Clinical death

Life of the organism is impossible without oxygen, which we receive through the respiratory and circulatory systems. If breathing is blocked or blood circulation is stopped, we will die. However, when breathing stops and the heartbeat stops, death does not occur immediately. There is a certain transitional stage that cannot be attributed to either life or death - this is clinical death.

This condition lasts for several minutes from the moment when breathing and heartbeat stop, the body's vital functions have died down, but irreversible damage has not yet occurred at the tissue level. A person can still be brought back to life from this condition if emergency measures are taken to provide emergency assistance.

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Causes of clinical death

The definition of clinical death is as follows - it is a state when only a few minutes remain before a person's actual death. During this short time, it is still possible to save and bring the patient back to life.

What is the potential cause of this condition?

One of the most common reasons is cardiac arrest. This is a terrible factor when the heart stops unexpectedly, although nothing had previously foreshadowed trouble. Most often, this occurs with some kind of disruption in the functioning of this organ, or when the coronary system is blocked by a thrombus.

Other common causes include:

• excessive physical or stressful overexertion, which negatively affects the blood supply to the heart;
• loss of significant volumes of blood due to injuries, wounds, etc.;
• shock (including anaphylaxis – a consequence of a strong allergic response of the body);
• respiratory arrest, asphyxia;
• severe thermal, electrical or mechanical damage to tissue;
• toxic shock – the effect of poisonous, chemical and toxic substances on the body.

The causes of clinical death may also include chronic protracted diseases of the cardiovascular and respiratory systems, as well as situations of accidental or violent death (the presence of injuries incompatible with life, head injuries, cardiac concussions, compression and contusions, embolism, aspiration of fluid or blood, reflex spasm of the coronary vessels and cardiac arrest).

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Signs of clinical death

Clinical death is usually determined by the following signs:

• the person has lost consciousness. This condition usually occurs within 15 seconds after the blood circulation has stopped. Important: the blood circulation cannot stop if the person is conscious;
• it is impossible to detect the pulse in the carotid artery area for 10 seconds. This sign indicates that the blood supply to the brain has stopped, and very soon the cells of the cerebral cortex will die. The carotid artery is located in the depression separating the sternocleidomastoid muscle and the trachea;
• the person has stopped breathing altogether, or against the background of the absence of breathing, the respiratory muscles periodically contract convulsively (this state of swallowing air is called atonal breathing, turning into apnea);
• a person's pupils dilate and stop reacting to a light source. This sign is a consequence of the cessation of blood supply to the brain centers and the nerve responsible for eye movement. This is the latest symptom of clinical death, so you should not wait for it; it is necessary to take emergency medical measures in advance.

The first signs of clinical death are determined within the first seconds after cardiac arrest. Therefore, when providing assistance, one should not waste precious time on tonometry and determining the pulse at the periphery. The sooner the diagnosis of clinical death is made, the greater the probability of successful resuscitation.

Clinical death in children

There are many known factors that provoke clinical death in childhood. These are respiratory pathologies (pneumonia, smoke inhalation, drowning, obstruction of the respiratory system by a foreign body, suffocation), cardiac pathologies (heart defects, arrhythmia, severe sepsis, ischemia), CNS lesions (seizures, intracranial injuries and hematomas, malignant brain tumors, meningitis) and other causes (anaphylactic reaction, poisoning).

Regardless of the factor that provoked clinical death, the symptoms of the condition are unchanged: the baby loses consciousness, goes into a coma, and lacks breathing and pulse. Several convulsive shallow breaths and one deeper breath can be detected: at this point, breathing stops.

The determination of clinical death in children should not take more than 10 seconds. A child's body is more vulnerable than that of an adult, so the risk of death in a child's body is somewhat higher.

Resuscitation measures, pulmonary cardiopulmonary resuscitation in childhood are practically no different from the measures carried out in adults.

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Clinical death due to drowning

Drowning occurs when a person is completely immersed in water, which causes difficulty or complete cessation of respiratory gas exchange. There are several reasons for this:

• inhalation of liquid through the human respiratory tract;
• laryngospastic condition due to water entering the respiratory system;
• shock cardiac arrest;
• seizure, heart attack, stroke.

In a state of clinical death, the visual picture is characterized by loss of consciousness of the victim, cyanosis of the skin, absence of respiratory movements and pulsation in the area of the carotid arteries, dilation of the pupils and their lack of reaction to a light source.

The probability of successful resuscitation of a person in such a state is minimal, since they have spent large amounts of energy in the fight for life while in the water. The possibility of a positive outcome of resuscitation measures to save the victim may directly depend on the length of time the person has been in the water, their age, their health, and the temperature of the water. By the way, at low temperatures of the reservoir, the chance of survival of the victim is much higher.

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Feelings of people who have experienced clinical death

What do people see during clinical death? Visions can be different, or they may not exist at all. Some of them are explainable from the point of view of scientific medicine, while others continue to surprise and amaze people.

Some victims who described their stay in the "claws of death" say that they saw and met with some deceased relatives or friends. Sometimes the visions are so realistic that it is quite difficult not to believe in them.

Many visions are associated with the ability of a person to fly above his own body. Sometimes resuscitated patients describe in sufficient detail the appearance and actions of the doctors who carried out emergency measures. There is no scientific explanation for such phenomena.

Often victims report that during the resuscitation period they were able to penetrate through the wall into adjacent rooms: they describe in quite great detail the situation, people, procedures, everything that was happening at the same time in other wards and operating rooms.

Medicine tries to explain such phenomena by the peculiarities of our subconscious: being in a state of clinical death, a person hears certain sounds that are stored in the brain's memory, and on a subconscious level supplements the sound images with visual ones.

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Artificial clinical death

The concept of artificial clinical death is often identified with the concept of artificial coma, which is not entirely correct. Medicine does not use special introduction of a person into a state of death, euthanasia is prohibited in our country. But artificial coma is used for therapeutic purposes, and even quite successfully.

Induction of an artificial comatose state is used to prevent disorders that can negatively affect the functions of the cerebral cortex, for example, hemorrhage, accompanied by pressure on areas of the brain and its swelling.

An artificial coma can be used instead of anesthesia in cases where several serious urgent surgical interventions are required, as well as in neurosurgery and in the treatment of epilepsy.

The patient is put into a coma using medical narcotic drugs. The procedure is performed according to strict medical and vital indications. The danger of putting the patient into a coma must be fully justified by the possible expected benefit from such a state. A big plus of an artificial coma is that this process is completely controlled by doctors. The dynamics of such a state are often positive.

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Stages of clinical death

Clinical death lasts exactly as long as the brain in a hypoxic state can maintain its own viability.

There are two stages of clinical death:

• the first stage lasts about 3-5 minutes. During this time, the areas of the brain that are responsible for the vital functions of the body, in normothermic and anoxic conditions, still retain their ability to live. Almost all scientific specialists agree that prolonging this period does not exclude the possibility of reviving a person, but can lead to irreversible consequences of the death of some or all areas of the brain;
• the second stage can occur under certain conditions and can last for several tens of minutes. Certain conditions are understood to mean situations that contribute to the slowing down of degenerative processes in the brain. This is artificial or natural cooling of the body, which occurs when a person freezes, drowns, or suffers an electric shock. In such situations, the duration of the clinical condition increases.

Coma after clinical death

Coma and the state of clinical death are separate concepts. The initial stage of coma can serve as one of the symptoms of clinical death. But the state of clinical death itself, unlike the comatose state, does not consist only of loss of consciousness, but also of cardiac and respiratory functions.

A patient in a coma, despite being unconscious, is able to breathe instinctively, his heart activity does not stop, and his pulse is detectable.

Often, upon exiting the state of clinical death after emergency measures, the resuscitated patient falls into a comatose state of varying depth. What to do in such a situation? Wait. Wait for symptoms that can determine whether the period of clinical death has affected the integrity and performance of the brain. If there are disturbances in brain activity, the patient goes into a deep stage of comatose state.

In a state of coma, the functions of the cortex and subcortex of the brain are suppressed, metabolic processes and the structure of the central nervous system are disrupted. The duration and depth of such a state are determined by the course of the underlying pathology that led to the development of the coma.

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Consequences of clinical death

The consequences of being in a state of clinical death depend entirely on how quickly the patient is resuscitated. The sooner a person returns to life, the more favorable the prognosis awaits him. If less than three minutes have passed after cardiac arrest until its resumption, then the probability of brain degeneration is minimal, and complications are unlikely.

In cases where the duration of resuscitation measures is delayed for any reason, the lack of oxygen in the brain can lead to irreversible complications, up to and including the complete loss of vital functions of the body.

During prolonged resuscitation, in order to prevent hypoxic disorders of the brain, a cooling technique is sometimes used for the human body, which allows increasing the period of reversibility of degenerative processes to several additional minutes.

Life after clinical death takes on new colors for most people: first of all, their worldview, views on their actions, and life principles change. Many acquire extrasensory abilities, the gift of clairvoyance. What processes contribute to this, what new paths open up as a result of several minutes of clinical death, is still unknown.

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Clinical and biological death

The state of clinical death, if emergency assistance is not provided, invariably passes into the next, final stage of life – biological death. Biological death occurs as a result of brain death – this is an irreversible condition, resuscitation measures at this stage are futile, inappropriate and do not bring positive results.

The fatal outcome usually occurs 5-6 minutes after the onset of clinical death, in the absence of resuscitation measures. Sometimes the time of clinical death can be somewhat extended, which depends mainly on the ambient temperature: at low temperatures, metabolism slows down, oxygen starvation of tissues is tolerated more easily, so the body can remain in a state of hypoxia longer.

The following symptoms are considered signs of biological death:

• clouding of the pupil, loss of luster (drying out) of the cornea;
• "cat's eye" - when the eyeball is compressed, the pupil changes shape and turns into a kind of "slit". If the person is alive, this procedure is impossible;
• the decrease in body temperature occurs by approximately one degree for each hour after death, so this sign is not an emergency;
• the appearance of cadaveric spots - bluish spots on the body;
• muscle compaction.

It has been established that with the onset of biological death, the cerebral cortex dies first, then the subcortical zone and spinal cord, after 4 hours - the bone marrow, and after that - the skin, muscle and tendon fibers, bones within 24 hours.

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What to do in case of clinical death?

If clinical death is suspected, this condition should be verified by taking the following steps:

• confirm the patient's lack of consciousness;
• confirm the absence of respiratory movements;
• confirm the absence of pulsation in the carotid artery, check the pupillary response.

First aid in case of clinical death should be provided immediately, within the first seconds after confirmation. This should be done by emergency doctors, resuscitation doctors, or simply people nearby who know how to provide emergency assistance.

• Provide free passage of air through the respiratory tract (unbutton the shirt collar, remove the sunken tongue, remove a foreign body from the throat). Resuscitation in clinical death in such cases involves aspiration of water from the trachea and bronchi, insertion of an airway or breathing mask.
• Deliver a sharp blow to the heart area (only a resuscitator can do this).
• Perform artificial ventilation by blowing air into the victim's mouth or nose.
• Perform closed heart massage (for adults - with two palms, for children - with one palm or using the thumb).
• Alternate ventilation and chest compressions – 2:15.

Methods of resuscitation in case of clinical death in intensive care include the following techniques:

• performing electrical defibrillation (on exhalation), alternating with closed cardiac massage until guaranteed symptoms of circulatory function are detected;
• performing drug defibrillation (using solutions of adrenaline, atropine, naloxone, lidocaine by intravenous or endotracheal administration).
• performing catheterization of the main venous system, introduction of hecodesis to support blood circulation;
• administer intravenous drip medications that correct the alkaline-acid balance (xylate, sorbilact);
• carry out drip therapy to support capillary circulation (reosorbilact).

If resuscitation measures are successful, the patient is transferred to the general medical department, where he is provided with further observation and therapy.

The above activities are not carried out in cases where:

• clinical death occurred despite the implementation of all necessary components of intensive treatment;
• the patient was in the final stages of an incurable disease;
• cardiac arrest occurred more than 25 minutes ago;
• if there is a certified refusal of the patient to undergo emergency medical procedures (if such a patient is a child under 14 years of age, the document must be signed by his parents or guardians).

They say that patients who have experienced clinical death live long lives and even get sick very rarely. Unfortunately, this condition has not yet been fully studied by scientists; it contains many unexplained facts. Perhaps, when science finally manages to reveal the secrets of clinical death, we will also learn the recipe for immortality.

Famous People Who Experienced Clinical Death

Among the people who survived the state of clinical death, there are many well-known personalities. What did they see there, on the other side of life?

The famous singer Irina Ponarovskaya experienced clinical death in 1979, when she was visiting the city of Kursk on tour. While on stage, during a solo performance, Irina felt unwell. Having barely reached the wings, she fell unconscious. Irina's heart stopped for a long 14 minutes: doctors saved her life for two months, and, fortunately, successfully. As it turned out, the cause of the cardiac arrest was improper nutrition, which provoked sudden kidney failure. Incidentally, since then Irina has noticed that she has extrasensory abilities: she senses future events and warns her family and friends about possible troubles.

The most common type of surgical operations that show business stars resort to is, without a doubt, plastic surgery. Boris Moiseyev became a victim of such a procedure: during the operation, his heart stopped. Resuscitation efforts lasted about 40 minutes. "I didn't notice the light or the tunnel, I didn't fly. I only saw the faces of my enemies, I flicked them on the nose and smiled," Boris said. After everything that happened, Moiseyev began to regularly visit churches, but he did not refuse further plastic surgery: "Beauty requires sacrifice!"

A similar situation happened to Alla Pugacheva: in the 90s, having decided to have breast and facial plastic surgery, as well as liposuction, she sought help from specialists at a clinic in Zurich. Doctors were afraid that the simultaneous volume of operations was too great and could be dangerous. However, Alla Borisovna still took the risk. Everything went well, but after the operation, the breast implant was rejected. Severe intoxication, loss of consciousness and clinical death. Fortunately, medical workers at the Moscow City Hospital saved Pugacheva. The singer did not talk about her visions during her clinical death.

Popular singer and songwriter Oleg Gazmanov once almost became the victim of an accident on stage: during a concert, technicians forgot to ground the microphone cable. Oleg was electrocuted. At that moment, he saw nothing, but heard an unfamiliar voice that calmed Gazmanov down, saying that he could stay on this earth if he wanted. Doctors successfully performed resuscitation measures, later noting that often in such situations the chances of survival are slim.

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