What does clinical death mean? What is clinical death? The main processes occurring in a state of clinical death

From the stories of people who have their own experience of near-death experience, one can learn that they felt the separation of their inner essence from your body. Being in such a state, outside the body, they managed to see themselves as if from the outside. At the same time, one felt an amazing lightness and hovering over an insensible body, which, apparently, the soul left for that short period of time.

After the transferred state, clinical death, people usually begin to think about what awaits them after leaving this world and have they managed to do everything in this life? A more significant question returns: what is the purpose of a person who gets the opportunity to be in this world?

People experience

Many of those who have been in a state between life and death, after returning to this world, gain faith in the Almighty. Daily fuss fades into the background, and service to the creator takes on a dominant role and comes to the fore. Great truths become comprehensible even to those who, before this event, considered themselves a convinced atheist.
Miracles occur not only in the rethinking of one's role in this world, but also in a series of events that become understandable without outside explanation. The interpretation of the surrounding world turns into a different perception. What was rejected due to prejudices and misinterpretations acquires the true essence, given at the discretion of the creator, and not the human representation of the material world, as if given to all of us in sensations.

The experience of events taking place in the life of an ordinary mortal and one who has undergone a test of transition to another reality undergoes a cardinal qualitative reassessment. The gift of insight can even be called the state into which a person passes, having acquired a number of hitherto unattainable extrasensory abilities. Sensitivity, in many ways, in such a person, is transformed into a combination with other equally important universal human values.

Despite the fact that after what happened, the return from the world of ghosts, a person in his behavior becomes somewhat strange for others, this does not prevent him from learning the truth. Everyone who has experienced clinical death is transformed spiritually. Having experienced a difficult bodily and qualitative spiritual test, someone perceives this event as almost God's providence, while for someone it seems to be a normal phenomenon. When a person is so entangled in his delusions that there is only one way out. But, the Almighty does not take the soul, but returns it to rethink its role in the world where a person needs to fulfill the prescribed role. A person begins to realize more and look at the same things and events from a completely different angle of view.

white light or hell

Is it only the “light at the end of the tunnel” that people who experience clinical death see, or are there those who watched hell?

People who have ever been in the next world have their own story about it. The most interesting thing is that all their stories coincided, regardless of the intellectual development and religious beliefs of each of these people. Unfortunately, there are times when there, in the other world, a person finds himself in a place that researchers have called hell since ancient times.

What is hell? We can get information about this phenomenon from a source called "The Acts of Thomas." In this book, the sinner shares with us her impressions of this place, where she once had to visit. Suddenly, she found herself on the ground, the surface of which was dotted with depressions exuding poison. But the woman was not alone, next to her was a terrible creature. In each of the depressions, she managed to see a flame that strongly resembled a hurricane. Inside it, uttering soul-chilling cries, many souls were spinning, which could not get out of this hurricane. There were the souls of those people who, during their lifetime, entered into a secret relationship with each other. In the other hollow, in the mud, were those who parted from their husbands and wives for the sake of others. And finally, in the third place, there were souls whose body parts were suspended. The creature accompanying the woman said that the severity of the punishment directly depends on the sin. People who, during earthly life, lied and insulted others, were hung up by the tongue. Those who stole and did not help anyone, but preferred only to live only for their own good, were hung by the hands. Well, those who dishonestly tried to achieve their goal were hung up by their legs.

After the woman saw all this, she was led to a cave, the smell of which was saturated with stench. There were people who tried to get out of this place and breathe in the air, but all their attempts were unsuccessful. The creatures guarding the cave wanted the woman to fulfill this punishment, however, her guide did not allow this, saying that the sinner was in hell temporarily. After the woman returned to reality, she made a promise to herself to radically change her life so that she would never go to hell again.

When we come across such stories, we immediately get the feeling that this is just fiction. After all, this does not happen! But besides the story of this woman, there are many others in the world that make us think that there is a place in the world that is the embodiment of evil itself, and where people are subjected to terrible torture. For a long time, a scientist named Moritz S. Roolings did not believe in these stories and considered them absurd. However, one day in his practice an event happened that radically changed his whole life. After this incident, the doctor began to study people who had ever experienced clinical death.

One day, a patient with a heart condition who was under his care suddenly collapsed.

At that very moment it became known that the heart of this man stopped. The doctor and his medical team did their best to bring the man back to life. As soon as the doctor finished doing the massage chest The patient's heart stopped immediately. His face was distorted by a grimace of pain, fear, despair and horror, and his body was convulsing. He shouted that he could not be in this place and that he urgently needed to be returned from there back. Not knowing what to do, he began to pray to God. To alleviate the suffering of the man and somehow help him, Moritz also began to read a prayer. After some time, the situation improved.

After that, Rawlings tried to talk to this man about what had happened to him, but the patient could not remember anything. It was as if someone had deliberately removed all the memories from his head. The only thing he remembered was his mother. Subsequently, it became known that she died when her son was just a baby. And despite the fact that the man had never seen his mother alive in his life, he recognized her in one of the photos left after her death. Having experienced clinical death, the man decided to reconsider his views on life and began to attend church regularly.

During the entire period of work of Roolings, other similar cases happened in his life. He treated one girl who decided to commit suicide because of poor grades in school. Doctors tried to rehabilitate her with everything possible ways. Only for a moment, the girl came to her senses and begged to save her. In her unconsciousness, she screamed something about the demons that won't let her escape. As in the previous case, after that the girl did not remember anything. But what happened to her left a deep imprint on her life, and subsequently she connected her life with religious activities.

Often people who have visited the other world talk about meetings with the dead and how they visited the unknown world. But almost no one ever talks about their death as the most terrible and sophisticated torture. Researchers believe that it is possible that people who have experienced clinical death remember everything that happened to them during the “journey to hell”, but these memories are stored in the depths of the subconscious, which they are not even aware of.

Ability after clinical death

Abilities after clinical death can manifest themselves in different options. And one of them is usually called the “sixth sense” or intuition, which unmistakably and very quickly helps to find the right solution in the most difficult situation. What is noteworthy is that the individual does not make any conscious reasoning, does not include logic, but listens only to his feelings.

Many people who have experienced clinical death, in their words, have anomalous abilities:

a person can completely stop sleeping and feel normal, while the body stops aging;
super intuition, and even psychic abilities may appear;
not hefty physical abilities may appear;
in some cases, a person can return with knowledge of all the languages of the planet, including those that have long since "sunk into oblivion";
sometimes a person can acquire deep knowledge about the universe;
but it can also cause serious consequences for human health.

In addition, people after clinical death, in most cases, change a lot: they often become detached, their attitude towards their loved ones changes. Often they have to get used to the familiar area, home and relatives again.

The abilities of the notorious Wolf Messing were discovered after he survived clinical death. At the age of eleven, he collapsed on the street into a hungry faint. In the hospital, they did not find any signs of life in him, they sent him to the morgue. There, the trainee noticed that the body of the boy, in some ways, differs from ordinary corpses and saved him. After that, Wolf Messing woke up with a strong intuition and other abilities.

Intuition is one of the types of thought process, experts say, in which everything happens unconsciously and only the result of this process is realized. But there is another hypothesis that when using intuition, a person draws information directly from the "general information field".

This is a real lifesaver, both personally and professionally. People with increased intuition are less likely to suffer from various neuroses and, as a result, are less susceptible to diseases of the circulatory and nervous system. Not to mention the low injury rate. Since it allows you to instantly determine the sincerity of the interlocutor, his inner feelings, other "sharp corners" and dangerous life situations including clinical death.

It is obvious that not all people have a strong intuition, there are data according to which their number is no more than 3%. It is believed that intuition is well developed among creative people, but sometimes it can wake up at some turning points in life, for example, the birth of a child or the state of being in love. But this can happen not only after positive events, but often after various traumas, stressful situations, such as clinical death.
What is it connected with? As you know, our brain is divided into 2 hemispheres. The right side of the body obeys the left hemisphere, and the left side - the right hemisphere (for left-handers - vice versa). Left hemisphere is responsible for logic and analysis, and the right one is responsible for emotions and affects the depth of perception of music, graphic images. As someone noticed that right hemisphere is an artist, and the left is a scientist. In ordinary everyday life, people use the left hemisphere more, but when an injury occurs, a serious illness or some other shock, the logic can turn off and the right hemisphere becomes the main one.

A reasonable question arises, what is the reason for such a “delimitation of rights”, and not vice versa? Obviously, one of the factors is definitely that our education is maximally focused on the development of the left hemisphere. Artistic and musical disciplines are far from the most important place among other subjects, the study of which takes the "lion's share" of school hours. Remember that we are used to performing all the basic actions right hand, and, of course, this contributes to a better development of the left (logical) hemisphere. Perhaps if the educational system were aimed at developing the right (creative) hemisphere, then many historical decisions would be made with less negative consequences for people's lives.

Consequences of clinical death

We are aware of numerous cases of postponed clinical death by people from all over the world. From the stories of these people it becomes known that they happened to experience extraordinary states of "leaving" and subsequent "return". Some of the survivors of clinical death are not able to remember anything on their own at all, and it is possible to revive their memories only by immersion in a trance. In any case, death leaves an indelible imprint on the consciousness of every individual.

From the memoirs of people who survived clinical death, it is possible to draw very interesting information. Most often, people behave closed, having experienced such a difficult test in their lives. At the same time, someone falls into a prolonged depression, and someone even behaves aggressively when they try to ask him about the details of what he experienced. In a certain sense, each person experiences obvious discomfort, plunging into memories of what happened.

The girl I met suffered clinical death twice. What could immediately be ascertained from her mental state was a clear loss of cheerfulness, rigidity and coldness in communication with others could be traced. We were just separated by a certain black void, but this did not reflect her character. She simply represented, after the transferred, only some kind of bodily shell, tangible by sight.

The most striking thing lies in the fact that similar sensations from communicating with those who have undergone clinical death have a difficult and very strange, incomprehensible nature. The respondents themselves, who “have been to the other world,” are reluctant to talk about the fact that the experience they had had forever changed their attitude to the perception of life. And the change is likely to be for the worse.

One girl said that she remembers everything that happened and in almost all the smallest details, but what really happened, she still cannot fully realize. Only she admits that, something "broke" inside. Being in post-traumatic depression for eight years, she has to hide this condition from others. Left alone, she is overcome by such a depressing state that even thoughts of suicide visit.

The memory of the state in which she had to visit pulls to such an extent that she is overcome by regret that she was brought back to life. But, the realization comes that life goes on and tomorrow you go back to work, having slapped yourself in the face and driving away extraneous thoughts, you have to live with it ...

Trying to find compassion among her friends, she tried to share her impressions and experiences, but nothing happened, the people around did not understand or did not even try to understand ...

She tried to write about her experiences, but the verses she read shocked her parents, because they found only suicidal impulses in these creative impulses. The search in life for something pleasant and capable of keeping in this world turned out to be so small that she is overcome with regret for the mistake that the doctors made, bringing her back to life, contrary to her will and desires.

People who have undergone clinical death are truly transformed, and, after suffering, they relate to everything around them in a completely different way. People close to them become distant and alien. At home, you have to adapt again to the hitherto native and familiar environment. In the frank confessions of a girl who suffered a clinical death, the "matrix" was mentioned. In her view, the impression remained that “there” is not this, the former familiar reality. Only you and no sensations and thoughts, and you can easily choose and give preference to arbitrary reality.

It's as good as home, but here it turns out something, not at all that you want to return back, they just “hailed” here and how they forcibly returned it. A fivefold return, by the grace of the doctors and their efforts, when the first death was an artifact sufficient to overcome the “point of no return”. However, returning to a different world than the one that she left, that's what the reality of the former world turned into, which had to be mastered anew, as if reborn.

Someone returning to a completely different reality does not break to such an extent that there are forces left to fight to adapt to an alien world. As psychiatrist Vinogradov noted, many who have returned from non-existence begin to look at their essence in this world from the position of an outside observer, and continue to live like robots or zombies. They try to copy their behavior from others, because it is customary, but they do not experience those feelings either from laughter or from crying, both from those around them, and from their own, squeezed out through force or simulated emotions. Compassion completely leaves them.

Not necessarily such critical transformations occur with those who have returned from clinical death, as R. Moody said in his own publication “Life after Life”. People re-evaluate their views on the world around them, strive to comprehend deeper truths and focus more on the spiritual perception of the world.

One thing can be said for sure that clinical death, as a transition to another reality, divides life into periods: “before” and “after”. It is very difficult, if possible, to assess this unambiguously, as a positive or negative impact that a person is exposed to after returning and what effect such an event has on the psyche. It requires comprehension and detailed study of what is happening to a person and what, as yet unexplored opportunities open up to him in comprehension. And yet, they say more about the fact that a person who has undergone brief near-death adventures returns in spiritual renewal and insight, with such consequences of clinical death that are not clear to others. This state for everyone who has not experienced this is a paranormal phenomenon and pure fantasy without any fiction.

- This is a reversible stage of dying, occurring at the moment of cessation of cardiac and respiratory activity. It is characterized by a lack of consciousness, a pulse on the central arteries and excursions of the chest, dilated pupils. Diagnosed according to the data obtained during the examination, palpation carotid artery listening to heart sounds and lung murmurs. An objective sign of cardiac arrest is small-wave atrial fibrillation or isoline on the ECG. Specific treatment - measures of primary cardiopulmonary resuscitation, transfer of the patient to mechanical ventilation, hospitalization in the ICU.

ICD-10

R96 I46

General information

Clinical death (CS) is the initial stage of the death of the body, lasting for 5-6 minutes. During this period, metabolic processes in tissues slow down sharply, but do not stop completely due to anaerobic glycolysis. Then irreversible changes occur in the cerebral cortex and internal organs, making it impossible to revive the victim. The duration of the condition depends on a number of factors. At low ambient temperatures, it increases, at high temperatures, it decreases. How the patient died also matters. Sudden death against the background of relative stability lengthens the reversible period, slow depletion of the body in incurable diseases reduces it.

The reasons

The factors that cause CS include all diseases and injuries that lead to the death of the patient. This list does not include accidents in which the body of the victim receives significant damage incompatible with life (crushing of the head, burning in a fire, decapitation, etc.). It is generally accepted to divide the causes into two large groups - associated and not associated with direct damage to the heart muscle:

Cardiac. Primary disorders of myocardial contractility caused by acute coronary pathology or exposure to cardiotoxic substances. They provoke mechanical damage to the cardiac muscle layers, tamponade, disturbances in the conduction system and the sinoatrial node. Circulatory arrest can occur against the background of acute myocardial infarction, electrolyte imbalance, arrhythmias, endocarditis, aortic aneurysm rupture, coronary disease.
non-cardiac. This group includes conditions accompanied by the development of severe hypoxia: drowning, suffocation, obstruction respiratory tract and acute respiratory failure, shocks of any origin, embolisms, reflex reactions, electric shocks, poisoning with cardiotoxic poisons and endotoxins. Fibrillation followed by cardiac arrest may occur with improper administration of cardiac glycosides, potassium preparations, antiarrhythmics, barbiturates. A high risk is noted in patients with organophosphate poisoning.

Pathogenesis

After stopping breathing and blood circulation, destructive processes begin to develop rapidly in the body. All tissues experience oxygen starvation, which leads to their destruction. The most sensitive to hypoxia are the cells of the cerebral cortex, which die after several tens of seconds from the moment the blood flow stops. In the case of decortication and brain death, even successful resuscitation does not lead to full recovery. The body continues to live, but there is no brain activity.

When the blood flow stops, the blood coagulation system is activated, microthrombi are formed in the vessels. Toxic decay products of tissues are released into the blood, metabolic acidosis develops. The pH of the internal environment drops to 7 and below. Prolonged lack of blood circulation causes irreversible changes and biological death. Successful resuscitation ends with the restoration of cardiac activity, a metabolic storm, and the occurrence of post-resuscitation disease. The latter is formed due to ischemia, thrombosis of the capillary network internal organs, significant homeostatic shifts.

Symptoms of clinical death

It is characterized by three main features: the absence of effective heart contractions, breathing and consciousness. An undoubted symptom is all three signs that are present in the patient at the same time. CS against the background of preserved consciousness or heartbeat is not diagnosed. Spontaneous residual breathing (gasping) can persist for up to 30 seconds after blood flow stops. In the first minutes, individual ineffective contractions of the myocardium are possible, which lead to the appearance of weak pulse shocks. Their frequency usually does not exceed 2-5 times per minute.

Secondary features include the absence muscle tone, reflexes, movements, unnatural position of the victim's body. The skin is pale, earthy. Arterial pressure not defined. After 90 seconds, pupil dilation occurs to a diameter of more than 5 mm without reaction to light. Facial features are pointed (Hippocratic mask). Such a clinical picture does not have a special diagnostic value in the presence of the main signs, therefore, the examination is carried out in the process of resuscitation, and not before they begin.

Complications

The main complication is the transition of clinical death to biological. This finally occurs 10-12 minutes after cardiac arrest. If it was possible to restore blood circulation and respiration, but clinical death before the start of treatment lasted more than 5-7 minutes, brain death or partial impairment of its functions is possible. The latter manifests itself in the form of neurological disorders, posthypoxic encephalopathy. AT early period the patient develops post-resuscitation disease, which can lead to multiple organ failure, endotoxicosis and secondary asystole. The risk of complications increases in proportion to the time spent in conditions of circulatory arrest.

Diagnostics

Clinical death is easily determined by external symptoms. If the pathology develops in conditions medical institution, apply additional hardware and laboratory methods. This is necessary to determine the effectiveness of ongoing resuscitation measures, to assess the severity of hypoxia and disorders acid-base balance. All diagnostic manipulations are carried out in parallel with the restoration work. heart rate. To confirm the diagnosis and monitor the effectiveness of the measures taken, the following types of studies are used:

physical. are the main method. On examination, they find characteristics KS. During auscultation, coronary tones are not auscultated, there are no respiratory sounds in the lungs. The presence of a pulse outside the ICU is determined by pressing on the projection area of the carotid artery. Probing shocks on peripheral vessels has no diagnostic value, since with agonal and shock states they can disappear long before the cessation of cardiac activity. The presence or absence of breathing is assessed visually, by the movements of the chest. The test with a mirror or a suspended thread is not advisable, as it requires additional time. BP is not determined. Tonometry outside the ICU is carried out only in the presence of two or more resuscitators.
Instrumental. Basic way instrumental diagnostics- electrocardiography. It should be taken into account that the isoline corresponding to complete cardiac arrest is not always recorded. In many cases, individual fibers continue to contract randomly without providing blood flow. On the ECG, such phenomena are expressed in fine waviness (amplitude less than 0.25 mV). There are no clear ventricular complexes on the film.
Laboratory. Appointed only with successful resuscitation. The main studies are acid-base balance, electrolyte balance, biochemical indicators. Metabolic acidosis, increased content of sodium, potassium, proteins and tissue breakdown products are found in the blood. The concentration of platelets and coagulation factors is reduced, there are phenomena of hypocoagulation.

Urgent care

The restoration of the vital functions of the patient is carried out with the help of basic and specialized resuscitation measures. They should be started as early as possible, ideally within 15 seconds of circulatory arrest. This helps to prevent decortication and neurological pathology, to reduce the severity of post-resuscitation disease. Measures that did not lead to the restoration of the rhythm within 40 minutes from the last electrical activity are considered unsuccessful. Resuscitation is not indicated for patients who die due to a documented, long-term incurable disease (oncology). The list of measures aimed at resuming heart contractions and breathing includes:

Base complex. Usually implemented outside the hospital. The victim is laid on a hard, flat surface, his head is thrown back, a roller made from improvised material (bag, jacket) is placed under his shoulders. lower jaw push forward, with fingers wrapped in cloth, clear the airways of mucus, vomit, remove existing foreign bodies, false teeth. An indirect heart massage is performed in combination with mouth-to-mouth artificial respiration. The ratio of compressions and breaths should be 15:2, respectively, regardless of the number of rescuers. Massage speed - 100-120 strokes / minute. After restoring the pulse, the patient is laid on his side, his condition is monitored until the arrival of doctors. Clinical death may recur.
Specialized complex. It is carried out in the conditions of the ICU or the SMP machine. To ensure lung excursion, the patient is intubated and connected to the ventilator. An alternative option is to use an Ambu bag. A laryngeal or face mask for non-invasive ventilation may be used. If the cause is an unrepairable airway obstruction, a conicotomy or tracheostomy with a hollow tube is indicated. Indirect massage is performed manually or with a cardio pump. The latter facilitates the work of specialists and makes the event more efficient. In the presence of fibrillation, the rhythm is restored using a defibrillator (electropulse therapy). Discharges with a power of 150, 200, 360 J. are used on bipolar devices.
Medical allowance. During resuscitation, the patient is given intravenous administration adrenaline, mezaton, atropine, calcium chloride. To maintain blood pressure after the rhythm is restored, pressor amines are administered through a syringe pump. To correct metabolic acidosis, sodium bicarbonate is used as an infusion. An increase in BCC is achieved through colloidal solutions - rheopolyglucin, etc. Correction of the electrolyte balance is implemented taking into account the information obtained during laboratory research. Can be assigned saline solutions: acesol, trisol, disol, saline sodium chloride solution. Immediately after the restoration of the work of the heart, antiarrhythmic drugs, antioxidants, antihypoxants, agents that improve microcirculation are indicated.

Measures are considered effective, during which the patient's sinus rhythm was restored, systolic blood pressure was set at 70 mm Hg. Art. or higher, heart rate is kept within 60-110 beats. Clinical picture indicates the resumption of blood supply to tissues. There is a narrowing of the pupils, the restoration of their reaction to a light stimulus. Skin color returns to normal. Spontaneous breathing or an immediate return of consciousness immediately after resuscitation is rare.

Forecast and prevention

Clinical death has a poor prognosis. Even with a short period of absent blood circulation, the risk of damage to the central nervous system is high. The severity of the consequences increases in proportion to the time elapsed from the moment the pathology developed to the start of the work of resuscitators. If this period was more than 5 minutes, the possibility of decortication and posthypoxic encephalopathy increases many times over. With asystole for more than 10-15 minutes, the chances of resuming myocardial work are sharply reduced. The cerebral cortex is guaranteed to be damaged.

Among the specific preventive measures hospitalization and constant monitoring of patients with a high risk of cardiac death. At the same time, therapy is carried out aimed at restoring normal functioning. of cardio-vascular system. Specialists working in healthcare facilities must carefully observe the dosages and rules for the administration of cardiotoxic drugs. A non-specific preventive measure is the observance of safety precautions in all areas of life, which reduces the risk of drowning, trauma, asphyxia resulting from an accident.

The death of a person is a complete cessation of biological and physiological processes in his body. The fear of making a mistake in its recognition forced doctors and researchers to develop accurate methods for diagnosing it and identify the main signs that indicate the onset of the death of the human body.

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

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

What is clinical death of a person

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

Further in the article, the comparative signs of biological and clinical death will be considered in more detail. By the way, the state of a person between these two types of death of the body is called terminal. And clinical death may well pass into the next, irreversible stage - the biological one, the indisputable sign of which is the rigor of the body and the subsequent appearance of cadaveric spots on it.

What are the signs of clinical death: preagonal phase

Clinical death may not occur immediately, but go through several phases, characterized as pre-agonal and agonal.

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

The pre-agonal signs of clinical death listed above contribute to the appearance of oxygen starvation in the tissues and the development of the so-called tissue acidosis (due to a decrease in pH). By the way, in the preagonal state, the main type of metabolism is oxidative.

Manifestation of agony

The beginning of the agony is marked by a short series of breaths, and sometimes by a single breath. Due to the fact that a dying person simultaneously excites the muscles that carry out both inhalation and exhalation, ventilation of the lungs almost completely stops. The higher parts of the central nervous system are turned off, and the role of the regulator of vital functions, as proven by researchers, at this moment passes to the spinal cord and medulla oblongata. This regulation is aimed at mobilizing the last possibilities of preserving the life of the human body.

By the way, it is during the agony that the human body loses those very notorious 60-80 g of weight, which are attributed to the soul leaving it. True, scientists prove that in fact, weight loss occurs due to the complete combustion in the cells of ATP (enzymes that supply energy to the cells of a living organism).

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

How does the state of clinical death manifest itself?

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

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

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

Three main signs of clinical death

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

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

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

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

What is sudden death

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

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

Signs of sudden clinical death are manifested by loss of consciousness, pallor of the skin, respiratory arrest and pulsation in the carotid artery (by the way, you can determine it if you put four fingers on the patient's neck between the Adam's apple and the sternocleidomastoid muscle). Sometimes this condition is accompanied by short-term tonic convulsions.

In medicine, there are a number of reasons that can cause sudden death. These are electrical injuries, lightning strikes, suffocation as a result of being hit foreign body into the trachea, as well as drowning and freezing.

As a rule, in all these cases, a person's life directly depends on the promptness and correctness of resuscitation measures.

How is heart massage done?

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

The sequence of resuscitation actions looks like this:

the assisting person takes a place to the left of the victim;
puts his hands on one another lower third sternum;
makes jerky pressures (15 times) at a frequency of 60 times per minute, while using your weight to achieve a deflection of the chest by about 6 cm;
then grabs the chin and pinches the nose of the dying person, throws back his head, makes maximum exhalation into his mouth;
artificial respiration is done after 15 massage shocks in the form of two exhalations into the mouth or nose of the dying person for 2 seconds each (at the same time, you need to make sure that the victim’s chest rises).

Indirect massage helps to compress the heart muscle between the chest and spine. Thus, the blood is pushed into large vessels, and during the pause between the tremors, the heart fills with blood again. In this way, cardiac activity is resumed, which after a while can become independent. The situation can be checked after 5 minutes: if the victim's signs of clinical death disappear, and a pulse appears, the skin turns pink and the pupils constrict, then the massage was effective.

How does an organism die?

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

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

How does brain death manifest?

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

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

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

What does biological death look like?

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

Biological or, in other words, the final death of the organism is the last stage of dying, which is characterized by irreversible changes that develop in all organs and tissues. At the same time, the functions of the main body systems cannot be restored.

The first signs of biological death include the following:

when pressing on the eye, there is no reaction to this irritation;
the cornea becomes cloudy, drying triangles form on it (the so-called Lyarche spots);
if eyeball gently squeeze from the sides, the pupil transforms 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. In the veins, the post-mortem process of blood coagulation occurs, and with a quick death there are few clots, and with a slow death - a lot.

Rigor mortis usually begins with the facial muscles and hands of a person. And the time of its appearance and the duration of the process are highly dependent on the cause of death, as well as on the temperature and humidity at the location of the dying. Usually, the development of these signs occurs within 24 hours after death, and after 2-3 days after death, they disappear in the same sequence.

A few words in conclusion

To prevent the onset of biological death, it is important not to waste time and provide needed help dying.

It should be borne in mind that the duration of clinical death directly depends on what caused it, at what age the person is, and also on external conditions.

There are cases when signs of clinical death could be observed for half an hour if it occurred, for example, due to drowning in cold water. Metabolic processes throughout the body and in the brain in such a situation are greatly slowed down. And with artificial hypothermia, the duration of clinical death is increased to 2 hours.

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

According to the instructions of the Ministry of Health of Russia (2003), resuscitation measures are stopped only when a person’s brain is dead or if medical assistance provided within 30 minutes is ineffective.

You can pull a person out of the other world not only in those 5-7 minutes, but much more. But here there are several options for development. If a person is resuscitated under normal conditions later than this period, within the next 10 or even 20 minutes, then such a “lucky person”, by and large, will not have to wear the proud title of “human”. The reason is as a result of the onset of decortication and even decerebration. To put it simply, a person will not be aware of himself and will simply be a plant. At best, he will be insane.

However, there are situations when successful resuscitation can last the same tens of minutes and the saved person will be fully capable and generally normal. This happens when conditions are created to slow down the degeneration of the higher parts of the brain, which is accompanied by anoxia (lack of oxygen), hypothermia (cooling) and even a strong electric shock.

History is teeming with such cases, from biblical times to modern times. For example, in 1991, a French fisherman discovered the lifeless body of an 89-year-old suicide woman. The resuscitation team could not revive her, but when she was taken to the hospital, she came to life on the way, thus having spent at least 30 minutes in the next world.

But this is by no means the limit. One of the most amazing stories happened in the USSR in March 1961. A certain 29-year-old tractor driver V. I. Kharin was driving along a deserted road in Kazakhstan. However, as is often the case, the engine stalled and he set off on foot in the cold. However, the path was long, which is not surprising for these places, and at one point the unlucky tractor driver decided to take a nap from fatigue and, very likely, from a little too much alcohol. Without realizing it, he began to sculpt one of the most fantastic cases in history, for which he had only to lie down with a snowdrift. He lay there for at least 4 hours before they found him. It is not possible to determine when he died. The fact is that he was found completely numb ...

When Dr. P.S. Abrahamyan decided for some unknown reason to perform resuscitation, the characteristics of the tractor driver were as follows: the body was completely stiff and from tapping on it a dull sound was made, like from a tree; eyes were open and covered with a film; there was no breathing; there was no pulse; body temperature at the surface was negative. In other words, a corpse. Having found such a person, it is unlikely that anyone would think of trying to revive him. But Abrahamyan decided to try his luck. Oddly enough, but he managed to do this by warming, heart massage and artificial respiration. As a result, the "corpse" not only came to life, but also remained completely healthy on the head. The only thing he had to part with his fingers. A similar incident occurred in 1967 in Tokyo, when a truck driver decided to cool off in his cold store. The situation was almost the same. In both cases, the victims remained alive after many hours of death.

Largely due to these cases in the 60-80s of the twentieth century, the topic of cryonics received a new explosion of interest around the world. After such cases, like it or not, you will believe in it. However, as noted in another book in this series, this field is not promising due to the fact that when the final freeze, human tissues are destroyed due to the fact that they consist of three-quarters of water, which expands when frozen. Perhaps, in the cases described above, it simply did not come to that completely. In the case of the tractor driver, only the fingers of the hands were completely frozen, which were removed. Just a few tens of minutes in the cold and he would definitely die. However, this time is more the exception than the rule. Perhaps this was due to excess alcohol in the blood, but there is no mention of this anywhere to this day.

In the long-term preservation of a person in clinical death, in the first place, it is not anoxia that plays a key role, but hypothermia. Since it is in the presence of only the second factor that all known records in this direction have been set, in which several people compete with a tractor driver from Kazakhstan. But the presence of both factors will still not allow you to stay in a revived state for more than 40-45 minutes. For example, Vegard Sletemunen from the Norwegian city of Lilistrem fell into a frozen river at the age of five, but he was able to be resuscitated after 40 minutes. While the rivals of the tractor driver, according to their assurances, were in the next world until 4 o’clock and this always happened in winter (often Canada and the USA). Some of these people, following the cherished rule of American capitalism, even wrote books about their misadventures.

However, all these achievements also look faded. According to one case that happened in Mongolia. There, a little boy lay in the cold at - 34 degrees for 12 hours ...

When it comes to the prolongation of death, in no case should these cases be confused with deep lethargy or the usual slowing down of vital processes. We all heard about how people are declared dead, but then they come to life, and easily after a couple of days. Naturally, it was not death. It's just that the doctors could not recognize the signs of life due to their barely noticeable. A similar incident happened at the morgue where my mother worked as a histologist in the early 1990s. The man was long dead when the pathologist tried to start the autopsy. However, at the first injection of the scalpel, he started up and jumped up. Since then, the doctor's professional passion for laboratory alcohol has significantly worsened.

In conditions clinical practice it is also possible to prolong the moment of final death. For example, this is achieved by cooling the brain, various pharmacological means transfusion of fresh blood. Therefore, in special cases, doctors can prolong the state of clinical death for several tens of minutes, but this is difficult and very costly, so such procedures are not used for an ordinary person. If earlier it was commonplace to bury almost every tenth person alive, even now doctors often do not perform procedures that can save one person for every few dozen.

The word "death" seems to have only one meaning, but in the medical field there are different classifications for this term, most of them are irreversible, but there is one that is not.

What is clinical death?

Clinical death (or apparent death) is the cessation of heartbeat and breathing without damaging brain cells. From a clinical point of view, death is the interruption of the organic functions of any living being, which most of the time is preceded by an agonizing stage, which includes a series of clinical manifestations who prescribe it.

The agony may be short or may last up to a month before death. In some special cases, the agony phase lasts for years, and suddenly there is an inexplicable improvement. In the event of clinical death, all external signs life, such as consciousness, pulse and breathing. In these cases, biological death occurs unless steps are taken to change the situation. On the other hand, biological death cannot be changed because it is physically irreversible.

In the event of clinical death, the state in which a person remains is highly dependent on the time required for the resumption of breathing and cardiac function. Moreover, the organs begin to be damaged due to lack of oxygen, and the same thing happens with the brain.

Every hospital has a protocol for when to stop trying to resuscitate, be it heart massage, assisted breathing, or electrical defibrillation, as deep brain damage or failure to recover can occur.

Signs of clinical death

Absence of pulse, it can be determined only on the carotid artery or femoral artery, the heartbeat can be heard by putting your ear to the heart area;
Circulatory arrest;
total loss consciousness;
Lack of reflexes;
Very weak breathing, which is checked by the movements of the chest when inhaling or exhaling;
Cyanosis of the skin, pallor of the skin;
Pupil dilation and lack of reaction to light;

Timely rendered first first aid the patient, is able to save a person's life: artificial respiration, heart massage, which must be carried out before the arrival of an ambulance. When patients return to life, most of them change their outlook on life and look at everything that happens in a completely different way. Very often, such people become detached from loved ones and live in their own world, some acquire supernatural abilities and begin to help other people.

What types of death are there?

While there is a medical term for near death for those who respond to reversible cardiorespiratory arrest, there are others that have the peculiarity of being irreversible.

Of course, you have heard of brain death, the brain dead patient suffers this level of damage in his brain, losing all functions beyond those automatic ones for which he needs the help of a respirator and other artificial machines.

To determine brain death, various tests are performed to determine the activity of neurons, which are reviewed by several doctors. If brain death is established, the person is a candidate donor unless there is some level of deterioration.

It is important to note that brain death and other conditions such as coma or a vegetative state are not the same, since recovery can occur in the second and third cases, which is not possible in the first.

Finally, we have biological death, absolute and irreversible death, because not only the organs stop working, but the brain also loses all activity, this is a classic type of death.

Causes of clinical death

The cause of clinical death is trauma, disease, or a combination of both responsible for initiating a series of pathophysiological disorders. The cause of death is unique (immediate and fundamental) when an injury or illness results in death so quickly that there are no complications. When there is a delay between the onset of an illness or injury and final death, one can distinguish between an immediate or final cause (the one that caused the immediate death) and another fundamental, initial, or root cause.