A message on the topic of biological death. Main signs of clinical death

A person is able to live without water and food for some time, but without access to oxygen, breathing will stop after 3 minutes. This process is called clinical death, when the brain is still alive, but the heart does not beat. A person can still be saved if you know the rules of emergency resuscitation. In this case, both doctors and those who are next to the victim can help. The main thing is not to get confused and act quickly. This requires knowledge of the signs clinical death, its symptoms and rules of resuscitation.

Symptoms of clinical death

Clinical death is a reversible state of dying in which the heart stops working and breathing stops. All external signs vital functions disappear, it may seem that the person is dead. This process is a transitional stage between life and biological death, after which it is impossible to survive. During clinical death (3-6 minutes), oxygen starvation has virtually no effect on the subsequent functioning of organs, general condition. If more than 6 minutes have passed, the person will be deprived of many vital important functions due to the death of brain cells.

To recognize in time this state, you need to know its symptoms. Signs of clinical death are:

Coma - loss of consciousness, cardiac arrest with cessation of blood circulation, pupils do not react to light.
Apnea – absence breathing movements chest, but metabolism remains at the same level.
Asystole - the pulse in both carotid arteries cannot be heard for more than 10 seconds, which indicates the beginning of destruction of the cerebral cortex.

Duration

Under conditions of hypoxia, the cerebral cortex and subcortex are able to maintain viability certain time. Based on this, the duration of clinical death is determined by two stages. The first of them lasts about 3-5 minutes. During this period, subject to normal temperature body, there is no oxygen supply to all parts of the brain. Exceeding this time range increases the risk of irreversible conditions:

decortication - destruction cerebral cortex;
Decerebration – death of all parts of the brain.

The second stage of the state of reversible dying lasts 10 minutes or more. It is characteristic of an organism with a reduced temperature. This process can be natural (hypothermia, frostbite) and artificial (hypothermia). In a hospital setting, this state is achieved by several methods:

hyperbaric oxygen therapy– saturation of the body with oxygen under pressure in a special chamber;
hemosorption - blood purification by a device;
drugs that sharply reduce metabolism and cause suspended animation;
transfusion of fresh donor blood.

Causes of clinical death

The state between life and death occurs for several reasons. They can be caused by the following factors:

heart failure;
blockage respiratory tract(lung diseases, suffocation);
anaphylactic shock– respiratory arrest due to the body’s rapid reaction to an allergen;
big loss blood from injuries, wounds;
electrical damage to tissues;
extensive burns, wounds;
toxic shock– poisoning with toxic substances;
vasospasm;
the body's response to stress;
excessive physical activity;
violent death.

Basic steps and first aid methods

Before taking first aid measures, you must be sure that a state of temporary death has occurred. If all of the following symptoms are present, it is necessary to proceed to treatment emergency assistance. You should make sure of the following:

the victim is unconscious;
the chest does not make inhalation-exhalation movements;
there is no pulse, the pupils do not react to light.

If there are symptoms of clinical death, it is necessary to call an ambulance resuscitation team. Before the arrival of doctors, it is necessary to maintain the victim’s vital functions as much as possible. To do this, apply a precordial blow to the chest with a fist in the area of the heart. The procedure can be repeated 2-3 times. If the victim’s condition remains unchanged, then it is necessary to proceed to artificial pulmonary ventilation (ALV) and cardiopulmonary resuscitation(CPR).

CPR is divided into two stages: basic and specialized. The first is performed by a person who is next to the victim. The second is by trained medical workers on site or in a hospital. The algorithm for performing the first stage is as follows:

Lay the victim on a flat, hard surface.
Place your hand on his forehead, tilting his head back slightly. At the same time, the chin will move forward.
With one hand, pinch the victim’s nose, with the other, stretch out your tongue and try to blow air into your mouth. Frequency – about 12 breaths per minute.
Go to indirect cardiac massage.

To do this, use the protrusion of the palm of one hand to press on the area lower third sternum, and place the second hand on top of the first. The chest wall is pressed to a depth of 3-5 cm, and the frequency should not exceed 100 contractions per minute. Pressure is performed without bending the elbows, i.e. straight position of the shoulders over the palms. You cannot inflate and compress the chest at the same time. You must make sure that your nose is pinched tightly, otherwise your lungs will not get required quantity oxygen. If the injection is done quickly, air will get in into the stomach, causing vomiting.

Resuscitation of a patient in a clinical setting

Resuscitation of a victim in a hospital setting is carried out according to a certain system. It consists of following methods:

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

If resuscitation measures are successful, the patient is transferred to the intensive care ward, where further treatment and condition monitoring. Resuscitation stops at following cases:

Ineffective resuscitation measures within 30 minutes.
Statement of condition biological death person due to brain death.

Signs of biological death

Biological death is the final stage of clinical death if resuscitation measures are ineffective. Tissues and cells of the body do not die immediately; it all depends on the organ’s ability to survive hypoxia. Death is diagnosed based on certain signs. They are divided into reliable (early and late), and orienting - immobility of the body, absence of breathing, heartbeat, pulse.

Biological death can be distinguished from clinical death using early signs. They occur 60 minutes after death. These include:

lack of pupillary response to light or pressure;
the appearance of triangles of dried skin (Larchet spots);
drying of the lips - they become wrinkled, dense, brown in color;
symptom " cat eye» – the pupil becomes elongated due to the lack of eye and blood pressure;
drying of the cornea - the iris becomes covered with a white film, the pupil becomes cloudy.

A day after dying, late signs of biological death appear. These include:

the appearance of cadaveric spots - localized mainly on the arms and legs. The spots have a marbled color.
rigor mortis is a condition of the body due to ongoing biochemical processes that disappears after 3 days.
cadaveric cooling - states the completion of biological death when the body temperature drops to a minimum level (below 30 degrees).

Consequences of clinical death

After successful resuscitation measures, a person returns to life from a state of clinical death. This process may be accompanied various disorders. They may affect both physical development, and psychological state. Damage to health depends on the time of oxygen deprivation important organs. In other words, than formerly man will return to life after a short death, the fewer complications he will experience.

Based on the above, we can identify temporary factors that determine the degree of complications after clinical death. These include:

3 minutes or less – the risk of destruction of the cerebral cortex is minimal, as is the appearance of complications in the future.
3-6 minutes – minor damage parts of the brain indicate that consequences may occur (speech impairment, motor function, coma state).
More than 6 minutes - destruction of brain cells by 70-80%, which will lead to a complete lack of socialization (the ability to think, understand).

At the level psychological state Certain changes are also observed. They are usually called transcendental experiences. Many people claim that being able to reversible death, soared in the air, saw a bright light, a tunnel. Some accurately list the actions of doctors during resuscitation procedures. Life values a person changes radically after this, because he escaped death and received a second chance at life.

Video

Dying is the final result of the life of any organism in general, and a person in particular. But the stages of dying differ, since they have distinct signs of clinical and biological death. An adult needs to know that clinical death is reversible, unlike biological death. Therefore, knowing these differences, the dying person can be saved by applying resuscitation steps.

Despite the fact that by appearance a person staying in clinical stage dying, looks already without obvious signs life and at first glance he cannot be helped, in fact, emergency resuscitation is sometimes able to snatch him from the clutches of death.

Therefore, when you see a practically dead person, you should not rush to give up - you need to find out the stage of dying, and if there is the slightest chance of revival, you need to save him. This is where knowledge of the differences between clinical death and irreversible, biological death comes in handy.

Stages of Dying

If this is not an instant death, but a process of dying, then the rule applies here - the body does not die at one moment, fading away in stages. Therefore, there are 4 stages - the pre-agony phase, the agony itself, and then the subsequent phases - clinical and biological death.

Predagonal phase. It is characterized by inhibition of the function of the nervous system, a drop in blood pressure, and circulatory disorders; on the part of the skin - pallor, spotting or cyanosis; from the side of consciousness - confusion, retardation, hallucinations, collapse. The duration of the preagonal phase is extended over time and depends on numerous factors; it can be extended with medication.
Agony phase. The pre-death stage, when breathing, blood circulation, and cardiac function are still observed, albeit weakly and briefly, is characterized by a complete imbalance of organs and systems, as well as a lack of regulation by the central nervous system life processes. This leads to the cessation of oxygen supply to the cells and tissues, the pressure in the vessels drops sharply, the heart freezes, breathing stops - the person enters the phase of clinical death.
Clinical death phase. This is a short-term stage, with a clear time interval, at which a return to previous life activities is still possible, if there are conditions for the further uninterrupted functioning of the body. In general, at this short stage, the heart no longer contracts, the blood freezes and stops moving, there is no brain activity, but the tissues do not yet die - metabolic reactions in them continue by inertia, fading. If, with the help of resuscitation steps, the heart and breathing are started, life can be restored to a person, since brain cells - and they die first - are still preserved in a viable state. At normal temperatures, the clinical death phase lasts a maximum of 8 minutes, but when the temperature drops, it can extend to tens of minutes. The stages of pre-agony, agony and clinical death are defined as “terminal”, that is, the last state leading to the cessation of a person’s vital existence.
Phase of biological (final or true) death, which is characterized by irreversibility physiological changes inside cells, tissues and organs, caused long absence blood supply, primarily to the brain. This phase, with the development of nano- and cryo-technologies in medicine, continues to be closely studied in order to try to delay its onset as much as possible.

Remember! In case of sudden death, the obligatory nature and order of the phases are erased, but the inherent signs are preserved.

Signs of clinical death

The stage of clinical death, defined unambiguously as reversible, allows you to literally “breathe” life into the dying person, starting the heartbeat and respiratory function. Therefore, it is important to remember the signs inherent in the clinical death phase so as not to miss the chance to revive a person, especially when the minutes are counting.

There are three main signs by which the onset of this phase is determined:

cessation of heartbeat;
cessation of breathing;
cessation of brain activity.

Let's look at them in detail, how it looks in reality and how it manifests itself.

The cessation of heartbeat also has the definition of “asystole,” which means the absence of cardiac activity and activity, as shown on the bioelectrical indicators of the cardiogram. It is manifested by the inability to hear the pulse in both carotid arteries on the sides of the neck.
The cessation of breathing, which is defined in medicine as “apnea,” is recognized by the cessation of up and down movement of the chest, as well as the absence of visible traces of fogging on a mirror brought to the mouth and nose, which inevitably appear when breathing is present.
The cessation of brain activity, which has medical term“coma”, characterized by a complete lack of consciousness and reaction to light from the pupils, as well as reflexes to any irritants.

At the stage of clinical death, the pupils are persistently dilated, regardless of illumination, skin have a pale, lifeless tint, the muscles throughout the body are relaxed, there are no signs of the slightest tone.

Remember! The less time has passed since the cessation of heartbeat and breathing, the greater the chance of bringing the deceased back to life - the rescuer has only 3 to 5 minutes on average! Sometimes in conditions low temperatures this period increases to a maximum of 8 minutes.

Signs of impending biological death

Biological human death means the final cessation of the existence of a person’s personality, since it is characterized by irreversible changes in his body caused by prolonged absence biological processes inside the body.

This stage is determined by early and later signs of true dying.

To the early ones initial signs, characterizing biological death that overtook a person no later than 1 hour, include:

on the side of the eye cornea, clouding first occurs for 15 to 20 minutes, and then dries out;
from the side of the pupil - the “cat's eye” effect.

In practice it looks like this. In the first minutes after the onset of irreversible biological death, if you look at the eye carefully, you can notice on its surface the illusion of a floating piece of ice, which turns into a further clouding of the color of the iris, as if it is covered with a thin veil.

Then the “cat’s eye” phenomenon becomes apparent when, with slight squeezing on the sides eyeball the pupil takes the form of a narrow slit, which is never observed in a living person. Doctors call this sign “Beloglazov’s symptom.” Both of these signs indicate the onset of the final phase of death no later than 1 hour.

Beloglazov's symptom

Late signs by which biological death has overtaken a person are recognized include the following:

complete dryness of the outer mucous membranes and skin;
cooling of the deceased body and its cooling to the temperature of the surrounding atmosphere;
the appearance of cadaveric spots in sloping areas;
rigor of a deceased body;
cadaveric decomposition.

Biological death alternately affects organs and systems, and therefore is also extended over time. The cells of the brain and its membranes die first - it is this fact that makes further resuscitation impractical, since full life It will no longer be possible to bring a person back, although the remaining tissues are still viable.

The heart, as an organ, loses its vitality completely within an hour or two from the moment biological death is declared, internal organs- for 3 - 4 hours, skin and mucous membranes - for 5 - 6 hours, and bones - for several days. These indicators are important for the conditions of successful transplantation or restoration of integrity in case of injury.

Resuscitation steps in case of observed clinical death

The presence of three main signs accompanying clinical death - absence of pulse, breathing and consciousness - is already sufficient to begin emergency resuscitation measures. They boil down to immediately calling an ambulance, in parallel - artificial respiration and cardiac massage.

Properly performed artificial respiration follows the following algorithm.

When preparing for artificial respiration, it is necessary to free the nasal and oral cavity from any contents, tilt your head back so that there is an acute angle between the neck and the back of the head, and a blunt angle between the neck and chin, only in this position will the airways open.
Having closed the dying man's nostrils with his hand, with his own mouth, after take a deep breath, tightly cover his mouth through a napkin or handkerchief and exhale into it. After exhaling, remove the hand from the nose of the dying person.
Repeat these steps every 4 to 5 seconds until chest movement appears.

Remember! You should not throw your head back too much - make sure that there is not a straight line between the chin and the neck, but an obtuse angle, otherwise the stomach will overflow with air!

It is necessary to correctly perform parallel cardiac massage, following these rules.

Massage is performed exclusively in horizontal position bodies on a hard surface.
Arms are straight, without bending at the elbows.
The rescuer's shoulders are exactly above the dying person's chest, and his outstretched straight arms are perpendicular to it.
When pressed, the palms are either placed on top of each other or in a lock.
The pressure is applied in the middle of the sternum, just below the nipples and just above the xiphoid process, where the ribs meet, using the heel of the palm with raised fingers, without lifting the hands from the chest.
The massage must be carried out rhythmically, with a break to exhale into the mouth, at a rate of 100 compressions per minute and to a depth of about 5 cm.

Remember! The proportionality of correct resuscitation actions is 1 inhalation-exhalation for 30 compressions.

The result of reviving a person should be his return to such mandatory initial indicators - the reaction of the pupil to light, palpation of the pulse. But the resumption of independent breathing is not always achievable - sometimes a person remains in temporary need of artificial ventilation, but this does not prevent him from reviving.

Clinical death is a reversible stage of dying. In this state, with external signs of death of the body (absence of heart contractions, spontaneous breathing and any neuro-reflex reactions to external influences), the potential possibility of restoring it remains vital functions using resuscitation methods.

Diagnosis of clinical death is based on a triad of signs: lack of consciousness (coma), breathing (determined by the method of catching a stream of air in the ear), pulse in the large arteries (carotid and femoral). To diagnose clinical death there is no need to resort to instrumental studies(ECG, EEG, auscultation of the heart and lungs).

Biological death occurs after clinical death and is characterized by the fact that against the background of ischemic damage, irreversible changes organs and systems. Its diagnosis is carried out on the basis of the presence of signs of clinical death, followed by the addition of early and then late signs of biological death. Early signs of biological death include drying and clouding of the cornea and the “cat's eye” symptom (to detect this symptom, you need to squeeze the eyeball; the symptom is considered positive if the pupil is deformed and elongated). Late signs of biological death include cadaver spots and rigor mortis.

« Brain (social) death “- this diagnosis appeared in medicine with the development of resuscitation. Sometimes in the practice of resuscitation doctors there are cases when, during resuscitation measures, it is possible to restore the activity of the cardiovascular system (CVS) in patients who were in a state of clinical death for more than 5-6 minutes, but in these patients irreversible changes have already occurred in the cerebral cortex. The breathing function in these situations can only be maintained mechanical ventilation method. All functional and objective research methods confirm brain death. In essence, the patient becomes a “cardiopulmonary” drug. The so-called “persistent vegetative state” develops (Zilber A.P., 1995, 1998), in which the patient can remain in the intensive care unit for a long time (several years) and exist only at the level of vegetative functions.

Signs of biological death

Lack of consciousness.

No heartbeat.

Lack of breathing.

Clouding and drying of the cornea. The pupils are wide and do not react to light (maybe a cat's pupil due to softening of the eyeball).

Cadaveric spots appear on the underlying areas of the body (2 hours after the onset of clinical death)

Rigor mortis (hardening of muscle tissue) is determined 6 hours after the onset of clinical death.

Decrease in body temperature (to temperature environment).

41. Basic methods of cardiopulmonary resuscitation.

Stages of resuscitation:

WITH. Ensuring the movement of blood through the vessels - indirect cardiac massage. Hand presses are frequent and short. The point of application of the hands is the place of attachment of the 5th left rib to the sternum (2 transverse fingers above the xiphoid process). During pressing, the chest should approach the spine by 4-5 cm. It is carried out for 5 minutes; if it is ineffective, defibrillation is started (this is already stage D). 100 compressions per minute (30 compressions 2 breaths).

A.(air of open) - to open air access - correct positioning of the patient, for men the trouser belt is unfastened, for women - everything that interferes with breathing (belts, bras, etc.) is torn off. foreign bodies are removed from the mouth. Laying the patient in the Safar position: the head is thrown back, the mouth is opened slightly, the lower jaw is extended. – this ensures airway patency.

B. artificial ventilation of the lungs - 5 artificial breaths are given to the patient (if there is an obstruction in the larynx, a tracheostomy is performed).

D. Mechanical defibrillation - precordial fist blow. Chemical defibrillation is the administration of medications that stimulate the heart. Electrical defibrillation is the action of an electric defibrillator.

Chemicals are injected only into a vein - atropine, adrenaline, calcium preparations.

Electrical defibrillation is carried out with a short pulse discharge through the axis of the heart. They start with 3.5 thousand volts, the next discharge is increased by 500 volts and brought to 6 thousand volts (i.e., 6 discharges are obtained: 3.5 thousand V, 4 thousand V, 4.5 thousand V, 5 thousand V, 5.5 thousand V, 6 thousand V ). After novocaine is administered intravenously to reduce arrhythmia, stage C and D are carried out again. Stages C and D are repeated 5-6 times.

Human death is the complete cessation of biological and physiological processes in his body. The fear of making a mistake in recognizing it forced doctors and researchers to develop precise methods its diagnosis and determine the main signs indicating the onset of death human body.

IN modern medicine distinguish clinical and biological (final) death. Brain death is considered separately.

We will talk about what the main signs of clinical death look like, as well as how biological death manifests itself, in this article.

What is clinical death of a person

This is a reversible process, which means stopping the heartbeat and breathing. That is, life in a person has not yet died out, and, therefore, restoration of vital processes with the help of resuscitation actions is possible.

Later in the article, the comparative signs of biological and clinical death will be discussed in more detail. By the way, the human condition between these two types of death of the body is called terminal. And clinical death may well move into the next, irreversible stage - biological, an indisputable sign of which is the rigor of the body and the subsequent appearance of cadaveric spots on it.

What are the signs of clinical death: preagonal phase

Clinical death may not occur immediately, but may go through several phases, characterized as preagonal and agonal.

The first of them manifests itself in inhibition of consciousness while it is preserved, as well as in dysfunction of the central nervous system, expressed by stupor or coma. The pressure, as a rule, is low (maximum 60 mm Hg), and the pulse is rapid, weak, shortness of breath appears, and the breathing rhythm is disturbed. This condition can last for several minutes or several days.

The preagonal signs of clinical death listed above contribute to the appearance of oxygen starvation in tissues and the development of so-called tissue acidosis (due to a decrease in pH). By the way, in the preagonal state the main type of metabolism is oxidative.

Manifestation of agony

The onset of agony is marked by a short series of breaths, and sometimes by a single breath. Due to the fact that a dying person has simultaneous excitation of the muscles that carry out both inhalation and exhalation, ventilation of the lungs almost completely stops. The higher parts of the central nervous system are switched off, and the role of the regulator of vital functions, as proven by researchers, at this moment passes to the spinal cord and medulla oblongata. This regulation is aimed at mobilizing the last possibilities of preserving the life of the human body.

By the way, it is during agony that a person’s body loses that notorious 60-80 g of weight, which is attributed to the soul leaving it. True, scientists prove that in fact, weight loss occurs due to the complete combustion of ATP in the cells (enzymes that supply energy to the cells of a living organism).

The agonal phase is usually accompanied by a lack of consciousness. A person's pupils dilate and do not respond to light. Blood pressure cannot be determined; the pulse is practically not palpable. In this case, the heart sounds are muffled, and breathing is rare and shallow. These signs of clinical death, which is approaching, can last several minutes or several hours.

How does the state of clinical death manifest?

When clinical death occurs, breathing, pulse, blood circulation and reflexes disappear, and cellular metabolism proceeds anaerobically. But this does not last long, because the amount of energy in the dying person’s brain is depleted, and his nervous tissue dies.

By the way, in modern medicine it has been established that after the cessation of blood circulation, death different organs does not occur simultaneously in the human body. So, the brain dies first, because it is most sensitive to lack of oxygen. After 5-6 minutes, irreversible changes occur in brain cells.

Signs of clinical death are: pale skin (they become cold to the touch), absence of breathing, pulse and corneal reflex. In this case, urgent resuscitation measures should be carried out.

Three main signs of clinical death

The main signs of clinical death in medicine include coma, apnea and asystole. We will look at each of them in more detail.

Coma is serious condition, which is manifested by loss of consciousness and loss of central nervous system functions. As a rule, its onset is diagnosed if the patient’s pupils do not react to light.

Apnea - cessation of breathing. It is manifested by a lack of movement of the chest, which indicates a cessation of respiratory activity.

Asystole - main feature clinical death, expressed by cardiac arrest together with the absence of bioelectrical activity.

What is sudden death

A special place in medicine is given to the concept of sudden death. It is defined as non-violent and occurring unexpectedly within 6 hours after the onset of the first acute symptoms.

This type of death includes those that occurred without apparent reason cases of cessation of heart function, which are caused by the occurrence of ventricular fibrillation (scattered and uncoordinated contraction of certain groups of muscle fibers) or (less often) acute weakening of heart contractions.

Signs of sudden clinical death are manifested by loss of consciousness, pale skin, cessation of breathing and pulsation in the carotid artery (by the way, it can be determined by placing four fingers on the patient’s neck between the Adam’s apple and the sternocleidomastoid muscle). Sometimes this condition is accompanied by short-term tonic convulsions.

In medicine, there are a number of other reasons that can cause sudden death. These are electrical injuries, lightning injuries, suffocation as a result of being hit foreign body into the trachea, as well as drowning and freezing.

As a rule, in all these cases, a person’s life directly depends on the efficiency and correctness of resuscitation measures.

How is cardiac massage done?

If the patient shows the first signs of clinical death, he is placed on his back on a hard surface (floor, table, bench, etc.), unfasten the belts, remove restrictive clothing and begin indirect massage hearts.

The sequence of resuscitation actions looks like this:

the person providing assistance takes a place to the left of the victim;
places hands one on top of the other on the lower third of the sternum;
pushes (15 times) at a rate of 60 times per minute, using your body weight to achieve a flexion of the chest of approximately 6 cm;
then grabs the chin and pinches the nose of the dying person, throws back his head, exhales as much as possible into his mouth;
artificial respiration is done after 15 massage pushes in the form of two exhalations into the mouth or nose of the dying person for 2 seconds each (you need to make sure that the victim’s chest rises).

Indirect massage helps compress the heart muscle between the chest and spine. Thus, the blood is pushed into large vessels, and during the pause between shocks the heart fills with blood again. In this way, cardiac activity is resumed, which after some time can become independent. The situation can be checked after 5 minutes: if the victim’s signs of clinical death disappear and a pulse appears, the skin turns pink and the pupils constrict, then the massage was effective.

How does an organism die?

Various human tissues and organs are resistant to oxygen starvation, as mentioned above, is not the same, and their death after the heart stops occurs in a different time period.

As is known, the cerebral cortex dies first, then the subcortical centers, and finally spinal cord. Four hours after the heart stops working, it dies bone marrow, and after a day the destruction of human skin, tendons and muscles begins.

How does brain death manifest?

From the above it is clear that precise definition Signs of clinical death of a person are very important, because from the moment the heart stops until the onset of brain death, leading to irreparable consequences, there are only 5 minutes.

Brain death is the irreversible cessation of all its functions. And its main diagnostic sign is the absence of any reactions to stimulation, which indicates the cessation of the functioning of the hemispheres, as well as the so-called EEG silence even in the presence of artificial stimulation.

Doctors also consider the absence of intracranial circulation to be a sufficient sign of brain death. And, as a rule, this means the onset of biological death of a person.

What does biological death look like?

To make it easier to navigate the situation, you should distinguish between the signs of biological and clinical death.

Biological or, in other words, the final death of the organism is the last stage dying, which is characterized by irreversible changes developing in all organs and tissues. In this case, the functions of the main body systems cannot be restored.

The first signs of biological death include the following:

when pressing on the eye there is no reaction to this irritation;
the cornea becomes cloudy, drying triangles form on it (the so-called Larche spots);
if the eyeball is gently squeezed from the sides, the pupil turns into a vertical slit (the so-called “cat’s eye” symptom).

By the way, the signs listed above also indicate that death occurred at least an hour ago.

What happens during biological death

The main signs of clinical death are difficult to confuse with late signs biological death. The latter appear:

redistribution of blood in the body of the deceased;
cadaveric spots purple in color, which are localized in lower places on the body;
rigor mortis;
and, finally, cadaveric decomposition.

The cessation of blood circulation causes a redistribution of blood: it collects in the veins, while the arteries are practically empty. The post-mortem process of blood coagulation occurs in the veins, and with a quick death there are few clots, and with a slow death there are many.

Rigor mortis usually begins in the facial muscles and hands of a person. And the time of its appearance and the duration of the process strongly depend on the cause of death, as well as on the temperature and humidity at the location of the dying person. Typically, the development of these signs occurs within 24 hours after death, and after 2-3 days after death they disappear in the same sequence.

A few words in conclusion

To prevent the onset of biological death, it is important not to waste time and provide necessary help dying.

It must be taken into account that the duration of clinical death directly depends on what caused it, what age the person is, as well as on external conditions.

There are cases when signs of clinical death could be observed for half an hour if it occurred, for example, due to drowning in cold water. Metabolic processes throughout the body and in the brain in such a situation slow down greatly. And with artificial hypothermia, the duration of clinical death is increased to 2 hours.

Severe blood loss, on the contrary, provokes rapid development pathological processes V nerve tissues even before cardiac arrest, and restoration of life in these cases is impossible.

According to the instructions of the Russian Ministry of Health (2003), resuscitation measures are stopped only when a person’s brain death is determined or if they are ineffective medical care provided within 30 minutes.

In case of severe injury, defeat electric shock, drowning, suffocation, poisoning, as well as a number of diseases, loss of consciousness may develop, i.e. a state when the victim lies motionless, does not answer questions, and does not react to others. This is the result of disruption of the central nervous system, mainly the brain.
The person providing assistance must clearly and quickly distinguish between loss of consciousness and death.

The onset of death is manifested in irreversible damage the basic vital functions of the body with the subsequent cessation of the vital functions of individual tissues and organs. Death from old age is rare. More often, the cause of death is disease or exposure to various factors.

With massive injuries (aircraft, railway injuries, traumatic brain injuries with brain damage), death occurs very quickly. In other cases, death is preceded by agony, which can last from a few minutes to hours and even days. During this period, cardiac activity weakens, respiratory function, the skin of the dying person becomes pale, facial features become sharper, and a sticky appearance appears. cold sweat. The agonal period passes into a state of clinical death.

Clinical death is characterized by:
- cessation of breathing;
- cardiac arrest.
During this period, irreversible changes in the body have not yet developed. Various organs die with at different speeds. The higher the level of organization of a tissue, the more sensitive it is to a lack of oxygen and the more quickly this tissue dies. The most highly organized tissue of the human body is the cortex. cerebral hemispheres the brain dies as quickly as possible, after 4-6 minutes. The period while the cerebral cortex is alive is called clinical death. During this period of time it is possible to restore function nerve cells and the central nervous system.

Biological death characterized by the onset of irreversible processes in tissues and organs.

If signs of clinical death are detected, it is necessary to immediately begin resuscitation measures.

Signs of clinical death

No signs of life.
Agonal breathing. Death in most cases is preceded by agony. After death occurs, the so-called agonal breathing continues for a short time (15-20 seconds), that is, breathing is frequent, shallow, hoarse, and foam at the mouth may appear.
Cramps. They are also manifestations of agony and continue short time(a few seconds). A spasm occurs in both the skeletal and smooth muscle. For this reason, death is almost always accompanied by involuntary urination, defecation and ejaculation. Unlike some diseases accompanied by convulsions, when death occurs, the convulsions are not strong and not clearly expressed.
Pupil reaction to light. As mentioned above, there will be no signs of life, but the reaction of the pupils to light in a state of clinical death remains. This reaction is a higher reflex that closes on the cerebral cortex. Thus, as long as the cerebral cortex is alive, the reaction of the pupils to light will also be preserved. It should be noted that the first seconds after death as a result of convulsions, the pupils will be maximally dilated.

Considering that agonal breathing and convulsions will occur only in the first seconds after death, the main sign of clinical death will be the presence of a reaction of the pupils to light.

Signs of biological death

Signs of biological death do not appear immediately after the end of the clinical death stage, but some time later. Moreover, each of the signs manifests itself in different times, and not all at the same time. Therefore, we will analyze these signs in chronological order their occurrence.

“Cat's eye” (Beloglazov's symptom). Appears 25-30 minutes after death. Where does this name come from? A person's pupil round shape, and in a cat it is elongated. After death, human tissues lose their elasticity and firmness, and if squeezed on both sides of the eyes dead person, it becomes deformed, and along with the eyeball, the pupil also becomes deformed, taking on an elongated shape, like a cat’s. In a living person, deforming the eyeball is, if not impossible, then very difficult.

Drying of the cornea and mucous membranes. Appears 1.5-2 hours after death. After death, the lacrimal glands, which produce tear fluid, which, in turn, serves to moisturize the eyeball, cease to function. A living person's eyes are moist and shiny. Cornea eyes of the dead As a result of drying, the human skin loses its natural human shine, becomes cloudy, and sometimes a grayish-yellowish coating appears. The mucous membranes, which were more moisturized during life, quickly dry out. For example, lips become dark brown, wrinkled, and dense.

Cadaveric spots. They arise as a result of post-mortem redistribution of blood in a corpse under the influence of gravity. After the heart stops, the movement of blood through the vessels stops, and the blood, due to its gravity, begins to gradually flow into the lower parts of the corpse, overflowing and expanding the capillaries and small venous vessels; the latter are visible through the skin in the form of bluish-purple spots, which are called cadaveric spots. The coloring of cadaveric spots is not uniform, but spotty, with a so-called “marble” pattern. They appear approximately 1.5-3 hours (sometimes 20-30 minutes) after death. Cadaveric spots are located in the underlying parts of the body. When the corpse is positioned on its back, cadaveric spots are located on the back and rear - lateral surfaces of the body, on the stomach - on the front surface of the body, face, vertical position corpse (hanging) - on lower limbs and lower abdomen. In some poisonings, cadaveric spots have an unusual color: pinkish-reddish (carbon monoxide), cherry (hydrocyanic acid and its salts), grayish-brown (Berthollet salt, nitrites). In some cases, the color of cadaveric spots may change with changes in environmental conditions. For example, when removing the corpse of a drowned person to the shore, the cadaveric spots on his body that are bluish-purple in color, due to the penetration of air oxygen through the loosened skin, can change color to pink-red. If death occurred as a result of large blood loss, then the cadaveric spots will have a much paler shade or be completely absent. When a corpse is exposed to low temperatures, cadaveric spots will form later, up to 5-6 hours. The formation of cadaveric spots occurs in two stages. As is known, cadaveric blood does not clot during the first 24 hours after death. Thus, in the first day after death, when the blood has not yet coagulated, the location of cadaveric spots is not constant and can change when the position of the corpse changes as a result of the flow of uncoagulated blood. In the future, after blood clotting, the cadaveric spots will not change their position. Determining the presence or absence of blood clotting is very simple - you need to press on the spot with your finger. If the blood has not coagulated, when pressure is applied, the cadaveric spot at the point of pressure will turn white. Knowing the properties of cadaveric stains, it is possible to determine at the scene of the incident the approximate age of death, as well as find out whether the corpse was turned over after death or not.

Rigor mortis. After death occurs in the corpse biochemical processes, leading first to muscle relaxation, and then to contraction and hardening - rigor mortis. Rigor mortis develops within 2-4 hours after death. The mechanism of rigor mortis formation is not yet completely clear. Some researchers believe that the basis is biochemical changes in muscles, others - in nervous system. In this state, the muscles of the corpse create an obstacle to passive movements in the joints, therefore, to straighten the limbs that are in a state of severe rigor mortis, it is necessary to use physical strength. Full development of rigor mortis in all muscle groups is achieved on average by the end of the day. Rigor mortis does not develop in all muscle groups at the same time, but gradually, from the center to the periphery (first, the muscles of the face, then the neck, chest, back, abdomen, and limbs undergo rigor). After 1.5-3 days, rigor disappears (resolves), which is expressed in muscle relaxation. Rigor mortis resolves in sequence, reverse development. The development of rigor mortis is accelerated in conditions high temperature, when low, its delay is noted. If death occurs as a result of a cerebellar injury, rigor mortis develops very quickly (0.5-2 seconds) and fixes the position of the corpse at the moment of death. Rigor mortis is resolved ahead of schedule in the event of a violent muscle strain.

Cadaveric cooling. Temperature of the corpse due to termination metabolic processes and energy production in the body gradually decreases to ambient temperature. The onset of death can be considered reliable when body temperature drops below 25 degrees (according to a number of authors - below 20). It is better to determine the temperature of a corpse in areas protected from environmental influences ( axilla, oral cavity), since skin temperature completely depends on the ambient temperature, the presence of clothing, etc. The cooling rate of the body can vary depending on the ambient temperature, but on average it is 1 degree/hour.

Photos from the autopsy...

Photo of a hematological patient, as bone marrow was taken from femur, this is evidenced by the seam on the left leg... I apologize for the quality of the photo - almost all the organs have already been opened... Number 1 is the brain. No. 2 - kidney with chronic pyelonephritis, this is indicated by the increased amount of fat... No. 3 - heart, the aorta is clearly visible, the amount of fat is also increased... No. 4 - stomach, the blood supply to the organ is clearly visible... No. 5 - lung... No. 6 - large omentum - covers organs abdominal cavity from blows from outside...No. 7 - a small piece of liver, pale pink... No. 8 - loops of the colon...

The same autopsy, but a slightly different angle...

The corpse of a woman, with multiple cadaveric spots on her back...

There is a refrigerator compartment, designed for 5 people, behind each door... Corpses are stored there until burial, and unclaimed corpses are stored for 3 months, then they go to State burial...

A sectional room is usually completely tiled, sectional tables are usually iron or tiled with a drain into the sewer, an essential attribute is a quartz lamp...

The woman's corpse was opened and dressed before being released to relatives...

At each autopsy, pieces are taken from many organs, then after the work of a histologist, they are turned into such preparations for a microscope...