on the victim's forehead and gently tilt their head back. Then, with your other hand, gently pull his chin forward to open his airway.
Within 5-10 seconds, try to make sure that there is normal breathing: look closely to see if the chest is moving, try to catch the sound of breathing or feel breathing with your cheek or ear. Separate noisy sighs cannot be considered normal breathing. If there is no normal breathing, and you have the skills of cardiopulmonary resuscitation, start mouth-to-mouth artificial respiration. If you think the victim has passed out due to a heart attack and you are not trained in first aid, do not give mouth-to-mouth rescue breathing but immediately proceed to chest compressions to restore circulation.

Restoration of breathing

Artificial respiration can be performed in two versions: mouth-to-mouth or mouth-to-nose (in cases where the mouth is seriously injured or cannot be opened).

Having opened the airways using the “head tilt with chin lift” technique, pinch the victim’s nostrils (during mouth-to-mouth breathing) and tightly wrap your lips around the victim’s mouth, ensuring tightness.
Get ready to take two exhalations "from mouth to mouth." Make the first exhalation into the victim's mouth (one second duration). See if the victim's chest rises. When you notice the movement of the chest, take a second breath. If there is no movement of the chest, repeat the head tilt with chin lift technique, then exhale a second time.
Begin chest compressions to restore circulation.

Restoration of blood circulation

Place the palm of one hand with the base in the middle of the victim's chest. Place the second palm on top of the first. Straighten your arms at the elbows, while the shoulders should be directly above the palms.
Using the weight of your upper body (not just your arm strength), start applying chest pressure (compressions) from top to bottom (compression depth is about 5 cm). The compressions should be strong and fast, with a frequency of two compressions per second (about 120 compressions per minute).
After doing 30 compressions, tilt the victim's head back and pull the chin forward, opening the airway. Get ready to take two exhalations "from mouth to mouth." Hold the victim's nose firmly and exhale into the mouth for one second. When you notice the movement of the chest, take a second breath. If there is no movement of the chest, repeat the head tilt with chin lift technique, then exhale a second time. These actions constitute one cycle of CPR.
Continue CPR until signs of movement appear or until the ambulance arrives.

Why is the law on placing defibrillators in public places important? Is there any possible downside to it?

Usually, there is no more than 10 minutes to save a person, and with every minute of inactivity, a person’s chance of survival decreases by 7-10%. Installation of automated external defibrillators (AEDs) in in public places- this necessity, which is dictated modern conditions and pace of life in major cities including heavy traffic and large crowds. AED allows you to help the victim of SCA even if the person does not have first aid skills. Modern devices, such as the Philips HeartStart FRx defibrillator, provide clear voice instructions and guide you through every step, from applying shock pads to performing CPR. Reporting the necessary actions, the defibrillator preliminarily assesses the patient's condition and even reminds you to call an ambulance. Taking into account the principles of operation of the AED, its use is absolutely safe, since the device is able to independently determine that defibrillation is not required, and in this case, even pressing the “discharge” button will not activate the device, and therefore will not harm the victim.

Aleksey Utin, an active promoter of healthy lifestyles, became one of the speakers at the large-scale educational program of the Alfa Future People-2018 festival and held a first aid master class “Technology that will save lives” with the support of Philips.

Cardiac arrest in the first few minutes leads to a state of clinical death. After a certain time, biological death occurs. If in the first case there are minimal chances for a person to survive, then the second option involves the development of disorders that are incompatible with life.

Emergency measures must be taken in the first seven minutes, it is almost impossible to survive after this period with a stopped heart. V exceptional situations the survivors will remain disabled or fall into a coma. This happens because the brain cells are rapidly destroyed in the absence of oxygen, and behind them the rest of the vital organs cease to function normally. First aid most often has to be provided to people who are far from medicine. But, unfortunately, they are rarely capable of self-control and do not always have sufficient knowledge in this area.

Cardiac arrest is diagnosed when an organ stops pumping blood without making contractile movements. Most often, the myocardium ceases to function during diastole. Blood no longer circulates in the organs, they remain without oxygen and nutrients, all vital processes in them also stop, and irreversible death of cells and tissues begins.

Such a state cannot arise by itself. Everything has a reason. They may be associated with pathologies circulatory system and its main organ. This is the most common explanation for most sudden deaths. You can name other conditions that lead to cardiac arrest and death.

Types of cardiac arrest:

Rarely enough, there are: asystole (bioelectric activity and heart contractions are completely absent), electromechanical dissociative states ( electrical impulses arise, but do not cause contractile activity in the ventricles), paroxysms of ventricular tachycardia (there are frequent contractions of the chambers, but the pulse is not audible).
The vast majority of cardiac arrests are associated with atrial fibrillation (separate groups of muscle cells of the ventricles contract in a chaotic manner, but the function of pumping blood is not performed).

Cardiac pathologies as the main reason for the cessation of the heart:

Acute myocardial insufficiency.
Acute coronary syndrome or manifestation of coronary heart disease (associated with thrombosis, atherosclerosis, arterial stenosis)
Heart defects associated with anomalies of the valvular apparatus and coronary vessels.
Cardiomyopathy.
Thromboembolism of the pulmonary vessel.
Ruptured aortic aneurysm.
Heavy inflammatory process in the myocardium.
development of cardiogenic shock.
Cardiac tamponade due to hydropericardium or hemopericardium.
Brugada syndrome (a genetic metabolic disease that causes sudden attacks of ventricular tachycardia). This pathology is a common cause of cardiac arrest in humans. young age(half of all incidents).
Hypertensive crisis.

Chronic or acute conditions associated with defeat internal organs and the brain, can also cause cardiac arrest:

Brain disorders (hemorrhage and tissue necrosis).
Dysfunction of the kidneys and liver.
Oncological diseases.
Infections (eg meningitis).
Severe form diabetes that can lead to diabetic coma.
Complications lung diseases(attack of bronchial asthma).

Causes of sudden cardiac arrest, not directly related to diseases:

Significant blood loss (more than half of the normal volume).
Different types of shock (anaphylactic, traumatic, bacterial, burn, pain, dehydration).
Toxic changes associated with an overdose or an incorrect combination of certain hazardous substances (alcohol, drugs, certain drugs taken without regard to contraindications).
Various life-threatening injuries (electrical injury, closed or open wounds, consequences of an accident).

anesthesia during surgery.
Critical exposure to low or high temperatures.
Suffocation (intentional or negligent, when a foreign object enters the respiratory tract).
Entry of water into the lungs.
Development of acute hypercalcemia.

Factors that increase the risk of sudden cardiac death:

old age;
bad habits (including regular overeating);
strong emotional shock;
physical overstrain (especially common in a professional athlete);
obesity;
high cholesterol or blood sugar;
hereditary factor.

Symptoms of cardiac arrest

The cessation of the work of the heart muscle is accompanied by the following symptoms:

Acute fainting with falling and loss of consciousness. Develops in 10-20 seconds.
Manifestation convulsive syndrome after 20-30 seconds.
The heartbeat is not audible.
The pulse is not palpable.
There is no breathing (no movement of the chest). Or it becomes rare, convulsive, with wheezing.
Changes on the cardiogram.

You can also determine cardiac arrest by the appearance of a person:

The skin turns pale, the limbs, ears, nose, mouth turn blue.
The pupils are wide, do not constrict under the influence of light.
The person lies motionless, does not respond to shouts, clapping on the cheeks.
Expression of fear on the face.
Reflex pressing of the hand to the heart.
The body twitches unnaturally.

Sudden Infant Death Syndrome

Sometimes registered individual cases death of healthy infants at night in sleep, for no apparent reason at the age of 2 to 5 months. Cardiac arrest in a newborn is explained by the following reasons:

insufficient physiological maturation of the cardiovascular system of the newborn;
the birth of a child from a multiple pregnancy;
transferred hypoxia inside the womb is one of the common causes of sudden cardiac arrest in the fetus;
oxygen deficiency during childbirth;
happened early birth, the baby is premature;
infectious lesion of an unborn embryo or baby in the first weeks of life;
abnormal development of the fetus in the womb;
pregnancy with pathologies.

There are a number of factors contributing to cardiac arrest in young children:

smoky, stale, hot air in the room of a sleeping child;
the baby sleeps on his stomach;
the bed is very soft, the child falls into it, he is covered with a fluffy blanket, he sleeps on a pillow;
a young inexperienced mother puts the child to sleep next to her, she can accidentally crush him in a dream;
parents drink alcohol, cannot adequately monitor the baby.

Diagnostics

A person lying unconscious can be in this position by different reasons. They need to be installed as soon as possible. Diagnosis of cardiac arrest (as opposed to short-term syncope) involves the following steps:

Call the fallen one, shake him, it is not very painful to hit him in the face, sprinkle with cold water. Try to bring the victim to his senses possible ways. If this does not help, cardiac arrest may be suspected.
Check the pulsation in the carotid artery in the neck. Determine if the person is breathing. To do this, it is often advised to bring a mirror to your mouth (it will fog up if there is breathing), observe the movement of the chest, listen to the heartbeat, leaning your ear to your chest. Another way is to expose your cheek to the lips of the victim, you can feel how it becomes warm and moist if the air continues to circulate in the lungs.
To direct a beam of light into the pupils, their narrowing will be a normal reaction.
Assess the appearance skin. Note cyanosis and excessive pallor.
Take ECG readings if possible.

Rendering of the first urgent pre-medical aid

Sudden cardiac arrest - critical condition where action is urgently required. This can happen everywhere, and most often clinical death overtakes a person outside medical institution. Therefore, first aid should be provided by people nearby. It is necessary to call an "ambulance", but you should not count on it too much. After all, the victim is measured only 7 minutes to return to life. Not every ambulance will be able to rush to the scene so quickly.

The sooner resuscitation is started, the greater the chance of saving a person from sudden death. late deadline such action significantly reduces these chances. With every minute in the body without oxygen, irreversible processes, destroying, first of all, brain tissue. Serious damage also occur in other organs important for life. If a person can be revived after 7-10 minutes of clinical death, he will most likely remain disabled from subsequent complications.

How to help with cardiac arrest before the doctor arrives:

Make artificial respiration. To do this, lay the person on his back, the surface should be as flat and firm as possible. The head is raised upward, the lower jaw is advanced. Check the airway for vomit or other foreign objects, if necessary, clean the mouth and throat. Prevent tongue slip. Next, draw as much air as possible into the lungs and exhale it into the mouth of the victim (having previously covered it with a handkerchief to avoid infection). The nasal openings must be clamped by hand. Two such injections are made, then an indirect massage of the heart muscle is done.
Perform a heart massage. Put the hand of one hand on the other, stretch the arms, place them on the chest (lower third of the chest). Press with force, sharply, five times in a row, if there is another assistant, who then performs one artificial breath. Otherwise, do 15 clicks and two blows following one after another. The speed of shocks should be approximately 100 per minute.

It is necessary to carry out resuscitation until signs of life appear: independent heartbeats or own breathing. Press hard enough, but at the same time try not to break the injured ribs (which often happens in such situations). However, after half an hour has passed since the moment of cardiac arrest, the implementation of any manipulations to bring a person out of a state of clinical death is considered inappropriate. At this point, biological death is declared.

Complications of cardiac arrest

According to the theory of pathology, after about the seventh minute of cardiac arrest, the brain begins to die. Optimal for saving lives without critical consequences for the mental and physical health a period of time up to 3-4 minutes is considered from the moment of clinical death. People rescued at the seventh minute and later develop complications of varying severity.

Short-term cardiac arrest is characterized by mild to moderate impairment of brain activity:

Regular for a long time pain in my head.
A loss visual functions up to and including blindness.
Problems with memory, hearing, concentration.
Convulsive seizures.
Disorder of the psyche and consciousness, manifested by auditory and visual hallucinations

Severe brain damage includes:

coma;
complete inability to mental activity, loss of all brain functions, impossibility of self-service;
paralysis of the whole body or its individual parts.

Forecast

In general, the prognosis for cardiac arrest cannot be called positive. Only a third of the victims can be saved. At the same time, only a tenth of the survivors can count on full or partial recovery functions of vital organs.

The most favorable outcome is considered in the case of the patient's exit from the state of clinical death in the first 3 minutes. The survival rate after a 10-minute cardiac arrest is one hundredth of all accidents.

A complete return of all brain functions is observed in 3-5% of people, about 15% of the survivors suffer from moderate damage to brain tissue. The rest of the percentage does not come out of a coma or turns into absolute invalids until the end of life.

People who returned "from the next world" in full consciousness and without any special health problems are considered to be "lucky". Cardiac arrest can almost equate to biological death. The chances of saving lives are too small. However, as long as there is hope to save a person, one must fight for him. Everyone needs to know how to do it right. Possibly the skills artificial respiration and indirect myocardial massage will be useful to help your loved ones. To prevent such conditions, one should protect the heart from overload, treat cardiac diseases in a timely manner, be careful and not get into life-threatening situations.