Which of the following signs indicate death? Biological death: its main features and difference from clinical death

All signs of death can be divided into two groups - probable and reliable.

Probable signs of death

Based on probable signs, death is expected. In everyday life, there are cases of a person developing a deep coma, fainting and other similar conditions that can be mistakenly accepted as death.

Possible signs of death:

1) body immobility;

2) pallor skin;

3) lack of reaction to sound, pain, thermal and other irritations;

4) maximum dilation of the pupils and their lack of reaction to light;

5) lack of corneal reaction eyeball to mechanical impact;

6) absence of pulse in large arteries, especially in carotid artery;

7) absence of heartbeat – according to auscultation or electrocardiography;

8) cessation of breathing - there is no visible excursion of the chest, a mirror brought to the victim’s nose does not fog up.

Reliable signs of death

The presence of reliable signs of death indicates the development of irreversible physical and biochemical changes, not characteristic of a living organism, about the onset biological death. The severity of these changes determines the time of death. Reliable signs of death are divided into early and late according to the time of manifestation.

Early cadaveric changes develop during the first 24 hours after death. These include rigor mortis, rigor mortis, cadaveric spots, partial cadaveric desiccation, cadaveric autolysis.

Cadaveric cooling. A reliable sign of death is a drop in temperature in the rectum to 25 °C or lower.

Normally, a person’s body temperature is in the range of 36.4-36.9 °C when measured in armpit. In the internal organs it is 0.5 °C higher, the temperature in the rectum is 37.0 °C. After death, thermoregulation processes stop and the body temperature tends to equal the temperature environment. At an ambient temperature of 20 °C, the cooling time lasts up to 24–30 hours, at 10 °C – up to 40 hours.

At the time of death, body temperature may be 2–3 °C higher than normal due to the development infectious diseases, in case of poisoning, overheating, after physical work. The rate of cooling of a corpse is affected by environmental humidity, wind speed, ventilation of rooms, the presence of contact of the body with massive cold (warm) objects, the presence and quality of clothing on the body, the severity of subcutaneous fatty tissue, etc.

A noticeable cooling of the hands and face to the touch is noted after 1.5–2 hours, the body under clothing remains warm for 6–8 hours.

With instrumental thermometry, the time of death is determined quite accurately. Body temperature decreases approximately by 1 °C per 1 hour in the first 7–9 hours, then it decreases by 1 °C in 1.5 hours. Body temperature should be measured twice with an interval of 1 hour, at the beginning and at the end of the examination of the corpse.

Rigor mortis. This is a peculiar condition of muscle tissue that causes limited movement in the joints. The expert tries with his own hands to make this or that movement in any part of the body, limb of the corpse. When encountering resistance, the expert determines the severity of muscle rigor by its strength and limited range of motion in the joints. To the touch, stiff muscles become dense.

Immediately after death, all muscles are usually relaxed and passive movements in all joints are fully possible. Rigor rigor is noticeable 2–4 hours after death and develops from top to bottom. Facial muscles stiffen faster (opening and closing the mouth is difficult, lateral movements are limited lower jaw) and hands, then – the muscles of the neck (movements of the head and cervical spine spine), then the muscles of the limbs, etc. The corpse becomes completely numb in 14–24 hours. When determining the degree of rigor, it is necessary to compare its severity in the right and left parts of the body.

Rigor mortis persists for 2–3 days, after which it resolves due to the activation of the process of decay of the actomyosin protein in the muscles. This protein causes muscle contraction. Resolution of rigor mortis also occurs from top to bottom.

Rigor mortis develops not only in skeletal muscles, but also in many internal organs (heart, gastrointestinal tract, bladder etc.) having smooth muscles. Their condition is judged during an autopsy.

The degree of rigor at the time of examination of the corpse depends on a number of reasons, which must be taken into account when determining the time of death. At low ambient temperatures, rigor mortis develops slowly and can last up to 7 days. On the contrary, in room conditions and more high temperature this process accelerates and complete rigor develops faster. Rigor rigor is severe if death was preceded by convulsions (tetanus, strychnine poisoning, etc.). Also, rigor develops more strongly in persons:

1) having well-developed muscles;

2) younger;

3) without diseases of the muscular system.

Muscle contraction is caused by the breakdown of ATP (adenosine triphosphate) in it. After death, some of the ATP is free from connection with carrier proteins, which is enough for complete relaxation of the muscles in the first 2–4 hours. Gradually, all ATP is utilized and rigor mortis develops. The period of complete utilization of ATP is approximately 10–12 hours. It is during this period that changes in the state of the muscles under external influence, you can, for example, straighten the brush and put an object into it. After changing the position of a part of the body, rigor is restored, but to a lesser extent. The difference in the degree of rigor is established by comparing different parts bodies. The difference will be smaller the sooner after death the position of the corpse or part of its body is changed. After 12 hours from the moment of death, ATP completely disappears. If the position of the limb is disturbed after this period, then rigor in this place is not restored.

The state of rigor is judged by the results of mechanical and electrical effects on the muscles. When a muscle is struck by a hard object (stick), an idiomuscular tumor forms at the site of the impact, which is determined visually in the first 6 hours after death. In more late dates such a reaction can only be determined by palpation. When a current of a certain strength is applied to the ends of the muscle, its contraction is observed, assessed on a three-point scale: strong contraction is observed in a period of up to 2–2.5 hours, medium – up to 2–4 hours, weak – up to 4–6 hours.

Cadaveric spots. The formation of cadaveric spots is based on the process of redistribution of blood in the vessels after death. During life, the muscle tone of the vascular walls and the contraction of the myocardium of the heart contribute to the movement of blood in a certain direction. After death, these regulatory factors disappear and the blood is redistributed to the underlying parts of the body and organs. For example, if a person lies on his back, blood flows into the back area. If the corpse is in an upright position (hanging, etc.), then the blood flows into the lower abdomen and lower limbs.

The color of the spots is most often bluish-purple. In carbon monoxide poisoning, carboxyhemoglobin is formed, and therefore the color of the stain is reddish-pink; in case of poisoning with certain poisons, the color is grayish-brown (formation of methemoglobin).

Blood is redistributed to areas that are not pressed. With severe blood loss, spots form slowly and are weakly expressed. With asphyxia, blood thins and the spots are abundant, diffuse and strongly pronounced.

In a living organism, the components of blood pass through the wall of blood vessels only in capillaries, the most small vessels. In all other vessels (arteries and veins), blood does not pass through the wall. Only in certain diseases or after death does the vascular wall and its structure change and it becomes permeable to blood and interstitial fluid.

Cadaveric spots go through three stages in their development.

Stage I – hypostasis, develops after 2–4 hours. If you press on the spot at this stage, it completely disappears. In this case, the blood is squeezed out of the vessels, the wall of which is still impenetrable, that is, the components of the blood do not pass through it into the tissue. If the pressure is stopped, the spot is restored. Fast recovery spots for 3-10 s correspond to 2-4 hours ago death, a time equal to 20-40 s corresponds to 6-12 hours. When the position of the corpse changes at this stage, the spots in the old place disappear, but other spots appear in the new place (“ migration of spots").

Stage II – diffusion (stasis), develops after 14–20 hours. At this stage, the vascular wall becomes permeable to a certain extent; intercellular fluid diffuses through the wall into the vessels and dilutes the plasma; hemolysis (destruction) of red blood cells occurs. At the same time, blood and its breakdown products diffuse into the tissue. When pressed, the spot turns pale, but does not disappear completely. Recovery of the spot occurs slowly, within 5-30 minutes, which corresponds to 18-24 hours after death. When the position of the corpse changes, the old spots fade, but new ones appear in those places that are located below the locations of the previous spots.

Stage III – hypostatic imbibition, develops after 20–24 hours or more. The vessel wall is completely saturated with blood plasma and interstitial fluid. Blood as a liquid system is completely destroyed. Instead, in the vessels and surrounding tissues there is a liquid formed from the mixing of destroyed blood and interstitial fluid that has permeated the tissues. Therefore, when pressed, the spots do not fade, maintaining their color and shade. When the position of the corpse changes, they do not “migrate”.

All of the above changes are observed in the internal organs, more precisely, in those parts of them that are located below other areas. There is an accumulation of fluid in the cavities of the pleura, pericardium, and peritoneum. The walls of all vessels, especially large ones, are saturated with liquid.

Partial cadaveric desiccation. Drying is based on the process of evaporation of moisture from the surface of the skin, mucous membranes and other open areas of the body. In living people, the evaporated liquid is compensated by the newly received one. There is no compensation process after death. Drying begins immediately after death. But its first visually noticeable manifestations are observed after a few hours.

If the eyes are open or half-open, drying quickly manifests itself in the form of clouding of the cornea, which takes on a grayish tint. When the eyelids are pulled apart, triangular-shaped opacities are visible. The time it takes for these spots to appear is 4–6 hours.

Next, the lip border dries (6–8 hours); the surface of the lip becomes dense, wrinkled, red-brown in color (very similar to intravital deposition). If the mouth is slightly open or the tongue protrudes from the oral cavity (mechanical asphyxia), then its surface is dense and brown.

The same changes are observed on the genitals, especially if they are exposed. Thinner areas of the skin dry out faster: the head of the penis, foreskin, scrotum. The skin in these places becomes dense, brown-red, and wrinkled (similar to intravital trauma).

Drying occurs faster if the body is naked; in dry air. Skin areas with post-mortem abrasions dry out faster. Their color is brown-red (on the underlying parts of the corpse) or “waxy” (on the overlying parts of the corpse). These are “parchment spots”, the central area of ​​which is located below the edges. Abrasions are life-time. Their surface also dries quickly, the color is red-brown, but it protrudes slightly due to swelling of the tissue. Microscopic picture - full-blooded vessels, swelling, hemorrhages, leukocyte infiltration.

Cadaveric autolysis. In the human body, a number of glands produce chemically active secretions. After death, these secretions begin to destroy the tissue of the glands themselves, since the organ’s own defense mechanisms are absent. Self-destruction of the gland occurs. This is especially true for the pancreas and liver. At the same time, secretions leave the glands into other organs (the gastrointestinal tract) and change it. Organs become flabby and dull. The faster death occurs, the stronger the effect of enzymes on the structure of organs. The shorter the agony lasts, the less time the body has time to utilize enzymes and the faster cadaveric changes develop. All changes caused by autolysis can only be seen during an autopsy.

Pupil reaction. During the first day, the pupils retain the ability to respond to the influence of certain pharmacological substances, introduced into the anterior chamber of the eye. The speed of pupillary reaction decreases with increasing time of death. After administration of pilocarpine, pupil constriction after 3-5 s corresponds to 3-5 hours after death, after 6-15 s - 6-14 hours, 20-30 s - 14-24 hours.

The Beloglazov phenomenon. 15–20 minutes after death, the level in the eyeballs decreases intraocular pressure. Therefore, when the eyeball is compressed, the pupil takes an oval shape. Living people don't have this.

Late cadaveric changes change dramatically appearance corpse. Their onset is noted during the period of manifestation of early cadaveric changes. But outwardly they appear later, some by the end of 3 days, others months and years later.

Depending on the preservation of individual characteristics of a person and damage to the corpse, late cadaveric changes are divided into types:

1) destructive - rotting;

2) preservatives: fat wax, mummification, peat tanning, freezing.

During conservation, the appearance changes, but to a certain extent, individual features and damage are preserved.

Rotting. Rotting – difficult process decomposition of organic compounds under the influence of microorganisms and their enzymes. According to their living conditions, microorganisms are divided into aerobes and anaerobes (living with or without oxygen). Aerobes produce destruction more intensively. Anaerobes slowly destroy tissue, releasing unpleasant odors.

Microorganisms decompose protein into peptones and amino acids. Next, valeric, acetic, oxalic acids, creosol, phenol, methane, ammonia, nitrogen, hydrogen, carbon dioxide, hydrogen sulfide, methyl mercaptan, ethyl mercaptan. The latter have bad smell. When rotting, unstable substances are formed - putrescine, cadaverine.

Optimal conditions for rotting are 30–40 °C. The rate of decay is highest in air. In water the process is underway slower, in soil even slower, in coffins very slow. At temperatures of 1 °C or less, 50 °C degrees or higher, the decay process slows down sharply and even stops. Decay is accelerated if death is preceded by prolonged agony (rapid destruction of the tissue barrier of the colon), purulent infection, sepsis.

After death, decay occurs immediately in the large intestine, where a living person has certain types bacteria, which are anaerobes, whose vital activity continues even after a person’s death. Microorganisms contribute to the formation of gases, especially hydrogen sulfide. It penetrates through the wall of the intestine and its vessels into the blood. In the blood, hydrogen sulfide combines with hemoglobin to form sulfohemoglobin, which has greenish color. Spreading through the vessels, sulfohemoglobin penetrates the venous network of the skin and subcutaneous tissue of the anterior wall of the abdomen and its hypogastric region. All this explains the greenish color of the skin groin areas 36–48 hours after death. Further, the color intensifies due to an increase in the concentration of sulfohemoglobin and the formation of iron sulfide (greenish-gray color).

The accumulation of gases in the intestines leads to bloating of the intestines and the entire abdomen. This pressure is so strong that pregnant women experience miscarriage (so-called “post-mortem labor”) and uterine inversion. The gas penetrates the subcutaneous tissue of the entire body and causes swelling of the face, lips, mammary glands, neck, and scrotum. The tongue protrudes from the mouth. Gases press on the stomach, which leads to post-mortem vomiting.

Sulfohemoglobin and iron sulfide, spreading through the vessels, color them, which is noted as “putrefactive venous network» dirty green after 3–5 days. After 8–12 days, the skin of the entire corpse has a dirty green color. The epidermis peels off, blisters with bloody contents form. Hair changes color after 3 years. Damage to the bones, gunshot marks on the skin and its pattern, and traces of cardiosclerosis persist for a relatively long time.

Fat wax. Synonyms: saponification, saponification of fats. Conditions for formation: a humid environment without access to air. This phenomenon is well expressed in people with significant subcutaneous fat.

Water penetrates the skin (maceration phenomenon), then penetrates the intestines and washes microorganisms out of it. The rotting weakens sharply and even stops. Fat is decomposed by water into glycerol and fatty acid: oleic, palmitic, stearic, etc. These acids combine with alkali and alkaline earth metals, which are abundant in body tissues and in the water of reservoirs. A fat wax is formed, which has a gelatinous consistency of a dirty gray color (compounds of potassium and sodium), or a dense substance of gray-white color (compounds of calcium and magnesium). This process is subjected to subcutaneous tissue, fat deposits in the chest and abdominal cavities, brain, liver. However, individual features, the shape of organs, and traces of damage to tissues and organs are preserved.

The first signs of saponification of corpse tissue are observed from 25 days to 3 months. Complete saponification occurs no earlier than 6–12 months on the corpses of adults, and faster on the corpses of children.

Mummification. Natural mummification occurs when different temperatures environment (usually high), lack of moisture, access and movement of dry air, rapid release of fluid from the corpse. In the first days after death, rotting processes occur intensively in the corpse. Parenchymal organs(lungs, liver, kidneys and other organs) turn into a liquid mass that flows out through the disintegrated tissues. A decrease in the amount of liquid creates unfavorable conditions for the life of putrefactive microorganisms, as a result of which putrefaction gradually stops and the corpse begins to dry out quickly. Drying begins, as a rule, in areas devoid of epidermis, in macerated areas of the skin, with open eyes– in the area of ​​the cornea and conjunctiva, on the lips, fingertips, etc. Complete drying of the corpse is most often observed in dry, loose, well-ventilated soil that absorbs moisture, in rooms with sufficient ventilation.

Corpses of thin and emaciated persons are easily mummified. On average, mummification of a corpse occurs after 6–12 months; in some cases, the corpse of an adult can be mummified in 2–3 months. The mass of the mummy is 1/10 of the original body mass. Skin color is parchment, yellowish-brown or dark brown. Internal organs dry and take on a flat shape. The tissues become dense. During mummification, a person's appearance is preserved to varying degrees. You can determine gender, age, anatomical features. Traces of a shot, acute wounds, and a strangulation groove remain.

Peat tanning. The impregnation and tanning of tissues and organs with humic acids, which are products of the decay of dead plants, occurs in peat bogs. The skin becomes dark brown and dense. Internal organs are reduced. Mineral salts are washed out of the bones, so the shape of the bones changes. Bones look like cartilage. All damage is preserved. In this state, corpses can be preserved for a very long time, sometimes for centuries.

Exist obvious signs biological death, which indicate that important processes in the body have stopped, leading to the irreversible death of a person. But since modern methods allow the patient to be resuscitated even when by all indications he is dead. At each stage of medical development, the symptoms of death become more precise.

Causes of biological death

By biological or true death we mean irreversible physiological processes occurring in cells and tissues. It can be natural or premature (pathological, including instantaneous). At a certain stage, the body exhausts its strength in the struggle for life. This leads to the stopping of the heartbeat and breathing, and biological death occurs. Its causes are primary and secondary, they can be such etiological factors, How:

• acute, profuse blood loss;
• concussion or compression of organs (vital);
• asphyxia;
• state of shock;
• injuries incompatible with life;
• intoxication;
• infectious and non-infectious diseases.

Stages of biological death

How does a person die? The process can be divided into several stages, each of which is characterized by a gradual inhibition of the main vital functions and their subsequent stop. The stages are called:

1. Pregonal state. Early symptoms of biological death are pale skin, weak pulse(it can be felt on the carotid and femoral arteries), loss of consciousness, decreased pressure. The condition worsens, oxygen starvation increases.
2. Terminal pause. A special intermediate stage between life and death. The latter is inevitable if urgent resuscitation measures.
3. Agony. The final stage. The brain stops regulating all body functions and the most important processes life activity. It becomes impossible to revive the body as an integral system.

How does clinical death differ from biological death?

Due to the fact that the body does not simultaneously die with the cessation of cardiac and respiratory activity, two similar concepts are distinguished: clinical and biological death. Each has its own symptoms, for example, in the case of clinical death, a preagonal state is observed: there is no consciousness, pulse and breathing. But the brain is able to survive without oxygen for 4-6 minutes; organ activity does not stop completely. This is the main difference between clinical death and biological death: the process is reversible. A person can be revived by performing CPR.

Brain death

Not always cessation important functions organism means death. Sometimes diagnosed pathological condition when necrosis of the brain (total) and the first cervical segments of the spinal column occurs, but gas exchange and cardiac activity are maintained with the help artificial ventilation lungs. This condition called cerebral, less often social death. In medicine, the diagnosis appeared with the development of resuscitation. Biological brain death is characterized by the presence of the following symptoms:

1. Lack of consciousness (including ).
2. Loss of reflexes.
3. Muscle atony.
4. Inability to breathe independently.
5. Lack of reaction to pupil light.

Signs of biological death in humans

Various signs of biological death confirm a fatal outcome and are a reliable fact of death. But if symptoms are noted under the inhibitory effect of drugs or conditions of deep cooling of the body, they are not the main ones. The time of death of each organ is different. Brain tissue is affected faster than others, the heart remains viable for another 1-2 hours, and the liver and kidneys - more than 3 hours. Muscle tissue and the skin remains viable even longer – up to 6 hours. Symptoms of biological death are divided into early and later.

Early signs of biological death

In the first 60 minutes after dying, early symptoms of biological death appear. The main ones are the absence of three vital parameters: heartbeat, consciousness, breathing. They indicate that resuscitation actions in this situation are meaningless. TO early symptoms biological death include:

1. Drying of the cornea, clouding of the pupil. It becomes covered with a white film, and the iris loses its color.
2. Lack of eye reaction to light stimulus.
3. A syndrome in which the pupil takes an elongated shape. This is the so-called cat eye, a sign of biological death, indicating that there is no eye pressure.
4. The appearance on the body of so-called Larche spots - triangles of dried skin.
5. Coloring lips brown. They become dense and wrinkled.

Late signs of biological death

After death occurs, additional – late – symptoms of the body’s dying appear within 24 hours. An average of 1.5-3 hours pass after cardiac arrest, and cadaveric spots appear on the body (usually in the lower part) marble color. In the first 24 hours due to biochemical processes Rigor mortis sets in in the body and disappears after 2-3 hours. Signs of biological death also include cadaveric cooling, when body temperature drops to air temperature, dropping by an average of 1 degree every 60 minutes.

A reliable sign of biological death

Any of the above symptoms are signs of biological death, evidence of which makes resuscitation pointless. All these phenomena are irreversible and represent physiological processes in tissue cells. A reliable sign of biological death is a combination of the following symptoms:

• maximum pupil dilation;
• rigor mortis;
• cadaveric body spots;
• absence of cardiac activity for more than 20-30 minutes;
• cessation of breathing;
• post-mortem hypostasis.

Biological death - what to do?

After the completion of all three dying processes (preagonia, terminal pause and agony), the biological death of a person occurs. It must be diagnosed by a doctor and confirmed as fatal. The most difficult thing to determine is brain death, which in many countries is equated to biological death. But after confirmation, it is possible to remove organs for subsequent transplantation to recipients. To make a diagnosis, you sometimes need:

• conclusions of such specialists as a resuscitator, a forensic expert;
• vascular angiography, confirming the cessation of blood flow or its critically low level.

Biological death - help

In case of symptoms of clinical death (cessation of breathing, cessation of pulse, etc.), the doctor’s actions are aimed at reviving the body. With the help of complex resuscitation measures, he tries to maintain circulatory and respiratory functions. But only when confirmed positive result resuscitating a patient is required condition. If signs of biological actual death are detected, resuscitation measures are not carried out. Therefore, the term has another definition - true death.

Ascertainment of biological death

IN different time existed different ways diagnosing human death. The methods were both humane and inhumane, for example, the Jose and Raze tests involved pinching the skin with forceps and exposing the limbs to a hot iron. Today, the ascertainment of a person’s biological death is carried out by doctors and paramedics, employees of healthcare institutions who have all the conditions for such a check. The main signs - early and late - that is, cadaveric changes allow us to conclude that the patient has died.

There are methods instrumental research, confirming death, mainly of the brain:

• cerebral;
• electroencephalography;
• magnetic resonance angiography;
• ultrasonography;
• a test for spontaneous breathing, it is carried out only after receiving complete data confirming brain death.

Numerous signs of biological death allow doctors to confirm the death of a person. IN medical practice There are known cases of not only lack of breathing, but also cardiac arrest. Because of the fear of making mistakes, life test methods are constantly being improved and new ones appear. At the first signs of death, before reliable symptoms of true death appear, doctors have a chance to bring the patient back to life.

Numerous studies have found that irreversible changes in the body, occurring during biological death, is preceded by clinical death lasting 3-5 minutes after cardiac and respiratory arrest. Revitalization measures begun at this time can lead to a complete restoration of body functions. Resuscitation methods can be used in any setting, without special equipment. The success of revival depends, first of all, on the time the revival begins, as well as on the strict execution of actions in a certain order.

Signs of biological death are: 1) cadaveric spots (blue-red coloring of parts of the body in sloping places; parts of the body located on top remain light). They appear 30-60 minutes after death; 2) rigor mortis. Starts with the face and hands and moves to the torso and lower limbs,

Clearly expressed 6 hours after death. Relaxation of this state is observed after 24 hours in the same sequence; 3) decomposition - specific smell, green coloration of the skin, swelling and disintegration.

Diagnostic signs of clinical death are: lack of breathing, pulse in the carotid and femoral arteries and consciousness; dilation of the pupils and lack of reaction of the pupils to light; cyanotic or grey colour skin.

Lack of breathing. To find out whether a patient or injured person is breathing, you need to look at the movement of the chest or, by placing your hand on the chest, check whether breathing movements are felt. In case of doubt, it should be assumed that there is no breathing. Shallow and infrequent breathing (5-8 breaths per minute) can also lead to cardiac arrest. With such breathing, it is necessary to begin measures to ensure normal breathing.

Absence of pulse in the carotid and femoral arteries. When breathing and heart stop, the pulse in the arteries disappears. It is easier to determine the pulse on the carotid artery. In this case, it must be taken into account that the one who provides the first medical care sometimes (especially when nervous) he can feel his own pulse.

Lack of pupillary response to light. This is the most reliable sign of clinical death. When blood circulation stops and breathing stops, the pupil dilates, occupies almost the entire iris and does not react to light, while in a living person, when the eyes are opened and there is good lighting, the pupils should narrow. In an unconscious state, an unnatural pupil width is a signal of disaster.

Changes in the color of the skin and visible mucous membranes. In a state of clinical death, the skin and mucous membranes become bluish or gray shade. The most pronounced changes in the color of the lips and nail bed.

Biological death is the irreversible stop of all biological processes in the body. Please note that today the timely cardiopulmonary resuscitation helps start the heart and restore breathing. In medicine, natural (physiological) death is distinguished, as well as premature (pathological). As a rule, the second death is sudden, occurring after a violent murder or accident.

Causes of biological death

TO primary reasons relate :

• Damage that is incompatible with life.
• Heavy bleeding.
• Concussion, compression of vital organs.
• State of shock.

Secondary causes include:

• Different .
• Severe intoxication of the body.
• Non-communicable diseases.

Symptoms of human death

It is on the basis of certain signs that death is declared. First the heart stops, the person stops breathing, and after 4 hours the a large number of cadaveric spots. Due to the stoppage of blood circulation, rigor occurs.

How to recognize biological death?

• There is no respiratory and cardiac activity - there is no pulse in the carotid artery, the heartbeat is inaudible.
• Absence of cardiac activity for more than half an hour.
• The pupils are maximally dilated, but there is no corneal reflex and no reaction to light.
• Hypostasis (appearance of dark blue spots on the body).

Please note that the listed signs do not always indicate the death of a person. The same symptoms appear in the case of severe hypothermia of the body, the inhibitory effect of medications on the nervous system.

It is important to understand that biological death does not mean that all organs and tissues die immediately. It all depends on individual characteristics body. First of all, the tissue dies (subcortical structure, cerebral cortex), but the spinal and stem sections die later.

After death is declared, the heart can be viable for two hours, and the liver and kidneys live for about four hours. The longest viable tissues are muscles and skin. Bone can retain its functions for several days.

Early and late signs of death

Within an hour the following symptoms appear:

• The appearance of Lyarche spots (triangles of dried skin) on the body.
• Cat's eye syndrome (elongated shape of the pupil during squeezing of the eyes).
• Cloudy pupil with white film.
• Lips become brown, dense and wrinkled.

Attention! If all the above symptoms are present, resuscitation is not performed. In this case it is meaningless.

Late symptoms include:

• Spots on the body are marbled in color.
• Cooling of the body because the temperature drops.

When does the doctor pronounce death?

The doctor reports the death of the patient in the absence of:

• Motor response to pain.
• Consciousness.
• Corneal reflex.
• Cough and pharyngeal reflex.

To confirm brain death, the doctor uses instrumental methods diagnostics:

• Electroencephalography.
• Angiography.
• Ultrasonography.
• Magnetic resonance angiography.

Main stages of biological death

• Predagonia– is sharply suppressed or completely absent. In this case, the skin turns pale, is difficult to palpate on the sleepy, femoral artery, the pressure drops to zero. The patient's condition deteriorates sharply.
• Terminal pause is an intermediate stage between life and death. If resuscitation is not carried out in a timely manner, the person will die.
• Agony– the brain ceases to control all physiological processes.

In case of negative impact of destructive processes, the above stages are absent. As a rule, the first and last stage lasts several minutes or days.

Medical diagnosis of biological death

To avoid the mistake of death, many experts use different tests and methods:

• Winslov test– a vessel filled with water is placed on the chest of a dying person, and with the help of vibrations they learn about respiratory activity.
• Auscultation , palpation of central and peripheral vessels.
• Magnus Test - they pull the finger tightly; if it is gray-white, it means the person has died.

Previously, more stringent tests were used. For example, Jose's test involved pinching a skin fold using special forceps. During the Desgrange test, boiling oil was injected into the nipple. But during the Raza test, a hot iron was used, they burned the heels and other parts of the body.

Providing assistance to the victim

Timely resuscitation makes it possible to restore the functions of vital system organs. We draw your attention to the following assistance algorithm:

• Immediately eliminate the damaging factor - body compression, electricity, low or high temperature.
• Free the victim from unfavorable conditions– take it out of the burning room, pull it out of the water.
• First aid will depend on the type of disease and injury suffered.
• Urgent transportation of the victim to the hospital.

Attention! It is important to transport the patient correctly. If he is unconscious, it is best to carry him on his side.

If you provide first aid, be sure to adhere to the following principles:

• Actions must be quick, expedient, calm, and deliberate.
• Really assess your surroundings.
• Don't panic, you need to assess the person's condition. To do this, you need to find out about the nature of the injury or disease.
• Call an ambulance or transport the victim yourself.

Thus, biological death is the end of a person’s life. It is very important to distinguish it from, in the latter case the victim can be helped. If you still could not avoid a tragic situation, you should not take measures on your own; you should immediately call ambulance. The sooner resuscitation methods are used, the greater the chance that a person will survive.

The concept and causes of clinical and biological death. Difference, signs.

People live as if the hour of their death will never come. Meanwhile, everything on planet Earth is subject to destruction. Everything that is born will die after a certain period of time.

IN medical terminology and in practice, there is a gradation of stages of the dying of the body:

• predagonia
• agony
• clinical death
• biological death

Let's talk in more detail about two latest states, their characteristics and distinctive features.

The concept of clinical and biological death: definition, signs, causes

Clinical death is a borderline state between life and biological death, lasting 3-6 minutes. Its main symptoms are the absence of activity of the heart and lungs. In other words, there is no pulse, no breathing process, no signs of body activity.

• In medical terms, signs of clinical death are called coma, asystole and apnea.
• The reasons that caused its onset are different. The most common are electrical trauma, drowning, reflex cardiac arrest, profuse bleeding, acute poisoning.

Biological death is an irreversible state when everything life processes bodies have ceased, brain cells are dying. Its symptoms in the first hour are similar to clinical death. However, then they become more pronounced:

• herring shine and veil on the iris of the eyes
• cadaveric purple spots on the lying part of the body
• dynamics of temperature decrease - every hour by a degree
• stiffening of the muscles from top to bottom

The causes of biological death are very different - age, cardiac arrest, clinical death without attempts at resuscitation or their late use, injuries incompatible with life received in an accident, poisoning, drowning, falling from a height.

How clinical death differs from biological death: comparison, difference

• Most important difference clinical death from biological - reversibility. That is, a person can be brought back to life from the first state if resuscitation methods are promptly resorted to.
• Signs. In clinical death, cadaveric spots on the body, rigor, narrowing of the pupils to “cat-like”, and clouding of the irises do not appear.
• Clinical is the death of the heart, and biological is the death of the brain.
• Tissues and cells continue to live without oxygen for some time.

How to distinguish clinical death from biological death?

At first glance, it is not always easy for a person far from medicine to determine the stage of dying. For example, spots on the body, similar to cadaveric ones, can form in the person being observed while still alive. The reason is circulatory disorders, vascular diseases.

On the other hand, the absence of pulse and breathing is inherent in both species. Partly it will help to distinguish clinical death from the biological state of the pupils. If, when pressed, they turn into a narrow slit like a cat's eyes, then biological death is evident.

So, we looked at the differences between clinical and biological death, their signs and causes. The main difference and vivid manifestations of both types of dying of the human body have been established.

Video: what is clinical death?