Signs of clinical and biological death of a person. Early signs of biological death

biological death

biological death(or true death) is an irreversible cessation of physiological processes in cells and tissues. See death. Irreversible termination is usually understood as “irreversible within the framework of modern medical technologies” termination of processes. Over time, the possibilities of medicine for the resuscitation of deceased patients change, as a result of which the border of death is pushed into the future. From the point of view of scientists - supporters of cryonics and nanomedicine, most people dying now can be revived in the future if their brain structure is preserved now.

Early signs of biological death include:

Lack of eye response to irritation (pressure)
Clouding of the cornea, the formation of drying triangles (Larcher spots).
The appearance of the symptom of "cat's eye": with lateral compression of the eyeball, the pupil transforms into a vertical spindle-shaped slit, similar to a cat's pupil.

In the future, cadaveric spots are found with localization in sloping places of the body, then rigor mortis occurs, then cadaveric relaxation, cadaveric decomposition. Rigor mortis and cadaveric decomposition usually begin with the muscles of the face and upper limbs. The time of appearance and duration of these signs depend on the initial background, temperature and humidity of the environment, the reasons for the development of irreversible changes in the body.

The biological death of the subject does not mean the simultaneous biological death of the tissues and organs that make up his body. The time to death of the tissues that make up the human body is mainly determined by their ability to survive under conditions of hypoxia and anoxia. In different tissues and organs, this ability is different. The shortest lifetime under anoxic conditions is observed in brain tissue, more precisely, in the cerebral cortex and subcortical structures. The stem sections and the spinal cord have greater resistance, or rather resistance to anoxia. Other tissues of the human body have this property to a more pronounced degree. Thus, the heart retains its viability for 1.5-2 hours after the onset of biological death. Kidneys, liver and some other organs remain viable for up to 3-4 hours. Muscle tissue, skin and some other tissues may well be viable up to 5-6 hours after the onset of biological death. Bone tissue, being the most inert tissue of the human body, retains its vitality for up to several days. The phenomenon of survival of organs and tissues of the human body is associated with the possibility of their transplantation, and the earlier after the onset of biological death organs are removed for transplantation, the more viable they are, the greater the likelihood of their successful further functioning in another organism.

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A living organism does not die simultaneously with the cessation of breathing and the cessation of cardiac activity, therefore, even after they stop, the organism continues to live for some time. This time is determined by the ability of the brain to survive without oxygen supply to it, it lasts 4-6 minutes, on average - 5 minutes. This period, when all the extinct vital processes of the body are still reversible, is called clinical death. Clinical death can be caused by heavy bleeding, electrical injury, drowning, reflex cardiac arrest, acute poisoning, etc.

Signs of clinical death:

1) lack of pulse on the carotid or femoral artery; 2) lack of breathing; 3) loss of consciousness; 4) wide pupils and their lack of reaction to light.

Therefore, first of all, it is necessary to determine the presence of blood circulation and respiration in a sick or injured person.

Definition of signs of clinical death:

1. The absence of a pulse on the carotid artery is the main sign of circulatory arrest;

2. Lack of breathing can be checked by visible movements of the chest during inhalation and exhalation or by putting your ear to your chest, hear the sound of breathing, feel (the movement of air during exhalation is felt on your cheek), and also by bringing a mirror, glass or watch glass to your lips, as well as cotton wool or thread, holding them with tweezers. But it is precisely on the definition of this feature that one should not waste time, since the methods are not perfect and unreliable, and most importantly, they require a lot of precious time for their definition;

3. Signs of loss of consciousness are the lack of reaction to what is happening, to sound and pain stimuli;

4. The upper eyelid of the victim rises and the size of the pupil is determined visually, the eyelid drops and immediately rises again. If the pupil remains wide and does not narrow after repeated eyelid lift, then it can be considered that there is no reaction to light.

If out of the 4 signs of clinical death one of the first two is determined, then resuscitation should be started immediately. Since only timely resuscitation (within 3-4 minutes after cardiac arrest) can bring the victim back to life. Do not do resuscitation only in case of biological (irreversible) death, when irreversible changes occur in the tissues of the brain and many organs.

Signs of biological death:

1) drying of the cornea; 2) the phenomenon of "cat's pupil"; 3) decrease in temperature; 4) body cadaveric spots; 5) rigor mortis

Determination of signs of biological death:

1. Signs of drying of the cornea is the loss of the iris of its original color, the eye is covered with a whitish film - “herring shine”, and the pupil becomes cloudy.

2. The eyeball is squeezed with the thumb and forefinger, if the person is dead, then his pupil will change shape and turn into a narrow slit - the “cat pupil”. It is impossible for a living person to do this. If these 2 signs appear, then this means that the person died at least an hour ago.

3. Body temperature drops gradually, by about 1 degree Celsius every hour after death. Therefore, according to these signs, death can be certified only after 2-4 hours and later.

4. Cadaverous spots of purple color appear on the underlying parts of the corpse. If he lies on his back, then they are determined on the head behind the ears, on the back of the shoulders and hips, on the back and buttocks.

5. Rigor mortis - post-mortem contraction of skeletal muscles "from top to bottom", i.e. face - neck - upper limbs - torso - lower limbs.

Full development of signs occurs within a day after death.

Body and signs of biological death

However, the biological death of a particular person does not lead to the simultaneous biological death of all organs and tissues of the body. The lifetime of body tissues depends on their ability to survive hypoxia and anoxia, and this time and ability are different for different tissues. Worst of all tolerate anoxia brain tissue, which die first. The spinal cord and stem sections resist longer, they have a greater resistance to anoxia. The remaining tissues of the human body can resist deadly influences even more strongly. In particular, it persists for another one and a half to two hours after fixing biological death.

A number of organs, for example, the kidneys and liver, can “live” up to four hours, and the skin, muscle tissue and part of the tissues are quite viable up to five to six hours after biological death is declared. The most inert tissue is that which is viable for several more days. This property of organs and tissues of the body is used in organon transplantation. The sooner after the onset of biological death, organs are removed for transplantation, the more viable they are and the higher the probability of their successful engraftment in another organism.

clinical death

Biological death follows clinical death and there is the so-called "brain or social death", a similar diagnosis arose in medicine due to the successful development of resuscitation. In some cases, cases were recorded when, during resuscitation, it was possible to restore the function of the cardiovascular system in people who were in a state of clinical death for more than six minutes, but by this time irreversible changes in the brain had already occurred in these patients. Their breathing was supported by mechanical ventilation, but the death of the brain meant the death of the individual and the person turned into only a "cardiopulmonary" biological mechanism.

Man, like every living organism on Earth, begins his journey from birth and inevitably ends with his death. This is a normal biological process. This is the law of nature. It is possible to prolong life, but it is impossible to make it eternal. People dream, create a lot of theories, offer different ideas about eternal life. Unfortunately, so far they are unjustified. And it is especially insulting when life ends not because of old age, but because of illness (see) or an accident. Clinical and biological death: what do they look like? And why doesn't life always win?

The concept of clinical and biological death

When all the vital functions of the body cease to function, death occurs. But a person, as a rule, does not die immediately. He goes through several stages before completely saying goodbye to life. The process of dying itself consists of 2 phases - clinical and biological death (see).

Signs of clinical and biological death give us the opportunity to consider how the death of a person occurs and, possibly, save him. Knowing the features and first symptoms of clinical death, as well as early signs of biological death, it is possible to accurately determine the condition of a person and begin resuscitation.

Clinical death is considered a process that is reversible. This is an intermediate moment between a living organism and a dead one. It is characterized by cessation of breathing and cardiac arrest and ends with physiological processes in the cerebral cortex, which are considered irreversible. The maximum duration of this period is 4-6 minutes. At low ambient temperatures, the time for reversible changes is doubled.

Important! Finding that there is no pulse on the carotid artery, immediately proceed to resuscitation without wasting a minute. You need to remember how it is done. Sometimes situations arise when someone's life is in your hands.

Biological death is an irreversible process. Without access to oxygen and nutrients, the cells of various organs die, and it is not possible to revive the body. He will no longer be able to function, it is no longer possible to revive a person. This is the difference between clinical death and biological death. They are separated by a period of only 5 minutes.

Signs of clinical and biological death

When clinical death occurs, all manifestations of life are absent:

no pulse;
no breathing;
"out of work" of the central nervous system;
muscle tone is absent;
skin color changes (pallor).

But imperceptibly for us, metabolic processes are still going on at a very low level, tissues are viable and can still fully recover. The time interval is determined by the work of the cerebral cortex. As soon as the nerve cells die, there is no way to completely restore a person.

Not all organs die immediately, some retain the ability to live for some time. After a few hours, you can revive the heart, the respiratory center. For several hours, the blood retains its properties.

Biological death happens:

physiological or natural, which occurs during the aging of the body;
pathological or premature, associated with a serious illness or injury incompatible with life.

In both cases, it is impossible to bring a person back to life. Signs of biological death in humans are expressed as follows:

cessation of the heart rhythm up to 30 minutes;
lack of breathing;
pupil dilation that does not respond to light;
the appearance of dark blue spots on the surface of the skin.

An early symptom of biological death is the “cat pupil symptom.” When pressing from the side of the eyeball, the pupil becomes narrow and oblong, like a cat.

Since organs do not die immediately, they are used in transplantation for organ transplantation. Patients whose kidneys, heart, and other organs fail are waiting for their donor. In European countries, people draw up documents allowing the use of their organs in the event of their death as a result of an accident.

How can you be sure a person is dead?

The diagnosis of clinical and biological death is important, it is carried out by doctors. But everyone should know how to define it. The irreversible death of a person can be established by signs:

"Symptom of the cat's pupil."
The cornea of the eye dries up and becomes cloudy.
The formation of cadaveric spots due to a decrease in vascular tone. Usually they occur after a few hours, when a person died.
Decrease in body temperature.
Rigor mortis also sets in after a few hours. Muscles become rigid, and the body becomes inactive.

A reliable sign of biological death, doctors diagnose by the data of medical equipment, which determines that electrical signals are no longer coming from the cerebral cortex.

How can a person be saved?

Clinical death differs from biological death in that a person can still be saved. An accurate signal of clinical death is considered if the pulse on the carotid artery is not heard and there is no breathing (see). Then resuscitation actions are carried out: indirect heart massage, the introduction of adrenaline. In medical institutions with modern equipment, such measures are more effective.

If a person has minimal signs of life, proceed to immediate revival. If there are doubts about ascertaining biological death, resuscitation measures are taken to prevent the death of a person.

It is also worth paying attention to the harbingers of clinical death:

lowering blood pressure to critical numbers (below 60 mm Hg);
bradycardia (heart rate below 40 beats per minute);
increased heart rate and extrasystoles.

Important! It should take no more than 10 seconds for a caregiver to establish a diagnosis of clinical death! Resuscitation measures taken no later than two minutes after the appearance of the first signs of clinical death are successful in 92% of cases.

Will the person be saved or not? At some stage, the body loses strength and stops fighting for life. Then the heart stops, breathing stops and death occurs.

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

In order to recognize this condition in time, 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 is the absence of respiratory movements of the chest, but the metabolism remains at the same level.
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 for a 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, under the condition of normal body temperature, 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 - 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 of the respiratory tract (lung disease, suffocation);
anaphylactic shock - respiratory arrest with a rapid reaction of the body to an allergen;
a large loss of blood during 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 activity;
violent death.

The main stages and methods of first aid

Before taking measures to provide first aid, 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 of emergency care. 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 proceed 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 put pressure on the area of \u200b\u200bthe lower third of the 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 the necessary 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 the victim in a hospital 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 with the introduction of Hecodese through a central venous catheter.
Correction of acid-base balance intravenously (Sorbilact, Xylate).
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 monitoring of the condition is carried out. Resuscitation stops in the following cases:

Ineffective resuscitation 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. 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 of "cat's 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 can be accompanied by various violations. They can affect both physical development and psychological state. The damage caused to health depends on the time of oxygen starvation of important organs. In other words, the sooner a person 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 to the brain indicates 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 of the psychological state, certain changes are also observed. They are called transcendental experiences. Many people claim that being in a state of reversible death, they hovered in the air, saw a bright light, a tunnel. Some accurately list the actions of doctors during resuscitation procedures. After this, a person’s life values change dramatically, because he escaped death and got a second chance at life.