Cardiac arrest for 1 minute. Causes and signs of sudden cardiac arrest

You've probably seen this more than once in movies or TV shows - the dramatic moment when the doctor announces that cardiac arrest has occurred. What does this mean in reality? Cardiologists share information about what happens at such a moment. It is extremely important for every person to know this data - you cannot predict when you will encounter danger.

What is sudden cardiac arrest?

As the name of this situation implies, this is a sudden cessation of heart function. It can occur without any warning symptoms. Exist different reasons for a similar situation - arrhythmia, genetic predisposition and others. Sometimes this leads to sudden death, but this does not always happen.

It's not a heart attack

It is worth understanding the difference between a heart attack and cardiac arrest. A heart attack may precede or follow cardiac arrest, but each situation affects your body differently. A heart attack is caused by problems with circulation, causing blood flow to the heart to be blocked but the heart to continue contracting. When the heart stops, the problem is electrical in nature and is associated with impaired contractions. This is the main difference between the two situations.

This indicates a disturbance in the functioning of the heart.

The sinus of the heart is located in the upper right part of the heart and is a specialized group of cells that generate electrical impulses in the heart. These cells work as a natural cardiac monitor. When the cells don't do their job, you experience arrhythmia. This leads to disruption of blood circulation in the body and deterioration of heart function.

Your heart is shrinking

The most common and potentially dangerous symptom is ventricular arrhythmia - the heart begins to beat quickly and chaotically, compressing too much, which leads to cessation of circulation.

The heart may beat faster or slower

Abnormal rhythms that lead to cessation of blood circulation include ventricular tachycardia, which is accompanied by a significant acceleration heart rate in the lower chambers of the heart, which is very inconsistent with the rate of contractions in the upper chambers. Brachycardia is a heart rate that drops below sixty beats per minute.

You may not feel anything

Sometimes the heart stops pumping blood, but there are no symptoms. Some people report feeling dizzy, tired, cool, or weak right before they lose consciousness. People around you may notice convulsions or rolling eyes. The heart pumps blood to all parts of the body, including the brain. When the brain does not receive the necessary blood, a person simply loses consciousness. The first cells to die when the heart stops are the brain cells.

Cardiac arrest is not a death sentence

If others react quickly, cardiac arrest may not be fatal. Try to check your pulse immediately. If there is no pulse, begin chest compressions and immediately call ambulance. With the help of massage, you can stimulate blood circulation in the body and this will provide a person with maximum chance for survival. Every person should know the rules of first aid in order to be able to respond correctly in a critical situation. Ninety percent of people who experience cardiac arrest outside of hospital die, but proper first aid can triple a person's chance of survival. Cardiac arrest can also occur in patients in hospital, in which case the chances of survival are much higher.

You will need a defibrillator

Defibrillators are now becoming more common, they are in schools, airports, hotels, restaurants, gyms. This helps save lives. The defibrillator allows you to instantly analyze the heart rhythm to determine whether the process that has begun in the heart is reversible. Defibrillation should be started as soon as possible. Once the abnormal heart rhythm has been addressed, it will be necessary further treatment. If it doesn't work, the person will need to spend some time in hospital in intensive care.

A clear diagnosis is required

When the electrocardiogram does not detect electrical activity in the brain, this indicates a risk of cardiac arrest. This is a type of arrhythmia that can lead to cardiac arrest directly or indirectly. Cardiovascular diseases can cause an attack that leads to arrhythmia.

Conclusion

The likelihood of survival depends on the cause of cardiac arrest and how promptly treatment is given. Thousands of people die from cardiac arrest every year. You should know basic first aid and act as quickly as possible to give the person a chance to overcome cardiac arrest. However, it is worth understanding that many people do not even realize that they are at risk.

What is sudden cardiac arrest and why does it happen? What help can each of us provide to a person whose heart has suddenly stopped? The editors of Vesti.Medicine talked about this with cardioblogger Alexey Utin.

Alexey Utin

What is sudden cardiac arrest? How often does it happen?

Sudden cardiac arrest (SCA) is the sudden and complete cessation of effective cardiac activity with or without bio electrical activity. According to the World Health Organization, 7 million people die from SCA every year around the world, in Russia – about 300 thousand people. One of the main factors of cardiac arrest is ventricular fibrillation - a dangerous chaotic contraction of myocardial fibers and the absence of coordinated contraction of the ventricles. In this condition, the heart stops performing its pumping functions and the blood supply to the entire body, including the brain, is cut off. If a person in such a situation is not helped within 7-10 minutes, the person will die. It is important to note that restore correct work In most cases, the heart can be treated with a defibrillator discharge. Cardiopulmonary resuscitation and chest compressions are done in order to maintain blood circulation in the main organs and wait for the arrival of the ambulance, which has this device at its disposal.

Are there any statistics: who develops this condition more often - gender, age, concomitant diseases, other factors?

When looking at statistics on cases of sudden cardiac arrest, there are usually two risk groups: people under 35 years of age, and people over 35 years of age. In the first group, the main factors are congenital pathologies hearts ( hypertrophic cardiomyopathy, Burgad's syndrome, long QT syndrome, etc.). They can be diagnosed by doing ECG studies, Echocardiography of the heart. Important role a hereditary factor plays a role: for example, if one of the parents or close relatives experienced sudden cardiac arrest.

After 35 years, these are the same factors that provoke myocardial infarction - smoking, high pressure, high cholesterol and blood sugar, overweight and a sedentary lifestyle, as well as male gender, strokes, heart attacks and sudden death in relatives under 60 years of age. In more than half of cases, SCA has no symptoms or warning signs, and it develops truly suddenly. This is why it is so important to undergo regular medical examinations to identify risk factors.

What do Russians even know about first aid? Do they know how to provide it? How are things going in other countries?

Unfortunately, Russians are not very knowledgeable about first aid skills. This is partly due to the lack of qualified personnel who could clearly and professionally teach citizens first aid skills according to protocols that are updated every 5 years. In theory, these skills should be taught in driving courses, but this is not observed everywhere. Of course, some people take various courses, but, in my opinion, such important skills should be taught at school during life safety lessons. And of course, the high mortality rate from SCA is also influenced by the absence of , since without these devices we lose precious minutes waiting for an ambulance. And our skills cardiopulmonary resuscitation(CPR) may not be sufficient to maintain adequate blood flow to the brain and heart.

What should you do if there is a sudden cardiac arrest and there is no defibrillator? How should you proceed?

In this case, you must immediately call an ambulance and begin cardiopulmonary resuscitation according to the first aid protocol for SCA. First of all, you need to determine whether the victim is conscious. To do this, you need to pat him or shake him by the shoulder and call out loudly. Next, check his breathing, pulse, and conduct an external examination. After this, it is necessary to put the person on his back, check the oral cavity: in the victim’s mouth during resuscitation measures there should be no foreign objects.

Before performing CPR, mentally set yourself three main tasks:

open Airways;
restore breathing;
restore blood circulation.

Opening the airways

Place the victim on his back on a hard surface.
Kneel at the side of the victim's neck and shoulders.
Open the victim's airway using the head-tilt-chin-lift technique. Place your palm on the victim's forehead and gently tilt his head back. Then use your other hand to gently pull his chin forward to open his airway.
Within 5-10 seconds, try to make sure there is normal breathing: Look closely to see if the chest is moving, try to catch the sound of breathing or feel the breath with your cheek or ear. Individual noisy sighs cannot be considered normal breathing. If there is no normal breathing, and you have CPR skills, start performing artificial respiration"mouth to mouth". If you think the victim has lost consciousness due to heart attack, and you do not have first aid skills, do not perform mouth-to-mouth artificial respiration, but immediately proceed to applying pressure on chest to restore blood circulation.

Restoring breathing

Artificial respiration can be performed in two versions: “mouth to mouth” or “mouth to nose” (in cases where the mouth is seriously injured or cannot be opened).

Having opened the airways using the “head tilt and chin lift” technique, pinch the victim’s nostrils (while breathing “mouth to mouth”) and tightly wrap your lips around the victim’s mouth, ensuring a tight seal.
Prepare to take two breaths from mouth to mouth. Make the first exhalation into the victim's mouth (lasting one second). Observe whether the victim's chest rises. When you notice the movement of your chest, exhale a second time. If there is no movement of the chest, repeat the “head tilt with chin lift” technique, then exhale a second time.
Start pressing on the chest to restore blood circulation.

Restoration of blood circulation

Place the palm of one hand with the base on the middle of the victim's chest. Place your second palm on top of the first. Straighten your elbows, with your shoulders directly above your palms.
Using the weight of your upper body (not just the strength of your arms), begin applying pressure to the chest (compression) from top to bottom (compression depth is about 5 cm). Compressions should be strong and fast, the frequency of compressions should be two per second (about 120 compressions per minute).
After doing 30 compressions, tilt the victim's head back and pull the chin forward, opening the airway. Prepare to take two breaths from mouth to mouth. Pinch the victim's nose tightly and exhale into the mouth for one second. When you notice the movement of your chest, exhale a second time. If there is no movement of the chest, repeat the “head tilt with chin lift” technique, then exhale a second time. These actions constitute one cycle of CPR.
Continue CPR until signs of movement appear or until emergency personnel arrive.

Why is the law regarding the placement of defibrillators in public places important? Is there at least one possible drawback?

Typically, there is no more than 10 minutes to save a person, and with every minute of inaction, a person’s chance of survival decreases by 7–10%. Installation of automated external defibrillators (AEDs) in in public places- this necessity, which is dictated modern conditions and the pace of life in major cities, including heavy traffic and large crowds. An AED allows you to help a victim of SCA even if the person does not have first aid skills. Modern devices, such as the Philips HeartStart FRx defibrillator, provide clear voice instructions and guide you through every step, from applying shock pads to administering CPR. Reporting necessary actions, the defibrillator pre-assesses the patient’s condition and even reminds them to call an ambulance. Taking into account the principles of operation of the AED, its use is absolutely safe, since the device is able to independently determine that defibrillation is not required, and in this case, even pressing the “discharge” button will not activate the device, and therefore will not harm the victim.

Alexey Utin, an active promoter of healthy lifestyle, became one of the speakers at the large-scale educational program Alfa Future People-2018 festival and held a master class on first aid “Technology that will save lives” there with the support of Philips.

Health

Many people believe that cardiac arrest occurs suddenly, but researchers say warning signs are often present.

That's why it's helpful to be aware of the symptoms and risk factors that many people ignore.

Cardiac arrest is not a heart attack

First of all, it is worth mentioning that a heart attack is a problem of circulation, and cardiac arrest is associated with the cessation of bioelectrical activity.

A heart attack occurs when blood flow to part of the heart is obstructed, such as by a blocked artery. Cardiac arrest is a problem with the electrical activity of the heart. The subtle, complex rhythms of your heartbeat become irregular and the heart cannot pump blood properly.

When the heart stops, a person suffocates or stops breathing and in the absence of necessary measures dies within a few minutes. A heart attack can cause cardiac arrest, but this is a separate disorder.

In most cases, according to experts, a heart attack does not lead to sudden cardiac arrest. But if sudden cardiac arrest occurs, the cause is often a heart attack.

Until some time, doctors believed that cardiac arrest always occurred unexpectedly, but some studies show the opposite. In more than half of cases, people experience symptoms a month before cardiac arrest, but are unaware that it is dangerous and ignore them.

Additionally, nearly a third of deaths from cardiac arrest can be prevented if the person experiencing the symptoms knows them and seeks help.

Sudden cardiac arrest

1. Chest pain

A classic warning sign is discomfort or tightness, as if an elephant had stepped on your chest.

Chest pain occurs when there is not enough oxygen circulating in the blood to reach the heart muscle. The pain may radiate to left hand and increases with physical activity.

It lasts more than a few minutes or subsides and returns after a few hours or even the next day.

2. Referred pain

You may also experience pain in less predictable parts of your body. This includes the stomach, shoulder, back, neck, throat, teeth and jaw. Referred pain is more common in women than in men.

3. Difficulty breathing

If you usually calmly walk up the stairs and suddenly find yourself short of breath after a few steps, this is a dangerous sign.

People who experience these symptoms are at greater risk of dying from heart disease than patients who do not. similar symptoms. This risk is even higher than in people with chest pain.

4. Excessive sweating

If you sweat more than usual, especially if you don't exert much effort, it could be a sign of heart problems.

The heart has a much harder time pumping blood if the arteries are blocked, and our body responds by sweating more.

Middle-aged women may confuse this symptom with hot flashes, but it is best to double-check.

5. Flu-like symptoms

Fatigue, nausea, vomiting, weakness, stomach pain and dizziness can also be signs of heart problems, especially in women. In a study of 5,000 women who had experienced heart problems, 71 percent experienced extreme fatigue within a month and during the attack.

And although heart disease is one of the leading causes of death in women, many still believe that heart problems are male disease and ignore symptoms, especially if they do not include chest pain.

6. Feeling of doom

People experiencing symptoms of cardiac arrest often begin to deny them.

A situation often arises when a person experiencing chest discomfort insists that everything is fine or considers the problem to be trivial.

At the same time, he is scared and feels that something bad might happen. If you feel something like this, it is better to check and not wait for something irreparable to happen.

When to worry

It can be quite difficult to distinguish a relatively minor problem, such as heartburn, from a serious problem (chest pain). Thus, with heartburn, pain often occurs in the esophagus, which feels very similar to a heart attack.

The nerve coming from the heart and the esophagus sends a signal to the same part of the brain, and the brain may not be able to tell them apart. If you feel chest pain or another symptom, you should not tempt fate, but rather consult a doctor.

Causes of sudden cardiac arrest

Risk factors

By knowing the risk factors, a person can also prevent serious problems. Among them we can note:

Age (the older you are, the higher the risk)

Cases of coronary heart disease in the family

Hypertension

High level cholesterol

Obesity
Passive lifestyle

Usage narcotic substances such as cocaine and amphetamine

Imbalance nutrients, such as low potassium or magnesium levels

Obstructive sleep apnea

Chronic illness kidney

Other heart conditions can also disrupt the heart rhythm and lead to sudden cardiac arrest. Among them:

Cardiomyopathy

Cardiac ischemia

Heart failure

Congenital heart defect

Arrhythmia, namely fibrillation of the ventricles of the heart

Long QT syndrome

Question about ibuprofen

There is also scientific evidence, including a study published in European Journal of Cardiovascular Pharmacotherapy that frequent use ibuprofen in high doses may also increase the risk of cardiac arrest.

Of course, the risk is not as high as with other factors. But if you take ibuprofen more than twice a month, you may need to talk to your doctor about switching to a different drug.

Calcium level

There is also evidence that people with low level blood calcium levels were more likely to cause cardiac arrest than those with high levels.

Experts say further research is needed to confirm or determine whether people with low calcium levels can eat more products containing calcium.

Check how your heart works

Hundreds of people die every day due to cardiac arrest. Death occurs due to cardiac pathologies or due to normal physiological reasons, such as old age or violent processes - accident, drowning. Is it possible to prevent a person's death in case of cardiac arrest? And if so, how can this be done? Let's take a closer look at the reasons that cause cardiac arrest and how can a human life be saved with such a diagnosis?

What reasons can lead to cardiac arrest?

In medicine, cardiac arrest is the complete cessation of the functioning of the heart, which occurs due to various internal or external factors. Initially, after cardiac arrest, a person experiences clinical death, which is a reversible process. If first aid is not provided to a person within 7–10 minutes, then biological death, which is an irreversible process.

Cardiac arrest due to cardiac pathology

If a person’s death is caused by cardiac failures or cardiac pathologies, then it has medical term– asystole or sudden cardiac death. This condition can cause:

Ventricular fibrillation (flutter) is a chaotic contraction of the muscle fibers of the heart, which leads to hemodynamic disturbances. In this condition, the heart produces more than 300 contractions in one minute. Blood flow circulatory system stops and clinical death occurs. Mortality with this diagnosis is more than 80% of cases.
Asystole is the absence of bioelectric impulses of heart activity. In this condition, the myocardium is in a complete “non-working” state. About 10% of people with heart pathologies die in such cases.
Electromechanical dissociation is a process in which electrical impulses are sent by the pacemaker, but mechanical contractions of the heart muscles do not occur.
Paroxysmal tachycardia is an increase in the rhythm of contractions, over 140 beats, which replaces sinus rhythm. Ventricular form paroxysmal tachycardia can cause a threat to life, since there is a risk of transition from rapid rhythm to ventricular fibrillation (flutter) and, as a result, clinical death.
Bradycardia is quite rare, but this disease, characterized by a slow heart rate, can cause complete cardiac arrest.

Cardiac massage during cardiac arrest

Cardiac arrest due to non-cardiac disease

As is known, not only cardiac diseases provoke high mortality. There are a number of non-cardiac conditions that can cause cardiac arrest.

Stroke is a disruption of blood flow in the brain. This category includes diseases such as:

subarachnoid hemorrhage;
cerebral infarction;
cerebral hemorrhage.

Liver failure can cause a lack of oxygen and an attack of suffocation can stop the heart.
Diabetes mellitus, which can cause coma and death.
Pulmonary edema, causing cessation of breathing and initially clinical, then biological death.
Oncological diseases at the terminal stage.
Anaphylactic or hemorrhagic shock.
Thromboembolism pulmonary artery when a detached blood clot blocks the lumen of the pulmonary artery.
Overdose medicines These are mainly drugs intended to treat the cardiovascular system.

Cardiac arrest due to accident

Asphyxia caused by a foreign object entering the respiratory tract or drowning.
Injuries incompatible with life resulting from an accident or electric shock.
Hypothermia, when a person’s body temperature is less than 28 degrees.
Bad habits such as smoking and drinking alcohol, which can cause poisoning and death.
Excessive exercise stress(overwork) can lead to cerebral hemorrhages or thromboembolism.
Stress. This condition provokes the development of heart pathologies and the possibility of a stroke.

Diagnosis of emergency conditions in cardiac arrest. What symptoms are present?

Cardiac arrest does not choose a time or place; it can occur at any time when a person is eating, sleeping, walking or driving. Symptoms of clinical death are:

Fainting or loss of consciousness. Due to a lack of oxygen to the brain, a person falls down without moving or reacting to external stimuli. In this case, it is necessary to pat the person on the cheeks or pour cold water to bring you to your senses. If this does not happen, then it is quite possible that the person’s hemodynamics are impaired.
Absence of a pulse, which is checked in the main arteries located in the person’s neck.
No breathing. This symptom is diagnosed using a mirror or glass. It is brought to the victim’s mouth or nose. If it does not fog up, it means there is no breathing. You can also check for breathing by placing your ear to the victim’s chest.
There is no reaction of the pupils to light. Only after you are sure that the person does not have the symptoms described above should you check the reaction of the pupils. This is done as follows:

at closed eyes spread the eyelids and monitor the reaction of the pupil;
at open eyes they bring the palm of their hand to them and abruptly remove it after 30 seconds, while monitoring the behavior of the pupils;
in the dark, any light source is used for checking.

In cases where the pupil does not show any reaction, one should speak of the absence of life in the human body.

In addition to the main symptoms of cardiac arrest, the following may be present:

visual pallor;
involuntary urination or defecation;
drop in body temperature.

How to save a person when diagnosing an emergency condition?

The initial actions to resuscitate a person in cardiac arrest should be aimed at restoring breathing to enrich the brain with oxygen and “restart” the heart. First aid should be provided immediately, since only the first seven minutes of restoration of vital functions will not cause serious consequences to the body. If a person is brought back to life after this time, then irreversible processes occur in the body, which subsequently manifest themselves in the form of mental or neurological disorders. In other words, delayed help will lead to incapacity and disability for the victim.

If you find yourself in a situation where it is necessary to provide immediate medical assistance, then first call a carriage emergency care. After you diagnose cardiac arrest in a victim (how to do this is described above), the following measures must be taken:

Lay the victim on a hard surface, on his back. Usually a person faints on the floor, so it is enough to give him correct position and throw back your head. You need to place a cushion under your head; it can be a bag, a folded jacket, or any other object that can serve as an impromptu cushion. Be sure to keep your airways clear. If there is a foreign body, blood or vomit in them, then it is necessary to release the oropharynx with a finger wrapped in a cloth, handkerchief or napkin.
Artificial respiration is performed mouth to mouth; if it is impossible to carry out such actions, ventilation of the lungs can be done using the mouth-to-nose principle. To do this, the victim's nose is pinched and air is inhaled into the mouth. For your own safety (to avoid direct contact with the victim’s saliva), you must use a handkerchief during artificial ventilation of the lungs.
Before starting indirect (closed) cardiac massage, it is necessary to perform a pericardial beat. It is applied with a fist in the area of the middle of the chest. It is believed that such a blow is effective in the first 30-60 seconds after complete cardiac arrest. If more time has passed, then it is necessary to alternate the following actions:

2 blows for ventilation;
15 chest compressions, which are performed with two palms located one on top of the other. Such pressures are performed two fingers above the third sternum. The easiest way to perform such actions is to kneel in front of the victim.

Continue alternating these actions until the person has a pulse and breathing.

If two people are resuscitating, then one does chest compressions, the other artificial ventilation lungs. In this situation, alternate between 1 blow and 5 presses.

Every 2–3 minutes, you need to check what’s wrong with the victim (pulse, breathing, reaction to light). As soon as the pulse and breathing are restored, you can stop resuscitation actions and wait for an ambulance. If recovery does not occur, continue ventilation and indirect massage until the ambulance arrives. After the doctors arrive, they will continue working to save the person’s life.

Prognosis and further life after cardiac arrest

No matter how sad it may sound, the survival rate after clinical death is only 30% (statistics). Of these, only 10% survive this phenomenon without irreversible processes and completely restore all body functions. Timely provision of first aid significantly increases a person’s chances of survival and life without deterioration in its quality.

After the restoration of vital functions, the person is placed in intensive care for complete normalization of the condition. Afterwards, a full examination is carried out to determine the presence of the reasons that provoked the arrest, usually this is done in the cardiology department of the hospital. The patient is diagnosed and the optimal treatment is prescribed.

Sudden cardiac arrest is a condition in which the heart muscle suddenly stops contracting, causing circulatory problems and preventing blood from flowing to the brain and other organs. This condition usually leads to death if the patient is not helped within a few minutes after the incident.

We will talk about what causes cardiac arrest, what are the reasons for the cessation of its activity, as well as how to provide first aid to a person in order to prevent his final death.

Causes of sudden cardiac arrest

Acute cessation of blood circulation, leading to a state of clinical death and threatening a person’s life, is caused not only by mechanical complete cardiac arrest - its causes may also lie in cases of a type of cardiac activity that cannot provide a minimum level of blood circulation.

This condition develops with various dangerous heart rhythm disturbances: ventricular fibrillation (fluttering), atrioventricular conduction disturbance (blockade that prevents the conduction of electrical impulses from the atria to the ventricles), paroxysmal ventricular tachycardia, etc.

Circulatory arrest caused by cardiogenic causes

From a medical point of view, the reasons that caused cardiac and circulatory arrest are divided into 2 groups - having a cardiogenic and non-cardiogenic nature.

The first include conditions that lead to a weakening of the pumping function of the heart and to disorder coronary circulation. Most common cause this becomes a myocardial infarction.

By the way, almost every fifth patient with this diagnosis dies within 6 hours from the onset of the attack. And most often this happens in the morning (before 7 am).

Cardiac arrest can be caused by: coronary disease, angina pectoris, arrhythmia (heart rhythm disturbance), damage to its valves, inflammatory processes in the lining of the heart (myocarditis or endocarditis), as well as changes in the shape of the heart and myocardial function (cardiomyopathy). No less dangerous in this sense can be cardiac tamponade (a disease in which the heart, simply put, “chokes” on its own blood), as well as aortic aneurysm, leading to its rupture, or pulmonary embolism.

Non-cardiogenic causes of cardiac arrest

If we mean non-cardiogenic cardiac arrest, the reasons for this may lie in dysfunction of other systems, which are manifested, for example, by the development of any type of acute respiratory failure or a disorder in the central regulation of blood circulation.

This condition can also be caused by situations with airway obstruction (ingestion of foreign body into the trachea, bronchi or even just into the mouth), a state of shock of any origin ( allergic reaction, pain, bleeding), overdose medicines, alcohol or drugs, severe intoxication chemicals, injuries, wounds, defeats electric shock, drowning.

Signs of cardiac arrest

Despite the many reasons that lead to cessation of blood circulation, it Clinical signs are the same in all patients.

Sudden cardiac arrest is characterized by the following external signs:

loss of consciousness;
absence of heart sounds and pulse in the carotid and femoral arteries;
stopping breathing or its appearance in an agonal manner;
dilated pupils;
cyanotic or gray skin tone.

By the way, it should be noted that cardiac arrest can be confirmed based on the first three of the listed signs.

At this time, it is especially important to do everything as quickly as possible. In order not to delay in determining the presence of a pulse, you should place your index finger and middle fingers on the area of the victim’s larynx, and then, without pressing too much, palpate side surfaces neck.

If there is no pulse, do not waste time listening to heart sounds or measuring arterial pressure- the absence of a pulse indicates an undoubted cessation of heartbeat.

What are other signs of cardiac arrest?

Dilated pupils, as well as changed skin color, cannot always serve as an absolute guide to confirm cardiac arrest.

Firstly, dilated pupils are, as a rule, a sign of oxygen starvation in the cerebral cortex, which manifests itself in quite late date- from 30 to 60 s after cardiac arrest.

Secondly, some medications can also affect the size of the pupil (for example, atropine, which dilates the pupils or narcotic drugs, which narrow them).

Skin color also depends on the level of hemoglobin in the blood (with severe blood loss there may not be cyanosis), as well as whether there is a certain chemical effect on the victim (during poisoning carbon monoxide or cyanide preserves the pink tint of the skin).

Cardiac arrest: first aid

When providing assistance to victims of cardiac arrest, you need to remember that in most cases with sudden death, almost healthy people, the experience of complete cessation of the blood circulation process lasts an average of 5 minutes, after which irreversible changes appear in the central nervous system. If the stop was preceded by serious illness heart, lungs or progressive hypoxia, the named time decreases sharply.

Based on this, assistance in case of cardiac arrest should begin immediately, since it is important not only to restore the patient’s blood circulation and breathing, but also to return him to life as a full-fledged person.

How to diagnose cardiac arrest

So, in order not to cause damage to the victim, cardiac arrest must be diagnosed within the first 15 seconds!

To do this you need to look for the pulse on carotid artery, listen to breathing (it stops in the first minute of sudden death). Lift the victim’s eyelids and if you find that the pupils are dilated and do not react to light in any way, then respiratory and cardiac arrest can be considered confirmed.

Remember that resuscitation actions in the form of cardiac massage, as well as artificial respiration, cannot be carried out if the victim has open injury on the chest or broken ribs. In this case, internal bleeding can be provoked.

Where to start resuscitation measures in case of cardiac arrest

Immediately after clinical death is declared, resuscitation measures must begin - restoring breathing, blood circulation and consciousness in the victim.

First aid for cardiac arrest begins as soon as clinical death has been established. Before you start indirect massage heart, so-called mechanical defibrillation is performed. To do this, you need to hit the victim's middle part of the sternum with your fist. But under no circumstances hit the heart area!

The proposed fist blow is needed to “shake” the heart; by the way, this is sometimes enough for the patient to come to his senses. But most often, this procedure increases the effectiveness of subsequent resuscitation measures.

First aid for cardiac arrest: artificial respiration

When doing everything necessary, you should remember that the described assistance in case of cardiac arrest is effective under conditions of sudden death, but if a person is sick for a long time, exhausted, or fading, then resuscitation actions, as a rule, have no prospects.

First of all, patency in the airways should be restored. To do this, the patient is placed on a hard, flat surface (a soft surface will greatly reduce the effect of the actions being performed) and, placing folded clothes under his shoulders, throw his head back. Then they open the victim’s mouth, pushing the lower jaw forward.

After removing vomit, blood or dentures (if any) from the mouth using gauze or a handkerchief, remove the patient’s tongue so that it does not block the respiratory tract. And then they do artificial respiration.

To do this, take a strong breath and, holding the victim’s nose, blow air into his mouth. If possible, this can be done using a special mask.

How blood circulation is restored

First health care in case of cardiac arrest, it requires closed massage to restore blood circulation.

The hands of a rescuer who became left side from the patient, should be placed with the base of the palm on the sternum (as the hard bone of the chest is called), one on top of the other. The rescuer, making rhythmic forward movements with them (one press every 2 seconds), accelerates blood from the heart muscle into the blood vessels.

By the way, when providing assistance in case of cardiac arrest, remember that too vigorous pressure can cause rib fractures, which, in turn, will lead to a puncture of the heart cavity or lung.

In the case when one person acts as a rescuer, after every two breaths he must press the victim’s chest 15 times. If two rescuers are doing this, then after each inhalation, with the help of one of them, the second presses on the chest five times.

Some more information

It is very important to remember that it is necessary to record the time of resuscitation measures. If there is only one rescuer, then after performing two cycles of cardiac massage, he should call an ambulance and then continue his actions.

Do not forget to check the patient’s pulse on the carotid artery and the condition of his pupils every 3 minutes during cardiac massage.

If you find that the pulse has returned but there is still no breathing, you need to continue artificial ventilation. As soon as breathing is restored, all other functions will resume on their own, since the brain, which has received oxygen, will immediately give the command to restore blood circulation.

If neither pulse nor breathing is restored, continue resuscitation until the ambulance arrives.