Unconsciousness - Causes, Symptoms and Treatment .MF .
Loss of consciousness, this condition which interferes with the functioning of the central nervous system.The man falls, there is no movement. (Exception - seizures in epileptic seizures), is not perceived by others, does not answer the question, does not respond to external stimuli (loud voice, clapping, slapping light, chips, cold, heat).
Transient loss of consciousness a few minutes to half an hour, in medicine has a term - "syncope".
More severe and prolonged state divided by severity to coma of varying degrees.
Causes of loss of consciousness:
1. Lack of blood flow to the brain.
2. Lack of oxygen in the blood
3. metabolic disorder that is brain food.
4. violation for any reason, transmission of impulses of brain axons or the occurrence of abnormal discharges in the brain neurons.
now analyze in order.
Lack of blood flow to the brain can occur:
1. As a result, an increased reaction of the autonomic nervous system on various psychological situations such as anxiety, fear, fatigue, there is a
2. Due to cardiac reasons, when sharply reduced ejection fraction of the heart, that is, the amount of blood ejected by the left ventricle during systole of the heart.This state is typical for acute myocardial infarction.Violations of the heart rhythm, such as atrial fibrillation (chaotic, independent of atrial ventricular heart contraction), atrioventricular conduction block the nerve impulses between the atria and ventricles, sick sinus syndrome (central nervous connection regulating the rhythm of the heart).As a result of these pathologies are formed interruptions disappear whole complexes of heart rate, blood flow becomes irregular, which also leads to cerebral hypoxia.With a significant stenosis of the aortic heart valve are also possible syncope due to difficulty in ejection of blood into the aorta.
Right in this section I want to mention that common on the cardiogram incomplete blockade of Hiss beam legs (nerve fibers in the heart ventricles), do not lead to seizures with loss of consciousness and even in many cases do not have any symptoms and the diagnostic value, if theyI exist for a long time.
3. Orthostatic syncope occurs in patients with low blood pressure when receiving inadequate doses of antihypertensive drugs hypertensive and elderly persons.There it is the sudden change in body position (sharp getting out of bed, chair).The reason for its occurrence delayed reaction vessels of the lower extremities, they have no time to shrink time and as a result there is a decrease in blood pressure, decrease cardiac output and, again, the lack of blood supply to the brain.
4. When atherosclerotic changes in large vessels that supply the brain, and this sleepy and vertebral artery.Atherosclerosis is known is cholesterol plaques tightly fused with the vessel wall and narrowing the lumen.
5. Unconsciousness possible when a blood clot completely closing the vessel, there is the risk of thrombosis in any of postoperative surgical interventions, particularly when replacing into artificial heart valves, coronary arteries following bypass surgery in the last two cases, as a foreign body in the organism, there is a risk of thrombosis throughout life and requires a constant reception of indirect anticoagulants.Violation of cardiac rhythm as a constant or intermittent atrial fibrillation of the heart (atrial fibrillation), too, has a high risk of blood clots and also requires the receiving antiplatelet agents or anticoagulants.
6. If anaphylactic shock (severe manifestation of allergic reaction to any medication) and infectious-toxic shock (for severe infections), loss of consciousness caused by, well, the expansion of peripheral blood vessels and blood flow from the heart, but at the expense ofReleased into the blood vasodilator (vasodilating) mediator of inflammatory and allergic - histamine and other intracellular elements that appear in the destruction of cellular structures, they not only have vasodilating properties, but also increase the permeability of the small capillaries, due to which the blood rushes to the skin, decreases circulatingblood volume, and again, reduced cardiac output, the result - a violation of cerebral circulation, and syncope.
Recommended examinations and tests to establish the cause of syncope (brief loss of consciousness), which are based may lie insufficient blood supply to the brain.
1. Consultation of a neurologist to exclude neuro - vegetative-vascular dystonia.
2. Consulting of a therapist to avoid hypotension (low blood pressure, lower numbers 100 \ 60 mm Hg.), As well as the appointment of adequate doses of Antihypertensive therapy in the presence of hypertensive disease disease.
3. ECHO CT (ultrasound of the heart), electrocardiogram, Holter electrocardiogram (ECG daily), all this to clarify the existence of heart disease, the presence of arrhythmias of the heart.
4. Doppler ultrasound examination of the vessels of the neck and brain reveal atherosclerotic or other pathology in these vessels.
Loss of consciousness from lack of oxygen in the blood occurs in the following diseases and conditions:
1. Lack of oxygen in the inspired air, that is, long stay in a stuffy room.
2. Possible loss of consciousness in severe lung disease, especially in exacerbations of asthma, status asthmaticus appearance, with high degrees of chronic obstructive pulmonary disease (obstructive bronchitis).
In a paroxysm of prolonged cough in patients with obstructive lung disease mechanism of occurrence of a double, firstly directly from the lack of oxygen in the blood and increases in the second with prolonged cough intrathoracic pressure, which prevents venous return, resulting in reduced cardiac output, and more.
3. When anemia with decreased hemoglobin high (less than 70- 80 g \ l) syncope is possible under any circumstances.With higher numbers of hemoglobin likelihood of loss of consciousness increases when in a stuffy room.
4. In the cases of carbon monoxide poisoning.CO - colorless gas without odor and taste, which increases the risk of poisoning.Poisoning often occurs in the home at the time of firing ovens, geysers and the absence of the required ventilation and extraction facilities at the exhaust enters the engine from the vehicle in the driver's cab (such as during sleep the driver in the car with the engine running with the windows closed, or in the garage).Penetrating through the lungs into the blood, carbon monoxide binds to hemoglobin to form carboxyhemoglobin, blocks the transport of oxygen in blood, there is an acute lack of oxygen - hypoxia, besides contacting the myoglobin (a protein contained in muscles), CO inhibits the reduction of myocardial muscle.
To eliminate the causes of transient loss of consciousness due to lack of oxygen in the blood is desirable following examinations and tests:
1 General analysis of blood, where it appears the amount of hemoglobin and red blood cells, as well as in the number of eosinophils can judge the presence of bronchial asthma.
2. X-ray light - exclude chronic bronchitis, cancer and other lung diseases.
3. Spirography (exhaled air with a force of a special device) provides an indication of respiratory function.
4. If you suspect a bronchial asthma of allergic genesis useful to visit an allergist and make samples for allergens.
syncope in violation of metabolism (power) of the brain, occurring mainly at such disease as diabetes.
1. In overdose of insulin decreases the amount of sugar in krovi- hypoglycemia, brain whereby power is disrupted, leading to disruption of nerve impulse transfer function.
2. ketoatsidoticheskaya Diabetic coma - contrary arises when lack of insulin and the increased amount of blood glucose (blood sugar above 17-20mmol \ l).characterized by increased formation of ketone bodies (acetone, urea) in the liver and an increase in their blood.As a result of errors of metabolism in the cells of the brain f, and as a consequence, loss of consciousness.The peculiarity of this coma acetone odor emanating from the patient.
Laktatsidoticheskaya (lactic coma) in diabetes usually occurs in patients with renal insufficiency and hypoxia.The blood was a large amount of lactic acid.Ketoatsidoticheskaya Unlike coma, no odor of acetone.
To diagnose diabetes require repeated blood donation for sugar from the finger on an empty stomach.With an increase in capillary blood glucose more than 7.0 mmol 6.1do \ l indicates on glucose tolerance disorders (i.e., the lowering of insulin sensitivity to glucose) glucose increase svyshe7,0 mmol \ l alarming in terms of diabetes, and if requiredblood donation after the load with glucose (fasting gives blood sugar, then consumed 75 grams of glucose dissolved in a glass of water and two hours later measured the level in the capillary blood glucose. glucose levels after a load above 11.1 indicates the presence of diabetes mellitus. also has a valueglucose in urine (normally should not be) .Samym accurate method of diagnosis diabetes considered measuring glycated hemoglobin, which is a time-averaged rate of blood glucose concentration over the preceding 6-8 weeks of observation.
makes sense to produce ultrasound pancreascancer, in order to avoid causing disease in diabetes.As known insulin is produced in the cells of the pancreas.
impulse transmission Violation by the axons of the brain or the occurrence of abnormal discharge in the neurons of the brain occurs under the following conditions:
1. First of all epileptic seizures syndromic repetitive, often with loss of consciousness arising from gipersinhronnogo discharge of brain neurons (abnormal foci of excitation.in the cerebral cortex).Seizures in contrast to other cases, loss of consciousness characterized by the presence of clonic (muscle twitching) and tonic (increased tone, muscle tension) seizures.
2. At various traumatic brain injury in which there is a concussion, contusion, brain compression, resulting in the displacement caused by the cerebral hemispheres, a relatively rigidly fixed brain stem, there is a transient increase in intracranial pressure, there is tension and twisting of long axons (nerve fibers) deep hemispheric white matter and brain stem.In mild cases, as a result of this process is temporarily impaired axonal conduction (temporary, transient loss of consciousness), in heavy going swelling and rupture of axons and their accompanying small vessels (coma, loss of consciousness -Duration varying degrees).
3.Poterya consciousness can occur when an ischemic or hemorrhagic stroke.their difference is that in the first case, the breach of cerebral blood flow occurs due to the blockage of a vessel by a blood clot, the cause of which may be atherosclerosis, or the toxic effects of certain substances (from the practice of observing a large number of ischemic strokes after drinking surrogate alcohol, includingand after taking in a large amount of alcohol tinctures sold in pharmacies.
hemorrhagic stroke (intracerebral hemorrhage) is the rupture of the vessel of the brain always has a heavy flow and a higher percentage of deaths.
One important factor in the development of both types of stroke is uncontrolledhypertension, for the brain is unfavorable in terms of stroke is consistently high and abrupt (low to high arterial blood pressure).
First aid for unconsciousness
What to do if you witness a loss of consciousness other person.
1. If loss of consciousness occurs in a stuffy room, during public events.More likely fainted due to lack of oxygen or due to overstimulation of the autonomic innervation of the body.The mechanism of this condition is sometimes mixed.
actions in this case:
1. Expand the shirt collar or other clothing.
2. Open the window for oxygen or render the victim in a well-ventilated room.
3. Hold the cotton wool with ammonia to the nasal passages to 1 -2 minutes.
4. If you then do not come to mind to put on the right side, right arm positioned along the body, head positioned at the back of the left hand.When this position is less likelihood of the tongue, and more free air passages.If you can check the index finger of his hand, after opening his jaws, whether the tongue in the throat, If there is, then you need to free up the airways by fixing the tongue to the side of the mouth (pressing with the thumb of your hand).Naturally fully on blocking airways.
5. Check whether the pulse and respiration (how to do this later) is present.
6. If there is no pulse and respiration can be, if you know how, before the arrival of the SMP to start rescue breathing and chest compressions (a technique is given below).
7. Call the ambulance, as closely as possible to describe the symptoms of loss of consciousness.
If you find a man unconscious on the street
1. Check with the witnesses, maybe someone knows what ill victim.
Sometimes pockets of patients with chronic data are available about the disease and the possible entry help.If they are detected or receiving data on the patient follow the recommendations of the note or mention the data ambulance.
2. Check by feeling whether the open injuries and bleeding are, if they are detected, try to stop the means available before the arrival of emergency medical services.
3. Check whether there is a pulse, it is best palpable pulse in the carotid artery, for this purpose, place the index and middle finger of his right hand on the thyroid cartilage of the victim, gently deflate the hand down the neck (at the position of the patient lying down) to mild depressions here and shouldpalpable pulse.
4. If no pulse, no breath (no chest movement, no fogging on prepodnosimye to the nose and mouth of the victim of glass), and the skin still warm, check the reaction of pupils to light.In a living person, or clinical death, pupil reaction to light persists.Check as follows:
If the patient is lying with closed eyes, open eyelids, seeing pupillary to light in the presence of signs of life.If a person's eyes are open, cover their hands for 10 seconds, then remove the hand must again observe pupillary constriction.In the dark to test using any lights (flashlight, a cell phone).Also, to determine signs of life corneal reflex is checked, this handkerchief or cotton swab, if not, the other soft textile touch the eyelids - a living person there is blinking.
the presence of signs of life or death experience possible before the arrival of emergency medical care, start artificial respiration and indirect (direct it to specialists, held at the opening of the chest) cardiac massage.The most common early start resuscitation is more beneficial than abiding by a time ambulance crew.The only exception for artificial respiration not specialists - a suspected fracture of the spine in the cervical region.
methodology of artificial respiration and chest compressions.
patient is positioned supine, after freeing from possible vomit and mucus airway.