The main sign of clinical death. The main signs of clinical and biological death

Following clinical death comes biological death, characterized by a complete stop of all physiological functions and processes in tissues and cells. With the improvement of medical technology, the death of man is moving further and further. Today, however, biological death is an irreversible condition.

Signs of a dying person

Clinical and biological (true) death are two stages of one process. Biological death is declared if resuscitation measures during clinical death were unable to “start” the body.

Signs of clinical death

The main sign of clinical cardiac arrest is the absence of pulsation in the carotid artery, indicating cessation of blood circulation.

Lack of breathing is checked by movement of the chest or by placing the ear to the chest, as well as by bringing a dying mirror or glass to the mouth.

Lack of reaction to a sharp sound and painful stimuli is a sign of loss of consciousness or a state of clinical death.

If at least one of the listed symptoms is present, resuscitation measures should begin immediately. Timely resuscitation can bring a person back to life. If resuscitation was not carried out or was not effective, the last stage of dying occurs - biological death.

Definition of biological death

The death of an organism is determined by a combination of early and late signs.

Signs of a person’s biological death appear after the onset of clinical death, but not immediately, but after some time. It is generally accepted that biological death occurs at the moment of cessation of brain activity, approximately 5-15 minutes after clinical death.

Accurate signs of biological death are the readings of medical devices that record the cessation of electrical signals from the cerebral cortex.

Stages of human dying

Biological death is preceded by the following stages:

Preagonal state - characterized by sharply depressed or absent consciousness. The skin is pale, blood pressure can drop to zero, the pulse can be felt only in the carotid and femoral arteries. Increasing oxygen starvation quickly worsens the patient's condition.
Terminal pause is a borderline state between dying and life. Without timely resuscitation, biological death is inevitable, since the body cannot cope with this condition on its own.
Agony - the last moments of life. The brain stops controlling vital processes.

All three stages may be absent if the body was affected by powerful destructive processes (sudden death). The duration of the agonal and preagonal periods can vary from several days and weeks to several minutes.

The agony ends with clinical death, which is characterized by the complete cessation of all life processes. It is from this moment that a person can be considered dead. But irreversible changes in the body have not yet occurred, therefore, during the first 6-8 minutes after the onset of clinical death, active resuscitation measures are carried out to help bring the person back to life.

The last stage of dying is considered irreversible biological death. Determination of the occurrence of true death occurs if all measures to remove a person from a state of clinical death have not led to results.

Differences in biological death

Biological death is distinguished between natural (physiological), premature (pathological) and violent.

Natural biological death occurs in old age, as a result of the natural decline of all body functions.

Premature death is caused by a serious illness or damage to vital organs, and can sometimes be instantaneous.

Violent death occurs as a result of murder, suicide, or is a consequence of an accident.

Criteria for biological death

The main criteria for biological death are determined by the following criteria:

Traditional signs of cessation of vital activity are cardiac and respiratory arrest, absence of pulse and reaction to external stimuli and strong odors (ammonia).
Based on brain death - an irreversible process of cessation of vital activity of the brain and its stem sections.

Biological death is a combination of the fact of cessation of brain activity with traditional criteria for determining death.

Signs of biological death

Biological death is the final stage of human dying, replacing the clinical stage. Cells and tissues do not die simultaneously after death; the lifespan of each organ depends on the ability to survive complete oxygen starvation.

The first to die is the central nervous system - the spinal cord and brain, this happens approximately 5-6 minutes after true death occurs. The death of other organs can last for several hours or even days, depending on the circumstances of the death and the conditions of the deceased body. Some tissues, such as hair and nails, retain the ability to grow for a long time.

Diagnosis of death consists of guiding and reliable signs.

Orienting signs include a motionless body position with absence of breathing, pulse and heartbeat.

A reliable sign of biological death includes the presence of cadaveric spots and rigor mortis.

There are also differences between early and late symptoms of biological death.

Early signs

Early symptoms of biological death appear within an hour of death and include the following signs:

Lack of reaction of the pupils to light stimulation or pressure.
The appearance of Larche spots - triangles of dried skin.
The appearance of the "cat's eye" symptom - when the eye is compressed on both sides, the pupil takes on an elongated shape and becomes similar to the pupil of a cat. The "cat's eye" symptom means the absence of intraocular pressure, which is directly related to arterial pressure.
Drying of the eye cornea - the iris loses its original color, as if becoming covered with a white film, and the pupil becomes cloudy.
Drying of the lips - the lips become dense and wrinkled, and acquire a brown color.

Early signs of biological death indicate that resuscitation measures are already pointless.

Late signs

Late signs of human biological death appear within 24 hours from the moment of death.

The appearance of cadaveric spots occurs approximately 1.5-3 hours after diagnosing true death. The spots are located in the underlying parts of the body and have a marble color.
Rigor mortis is a reliable sign of biological death, occurring as a result of biochemical processes occurring in the body. Rigor mortis reaches full development in about a day, then it weakens and after about three days disappears completely.
Cadaveric cooling - it is possible to state the complete onset of biological death if the body temperature has dropped to air temperature. The rate at which the body cools depends on the ambient temperature, but on average the decrease is approximately 1°C per hour.

Brain death

The diagnosis of “brain death” is made when there is complete necrosis of brain cells.

The diagnosis of cessation of brain activity is made on the basis of the obtained electroencephalography, showing complete electrical silence in the cerebral cortex. An angiography will reveal a cessation of cerebral blood supply. Artificial ventilation and drug support can keep the heart pumping for some time - from a few minutes to several days or even weeks.

The concept of “brain death” is not identical to the concept of biological death, although in fact it means the same thing, since the biological dying of the organism in this case is inevitable.

Time of biological death

Determining the time of onset of biological death is of great importance for ascertaining the circumstances of the death of a person who died in non-obvious conditions.

The less time has passed since death, the easier it is to determine the time of its occurrence.

The age of death is determined by various indications when examining the tissues and organs of a corpse. Determining the moment of death in the early period is carried out by studying the degree of development of cadaveric processes.

Ascertainment of death

The biological death of a person is determined by a set of signs - reliable and orienting.

In case of death from an accident or violent death, it is fundamentally impossible to declare brain death. Breathing and heartbeat may not be audible, but this also does not mean the onset of biological death.

Therefore, in the absence of early and late signs of dying, the diagnosis of “brain death”, and therefore biological death, is established by a doctor in a medical institution.

Transplantology

Biological death is a state of irreversible death of an organism. After a person dies, his organs can be used as transplants. The development of modern transplantology allows us to save thousands of human lives every year.

The moral and legal issues that arise appear to be quite complex and are resolved in each case individually. The consent of the relatives of the deceased for the removal of organs is required.

Organs and tissues for transplantation must be removed before early signs of biological death appear, that is, in the shortest possible time. Late declaration of death—about half an hour after death—makes organs and tissues unsuitable for transplantation.

The removed organs can be stored in a special solution for 12 to 48 hours.

In order to remove the organs of a deceased person, biological death must be established by a group of doctors with the drawing up of a protocol. The conditions and procedure for removing organs and tissues from a deceased person are regulated by the law of the Russian Federation.

The death of a person is a socially significant phenomenon, including a complex context of personal, religious and social relationships. However, dying is an integral part of the existence of any living organism.

Clinical death is a reversible process of dying, a kind of portal between life and death. The condition is characterized by the cessation of heart activity, breathing stops, and signs of vital activity of the body are completely absent. It is known that at this moment hypoxia (oxygen starvation) occurs in all organs and systems, but this does not lead to irreversible changes. The terminal state of a person in most cases can last no more than four minutes, but in history there have been cases of longer clinical death (up to 6 minutes), while the body temperature remains at the same level or decreases slightly.

Signs of clinical death

The main signs of clinical death are:

coma (a severe pathological condition characterized by loss of functions of the central nervous system and consciousness), diagnosed when dilated pupils appear that do not respond to light;
apnea (stopping breathing), which we mentioned in the example of snoring; diagnosed as the absence of movements of the respiratory cell, indicating the cessation of respiratory activity;
asystole (cardiac arrest with cessation of bioelectrical activity), diagnosed as the absence of pulse in the two main arteries.

The combination of these symptoms is characteristic only in the first stages of this condition, but is absent when biological death occurs. And the life of a person in a terminal condition depends entirely on the efficiency and effectiveness of resuscitation measures.

The duration of clinical death is influenced by the higher parts of the brain, or rather by their ability to maintain viability in conditions of critical condition (hypoxia). The duration of this state can be significantly increased by cooling the body or head (hypothermia), by drowning, or by exposure to electric current.

Despite the level of development of modern medicine, a clear list of uniform recommendations applicable to revive the body was developed and approved only in 2000 during the First World Scientific Conference on Cardiopulmonary Resuscitation, during which the following were divided into two stages:
1. Basic cardiopulmonary resuscitation - restoration of function and airway patency (can be performed by any person with first aid skills or a physician performing artificial ventilation of the lungs).
2. Specialized cardiopulmonary resuscitation - carrying out the same techniques for restoring airway patency, but carried out by specially trained medical personnel using appropriate equipment, medications, etc.

Myths and truth about clinical death

Today, anywhere you can hear revelations from people who have experienced such a condition as clinical death. At the same time, they all claim that they saw the afterlife, communicated with deceased relatives, famous people, heavenly angels or the Lord God himself. Almost all stories tell about the unusual lightness of the body, its flight, the light at the end of the tunnel, etc. Doctors tend to be very skeptical about such stories, because it has been scientifically proven that in a terminal state a person’s brain is completely turned off, which means he cannot see or feel anything at that moment. However, here those who prove that a person can exist outside his brain enter the arena, but no one has been able to confirm or refute this yet.

Skeptical scientists explain everything by hallucinations and brain hypoxia, which is not at all surprising, because the state of oxygen starvation of the brain is characterized by a different algorithm of its work - from top to bottom. Under the influence of depression of the cerebral cortex, the effect of “tunnel vision” may appear, which is unanimously stated by all patients who are on the verge of death. The function responsible for image recognition is completely turned off and instead of a point glowing in the distance, a person begins to see a bright light, calling these visions the glow of paradise, the approach of angels, moving to the afterlife, etc. In fact, the process of signal reverberation in the visual cortex enhances the effect of light approaching and spreading around. By the way, a completely blind person can also see these spots of light, the signal about which comes to his brain from the visual analyzer.

The phenomenon of such a phenomenon as the sensation of flight has also found its explanation in scientific circles and is due to ordinary ischemia. The lack of oxygen entering the body, in the form of a kind of signal, enters the vestibular analyzer, and from there to the brain, which gradually loses the function of adequate data perception.

The question of what clinical death is can be answered by both believers who sacredly revere the scriptures about the existence of an afterlife, and physicians who rely on bare facts and scientifically proven studies. How do you interpret this concept for yourself? Perhaps it is your point of view that will be of interest to users of our resource. Share your guesses on this subject so that everyone can find their own answer to this question.

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 the clinical stage of dying already looks without obvious signs of life and at first glance he cannot be helped, in fact, emergency resuscitation can sometimes 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 of 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, dying out, by inertia. If, with the help of resuscitation steps, the heart and breathing are started, a person can be brought back to life, 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 irreversible physiological changes inside cells, tissues and organs, is caused by a prolonged lack of 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 phase of clinical death, 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 the medical term “coma,” is 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 the light level, the skin has a pale, lifeless tint, the muscles throughout the body are relaxed, and 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 low temperature conditions this period increases to 8 minutes maximum.

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 the prolonged absence of biological processes within the body.

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

Early, initial signs characterizing biological death that overtakes 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 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 pressure on the sides of the 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 that 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 it will no longer be possible to return a person to a full life, although the remaining tissues are still viable.

The heart, as an organ, loses complete viability within an hour or two from the moment biological death is declared, internal organs - within 3 - 4 hours, skin and mucous membranes - within 5 - 6 hours, and bones - within 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, you need to empty the nasal and oral cavities of all 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 person's nostrils with their hand, with their own mouth, after a deep breath, tightly clasp 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.

The massage is done exclusively in a horizontal position of the body on a hard surface.
Arms are straight, without bending at the elbows.
The rescuer's shoulders are located 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.

The death of a person 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 accurate methods for diagnosing it and identifying the main signs indicating the onset of death of the human body.

In modern medicine, clinical and biological (final) death are distinguished. 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, modern medicine has established that after the cessation of blood circulation, the death of different organs in the human body does not occur simultaneously. 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 a serious condition that 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 - stopping breathing. It is manifested by a lack of movement of the chest, which indicates a cessation of respiratory activity.

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

What is sudden death

A separate 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 cases of heart failure that occur without any apparent reason, 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 reasons that can cause sudden death. These include electrical injuries, lightning, suffocation due to a foreign body entering 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 heart 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.), the belts are unfastened, restrictive clothing is removed and chest compressions begin.

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 beats the heart is filled 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?

Different human tissues and organs have different resistance to oxygen starvation, as mentioned above, and their death after the heart stops occurs in different time periods.

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

How does brain death manifest?

From the above, it is clear that accurately determining the signs of a person’s clinical death is 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 an irreversible stoppage 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 the 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 body is the last stage of dying, which is characterized by irreversible changes developing 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 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 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 of biological death. The latter appear:

redistribution of blood in the body of the deceased;
cadaverous spots of purple color, 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 the necessary assistance to the 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 where 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 the rapid development of pathological processes in 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 medical care provided within 30 minutes is ineffective.

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 of clinical death, its symptoms and the 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 of vital activity disappear, and 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 or general condition. If more than 6 minutes have passed, the person will be deprived of many vital functions due to the death of brain cells.

To recognize this condition in time, 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 is the absence of respiratory movements of the 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 remain viable for a 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, provided that the body temperature is normal, there is no oxygen supply to all parts of the brain. Exceeding this time range increases the risk of irreversible conditions:

decortication - destruction of the 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 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;
obstruction of the respiratory tract (lung disease, suffocation);
anaphylactic shock – respiratory arrest due to the body’s rapid reaction to an allergen;
large loss of blood due to 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 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. Until the doctors arrive, 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 move on 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 palm of one hand to press on the area of the lower third of the 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. 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 pinched, otherwise the lungs will not receive the required amount of oxygen. If the breath is taken quickly, air will enter the stomach, causing vomiting.

Resuscitation of the patient in the clinic

Resuscitation of a victim in a hospital setting is carried out according to a certain system. It consists of the 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 of 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 unit, where further treatment and monitoring of the condition is carried out. Resuscitation is stopped in the following cases:

Ineffective resuscitation measures within 30 minutes.
Statement of the state of biological death of a 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 of “cat's 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 death, 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 - 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).