Asystole of the heart – what is it Symptoms, causes, emergency care, treatment

Let’s start by examining the forms of the disease, and then we will understand why asystole occurs, we will study the causes and find out what risk factors exist with such an ailment. So, in medicine, the following forms of pathology are distinguished:

  • the primary form occurs when the cardiac muscle stops instantly;
  • in the secondary form, arrhythmia initially occurs, in most cases the situation is associated with fibrillation, which lasts for some time.

Fibrillation involves an irregular heart rhythm that causes circulatory disorders. The contractile function is nullified by the depletion of energy reserves.

There are many reasons for which ventricular asystole can occur. Their list is as follows:

    exceeding the allowable dosage when taking cardiac glycos >

In addition, about 5% of severe forms of heart disease lead to asystole. Among them, the most dangerous are the following ailments:

  • myocardial infarction;
  • heart block complete and trifascicular;
  • blockade of the second degree;
  • pulmonary embolism;
  • neglected, uncorrected ischemic heart disease, which is accompanied by myocarditis in a complex form.

Also, a similar problem, including atrial asystole, can occur when potassium solution is rapidly ingested. In this situation, the myocardium gets very excited.

In addition to the reasons described above, there are risk factors. They contribute to the development of asystole if one of the above problems is present in the body. Risk factors are as follows:

  • diabetes;
  • elderly age;
  • alcohol and smoking;
  • left ventricular hypertrophy.
  • hypertension;
  • atherosclerosis of blood vessels.

Atherosclerosis Attack

In childhood, asystole can occur in the following cases:

  • shock, regardless of its nature;
  • respiratory failure;
  • poisoning;
  • trauma.

About 5% of severe cardiac pathologies lead to the fact that the patient develops asystole of the heart. The causes of this life-threatening condition lie most often in the occurrence of an acute form of myocardial infarction or pulmonary thromboembolism. An overdose of cardiac glycosides, antiarrhythmic drugs or anesthesia, which affect the functioning of the named muscle, can also provoke asystole. Before cardiac arrest, electrical injury, intracardiac manipulation, or general severe metabolic disturbances can also result.

The main factors of a cardiac nature that contribute to sudden cardiac arrest:

  • IHD in acute or chronic form
  • Extensive myocardial tissue death
  • Extreme left ventricular failure, in which there is a sudden decrease in heart muscle contractions (cardiogenic shock)
  • Complications associated with various heart diseases when blood clots form in its cavity (heart disease and aneurysm, myocardial infarction, septic endocarditis, hypertension and atherosclerosis)
  • Accumulation of fluid in the pericardial cavity with vascular damage, which violates the contractility of the organ
  • The inflammatory process of an infectious etiology that affects the myocardium or endocardium
  • An abnormal increase in muscle mass of the heart
  • Narrowing the lumen of the aortic valve, responsible for the normal passage of blood flow to the left ventricle
  • Malfunctioning Artificial Valves

Asystole is characterized by the absence of heart contractions and symptoms of cardiac electroactivity on the ECG, that is, clinical death has occurred. Asystole needs urgent resuscitation measures in which Adrenaline, Atropine are administered intravenously, cardiac pacing, indirect or direct heart massage and mechanical ventilation are performed. But the likelihood of a positive outcome with asystole is very low.

Asystole can occur both atrial and ventricular.

Asystole of the ventricles is a state of the body in which the electrical and mechanical activity of the ventricles, the heart as a whole, and its arrest stops. This pathology is characterized by cessation of blood circulation and clinical death.

As a rule, the occurrence of ventricular asystole and hemodynamically ineffective electrical activity of the heart is mainly promoted by severe irreversible heart damage and progressive circulatory disorders. Therefore, causes of cardiac arrest can cause cardiac and non-cardiac origin.

The root causes of electrical instability of the heart muscle include: coronary heart disease in acute form, as well as chronic; various injuries, post-infarction heart recovery in the presence of heart failure. In addition, the occurrence of primary circulatory arrest is associated with electrical instability of the heart muscle. Quite often, asystole develops as a result of complications of acute myocardial infarction, significant myocardial damage with complete transverse blockade against ventricular fibrillation.

But in terms of forecasting, the instantaneous form of asystole is considered unfavorable. Cardiac arrest following VF is characterized by a positive prognosis, especially against the background of a large-wave VF, in contrast to a small-wave VF.

Causes of asystole can be heart ruptures and cardiogenic shock. Significantly increased risk of cardiac arrest with unstable angina. Approximately 12% of these patients develop sudden death and myocardial infarction.

Risk factors for the occurrence of asystole in CHF are cardiac remodeling after a heart attack with further formation of dilatation and hypertrophy of the heart chambers, as well as existing arrhythmia and blockade, multivascular lesions, alcohol abuse, advanced age, smoking, arterial hypertension, atherosclerosis with a hereditary predisposition and hypercholemia.

Other cardiac reasons for the development of asystole can be attributed to: pericarditis of exudative origin, obstruction of the inflow or outflow of blood into the heart (thrombosis within the heart, valve or myxoma dysfunction). As well as low blood flow, myocarditis in the presence of influenza or diphtheria, endocarditis of infectious etiology, cardiomyopathy, aortic stenosis, trauma with the formation of tamponade, cardiac pacing in the open heart, coronary angiography and catheterization are all reasons for a possible stop of blood circulation.

Extracardial causes that can cause asystole include: circulatory (hypovolemia, shock of various origins, intense pneumothorax in pulmonary diseases, chest injuries or mechanical ventilation, pulmonary embolism, vaso-vagal reflex). In addition, respiratory causes (hypercapnia and hypoxemia) and metabolic (hypothermia, acidosis, hyperkalemia);

However, there are many other different factors that cause cardiac arrest. It can be an electric shock as a result of electric shock, lightning; asphyxia; intoxication; sepsis; cerebrovascular complications; various diets, which are based on the intake of protein and a significant amount of fluid.

Classification

Doctors distinguish the following types of asystole:

In the first case, the manifestation of the pathological process is not associated with a violation of the heart rhythm, and asystole occurs due to the cessation of the supply of pulses that provide a reduction in the myocardium. Ventricular fibrillation provokes the depletion of the amount of phosphate in the tissues of the heart, which leads to disruption of its work.

The reason for this deviation is an acute decrease in blood circulation, leading to organ damage, with coronary artery disease. In the preceding occurrence of asystole in humans, there is a sharp decrease in heart rate (less than 60 beats per minute) due to complete blockage of the organ or sinus node, as well as a combination of both factors.

The secondary form of the pathological condition is due to the effect on the work of the heart of various internal and external factors, the result of which in most cases is an insufficient supply of oxygen to the tissues of the organ, accompanied by metabolic acidosis.

What are the clinical and physiological signs of the condition?

The signs that help to determine that the patient’s heart stopped have probably been known to everyone, but we will repeat them all the same.

  • In large arteries there is no pulse. To verify this, folded index and middle fingers should check its presence in the carotid artery (it is groped in the fossa next to the thyroid cartilage of the larynx (Adam’s apple). If there is no pulse, then a person has asystole of the heart.
  • Emergency help is also needed if the pupils do not respond to the flashlight directed into the eyes. Normally, they should narrow, and if this does not happen, then the myocardium is not functioning.
  • The absence of breathing also indicates cardiac arrest, occurs after 2 minutes. after the disappearance of the pulse. This can be checked by holding a mirror to the lips of the victim.
  • No less eloquent is the complexion of the skin. If it acquires a grayish or bluish tint (especially the lips, tip of the nose and earlobes) – this is a signal of a serious circulatory disturbance.
  • And, finally, if the patient lost consciousness, it is not possible to bring to life for more than 10-20 seconds with the help of ammonia, pats on the cheeks or vowels, then this can also be a sign of asystole. All of these symptoms are dangerous to human life, so they require urgent resuscitation, which should be provided before the arrival of the ambulance crew. Remember that you have a maximum of 10 minutes to save a life (the brain of a person still lives so much time after a cardiac arrest).

    Cardiac Emergency Rules

    So, if you have discovered a person’s heart asystole, treatment of the patient, or rather urgent emergency care is reduced to the following:

  • Call an ambulance.
  • Using a napkin, free the victim’s nose and mouth from vomiting, foreign bodies or mucus.
  • Lay the person on his back, but so that his head is slightly thrown back.
  • Add a slightly elevated position to his legs with folded clothes or a pillow.
  • blows air into the victim’s lungs either from the mouth into the mouth (a scarf can be identified on it), or from the mouth into the nose. After one blow, massage the heart.
  • To do this, place the palm of a weak hand so that it rests with the base on the lower edge of the sternum of the victim. On top of it, place the other hand perpendicularly and with the whole weight of the body on outstretched arms, do rhythmic shocks with sharp movements (5 clicks). The interval between them is no more than a second. After each push of the hand from the chest, take away so as not to interfere with the blood flow freely into the heart. At least 100 shocks must be made per minute.

    Some more tips for providing emergency care

    It is better if two people do the resuscitation measures described above – one blows air and the other does a heart massage. It is important to remember that if the patient can be saved, but more than ten allotted minutes are spent, he may develop serious neurological disorders. Therefore, be collected and, most importantly, calm, the only way the asystole of the heart (what it is you, of course, understand) will be defeated. Every 2 minutes, check the patient’s condition – his breathing, pulse and the reaction of the pupils, as soon as breathing appears, emergency care can be stopped. If a pulse appears, but there is no breathing, continue ventilation. Even if you are unable to bring the victim back to life, do not stop providing emergency care. It can only be stopped when emergency doctors arrive. They will use their methods to maintain the patient’s life.

    Possible complications after cardiac arrest

    As mentioned above, the rescuers have little time to help a person who has heart asystole. This is only 10 minutes. And, unfortunately, even in the case of a favorable outcome, the victim may have the consequences of cardiac arrest, for example,

  • ischemic damage to the brain, liver or kidneys due to insufficient blood supply to these organs during clinical death;
  • fracture of ribs as a result of strong pressing during a heart massage;
  • air entering the cavity between the pleura sheets covering the lungs and chest (in medicine, this pathology is called pneumothorax). But you understand that a saved life still means more broken ribs, and therefore, without hesitation, provide emergency assistance to a needy person.

    Features of emergency care in a child

    Unfortunately, for children of the first years of life, the resuscitation measures described in the article are especially relevant and, therefore, parents should know well how to act in cases when their baby’s heart has asystole (that this action is somewhat different from that used in the situation in adults , of course, you understand). And most importantly, do not succumb to panic and act very quickly, since the time mentioned above in a child is reduced to 5 minutes. Call an ambulance first.

  • Then the baby needs to be laid on the table, undressed or swaddled and his mouth freed from mucus and foreign objects.
  • Pads of the index and middle finger attach to the lower chest. Press them on the chest intensively, but gently, with a frequency of 120 shocks in 1 min.
  • During the push, the sternum should be shifted to the depth of the finger.
  • Every 15 pressures, make 2 blows into the baby’s mouth and nose with a tissue.

    Asystole of the heart: treatment in the intensive care unit

    Specialized resuscitation measures for cardiac arrest in a hospital are carried out by means of tracheal intubation (a flexible plastic tube is placed in it through which mechanical ventilation is carried out) and a bolus (that is, fast, unlike a dropper) injection of “Adrenaline hydrochloride” and “ atropine”. If the usual doses are ineffective, these drugs begin to be administered every 5 minutes. inkjet. Then the dose is gradually increased to 5 mg and is administered every 3 minutes. In situations where there is no access to the vein, drugs are injected into the trachea, and their dosage is doubled. Injections into the heart are carried out only if other methods of drug administration are not possible.

    Is it possible to prevent asystole?

    We are talking in the article how dangerous asystole of the heart is, this is a condition that can easily lead a person to death. But can such a result be avoided? And how to prevent it? In some cases, doing this is absolutely real. It is only necessary to observe some preventive rules. So, regardless of the diagnosis, patients with cardiac pathologies must strictly follow the doctor’s instructions – do not violate the dosage of the drugs and the timeliness of their use, monitor the level of physical activity and avoid the use of certain drugs specified by the specialist. If necessary, such patients are also prescribed medical equipment in the form of cardioverter defibrillators or pacemakers supporting an adequate heart rate. And relatives of the patient should be prepared for an emergency and know how to act in a particular case. All the details of primary prevention are necessarily discussed in detail with a cardiologist and are binding.

    Most people on the eve of the onset of asystole begin to complain of the following symptoms:

    • Dizziness
    • Severe weakness
    • Dyspnea
    • Pain in the heart and sometimes in the abdomen or back
    • Pulse weakness
    • Nausea
    • Palpitations

    But in some cases, the patient does not feel the above symptoms, and the clinical picture of the underlying disease changes dramatically, while blood pressure drops, the frequency and rhythm of heart contractions are disturbed, and respiratory function malfunctions are observed.

    Often, the patient has fainting. In case of loss of consciousness, the pulse on the large arteries disappears (the middle and index fingers put together do not feel the pulse in the carotid artery) and the pupils stop responding to the light directed into the eyes through the flashlight.

    This requires immediate emergency assistance, which in some cases helps to save a person’s life.

    Sudden primary cardiopulmonary arrest is the first sign of cardiac ischemia, although in most cases it has certain precursors. For example, when interviewing patients after resuscitation was performed, 40% of patients did not have any signs of asystole, 30% experienced pain behind the sternum, 32% complained of dizziness or loss of consciousness, and 25% had difficulty breathing in the form of shortness of breath . All other cases are characterized by the development of asystole as a result of pathological conditions that caused its formation.

    Typically, circulatory arrest occurs in patients who are seriously ill for a long time. In this case, the combination of extracardiac and cardiac factors significantly affects. In this case, patients experience hypotension, tachycardia, pain behind the sternum, dyspnea, and also fever. In addition, they become restless, and then all this causes a violation of consciousness.

    Ventricular asystole is characterized by the sudden disappearance of the pulse, heart sounds, and pressure. In the very near future, loss of consciousness occurs, the patient becomes pale and breathing is interrupted. After the blood circulation in the brain stops, that is, after forty-five seconds, the pupils dilate, which reach a maximum within one minute of forty-five seconds. Asystole on the ECG is confirmed by the absence of cardiac electroactivity, but resuscitation measures should be started before the results of the ECG study.

    Asystole is generally regarded as the clinical death of a patient, which is a reversible stage of dying. In this case, the symptoms are manifested by the absence of contractions of the heart, independent breathing and reflexes to external influences. However, there is the possibility of a potential restoration of body functions by resuscitation methods.

    What emergency help is needed to restore rhythm?

    Since ordinary passersby and relatives find themselves close to a person at the time of the onset of asystole, a lot depends on their actions. You should call an ambulance, and while she arrives, take all the necessary steps to restore heart rhythm.

    1. Lash a man, speak loudly, beat him on the cheeks. If he regains consciousness, this is a good sign. Provide him with fresh air and put his head below his shoulders.
    2. Feel the pulse if the first attempts to restore contact do not work. It is necessary to restore breathing, heart rate and provide blood circulation in the brain.

    In the latter case, the following measures are taken:

    • Put the person on a hard surface.
    • Throw back your head. Check the airway so that food debris, dentures and other foreign bodies do not get into them when breathing is restored.
    • Blow air into the nose or mouth with the mouth while closing the second hole. The chest should rise with such breathing.
    • Perform shocks with two palms on the chest between breaths 4-5 times.

    Perform these procedures until a pulse appears or an ambulance arrives.

    Emergency care in a medical institution with asystole includes:

    • the installation of an endotracheal (inside the trachea) endotracheal tube for hardware ventilation of the lungs or mechanical ventilation using an Ambu bag;
    • catheterization of large vessels with the introduction of adrenaline, atropine and other components of infusion therapy, depending on the causes of circulatory arrest;
    • conducting electrical pulse pacemaking.

    It must be remembered that the time allotted for resuscitation is 30 minutes. The sooner the provision of first aid begins, the greater the chances of the injured person or patient for a favorable outcome.

    European states and the United States have introduced CPR skills to the public, including the use of stationary street defibrillators.

    These devices, which constitute a good help for resuscitation, make it possible to determine the need for their use. Thanks to programmatic voice prompts, anyone can understand whether cardiac defibrillation is required or not.

    Treatment of cardiac asystole according to the approved clinical protocols implies resuscitation in the presence of signs of circulatory arrest. At the prehospital stage (before the arrival of the ambulance crew, which witnesses must call), it is necessary:

    • straightening and releasing the airways (unfasten a narrow collar, remove foreign objects from the oral cavity).
    • mouth-to-mouth breathing;
    • Indirect cardiac massage (at least 100 compressions per minute) – this method of artificial myocardial contraction contributes to the minimal restoration of hemodynamics. The effectiveness of the event is provided by the activation of the nervous system and sinus node.

    Ambulance doctors use intravenous adrenaline, which helps activate the autonomic nervous system and trigger cardiac activity.

    In a hospital setting, the patient is treated for the consequences of resuscitation (“postresuscitation disease”) and the primary cause of circulatory arrest, which implies:

    • adequate ventilation of the lungs (using an apparatus or oxygen therapy);
    • surgical interventions for injuries;
    • correction of metabolic processes;
    • the use of antidotes;
    • the introduction of an intravenous glucose solution;
    • blood replacement therapy after significant loss and hypovolemia.

    Folk methods of treatment or prevention of asystole do not exist, cardiac arrest is one of the signs of death, which requires emergency resuscitation.

    Call out loudly, shake your shoulders, pat on the cheeks. Perhaps he has the usual swoon.

    If the fallen man does not recover, it is necessary to determine whether he has a pulse and breathing. Many begin to search and ask passers-by for a mirror to check their breathing. And precious time is running out. It is better to bring your ear closer to the chest or to the face of the fallen person and listen.

    At the same time, the pulse on the carotid or femoral artery is checked. Do not feel the peripheral vessels on the wrists – there may not be a heartbeat. The exact criterion for stopping blood circulation is the absence of a pulse in the central arteries. If not, call an ambulance and begin a simple set of resuscitation.

    A – preparation of the respiratory tract for resuscitation. The patient’s head, laid on a hard plane, is thrown up and back to gain free access to the oral cavity. Wrapping a finger with a napkin, clean the oropharynx of mucus, blood, vomit, earth.

    In – carrying out artificial respiration. If after completing the first step there are no signs of spontaneous breathing, the resuscitator kneels over the victim and blows air through his mouth. In this case, the patient’s nose must be clamped with fingers. The effectiveness of artificial ventilation is determined by raising and lowering the chest. To exclude contact with the saliva and blood of the victim, air is blown through a handkerchief.

    According to the latest regulations, if the resuscitator believes that the “mouth-to-mouth” method of restoring breathing can damage his health, then he has the right not to. Then, without wasting time, proceed to the third point.

    C – compression of the chest. If no more than 30 seconds have elapsed since the onset of the unconscious state, the precardial stroke method can be used. A man lying on his back is laid on the lower border of the ribs. Clutching the other hand into a fist, they hit them in the lower third of the sternum. If after a stroke the heartbeat does not resume, begin a closed massage of the heart muscle.

    The victim’s legs can be bent at the knees and placed above the head to increase passive blood flow to the heart. Resuscitation is continued until the doctors arrive.

    On the way to the hospital, the following actions are carried out:

    • ECG removal;
    • Intravenous administration of atropine, adrenaline, dopamine. Injections directly into the heart muscle are allowed with the ineffectiveness of intravenous infusions;
    • Artificial pulmonary ventilation mask. In case of inefficiency – tracheal intubation (insertion of a tube to connect an artificial ventilation apparatus);
    • Blood transfusion if massive blood loss has occurred;
    • Use of a defibrillator (a device for exposing a patient to an electric current of high power to “start” the heart, restore ventricular contractions);
    • Transesophageal, percutaneous pacing, if the ECG shows at least minimal contractions.

    If after half an hour there are no signs of positive dynamics (spontaneous breathing, palpitations, narrowing of the pupils in bright light), resuscitation stops and states the onset of biological death.

    If resuscitation is successful, the patient is transferred to the intensive care unit.

    According to indications, surgical treatment is performed:

    • Puncture of the pericardium with accumulation of blood or other fluid in its cavity;
    • Puncture of the pleural cavity with pneumothorax.

    Next, constant ECG monitoring, monitoring of blood composition, and maintenance of normal blood pressure values ​​are carried out. The patient’s head is covered with ice so that the temperature in the area of ​​the external auditory meatus does not exceed 34 degrees. Low molecular weight solutions, glucose, panangin, sodium bicarbonate are injected into the subclavian vein.

    To provide primary medical care in such a situation should be able to all employees of medical institutions. Only the correctness and speed of its implementation can help save a person’s life.

    A 1-minute slowdown reduces the chances of survival by about 10%. After 10 minutes emergency assistance will be unsuccessful.

    Rules for cardiopulmonary resuscitation:

    1. Determine if a person has a reaction when accessing him. Touch your shoulder and clarify loudly if everything is okay with him. If a person has any reaction to your words, then call an ambulance and stay close, watching his condition.
    2. If there is no reaction to the question, turn the person on his back if he is in a different position. Then put your hand on your forehead, and with two fingers of your other hand, raise your chin up and open your mouth. If a person had vomiting, then using a handkerchief to clean the mouth and nose of vomit.
    3. Check for breathing. To do this, bend over him, keeping his mouth open. Now use the method: see (movement of the chest) – hear (sound of air coming out of the mouth) – feel (movement of exhaled air by the skin). You need to spend no more than 10 seconds on this.
    4. When there is no breathing, dial an ambulance or ask a person nearby to call. During this action, do not go anywhere, but turn on the speakerphone and follow the doctor’s instructions.

    Indirect cardiac massage. Unfasten tight clothing on the patient’s chest. Get down on your knee, place the base of your right palm in the middle of the chest of the person, and lower the other palm from above. Fingers should be intertwined and elbows not bent. Press on the sternum with your hands in the amount of 100 r. in 1 min., so that its depth is 5 cm. After one push, the hands should be removed so as not to interfere with the access of blood to the heart.

    So, if you have discovered a person’s heart asystole, treatment of the patient, or rather urgent emergency care is reduced to the following:
    Unfortunately, for children of the first years of life, the resuscitation measures described in the article are especially relevant and, therefore, parents should know well how to act in cases when their baby’s heart has asystole (that this action is somewhat different from that used in the situation in adults , of course, you understand). And most importantly, do not succumb to panic and act very quickly, since the time mentioned above in a child is reduced to 5 minutes. Call an ambulance first.

    Asystole Treatment

    Specialized treatment of asystole is optimal lung ventilation by intubation of the trachea and providing access to the central or peripheral veins through which Adrenaline hydrochloride and Atropine are bolus injected. This is due to the fact that supraventricular and ventricular pacemakers are rarely suppressed as a result of increased parasympathetic tone.

    In case of inefficiency of adrenaline in usual doses, it is injected jet every five minutes, then the dose is increased to five milligrams with the introduction every three minutes. Basically, all drugs should be administered intravenously and quickly. If the drugs are injected into the veins on the periphery, then they are diluted with saline.

    The existing minimal contractile activity of the heart undergoes pacing of the endocardial, transdermal or transesophageal type.

    Pacemaking is carried out in the acute form of the myocardium, bradycardia, tachyarrhythmia, an overdose of Digitalis drugs and inadequate blood circulation. In addition, simultaneously perform mechanical ventilation and indirect heart massage, while trying to eliminate the causes of asystole: hypoxia, hyperkalemia, acidosis, hypothermia, drug overdose, cardiac tamponade and pulmonary embolism.

    If hypovolemia develops, then they quickly restore BCC (the volume of blood that is involved in the circulation). With pneumothorax, a catheter is inserted, left open, and then replaced with drainage. In the presence of cardiac tamponade, pericardiocentesis is performed, followed by catheter drainage or pericardiotomy. In case of intracardiac thrombosis and myxoma, an emergency operation is prescribed.

    For the treatment of hypoxia, mechanical ventilation is used, and if asystole occurred as a result of an overdose of drugs, an etiological method of therapy is prescribed. Hyperkalemia is treated with the introduction of calcium chloride and sodium bicarbonate (must be injected into different veins) and a mixture of glucose and insulin. For the treatment of acidosis, mechanical ventilation is carried out intensively and sodium bicarbonate is administered intravenously at the same dosages.

    All resuscitation measures are terminated if after half an hour there is no effectiveness from their implementation. In this case, there will be no consciousness, arbitrary breathing, the heart is inactive, and the pupils are very dilated and do not respond to light.

    Further therapeutic measures are performed in the intensive care unit, where they monitor the electrocardiogram, respiration, BCC, hemodynamics, electrolytes. With the help of medications, blood pressure is maintained closer to the norm, Reopoliglukin is administered to improve the rheological properties of the blood, and intensive treatment of the underlying pathology is carried out.

    Actions should be carried out as follows:

    • Indirect cardiac massage
    • artificial respiration;
    • the introduction into the vein of “Adrenaline”, “Atropine” and “Calcium chloride”.

    The same drugs can be administered intracardially or through the endotracheal tube. In the latter case, “Lidocaine” is added, and the dosage is doubled. With the appearance of weak contractions, pacing is performed. Resuscitation measures cease after half an hour if attempts to restore blood circulation have not been successful.

    If the provision of first aid was successful, then the person is placed in the intensive care unit. Doctors during cardiac arrest monitor the main vital signs:

    • hemodynamic characteristics;
    • the breathing process is controlled;
    • the electrolyte composition of the blood is examined;
    • ECG data is recorded.

    A set of measures aimed at treating the patient is also carried out:

    • electrocardiostimulation of electrotrans venous or transthoracic type;
    • jet injection of low molecular weight fluids into the central vein, which is located under the collarbone;
    • the introduction of a number of drugs (Panangin, Sodium bicarbonate, Glucose, Insulin);
    • infusion therapy by the introduction of plasma substitutes and blood thinners.

    The patient’s blood pressure should be moderate or at an elevated level.

    Specialized resuscitation measures for cardiac arrest in a hospital are carried out by means of tracheal intubation (a flexible plastic tube is placed in it through which mechanical ventilation is carried out) and a bolus (that is, fast, unlike a dropper) injection of “Adrenaline hydrochloride” and “ atropine”.

    If the usual doses are ineffective, these drugs begin to be administered every 5 minutes. inkjet. Then the dose is gradually increased to 5 mg and is administered every 3 minutes. In situations where there is no access to the vein, drugs are injected into the trachea, and their dosage is doubled. Injections into the heart are carried out only if other methods of drug administration are not possible.

    Asystole begins her treatment in the ambulance and continues in the intensive care unit. Doctors continue to perform indirect heart massage, maintain lung ventilation with a special mask, administer intravenous adrenaline and use a defibrillator.

    Upon arrival at the intensive care unit, intensive care continues, which takes at least 30 minutes. The patient is connected to hardware breathing. Various drugs are injected into the subclavian vein to maintain brain functions that are reversible within the first 8 minutes after respiratory arrest. Such drugs are used here:

    • Dopamine.
    • Sodium oxybutyrate.
    • Alkaline solution.
    • Reopoliglyukin.
    • Glucose.
    • Panangin.
    • Sodium bicarbonate.
    • Insulin.

    Specialized treatment is carried out in the form of providing mechanical ventilation and the introduction of Atropine and Adrenaline hydrochloride into the veins. In the absence of the effect of adrenaline, the drug is administered jet every 5 minutes or every 3 minutes with an increase in dose to 5 mg.

    The introduction of drugs into peripheral veins occurs when they are diluted with saline. In the absence of access to veins, adrenaline, atropine, lidocaine are injected into the trachea with a 2-fold increase in dose. And intracardiac administration of drugs occurs in the absence of the possibility of another administration.

    Concomitant symptoms are also noted, which are eliminated by available methods:

    • Hypovolemia is eliminated by restoring blood volume.
    • Pneumothorax is removed by a catheter, which is left open and then replaced by drainage.
    • Cardiac tamponade is eliminated by pericardiocentesis, pericardiotomy and catheter drainage.
    • Intracardiac thrombosis and myxoma are treated with surgical intervention.
    • Hypoxia eliminates mechanical ventilation.

    Features of emergency care in a child

    It should be remembered that it is the asystole of the ventricles of the heart (a complete stop of their contractions), in contrast to the joint atrial asystole, which leads to the death of the patient. This pathology does not apply to those rhythm disturbances that are provoked by increased ectopic excitability. The causes of its occurrence are conduction disorders with a parallel suppression of the ability of the ventricles to rhythmically contract.

    Stopping the ventricles, in contrast to atrial asystole, in most cases is fatal. This pathology is not associated with ectopic excitability of the ventricles, but occurs due to inhibition of their ability to contract.

    On the ECG, you may notice a manifestation of slight contractions, the frequency of which is too weak to push blood into the arteries. If the contractions are very rare, then the term is used – a dying heart.

    All these reasons apply to children, but an important difference from adults is a special type of asystole, which is part of the general concept of “sudden infant death syndrome”. In this case, cardiac arrest is recorded in a child more often under the age of 5 months against the background of sleep and the absence of any diseases in this period.

    It is believed that asystole of the ventricles in the baby is caused by underdevelopment of myocardial cells, impulse transmission paths. Perhaps it is associated with the pathological course of pregnancy and labor in the mother:

    • hypoxia (lack of oxygen) in the fetus with anemia, diseases of the mother’s body;
    • asphyxia during childbirth;
    • vacuum extraction of the fetus;
    • multiple pregnancy;
    • the birth of a premature baby;
    • smoking and drinking by the future mother of alcohol.

    Contributing factors are:

    • laying the baby on a soft mattress;
    • unventilated hot room;
    • many blankets that shelter the child and lead to his overheating;
    • tight swaddling.

    Sleep in the abdomen is one of the risk factors for asystole.

    Many causes of a baby’s death due to asystole are due to the lack of proper adult care for the child.

    First you need to figure out what it is – ventricular asystole. In such a situation, clinical death occurs, blood flow stops in the vessels, the heart muscle does not contract and does not pump blood. The vast majority of cases lead to death, but not always. Even with such a serious pathology, doctors manage to maintain vital processes in the body.

    With asystole, electrical instability is observed. In other words, the fibers cease to obey a single rhythm. Their work becomes chaotic with such a frequency that there is a threat to human life. On the results of the ECG, reductions are not always completely absent. Abbreviations can be very weak or rare. In the first case, the force of contractions is not enough to push the blood. With rare contractions, the concept of a dying heart is used.

    How long do they live with asystole?

    It is not necessary to talk about favorable prognoses for asystole, since in rare cases a person receives sufficient help. How long do they live with asystole? The count is for the minutes when the basic functions of the body cease: heartbeat, respiration and brain function.

    In most cases, death occurs. Even with timely delivery of the patient to the hospital, only in 15% of cases it can be saved from death.

    How often does asystole manifest? In newborns, it occurs with a frequency of 72.1 per 100000, in childhood – 3.73, in adolescents – 7.37, in adulthood – 126.5.

    Ventricular fibrillation gives more favorable prognoses (4 times more) than asystole. However, a fatal outcome is observed in both variations. If the destruction of brain cells or other organs occurs, then the predictions become even more unfavorable.

    The heart muscle has a number of functions: automatism, conduction of a nerve impulse, excitability, as well as the ability to contract. Their combination provides the main purpose of the myocardium – blood circulation throughout the body.

    Asystole of the heart is a critical situation in which the human “motor” stops. What is it, what threatens it, what measures are required to eliminate it?

    Various internal processes can form the basis of the same external manifestations of this condition. Heart asystole is represented by two basic groups:

    1. The lack of bioelectric potentials on the part of the myocardial conductive system and, as a consequence, its contractions.
    2. The presence of impulses recorded on the cardiogram without maintaining normal blood circulation. This condition is called hemodynamically ineffective electrical activity. At the same time, a coordinated rhythm can be recorded on the ECG, but contractions of the heart muscle do not provide the necessary discharge of blood into the arterial bed. The study of the objective status of the patient does not reveal a pulse on the main vessels (carotid, femoral arteries).

    The clinical picture of circulatory arrest

    Symptoms of cardiac arrest are characterized by a clinic of sudden death and are accompanied by respiratory arrest. Consider the possible options for the detection of the patient.

    • Option 1 – an outwardly ordinary person at work or on the street, suddenly falls in a transport, a hoarse rare breath breaks out of the throat, lips and face turn blue, consciousness is absent, attempts to contact are unsuccessful.
    • Option 2 – fatal cardiac arrest occurs in a dream, and the patient lies and looks like an ordinary sleeping person. People around do not immediately pay attention to the absence of any reactions.

    In both cases, the patient does not have time to call for help, complain about the deterioration of health.

    • Option 3 – the patient is being treated in a specialized department for heart disease in the general ward, he is allowed to walk or he forces the regime on his own. He may fall in the corridor, in the ward, on the stairs. Symptoms correspond to clinical death.
    • Option 4 – the patient is in an acute stage of a heart attack or with severe somatic lesions, the injury is in the intensive care unit, the condition is monitored by the monitor, the ECG pattern is constantly monitored, any deviation in the rhythm activity is indicated by an audio signal.

    The latter option is most favorable in terms of providing the necessary assistance.

    Doctors in a specialized department do not need to spend time searching for a pulse, all equipment for resuscitation is usually at hand

    Not every passerby can find a pulse on the carotid artery (at an angle of the lower jaw) or make sure that there is no heartbeat. Usually in the first place are:

    • loss of consciousness;
    • pallor and blueness of the face;
    • lack of respiratory movements.
    • pain behind the chest;
    • disturbed heart rhythm;
    • fainting or pre-syncope;
    • dizziness and difficulty breathing.

    Such symptoms are characteristic of sudden asystole. In other cases, the problem is associated with pathologies, not necessarily cardiac. Here, the signs of asystole look a little different:

    • low pressure;
    • malfunctions of the heart;
    • swelling;
    • accumulation of fluid in the chest or / and abdominal cavity;
    • pain sensations;
    • reduction in the number and duration of breaths to their complete absence.

    Here, by such signs, ventricular asystole can be determined. They are difficult to confuse with the symptoms of other diseases.

    Acutely developed asystole of the ventricles is manifested by a lack of consciousness, dilated pupils, the inability to determine the pulse on the main vessels and to listen to the heartbeat.

    At the same time, or somewhat later, the respiratory movements of the chest stop. The condition requires urgent cardiopulmonary resuscitation (CPR).

    Cardiac arrest may occur gradually. For the phased development of atrioventricular blockades with subsequent asystole, attacks of Morgagni-Adams-Stokes are characteristic.

    The patient’s mind becomes cloudy, the patient is agitated, then clonic-tonic convulsions occur, heart contractions are interrupted.

    Asystole on the ECG is recorded as a straight line. When recording a cardiogram before complete cardiac arrest, chaotic oscillations of various kinds, ventricular fibrillation are often detected, or blockages are present before.

    • unconsciousness (with sudden development – a person falls);
    • lack of pulsation in the carotid arteries;
    • pupil reaction to light (pathological expansion).
    • lack of breathing;
    • decreased muscle tone;

    Pathophysiological mechanisms of the development of signs are based on the absence of an electrical impulse, which causes a decrease in myocardial muscle mass. Circulatory arrest leads to a disruption in the transport of glucose and oxygen to vital organs: lungs, brain and heart.

    Due to metabolic changes, the control of the nervous system (central and autonomic) over conscious activity, involuntary breathing and heartbeat is disrupted.

    The diagnostic algorithm for suspected asystole includes:

    • checking the patient’s response to the voice, visual images;
    • pulse measurement on the carotid arteries;
    • checking for breathing;
    • pupil reaction to light (a special flashlight is used at night).

    The diagnosis of “asystole” is carried out according to electrocardiography, which determines the contour (flat line, without teeth and other signs of activity of the conduction system of the heart).

    Asystole of the heart in children is most often provoked by injuries, poisoning and various types of respiratory distress (for example, obstruction of the airways, inhalation of smoke, drowning or infection). By the way, it was noticed that in 15-20% of patients cardiac arrest is preceded by fibrillation or ventricular tachycardia.

    But the most common sign that a child is threatened with the development of asystole is the presence of bradyarrhythmia (a significant reduction in heart rate). If in children or adolescents there are severe congenital heart pathologies before asystole, the occurrence of frequent shallow breathing, hypotension and impaired consciousness can be previously observed in them. In some situations, cardiac arrest is preceded by a collapse with a short (less than five seconds) seizure.

    Asystole in children is much more common than in adults, and relates mainly to the secondary species. The following factors are considered its causes:

    • Injuries
    • Poisoning, especially when inhaling carbon monoxide
    • Obstruction or respiratory tract infection

    It has been recorded that tachycardia or ventricular fibrillation before cardiac arrest is observed in 20% of patients of this age, and bradyarrhythmia is the main symptom that threatens the life of the child.

    Some of these reasons, associated mainly with congenital heart defects, are also characteristic of children. In addition to them, there is also a sudden death syndrome in infants (ADS).

    The indicated condition is also associated with the cessation of myocardial pressure function. The syndrome is characteristic of children under 5 months of age.

    Circulatory arrest occurs during sleep. Cardiologists call the main reason physiological immaturity of the internal organs of the child.

    • Multiple pregnancy;
    • Prematurity;
    • Fetal hypoxia;
    • Asphyxia of the child in childbirth;
    • Past infections.

    Parents’ smoking, tight swaddling, sleeping on a soft pillow in the stomach position can contribute to the death of a baby.

    In some cases, the threatening asystole of the heart makes itself felt with obvious signs:

    • Pale skin, blue of nails, lips, nasolabial triangle;
    • Acute hypotension (drop in blood pressure below 60 mmHg);
    • Reducing the number of heart contractions to 30-40 beats / min.

    But these symptoms, as well as extrasystole and ventricular tachycardia, can be noticed only with constant monitoring of the patient. According to statistics, only 30% of patients with cardiac arrest are at this moment in the hospital or under the control of relatives.

    The remaining cases occur in front of strangers who are far from medicine.

    To prevent death, you need to know the reliable signs of cardiac arrest:

    • Loss of consciousness (occurs within 10-15 seconds after the termination of ventricular function);
    • Rare noisy breathing (sobs);
    • Cramps;
    • Persistent dilated pupils;
    • Lack of pulse.

    The consequences of asystole

    Survival after sudden death is low – in different sources numbers from 14% to 30% are indicated. Further well-being of the patient depends on how long he was in a state of clinical death.

    Most often, such complications arise:

    • Memory impairment;
    • Hearing impairment;
    • Loss of vision. In some cases, other areas take on the function of the affected part of the brain, and blindness passes;
    • Periodic seizures of an isolated nature (of a single limb, facial, chewing muscles);
    • Auditory, tactile and visual hallucinations;
    • Persistent headaches;
    • Postresuscitative disease – loss of consciousness, impaired activity of the respiratory system, blood circulation, ischemia of internal organs. In most patients, the main functions are restored within 3 hours. Approximately 20% of patients have coma. If a deep loss of consciousness lasts more than 6 hours, the hope of restoration of brain function is sharply reduced. A coma lasting more than two days most often means the patient’s subsequent vegetative state.

    As mentioned above, the rescuers have little time to help a person who has heart asystole. This is only 10 minutes. And, unfortunately, even in the case of a favorable outcome, the victim may have the consequences of cardiac arrest, for example,

    The causes of asystole are usually divided into cardiac and extracardiac. The first category of etiological factors are:

    • cardiac ischemia;
    • acute coronary syndrome, myocardial infarction;
    • myocarditis;
    • pericarditis with cardiac tamponade (the result of treatment is visible immediately after the evacuation of accumulated fluid);
    • congenital and acquired heart defects (including aortic stenosis, damage to the valvular apparatus);
    • cardiomyopathy;
    • heart injuries;
    • invasive medical procedures (coronary angiography, catheterization of cardiac cavities and large vessels), direct cardiac pacing.

    Termination of heart rate is a possible complication of these measures.

    The development of asystole can provoke violations of homeostatic constants. What are extracardiac factors?

    1) Various disorders of the vascular tone in shock.

    2) A significant decrease in the volume of circulating blood.

    3) Thrombosis in the area of ​​large branches of the pulmonary trunk.

    4) Reflex cardiac arrest due to vagus nerve irritation due to blunt abdominal injury.

    5) Accumulation of air in the pleural cavity (pneumothorax).

    6) Violations of the gas composition of the blood (O2 deficiency and / or the prevalence of CO2).

    7) Marked electrolyte changes: low blood pH, a sharp increase in potassium and calcium, nitrogen compounds. Increased production of stress hormones.

    An overdose of drugs, an individual reaction to barbiturates, drugs, adrenergic blockers, quinidine, cardiac glycosides.

    9) All conditions leading to the impossibility of oxygen supply to the lungs (drowning, asphyxiation, aspiration by foreign bodies).

    10) Electric shock and lightning.

    The pathogenetic process of asystole depends on the initial state of the myocardium, quality, as well as the severity of the etiotropic factor. Cardiac arrest may develop at the level of the main pacemaker (sinus node), blockade in the AV connection, or primary ventricular asystole.

    Treatment of asystole begins regardless of the availability of specialized care. Each person should be trained in primary resuscitation.

    To perform CPR at the level of an ordinary citizen, it is necessary to be able to carry out artificial ventilation of the lungs and indoor heart massage.

    Mechanical ventilation is carried out “mouth-to-mouth” and “mouth-to-nose”, in children a mixed variant is possible with simultaneous blowing of air into the nasal and oral cavity. Preliminarily check the patency of the airways, maximally cleanse them of mucus, vomit, with drowning – from water and mud. Air is exhaled through the handkerchief into the victim’s mouth or nose with obstruction of the return air flow (mouth-to-mouth reception requires closing the nose and vice versa).

    Efficiency is estimated by the movements of the chest.

    Closed heart massage is performed just above the xiphoid process over the projection of the heart (the reference point is the lower third of the sternum), with a cruciform setting of the hands and arms straightened in the elbow joints. Compression is carried out to a depth of ¾ of the thickness of the chest. The presence of a pulse wave from the vessels of the neck at this moment indicates the correctness of the implementation of measures.

    Under ideal conditions, resuscitation is carried out together, trying to achieve a heart massage frequency of up to 100 per minute, for every 30 compressions there are 2 injections into the lungs.

    Among the complications of asystole, the following pathological conditions are identified that occur due to cardiac arrest or CPR:

    • Neurological Disorders
    • Cerebral ischemia
    • Pneumothorax
    • Air embolism
    • Aspiration
    • Damage to the kidneys and liver
    • Gastrointestinal rupture
    • Fractures of the ribs of the chest
    • Damage to the integrity of the pleural cavity and filling it with blood

    For the body, even a short stop of the “main motor” threatens considerable troubles. All organs suffer from oxygen starvation, and most of all the brain.

    In patients who survived asystole, various neurological manifestations are possible. They depend on damage to specific nuclei of the brain and transmission paths, as well as the previous state of the tissues. In elderly and debilitated patients, full recovery cannot be expected. Because the neurons were already sufficiently depleted by the disease.

    Sometimes the patient is in a prolonged coma. The best result can be achieved with injuries in young people without previous myocardial damage.

    The prognosis is the best if help began to be provided in the first 3 minutes of asystole and the ambulance crew managed. Statistics record unsuccessful resuscitation with asystole in 70% of patients.

    Patients with complete atrioventricular block after an attack need to resolve the issue of installing a pacemaker. It will help to lead an active life and maintain a given rhythm of contractions.

    For surviving people, it is imperative to maintain good dietary health, stop bad habits, and regularly take medications recommended by your doctor. Some patients have to decide on the surgical treatment of defects.

    The correct attitude to the second chance to live sometimes dramatically changes the nature of people, forces them to leave the profession, to reconsider relations with friends and family. Here medicine is powerless.

    Clinical death or asystole is a reversible phenomenon, although it is very dangerous for humans. Much depends on the nature of the problem and timely assistance.

    • in the case of blockade of the pathways with immediate massage of the heart, a person regains consciousness, which allows for further resuscitation;
    • blockage of the pulmonary artery reduces a person’s response to first aid, recovery will be long;
    • with cardiac tamponade, even short-term improvement is problematic;
    • fibrillation with timely diagnosis and restart of the heart allows you to make the most optimistic forecasts;
    • cases of air entering the chest are not complete without the intervention of surgeons, only in this way you can get a positive, lasting result;
    • also surgery is the only option for thrombus, swelling and abnormalities in the operation of the artificial valve;
    • the lack of consciousness for no more than 6 hours with the appearance of contractile function and artificial ventilation of the lungs leaves a high chance for the patient;
    • coma over 6 hours allows you to make disappointing predictions, after a day of unconsciousness the probability of a positive outcome is very small, and after two days it is equal to zero.

    Cardiac asystole is a serious problem that leaves its mark on human life. Postponed cardiac arrest requires a fundamental change in life. Otherwise, asystole may occur again, but the chances of success will be much lower. We have given the rules that must be followed after a clinical death and a successful rehabilitation:

    1. Complete cessation of alcohol and smoking.
    2. Each medicine should be agreed with the doctor. Self-medication is strictly prohibited.
    3. Remove or reduce to a minimum the content of fast carbohydrates, cholesterol and salt in the diet. This primarily concerns confectionery, fatty foods and sausages.
    4. Stressful situations and high physical exertion should be avoided.
    5. The regimen of the day, the correct schedule, good sleep and rest.
    6. In the presence of a disease that caused asystole, a person is required to be registered, regularly visits a doctor and takes prescribed medications. Some drugs are taken continuously, which helps maintain the heart and blood vessels in good condition.

    Diagnostics

    To begin with, we turn to the international classification and find the problem that interests us there. According to ICD 10, asystole has the code I46 and is called cardiac arrest. The problem can be identified without the use of special equipment:

    • there is no pulse on the carotid artery;
    • dilated pupils and weak breathing, which is difficult to determine.

    In the presence of these manifestations, there is no sense in further diagnosis; rehabilitation measures are immediately carried out. In the first 5 minutes it is necessary to restore blood flow. Otherwise, the process of dying off brain cells will begin. Even if after this time the heart is restarted, its operation will be unstable. The cause is cerebral edema.

    With the restoration of blood circulation, at least at the minimum level, there is a need for an electrocardiographic study. These data will reveal the nature and mechanism of the disturbance in cardiac activity.

    Asystole on the ECG manifests itself in the form of an isoline without the presence of any waves. In rare cases, isolated ventricular asystole may occur. In this case, the ECG registers both QRS complexes and atrial P waves. This situation is associated with atrial contraction, which continues after the ventricles cease to function. What follows is complete asystole.

    Asystole refers to heart rhythm disturbances. There are 4 types of such deviations, therefore, it is possible to determine which of them caused cardiac arrest only with the help of an ECG.

    Prevention of asystole

    It is not always possible to prevent the occurrence of such a condition. Preventive measures are aimed at reducing the risk of asystole:

    1. If there is a history of cardiac pathologies, it is necessary to undergo a timely examination by the attending physician, do not exceed the dosage of the drugs used and the level of physical activity
    2. Stop drinking alcohol and nicotine
    3. Avoid hypothermia, stress and traumatic situations
    4. Balance Diet
    5. Do not neglect preventive medical examinations
    6. Timely treat chronic diseases, the complication of which may be cardiac arrest

    Depending on the cause of the occurrence of asystole, its type, time of emergency care and the age of the person, the prognosis may be either the preservation of the patient’s life or death. Survival rate in a hospital reaches 22%, and beyond – 3-16% in children and about 8% in adults. Based on these figures, we can say that the forecast is mostly pessimistic.

    Asystole mainly occurs against the background of serious pathologies, so the patient’s chance of survival is very small. It is a sudden cardiac arrest, which in most patients leads to death. In some cases, even timely emergency care will not lead to a positive result. Therefore, adherence to prevention is the only way to reduce the risk of heart failure.

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    Asystole resulting from accidents is not preventable. No one is safe from such situations. But many pathologies of the heart and blood vessels that can lead to asystole can be prevented and prevented. The secret is simple and consists of only a few points:

    • regular visits to the doctor;
    • appeal to a cardiologist immediately when the first symptoms of the disease appear;
    • strict compliance with the instructions given by a specialist;
    • a healthy lifestyle in which there will be no place for bad habits, stress, disturbances in the diet, lack of sleep and lack of exercise;
    • surgical interventions recommended by specialists should be carried out without delay.

    Compliance with these simple rules will significantly reduce the risk of asystole.

    You need to be careful about your body, listen to its signals and reactions. In this case, you can live a long life, not overshadowed by serious diseases and problems such as asystole.

    Desired random passer action algorithm

    According to the researchers, the problem of cardiac arrest occurs in newborns with a frequency of 72,1 per 100 cases, in children – 000, in adolescents – 3,73, in adults – 7,37.

    The chances of survival with both variants of fatal rhythm disturbance are small, and with asystole they are 4 times lower than with ventricular fibrillation. Subsequent violations of the vital functions of the brain and other organs determine an unfavorable prognosis.

    1. Shake the victim, shake, slap on the cheeks, speak loudly. If a person regains consciousness, this indicates a short-term violation of cerebral circulation. Accordingly, you need to try to ensure free breathing, a position with a low head end.
    2. If there is no reaction to the intervention, then you should try to feel the pulsation of the carot >

    At the sight of a fallen person you can’t pass by, your relatives and close people may be in the same situation

    Asystole (another clinical name – isoline) is called the cessation of the synthesis and conduct of electrical impulses in the heart. The development of pathology is a non-specific consequence of many conditions.

    According to the recommendations of the American Society of Cardiology, ventricular asystole develops in the following cases:

    • hypovolemia (reduced volume of circulating blood due to trauma, damage to the integrity of the arteries, redistribution of fluid in the vascular bed);
    • hypoglycemia – a glucose deficiency that often develops in patients with diabetes mellitus after physical activity or when they go to bed without observing the diet and the use of insulin;
    • hypoxia is an oxygen deficiency that is delivered to organs and tissues. The condition develops against a background of cardiac or respiratory pathology, blood diseases;
    • electrolyte imbalance, especially potassium metabolism (hypo- and hyperkalemia). An increased concentration of ions accompanies injuries, metabolic disorders, renal failure and prolonged compression syndrome;
    • acidosis – a decrease in blood pH due to the accumulation of under-oxidized products;
    • hypothermia is one of the most common causes of a child’s death in the first days of life (sudden infant death syndrome) due to exposure to low temperatures, which inhibits the activity of the nervous system and heart rate driver;
    • intense pneumothorax – a pathology characterized by an accumulation of air in the pleural cavity, which compresses the lung tissue;
    • thrombosis – blockage of blood vessels of the heart or brain with a blood clot;
    • intoxication with toxic substances or medications;
    • tamponade – the accumulation of blood in the pericardial cavity due to rupture of the heart wall.

    These conditions develop with myocardial infarction, traumatic shock, an overdose of pharmacological drugs.

    conclusions

    The development of asystole is accompanied by circulatory arrest, which is a direct threat to human life. The risk of this condition exists in all patients with chronic diseases or in the presence of acute pathologies with intoxication, metabolic disorders. Diagnosis of the first signs of clinical death, timely call of a doctor and the provision of primary care at home contributes to the success of resuscitation.

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  • Svetlana Borszavich

    General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
    Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
    The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
    The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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