Cardiac arrest - Causes, Symptoms and Treatment .MF .
heart How to determine that heart stopped
Complications and prognosis
Heart failure - a complete cessation of cardiac activity due to various factors and leading to clinical (possibly reversed), and thenand biological (irreversible) death of the person.As a result of the termination of the pumping function of the heart stops the blood circulation throughout the body and there is oxygen starvation of all human organs, especially the brain.In order to "start" the heart again, assisting there is no more than seven minutes, because after this period of cardiac arrest irreversible brain death.
hearts This dangerous condition can occur due to diseases of the heart, and then it is called sudden cardiac death, or other diseases.
1. The cardiac (heart) disease, which can lead to heart failure, 90% of all cases are the cause.These include:
- life-threatening cardiac arrhythmias - paroxysmal ventricular tachycardia, frequent ventricul
- Brugada syndrome,
- ischemic heart disease - about halfpatients with coronary artery disease occurs sudden cardiac death,
- acute myocardial infarction, especially with advanced complete blockade of the left bundle branch block,
- pulmonary embolism,
- rupture of an aortic aneurysm,
- acute heart failure,
- cardiogenic shock and arrhythmogenic.
2. Risk factors that increase the likelihood of sudden cardiac death in patients with existing diseases of the cardiovascular system:
- age over 50 years, although heart failure may develop in young people,
- alcohol abuse,
- excessive exercise,
- severe emotional distress,
- high cholesterol in the blood.
3. noncardiac (extracardiac) disorders:
- severe chronic diseases in the later stages (oncological processes, respiratory diseases, etc.), natural aging,
- asphyxia, suffocation as a result of contact with a foreign body in the upper respiratory tract,
-traumatic, anaphylactic, burn, and other forms of shock,
- poisoning by drugs, narcotics and alcohol substitutes,
-. drowning, violent cause of death, injury, severe burns and other
4. special attention should be sudden infant death syndrome (SIDS)or the death of a baby "in the cradle."This death of a child aged up to one year, usually about 2 - 4 months, due to cardiac arrest and breathing at night during sleep, without any previous serious health problems that could lead to death.Factors that increase the risk of sudden infant death include:
- position during a night's sleep on your stomach,
- sleeping on a too soft bed on a fluffy linens,
- sleep in a stuffy, hot room,
- smoking mothers,
- prematurity, premature birth with low weight of the fetus,
- multiple pregnancy,
- intrauterine hypoxia, and delayed fetal development,
- family history in the event that the other children in the same family were killed for the same reason,
- borne infectionthe first months of life.
Symptoms of heart failure
Sudden cardiac death develops on the background of the general well-being or a small subjective discomfort.A person can sleep, eat, or go to work.Suddenly he becomes ill, he grabs the hand of the left chest, loses consciousness and falls.From an ordinary unconscious cardiac arrest following features distinguish:
- absence pulse on the carotid arteries in the neck or femoral arteries in the groin,
- not breathing or agonistic type of respiratory movements for a few seconds after cardiac arrest (no moretwo minutes) - a rare, short, spasmodic, wheezing gasps,
- absence of reaction of pupils to light , normally there is a narrowing of the pupil in contact with it light,
- sudden pallor skin with the appearance of a bluish coloring on the lips, face,ears, limbs or the entire body.
about it like this: a man fell unconscious, not responding to hails or tormoshenie, blanched and turned blue, stopped breathing, and wheezing.After 6 - 7 minutes develop biological death.If a person's heart stops during sleep, it looks like sleeping peacefully, until you find that it is impossible to wake up.
second option is more neblagoprityany as others may wrongly assume that the person is simply asleep, and, accordingly, do not consider it necessary to take some measures to save human life.Also happens with young children, whose mother see the baby sleeping peacefully in his bed, while the biological death has occurred.
About 2/3 of all cases of cardiac arrest occur outside health facilities, ie in everyday life.Therefore witnessed such dangerous conditions are in most cases, ordinary people, are not directly related to medicine.However, everyone should know how to recognize cardiac arrest and what activities should be carried out.This way you may save the life of not only his cousin, but a stranger on the street.
If you see that the person is unconscious, it is necessary to conduct a quick inspection:
- whether he Slightly hit him on the cheeks, loudly call out, potormoshit shoulder and evaluate reacts to it.It is possible that people just fainted.
- should assess whether self normal breathing, it is enough to just put your ear to the chest and listen, if he breathes, or bring your cheek to the patient's nostrils, after throwing back his head back and sliding jaw to feel or hear him presentbreath, or see the chest movement.Do not waste valuable time searching for a mirror, in order to fasten it to the lips of the victim and see if it will cloud up from the exhaled breath of the patient air, as indicated in some benefits in providing first aid.
- palpate the carotid artery in the neck between the angle of the lower jaw, throat and neck muscles, or the femoral artery in the groin.In the absence of a pulse - to begin chest compressions.Do not waste time searching for peripheral artery on the wrist, a reliable criterion for heart failure is the lack of a pulse only on major arteries.
All actions must be carried out accurately, consistently and quickly.Assessment of severity of the condition and the beginning of resuscitation should be made for 15 - 20 seconds .In parallel, it is necessary to call for help and ask a number of people are present call an ambulance on the phone "03".
First aid and treatment
Providing emergency first aid the first victim is placed on a hard surface while stopping
heart.After establishing the fact of cardiac arrest should immediately begin resuscitation according to the ABC algorithm:
- A (air open the way) - airway.To do this you need to wrap assisting the finger piece of cloth, to push forward the lower jaw of the victim, threw back his head back and try to eliminate possible foreign substances in the oral cavity (vomit, mucus, derive sunken language, etc.).
- in (breath support) - mechanical ventilation by "mouth to mouth" or "mouth-to-nose".In the first method should hold his nose with two fingers of the patient and start blowing air into his mouth, monitoring the effectiveness of the movements of the chest - the rise of the ribs when filled with air and lowering the passive "exhalation" patient.Acceptable use of a thin cloth or handkerchief is superimposed on the lips of the victim to avoid direct contact with its saliva.According to the latest recommendations, providing assistance has the right to not be in contact with the affected biological fluids such as saliva, blood in the mouth, in order to avoid damage to health care provider, for example, the threat of infection with tuberculosis and HIV-infection in the presence of blood in the mouth and so on.Especially, that the brain is more important to provide blood quickly access its vessels using cardiac massage, rather than to start ventilation.
- C (circulation support) - chest compressions.Specialists before starting chest compressions applied precordial punched in the sternum area from a distance of 20 - 30 cm. However, it is effective only within the first 30 seconds from the time of cardiac arrest and dangerous fractured ribs and sternum.Therefore, a person who is not a physician, precordial blow is better not to apply.All the more that Western doctors - resuscitators believe that the strike is only useful when ventricular fibrillation and can be dangerous if asystole.
Massage heart held true.It is necessary to visually identify the lower third of the sternum, measure out the distance on two transverse fingers above the lower edge, clasped his hands brush the castle, one hand to the other, place the brush straightened hands on found one-third of the sternum and begin rhythmic compression of the chest with a frequency of 100 per minute.If there is one rescuer frequency of clicks on the sternum and the frequency of blowing air into the lungs is 15: 2, and when there are two rescuers - 5: 1.In the latter case, the rescuer, the conductive pressing on the sternum should be aloud to count the number of clicks, after every fifth - the first rescuer holds one blowing air.
Important: hands should be maintained in a straightened state, and compression of the exercise so as to avoid inadvertent fracture of ribs, as it negatively affects the intrathoracic pressure, which has a crucial role in the effectiveness of chest compressions.To enhance passive flow to the heart in the groin bent lower limbs can be raised by 30 - 40 ° above the surface.
described the event continues until until the pulse in the carotid arteries, appears spontaneous breathing or until the patient wakes up.If it does not, continue to resuscitate the victim should be before the arrival of an ambulance, or within 30 minutes, as the biological death occurs after this time.
Medical care in cardiac arrest
Upon arrival of medical aid teams carried out the introduction of drugs (epinephrine, norepinephrine, atropine, etc.), sniyatie electrocardiogram or diagnosis of heart rate via the monitor when overlaying the electrodes of a defibrillator and the implementation of defibrillation - an electrical discharge with a view to launchand to restore the heart rhythm.Interventions are in the ambulance on the way to the intensive care unit of a hospital.
life of patients undergoing cardiac arrest and survived, some time should be in the intensive care unit, and then carefully examined in the cardiology department of the hospital.At this time, set cause of the cardiac arrest, selected the optimal treatment to prevent repetition of this state, and also addressed the issue of the need and the implantation of an artificial pacemaker in the presence of cardiac arrhythmias.
After discharge from the hospital the patient should be careful in everyday life - give up bad habits, eating right, avoiding stress and excessive exercise, constantly take medication as prescribed by your doctor.
For the prevention of sudden infant death syndrome infant's parents must carry the following recommendations - to lay the baby on a night's sleep in a well ventilated room, on the bed with a firm mattress, without pillows, duvets and without toys in the crib.Do not tightly swaddled baby at night, since it constrains its movement, it prevents to take a comfortable position during sleep and prevents spillage when you stop breathing during sleep (sleep apnea).Do not lay baby to sleep on his stomach.Some experts believe that sleeping together significantly reduces the risk of cot death, because the child feels close to his mother, and tactile skin beneficial to his respiratory and cardiovascular center in the brain.Of course, parents should not smoke, drink alcohol or drugs, you do not lose vigilance and sensitivity during the night the baby.
heart Possibility of consequences after cardiac arrest depends on the time during which the brain is in a state of acute shortage of oxygen.Thus, if the recovery of vital signs was performed during the first 3.5 minutes and the subsequent function of brain activities is not likely to be affected.In the case of longer periods of brain hypoxia (6 - 7 minutes or more), may develop neurological symptoms, from mild to severe brain damage when postresuscitative disease.
Violations mild to moderate include memory loss, reduced vision and hearing loss, persistent headaches, convulsions, hallucinations.
postresuscitation disease develops in 75 - 80% of successful resuscitation after cardiac arrest.In 70% of patients with this disease occurs lack of consciousness for no more than 3 hours, and then a full recovery of consciousness and mental functions.In some of the patients have severe brain damage, coma and subsequent vegetative state.
prognosis of cardiac arrest unfavorable, since 30% of surviving patients, and only 10% of full recovery of the functions of the body without adverse effects.
chances of patient survival increased significantly if the first assistance was provided in a timely manner, and to restore cardiac function failed during the first three minutes after cardiac arrest.
therapists Sazykina OJ