Essay on biological death. The 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 the one who is next to the victim can help. The main thing is not to get confused, act quickly. This requires knowledge of the signs clinical death, her symptoms and resuscitation rules.

Symptoms of clinical death

Clinical death is a reversible state of dying, in which the work of the heart stops, breathing stops. All external signs vital functions disappear, it may seem that the person is dead. Such a 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 practically does not affect the subsequent work of organs, general condition. If more than 6 minutes have passed, then the person will be deprived of many vital important functions due to brain cell death.

To recognize in time given state you need to know its symptoms. Signs of clinical death are as follows:

Coma - loss of consciousness, cardiac arrest with cessation of blood circulation, the pupils do not react to light.
Apnea - no respiratory movements chest but metabolism stays the same.
Asystole - the pulse on both carotid arteries is not heard for more than 10 seconds, which indicates the beginning of the destruction of the cerebral cortex.

Duration

Under conditions of hypoxia, the cortex and subcortex of the brain are able to maintain viability. certain time. Based on this, the duration of clinical death is determined by two stages. The first one 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 - the death of all parts of the brain.

The second stage of the state of reversible dying lasts 10 or more minutes. 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 oxygenation- saturation of the body with oxygen under pressure in a special chamber;
hemosorption - blood purification by the apparatus;
drugs that sharply reduce metabolism and cause suspended animation;
transfusion of fresh donated 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 disease, suffocation);
anaphylactic shock- respiratory arrest with a rapid reaction of the body to the allergen;
big loss blood in case of injuries, wounds;
damage to tissues by electricity;
extensive burns, wounds;
toxic shock- poisoning with toxic substances;
vasospasm;
the body's response to stress;
excessive physical exercise;
violent death.

The main stages and methods of first aid

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

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

In the presence of symptoms of clinical death, it is necessary to call an ambulance resuscitation team. Before the arrival of doctors, it is necessary to maintain the vital functions of the victim as much as possible. To do this, apply a precordial blow with a fist on the chest in the region of the heart. The procedure can be repeated 2-3 times. If the condition of the victim remains unchanged, then it is necessary to switch to artificial lung 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 health workers on site or in a hospital. The algorithm for performing the first stage is as follows:

Lay the victim down on a flat, hard surface.
Put your hand on his forehead, slightly tilting his head. This will push the chin forward.
With one hand, pinch the victim's nose, with the other - stretch out the tongue, try to blow air into the mouth. The frequency is about 12 breaths per minute.
Go to chest compressions.

To do this, with the protrusion of the palm of one hand, you need to press on the area lower third sternum, and put the second hand on top of the first. The indentation of the chest wall is made to a depth of 3-5 cm, while the frequency should not exceed 100 contractions per minute. The pressure is performed without bending the elbows, i.e. direct position of the shoulders above the palms. It is impossible to blow in and squeeze the chest at the same time. It is necessary to ensure that the nose is tightly clamped, otherwise the lungs will not receive required amount oxygen. If the breath is taken quickly, air gets in into the stomach, causing vomiting.

Resuscitation of the patient in the clinic

Resuscitation of the victim in a hospital 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 with the introduction of Hecodese through a central venous catheter.
Correction acid-base balance intravenously (Sorbilact, Xylat).
Restoration of capillary circulation by drip(Rheosorbilact).

In case of successful resuscitation, the patient is transferred to the intensive care unit, where further treatment and condition monitoring. Resuscitation stops at the following cases:

Ineffective resuscitation within 30 minutes.
Status Statement biological death human due to brain death.

Signs of biological death

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

Biological death can be distinguished from clinical death by early signs. They are noted after 60 minutes from the moment of dying. These include:

lack of pupillary response to light or pressure;
the appearance of triangles of dried skin (Larcher 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 is covered with a white film, the pupil becomes cloudy.

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

the appearance of cadaveric spots - localization mainly on the arms and legs. The spots are marbled.
rigor mortis - the state of the body due to ongoing biochemical processes, disappears after 3 days.
cadaveric cooling - states the completion of the onset of biological death, when the body temperature drops to a minimum level (below 30 degrees).

Consequences of clinical death

After successful resuscitation, a person from a state of clinical death returns to life. This process may be accompanied various violations. They can affect how physical development as well as psychological state. Damage to health depends on the time of oxygen starvation important organs. In other words, than earlier man returns to life after a short death, the fewer complications he will experience.

Based on the above, it is possible to identify temporal 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 well as the appearance of complications in the future.
3-6 minutes - minor damage areas of the brain indicate that consequences may occur (impaired speech, motor function, coma).
More than 6 minutes - the 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 called transcendental experiences. Many people claim that being able 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 after this changes dramatically, because he escaped death and got a second chance at life.

Video

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

Despite the fact that in appearance a person who is in clinical stage dying, looks already without obvious signs life and at first glance it 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 reviving, you need to save him. This is where knowledge of how clinical death differs from irrevocable, biological death in terms of signs.

Dying stages

If this is not instantaneous death, but the 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 phase of pre-agony, the actual agony, and then the subsequent phases - clinical and biological death.

Pre-agonal phase. It is characterized by inhibition of the function of the nervous system, a drop in blood pressure, impaired blood circulation; on the part of the skin - pallor, spotting or cyanosis; from the side of consciousness - confusion, lethargy, hallucinations, collapse. The duration of the preagonal phase is extended in time and depends on numerous factors; it can be extended with medication.
Phase of agony. The pre-death stage, when breathing, blood circulation, and cardiac function are still observed, albeit weakly and for a short time, 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 stops, breathing stops - the person enters the phase of clinical death.
Clinical death phase. This is a short-term, having a clear time interval, a stage at which a return to the previous life activity 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 die yet - exchange reactions continue by inertia, fading. If, with the help of resuscitation steps, the heart and breathing are started, a person can be brought back to life, because the brain cells - and they die first - are still preserved in a viable state. At normal temperature, the phase of clinical death lasts a maximum of 8 minutes, but with a decrease in temperature, it can be extended 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 termination of a person's life.
Phase of biological (final or true) death, which is characterized by irreversibility physiological changes inside cells, tissues and organs, caused by prolonged 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 push back its onset as much as possible.

Remember! With a sudden death, the obligatoriness and sequence of the phases are erased, but the inherent signs are preserved.

Signs of the onset of clinical death

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

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

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

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

The cessation of the heartbeat also has the definition of "asystole", which means the absence of activity from the heart and activity, which is shown on the bioelectric indicators of the cardiogram. Manifested by the inability to hear the pulse on 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 the movement up and down the chest, as well as the absence of visible traces of fogging on the 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 stimuli.

At the stage of clinical death, the pupils are steadily dilated, regardless of the 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 from the cessation of heartbeat and breathing, the more chances there are to bring the deceased back to life - the rescuer has only 3-5 minutes on average at his disposal! Sometimes in conditions low temperatures this period is extended to a maximum of 8 minutes.

Signs of the onset of 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 a long absence biological processes inside the body.

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

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

on the part of the eye cornea, first clouding - for 15 - 20 minutes, and then drying;
from the side of the pupil - the effect of "cat's eye".

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

Then the phenomenon of the "cat's eye" 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 called this symptom "Beloglazov's symptom". Both of these signs indicate the onset of the final phase of death no later than 1 hour.

symptom of Beloglazov

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

complete dryness of the mucous and skin integuments;
cooling of the deceased body and its cooling to the temperature of the surrounding atmosphere;
the appearance of cadaveric spots in the sloping zones;
rigor of the dead body;
cadaveric decomposition.

Biological death alternately affects organs and systems, therefore it is also extended in time. The cells of the brain and its membranes are the first to die - it is this fact that makes further resuscitation inexpedient, since full life it will not be possible to return a person, although the rest of the tissues are still viable.

The heart, as an organ, completely loses its viability 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 for successful transplantation or restoration of integrity in case of injuries.

Resuscitation steps in observed clinical death

The presence of three main signs accompanying clinical death - the absence of a pulse, breathing and consciousness - is already enough to start emergency resuscitation measures. They boil down to an immediate call for an ambulance, in parallel - artificial respiration and heart massage.

Competently carried out artificial respiration obeys the following algorithm.

In preparation for artificial respiration, it is required to free the nasal and oral cavity from any contents, tilt your head back so that an acute angle is obtained between the neck and the back of the head, and a blunt one between the neck and chin, only in this position the airways will open.
Holding the nostrils of the dying man with his hand, with his own mouth, after deep breath, through a napkin or handkerchief, tightly wrap around his mouth and exhale into it. After exhaling, remove the hand from the nose of the dying.
Repeat these steps every 4 to 5 seconds until chest movement occurs.

Remember! You can’t throw your head back excessively - make sure that not a straight line forms between the chin and the neck, but an obtuse angle, otherwise the stomach will overflow with air!

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

Massage is done exclusively in horizontal position body on a hard surface.
Arms are straight, without bending at the elbows.
The shoulders of the rescuer are exactly above the chest of the dying person, outstretched straight arms are perpendicular to it.
The palms, when pressed, are either placed one on top of the other, or in the castle.
Pressing is carried out in the middle of the sternum, just below the nipples and just above the xiphoid process, where the ribs converge, with the base of the palm with raised fingers, without taking the hands off the chest.
Massage must be carried out rhythmically, with a break to exhale into the mouth, at a pace of 100 clicks per minute and to a depth of about 5 cm.

Remember! Proportionality of the correct resuscitation actions - 1 breath-exhalation is done for 30 clicks.

The result of the revival of a person should be his return to such mandatory initial indicators - the reaction of the pupil to light, probing the pulse. But the resumption of spontaneous breathing is not always achievable - sometimes a person retains a temporary need for artificial lung ventilation, but this does not prevent him from coming to life.

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

Diagnosis of clinical death is based on a triad of signs: lack of consciousness (coma), breathing (determined by the method of catching a jet of air with the ear), pulse on large arteries (carotid and femoral). For the diagnosis of clinical death, one does not need to resort to instrumental research(ECG, EEG, auscultation of the heart and lungs).

Biological death follows clinical 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 symptom of "cat's eye" (to detect this symptom, you need to squeeze the eyeball; the symptom is considered positive if the pupil is deformed and stretched in length). Late signs of biological death include cadaveric spots and rigor mortis.

« Brain (social) death "- this diagnosis appeared in medicine with the development of resuscitation. Sometimes in the practice of resuscitators there are cases when, during resuscitation, 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 these patients have already undergone irreversible changes in the cerebral cortex. The respiratory function in these situations can only be maintained ventilator method. All functional and objective methods of research confirm brain death. In fact, the patient becomes a "cardiopulmonary" drug. The so-called "persistent vegetative state" develops (Zilber A.P., 1995, 1998), in which the patient can be 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.

Absence of heartbeat.

Absence of breath.

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

Cadaverous spots appear on the underlying parts 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 the temperature environment).

41. Basic methods of cardiopulmonary resuscitation.

Stages of resuscitation:

WITH. Ensuring the movement of blood through the vessels - an indirect heart massage. Hand pressing 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 pushing, the chest should approach the spine by 4-5 cm. It is carried out within 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) - open air access - correct laying of the patient, for men the trouser belt is unfastened, for women - everything that prevents breathing (belts, bras, etc.) is torn. foreign bodies are removed from the mouth. Laying the patient in the Safar position: the head is thrown back, the mouth is slightly opened, the lower jaw is advanced. - this ensures the patency of the airways.

B. artificial ventilation of the lungs - 5 artificial breaths of the patient are taken (if there is an obstacle in the larynx, a tracheostomy is done).

D. Mechanical defibrillation - precordial punch. Chemical defibrillation - the introduction of drugs that stimulate the activity of 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 pulsed 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 intravenous injection of novocaine to reduce arrhythmias, stage C and D are carried out again. Continue repeating stages C and D 5-6 times.

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

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

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

What is clinical death of a person

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

Further in the article, the comparative signs of biological and clinical death will be considered in more detail. By the way, the state of a person between these two types of death of the body is called terminal. And clinical death may well pass into the next, irreversible stage - the biological one, the 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 go through several phases, characterized as pre-agonal and agonal.

The first of them is manifested in the inhibition of consciousness while maintaining it, as well as in violation of the functions of the central nervous system, expressed by stupor or coma. The pressure, as a rule, is low at the same time (maximum 60 mm Hg), and the pulse is rapid, weak, shortness of breath appears, the breathing rhythm is disturbed. This state can last for several minutes or several days.

The pre-agonal signs of clinical death listed above contribute to the appearance of oxygen starvation in the tissues and the development of the 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 beginning of the agony is marked by a short series of breaths, and sometimes by a single breath. Due to the fact that a dying person simultaneously excites 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 turned 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 the agony that the human body loses those very notorious 60-80 g of weight, which are attributed to the soul leaving it. True, scientists prove that in fact, weight loss occurs due to the complete combustion in the cells of ATP (enzymes that supply energy to the cells of a living organism).

The agonal phase is usually accompanied by a lack of consciousness. The pupils of a person dilate and do not react to light. Blood pressure can not be determined, the pulse is practically not palpable. Heart tones in this case are muffled, and breathing is rare and shallow. These signs of clinical death, which is impending, can last for several minutes or several hours.

How does the state of clinical death manifest itself?

With the onset of clinical death, respiration, pulse, blood circulation and reflexes disappear, and cellular metabolism takes place anaerobically. But this does not last long, because the number of energy drinks in the brain of a dying person is depleted, and his nervous tissue dies.

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

Signs of clinical death are: pallor of the skin (they become cold to the touch), lack of respiration, pulse and corneal reflex. In this case, urgent resuscitation measures should be taken.

Three main signs of clinical death

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

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

Apnea - stopping breathing. It is manifested by the absence of movement of the chest, which indicates a stop in respiratory activity.

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

What is sudden death

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

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

Signs of sudden clinical death are manifested by loss of consciousness, pallor of the skin, respiratory arrest and pulsation in the carotid artery (by the way, you can determine it if you put 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 reasons that can cause sudden death. These are electrical injuries, lightning strikes, 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 promptness and correctness of resuscitation measures.

How is heart massage done?

If the patient shows the first signs of clinical death, they lay him on his back on a hard surface (floor, table, bench, etc.), unfasten the belts, take off the restrictive clothing and start indirect massage hearts.

The sequence of resuscitation actions looks like this:

the assisting person takes a place to the left of the victim;
puts his hands on top of each other on the lower third of the sternum;
makes jerky pressures (15 times) at a frequency of 60 times per minute, while using your weight to achieve a deflection of the chest by about 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 shocks in the form of two exhalations into the mouth or nose of the dying person for 2 seconds each (at the same time, you need to make sure that the victim’s chest rises).

Indirect massage helps to compress the heart muscle between the chest and spine. Thus, the blood is pushed into large vessels, and during the pause between the beats, the heart fills with blood again. In this way, cardiac activity is resumed, which after a while 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?

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

As you know, the cerebral cortex dies first, then the subcortical centers, and finally spinal cord. Dies four hours after the heart stops working. Bone marrow, and a day later, the destruction of the skin, tendons and muscles of a person begins.

How does brain death manifest?

From the above, it is clear that precise definition signs of clinical death of a person is very important, because from the moment of cardiac arrest to the onset of brain death, which entails irreparable consequences, there are only 5 minutes.

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

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

What does biological death look like?

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

Biological or, in other words, the final death of the organism is last step dying, which is characterized by irreversible changes that develop in all organs and tissues. At the same time, 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 Lyarche spots);
if the eyeball is gently squeezed from the sides, then the pupil will transform into a vertical slit (the so-called "cat's eye" symptom).

By the way, the signs listed above also indicate that the 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, which are localized in the underlying places on the body;
rigor mortis;
and, finally, cadaveric decomposition.

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

Rigor mortis usually begins with the facial muscles and hands of a person. And the time of its appearance and the duration of the process are highly dependent on the cause of death, as well as on the temperature and humidity at the location of the dying. Usually, 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 needed help dying.

It should be borne in mind that the duration of clinical death directly depends on what caused it, at what age the person is, and also 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 are greatly slowed down. And with artificial hypothermia, the duration of clinical death is increased to 2 hours.

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

According to the instructions of the Ministry of Health of Russia (2003), resuscitation measures are stopped only when a human brain is dead or if it is ineffective medical care rendered within 30 minutes.

In case of severe injury, injury 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, does not respond to others. This is the result of a violation of the activity of the central nervous system, mainly the brain.
The caregiver must clearly and quickly distinguish loss of consciousness from death.

The onset of death manifests itself in irreversible damage the main vital functions of the body, followed by the cessation of vital activity of individual tissues and organs. Death from old age is rare. Most often, the cause of death is a disease or exposure to various factors on the body.

With massive injuries (aircraft, railway injuries, craniocerebral injuries with brain damage), death occurs very quickly. In other cases, death is preceded by agony which can last from minutes to hours or even days. During this period, cardiac activity is weakened, respiratory function, the skin of the dying person becomes pale, facial features are sharpened, sticky 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 different speed. The higher the level of tissue organization, the more sensitive it is to a lack of oxygen and the faster this tissue dies. The most highly organized tissue of the human body is the cortex 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, restoration of function is possible. 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 found, it is necessary to immediately begin resuscitation measures.

Signs of clinical death

No signs of life.
Agony breathing. Death in most cases is preceded by agony. After the onset of death, the so-called agonal breathing continues for a short time (15-20 seconds), that is, breathing is frequent, shallow, hoarse, foam may appear at the mouth.
Seizures. Are also manifestations of agony and continue a short time(few seconds). There is a spasm of both 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, convulsions are mild and not pronounced.
Pupillary 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 the highest reflex, closing on the cerebral cortex. Thus, while 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 expanded.

Given 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 pupillary reaction to light.

Signs of biological death

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

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

Drying of the cornea of the eye and mucous membranes. Appears 1.5-2 hours after death. After death, the lacrimal glands cease to function, which produce tear fluid, which, in turn, serves to moisten the eyeball. 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 luster, becomes cloudy, sometimes a grayish-yellowish coating appears. The mucous membranes, which were more hydrated during life, dry out quickly. For example, lips become dark brown, wrinkled, dense.

Dead spots. Arise as a result of the post-mortem redistribution of blood in the corpse under the influence of gravity. After cardiac arrest, 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 translucent through the skin in the form of bluish-purple spots, which are called cadaveric. The color of cadaveric spots is not uniform, but spotty, has a so-called “marble” pattern. They appear approximately 1.5-3 hours (sometimes 20-30 minutes) after death. Dead spots are located in the underlying parts of the body. With the position of the corpse on the back, cadaveric spots are located on the back and back - lateral surfaces of the body, on the stomach - on the front surface of the body, face, with vertical position corpse (hanging) - on lower limbs and lower abdomen. With some poisoning, 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 when the environment changes. For example, when the corpse of a drowned man is taken ashore, the bluish-purple cadaveric spots on his body, due to the penetration of air oxygen through loosened skin, can change color to pink-red. If death occurred as a result of a large blood loss, then the cadaveric spots will have a much paler shade or be absent altogether. When a corpse is kept at low temperatures, cadaveric spots will form later, up to 5-6 hours. The formation of cadaveric spots takes place in two stages. As you know, cadaveric blood does not coagulate during the first day after death. Thus, on the first day after death, when the blood has not yet clotted, 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, 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 clotted, when pressed, the cadaveric spot at the site of pressure will turn white. Knowing the properties of cadaveric spots, it is possible to determine the approximate prescription of death at the scene of the incident, and also to find out whether the corpse was turned over after death or not.

Rigor mortis. After the onset of death in the corpse occur 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 fully understood. Some researchers believe that the basis is biochemical changes in the muscles, others - in nervous system. In this state, the muscles of the corpse create an obstacle to passive movements in the joints, therefore, to extend the limbs in a state of pronounced rigor mortis, it is necessary to apply physical strength. The full development of rigor mortis in all muscle groups is achieved on average by the end of the day. Rigor mortis develops not 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, limbs undergo rigor mortis). After 1.5-3 days, stiffness disappears (allowed), which is expressed in muscle relaxation. Rigor mortis is resolved in the sequence reverse development. The development of rigor mortis is accelerated under conditions high temperature, at low, its delay is noted. If death occurs as a result of trauma to the cerebellum, rigor mortis develops very quickly (0.5-2 seconds) and fixes the posture of the corpse at the time of death. Rigor mortis is allowed before the deadline in case of forced muscle stretching.

Corpse cooling. Body temperature due to discontinuation metabolic processes and energy production in the body is gradually reduced to ambient temperature. The onset of death can be considered reliable when the body temperature drops below 25 degrees (according to some authors, below 20). It is better to determine the temperature of a corpse in areas closed from environmental influences ( armpit, oral cavity), since the temperature of the skin is completely dependent on the ambient temperature, the presence of clothing, etc. The rate of cooling of the body can vary depending on the ambient temperature, but on average it is 1 degree / hour.

Photos from the opening...

Photo of a hematological patient, as the 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 ... Under No. 1 - the brain. No. 2 - kidney with chronic pyelonephritis, this is evidenced by an increased amount of fat ... No. 3 - the heart, the aorta is clearly visible, the amount of fat is also increased ... No. 4 - the 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 the liver, pale pink in color ... No. 8 - loops of the large intestine ...

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

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

Refrigeration chamber, designed for 5 people, behind each door ... Corpses are stored there until the moment of burial, and unclaimed corpses for 3 months, then they go to the State burial ...

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

The corpse of a woman, opened and dressed, before issuing to relatives ...

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