Update: October 2018
Cardiac arrest is the equivalent of clinical death. Once
the heart stops performing its pumping functions and pumping blood, in
changes begin in the body, called tanatogenesis or
the birth of death. Fortunately, clinical death is reversible, and in
a number of situations of sudden cessation of breathing and their heart can
Actually a sudden cardiac arrest is precisely the cessation.
its effective work. Since the myocardium is a commonwealth of
muscle fibers, which are obliged to contract rhythmically and synchronously,
then their chaotic abbreviation, which will even register on
cardiogram may also refer to cardiac arrest.
Causes of heart failure
- The cause of 90% of all clinical deaths is ventricular fibrillation.
At the same time, the very chaos of contractions of individual myofibrils will be
take place, but the pumping of blood will stop and the tissues will begin
to experience oxygen starvation.
- Reason 5% of cardiac arrest – complete cessation
contractions of the heart or asystole.
- Electromechanical dissociation – when the heart does not contract,
but its electrical activity persists.
- Paroxysmal ventricular tachycardia, in which an attack
heartbeats with a frequency of more than 180 per minute accompanied by
lack of pulse on large vessels.
The following can lead to all the listed conditions.
changes and diseases:
- IHD (ischemic heart disease) – angina pectoris, arrhythmias, acute
myocardial oxygen deprivation (ischemia) or its necrosis, for example,
with myocardial infarction
- inflammation of the heart muscle (myocarditis)
- valvular disease
- pulmonary embolism
- cardiac tamponade, for example, blood pressure when injured
- dissecting aortic aneurysm
- acute coronary artery thrombosis
- drug overdose
- chemical poisoning (intoxication)
- overdose of drugs, alcohol
- airway obstruction (foreign body in bronchi, mouth,
in the trachea) acute respiratory failure
- Accidents – electric shock
(use of weapons for self-defense – stun guns),
gunshot wounds, falling, blows
- shock condition – painful shock, allergic, with
- acute oxygen starvation of the whole body by suffocation or
- dehydration, circulating blood volume drop
- spasmodic rise in blood calcium levels
Predisposing factors in cardiac abnormalities
- genetic predisposition
- age over 50 for men and over 60 for women
- heart overload (stress, intense exercise,
Heart Cause Drugs
A number of medications can trigger heart failure.
catastrophe and cause clinical death. As a rule, these are cases.
drug interactions or overdose:
- Remedies for anesthesia
- Antiarrhythmic drugs
- Psychotropic drugs
- Combinations: calcium antagonists and third antiarrhythmic
class, calcium antagonists and beta blockers cannot be combined
some antihistamines and antifungals, etc.
The cause of drugs is death in about 2% of all cases,
therefore, it is absolutely impossible to take any drugs without
indications. Any product should be taken only as directed.
doctors in the indicated dosages, and also to inform the attending physician about
those drugs that you take about the treatment of another
diseases (prescribed by another doctor), because it is a combination
and overdosing can lead to serious consequences (see also
causes of pain in the heart area).
Signs of heart failure
The appearance of the patient, as a rule, leaves no doubt that
that something is wrong here. As a rule, the following are noted
manifestations of cardiac arrest:
- Lack of consciousness that develops after 10-20 seconds from
the beginning of an acute situation. In the first seconds a person can still
make simple movements. After 20-30 seconds, additional
- Pallor and cyanosis of the skin, first of all the lips,
tip of the nose, earlobes.
- Rare breathing, which stops after 2 minutes from
- Lack of pulse on large vessels of the neck and wrists.
- No palpitations in the area below the left nipple.
- Pupils dilate and stop responding to light – after 2
minutes after stopping.
Thus, after a cardiac arrest comes clinical
death. Without resuscitation it will grow into irreversible
hypoxic changes in organs and tissues called
- The brain after heart failure lives 6-10 minutes.
- As casuistry, cases of preservation of the cerebral cortex are described.
after a 20 minute clinical death when falling into a very cold
- From the seventh minute, brain cells begin progressively.
And although resuscitation it is necessary to spend at least 20
minutes, the victim and his rescuers have only
5-6 minutes guaranteeing the subsequent full life
пострадавшего от cardiac arrest.
First aid for cardiac arrest
Given the high risk of death from sudden fibrillation
ventricles, civilized countries equip public spaces
defibrillators, which can use almost any
citizen. The device has detailed instructions or voice
support in several languages. Russia and CIS countries like
excesses are not spoiled, therefore in case of a sudden cardiac
death (suspicion of her) will have to act independently.
More and more legislation restricts even a doctor undergoing
past the fallen on the street, in the possibilities of the primary
cardiopulmonary resuscitation. After all, now the doctor can do
his work only in the hours allotted to him in his territory
medical institution or jurisdiction and only
according to its specialization.
That is, an obstetrician-gynecologist resuscitating a person with
sudden cardiac arrest, can get quite beyond merit.
Fortunately, similar punishments do not apply to nonmedic ones, therefore
mutual aid is still the main chance for salvation
That in a critical situation not to look indifferent or
illiterate, it is worth remembering the simple algorithm of actions that
can save a fallen or lying on the street life and save it
To make it easier to remember the order of actions, let’s call them by the first
буквам и цифрам: ОП 112 СОДА.
- О – оцениваем опасность
Going to the bedside is not too close, ask loudly, hear
whether he us. People in alcoholic or drug intoxication, as
usually something moo. If possible, we pull off the body with
roadway / passage part, remove from the affected electrical wire
(if an electric shock has occurred), release
- П – проверяем реакцию
From a standing position, preparing for the occasion of which to jump off and quickly
run away, pinching the earlobe and waiting for a response.
If there were no groans or curses, and the body is breathless,
go to paragraph 112.
- 112 — звонок по телефону
This is a general emergency telephone number
mobile in the Russian Federation, the countries of the CIS and many European states. So
as time cannot be lost, someone else will take care of the phone,
choose who in the crowd should be you, referring to the person
personally so that he had no doubts in the assigned case.
- С — сердца массаж
Putting the victim on a flat hard surface, you need
start an indirect heart massage. Immediately forget everything you saw on
this topic in movies. Squeezing away from the sternum on bent arms, heart
impossible to start. Hands should be straight all the time.
resuscitation. A straight line will be laid across the lower third of the sternum.
palm weaker hand. Perpendicularly installed on top of it
palm stronger. This is followed by five non-child oppressors.
movements all weight on outstretched arms. Chest at the same time
should shift no less than five centimeters. Work
will have, like in the gym, not paying attention to the crunch and
gnashing hands (ribs then heal, and pleura sutured). Behind
a minute should be made 100 pushes.
- О – обеспечить проходимость дыхательных
For this, the head of a person is careful not to damage the neck,
throw a few, wrapped with any handkerchief or napkin
use your fingers to quickly pull out dentures and foreign objects from
mouth, pushing the lower jaw forward. The point is basically possible
miss, The main thing is not to stop pumping the heart. Therefore, on this
item can put someone second.
- Д – искусственное дыхание
At thirty strokes of the sternum, there are 2 breaths from mouth to mouth,
pre-covered with gauze or scarf. These two breaths should not
take more than 2 seconds, especially if resuscitation is performed by one
- А – это адьес
Upon arrival at the ambulance or rescue services need
prudently and in time to leave home, if only
The victim is not your close friend or relative. This is insurance from
unnecessary complexity of personal life.
First Aid Child
A child is not a small adult. This is completely original.
organism, approaches to which differ. Especially relevant
cardiopulmonary resuscitation remains for children of the first three years
of life. You should not panic and act.
as quickly as possible (after all, only five minutes left).
- The child is placed on the table, dressed or stripped,
free the mouth from foreign objects or impurities.
- Behindтем подушечками второго и третьего пальцев руки,
located on the lower third of the sternum, press down with a frequency of 120
jolts in a minute.
- The shocks should be neat but intense (sternum at
this is shifted to the depth of the finger).
- After 15 compressions, take two breaths in the mouth and nose, covered
- In parallel with the resuscitation, an ambulance is called.
First aid for cardiac arrest
Medical care depends on the reason why developed
heart failure. The most commonly used defibrillator.
The efficiency of manipulation decreases every minute by about 7%,
therefore, the defibrillator is relevant for the first fifteen
minutes from disaster.
For ambulance teams, the following algorithms have been developed for
sudden cardiac arrest.
- If clinical death occurred in the presence of a brigade,
applied precardiac punch. If after it was restored
cardiac activity, then a saline solution is administered intravenously,
an ECG is taken, if the heart rhythm is normal, an artificial
ventilation of the lungs and take the patient to the hospital.
- If there is no heartbeat after the precordial beat,
восстанавливают проходимость дыхательных ways, используя
air duct, tracheal intubation, Ambu bag or mechanical ventilation. Behindтем
consistently carry out an indoor heart massage and defibrillation
ventricles, after restoring the patient’s rhythm is delivered to
- With ventricular tachycardia or ventricular fibrillation
I use the defibrillator discharges 200, 300 and 360 J sequentially
or 120, 150 and 200 J biphasic defibrillator.
- If the rhythm is not restored, amiodarone, procainamide is used.
intravenously with a discharge of 360 J after each injection of drugs.
At achievement of success the patient is hospitalized.
- In the case of asystole, confirmed on an ECG, the patient is transferred
Atropine and epinephrine are injected on the ventilator. Re-record the ECG. Further
looking for a cause that can be eliminated (hypoglycemia, acidosis) and
work with her. If fibrillation becomes the result, go
to the algorithm of its elimination. With the stabilization of the rhythm – hospitalization.
With continued asystole – a statement of death.
- With electromechanical dissociation – tracheal intubation.
Venous access, search for a possible cause and its elimination.
Epinephrine, atropine. With asystole as a result of events
to act on the asystole algorithm. If the result was
фибрилляция, перейти to the algorithm of its elimination.
Soим образом, если произошла внезапная остановка сердца, первый
and the main criterion to take into account is time.
From the rapid onset of care, the survival rate of the patient and
качество его дальнейшей of life.