Critical loss. Fatal blood loss for humans

The average amount of blood in the body of an adult is 6-8% of the total mass, or 65-80 ml of blood per 1 kg of body weight, and in the body of a child - 8-9%. That is, the average blood volume in an adult man is 5000-6000 ml. Violation of the total blood volume in the direction of decrease is called hypovolemia, an increase in blood volume compared to the norm is called hypervolemia

Acute blood loss develops when a large vessel is damaged, when there is a very rapid drop in blood pressure to almost zero. This condition is noted with a complete transverse rupture of the aorta, superior or inferior veins, and pulmonary trunk. The volume of blood loss is insignificant (250-300 ml), but due to a sharp, almost instantaneous drop in blood pressure, anoxia of the brain and myocardium develops, which leads to death. The morphological picture consists of signs of acute death, an insignificant amount of blood in the body cavities, damage to a large vessel and a specific feature - Minakov's spots. With acute blood loss, exsanguination of internal organs is not observed. With massive blood loss, a relatively slow outflow of blood from damaged vessels occurs. In this case, the body loses about 50-60% of the available blood. Within a few tens of minutes, a gradual drop in blood pressure occurs. At the same time, the morphological picture is quite specific. "Marble" skin, pale, limited, insular cadaveric spots that appear in more late dates than with other types of acute death. Internal organs are pale, dull, dry. It is found in body cavities or at the scene of an accident a large number of spilled blood in the form of bundles (up to 1500-2500 ml). With internal bleeding, large enough blood volumes are required to soak the soft tissue around the lesions.

The clinical picture of blood loss does not always correspond to the amount of blood lost. With a slow flow of blood, the clinical picture may be blurred, and some symptoms may be absent altogether. The severity of the condition is determined primarily on the basis of clinical picture... With very large blood loss, and especially with rapid blood flow, compensatory mechanisms may be insufficient or not have time to turn on. In this case, hemodynamics progressively deteriorate as a result of a vicious circle. Blood loss reduces oxygen transport, which leads to a decrease in oxygen consumption by tissues and an accumulation of oxygen debt, as a result of oxygen starvation of the central nervous system, the contractile function of the myocardium is weakened, the IOC decreases, which, in turn, further impairs oxygen transport. If this vicious circle is not broken, then the increasing disturbances lead to death. Increase sensitivity to blood loss, overwork, hypothermia or overheating, the season (in the hot season, blood loss is worse tolerated), trauma, shock, ionizing radiation, concomitant diseases. Age and gender matter: women are more resistant to blood loss than men; newborns, infants and the elderly are very sensitive to blood loss.

Blood loss is a deficiency in the volume of circulating blood. There are only two types of blood loss - latent and massive. Latent blood loss is a deficiency of erythrocytes and hemoglobin, plasma deficiency is compensated by the body as a result of the phenomenon of hemodilution. Massive blood loss is a shortage of circulating blood volume, leading to dysfunction of the cardiovascular system. The terms "latent and massive blood loss" are not clinical (referring to the patient), they are academic (physiology and pathophysiology of blood circulation) educational terms. Clinical terms: (diagnosis) posthemorrhagic Iron-deficiency anemia corresponds to latent blood loss and the diagnosis hemorrhagic shock- massive blood loss... As a result of chronic latent blood loss, you can lose up to 70% of red blood cells and hemoglobin and save life. As a result of acute massive blood loss, you can die, losing only 10% (0.5 l) of the BCC. 20% (1L) often leads to death. 30% (1.5 L) of the BCC is absolutely fatal blood loss, if it is not reimbursed. Massive blood loss is any blood loss in excess of 5% of the blood volume. The volume of blood taken from a donor is the boundary between latent and massive blood loss, that is, between that to which the body does not respond, and that which can cause collapse and shock.

• Low blood loss (less than 0.5 l) 0.5-10% BCC. Such blood loss is tolerated healthy body without consequences and manifestation of any clinical symptoms... There is no hypovolemia, blood pressure is not reduced, pulse is within normal limits, slight fatigue, skin is warm and moist, has a normal shade, clear consciousness.
• Medium (0.5-1.0 L) 11-20% BCC. Mild hypovolemia, blood pressure reduced by 10%, moderate tachycardia, pallor of the skin, cold extremities, pulse is slightly rapid, breathing is rapid without disturbing the rhythm, nausea, dizziness, dry mouth, possible fainting, twitching of individual muscles, severe weakness, weakness, slow reaction to others.
• Large (1.0-2.0 L) 21-40% BCC. The average severity of hypovolemia, blood pressure is reduced to 100-90 mm Hg. Art., severe tachycardia up to 120 beats / min, breathing is very rapid (tachypnea
) with rhythm disturbances, a sharp progressive pallor of the skin and visible mucous membranes, lips and nasolabial triangle are cyanotic, the nose is pointed, cold clammy sweat, acrocyanosis, oliguria, consciousness is darkened, agonizing thirst, nausea and vomiting, apathy, indifference, the appearance of pathological drowsiness (a sign of oxygen starvation), pulse - frequent, low filling, weakening of vision, flickering of flies and darkening in the eyes, corneal opacity, hand tremors.
• Massive (2.0-3.5 L) 41-70% BCC. Severe hypovolemia, blood pressure reduced to 60 mm Hg, sharp tachycardia up to 140-160 beats / min, threadlike pulse up to 150 beats / min, it is not palpable on peripheral vessels, on the main arteries it is determined much longer, the patient's absolute indifference to the environment environment, delirium, consciousness is absent or confused, a sharp deathly pallor, sometimes a bluish-gray skin tone, "goose bumps", cold sweat, anuria, Cheyne-Stokes type breathing, convulsions may occur, the face is sunken, its features are pointed, sunken dull eyes , a blank look.
• Fatal (more than 3.5 liters) more than 70% of the BCC. Such blood loss is fatal for a person. Terminal state (pre-agony or agony), coma, blood pressure below 60 mm Hg. Art., may not be detected at all, bradycardia from 2 to 10 beats / min, agonal breathing, superficial, barely noticeable, skin dry, cold, characteristic "marbling" of the skin, disappearance of pulse, convulsions, involuntary discharge of urine and feces, dilated pupils , further agony and death develop.

4 question basic requirements when performing blood transfusion

The main task in the treatment of hemorrhagic shock is to eliminate hypovolemia and improve microcirculation. From the first stages of treatment, it is necessary to establish a jet transfusion of fluids (saline, 5% glucose solution) to prevent reflex cardiac arrest - empty heart syndrome.

Immediate stopping of bleeding is possible only when the source of bleeding is available without anesthesia and everything that accompanies a more or less extensive operation. In most cases, patients with hemorrhagic shock have to be prepared for surgery by injecting various plasma-substituting solutions and even blood transfusions into the vein and continue this treatment during and after surgery and stopping bleeding.

Infusion therapy aimed at eliminating hypovolemia is carried out under the control of central venous pressure, blood pressure, cardiac output, total peripheral vascular resistance and hourly urine output. For substitution therapy in the treatment of blood loss, combinations of plasma substitutes and canned blood preparations are used, based on the volume of blood loss.

For the correction of hypovolemia, blood substitutes of hemodynamic action are widely used: dextran preparations (rheopolyglucin

Polyglyukin), gelatin solutions (gelatinol), hydroxyethyl starch (refortan

The reason acute blood loss can become trauma and some diseases. Manifested by pallor, tachycardia, decreased blood pressure, shortness of breath, euphoria or depression of consciousness. Treatment - elimination of the source of bleeding, infusion of blood and blood substitutes.

Acute blood loss

Acute blood loss is a condition in which the body quickly and irreversibly loses a certain amount of blood as a result of bleeding. It is the most common damage to the human body throughout history. It occurs with injuries (both open and closed) and destruction of the vessel wall in some diseases (for example, ulcerative processes in the gastrointestinal tract). The loss of a large volume of blood is life-threatening due to a sharp decrease in the BCC and the subsequent development of hypoxia, hypoxemia, hypotension, insufficient blood supply to internal organs and metabolic acidosis. In severe cases, the development of disseminated intravascular coagulation is also possible.

The greater the volume of blood loss and the faster the blood is poured out, the more severe the patient's condition and the worse the prognosis. In addition, factors such as age, general condition of the body, intoxication, chronic diseases, and even the season (in the warm season, blood loss is more difficult to tolerate) affect the body's response. The loss of 500 ml (10% of the BCC) in a healthy adult does not lead to significant hemodynamic disturbances and does not need special correction. With a loss of a similar volume by a patient suffering from a chronic disease, it is necessary to replenish the BCC with the use of blood, blood and plasma substitutes. This condition is most difficult for the elderly, children and pregnant women suffering from toxicosis.

Causes and classification of acute blood loss

The most common causes are injuries: injuries of soft tissues and internal organs, multiple fractures or damage to large bones (for example, a severe fracture of the pelvis). In addition, acute blood loss can result from blunt trauma with rupture of an organ. Particularly dangerous are wounds with damage to large vessels, as well as injuries and ruptures of parenchymal organs. Among the diseases that can cause blood loss are stomach ulcers and duodenum, Mallory-Weiss syndrome, cirrhosis of the liver, accompanied by varicose veins of the esophagus, malignant tumors Gastrointestinal tract and organs chest, gangrene of the lung, pulmonary infarction and other diseases in which the destruction of the vessel wall is possible.

There are several classifications of acute blood loss. The following classification is most widely used in clinical practice:

• Mild degree - loss of up to 1 liter (10-20% BCC).
• The average degree is a loss of up to 1.5 liters (20-30% BCC).
• Severe degree - loss of up to 2 liters (40% BCC).
• Massive blood loss - loss of more than 2 liters (more than 40% of the BCC).

In addition, supermassive or fatal blood loss is isolated, in which the patient loses over 50% of the BCC. With such acute blood loss, even in the case of immediate volume replenishment, in the vast majority of cases, irreversible changes in homeostasis develop.

Pathogenesis of acute blood loss

With acute blood loss of a mild degree, the receptors of the veins are irritated, as a result of which a persistent and total venous spasm occurs. There are no significant hemodynamic disturbances. Replenishment of the BCC in healthy people occurs within 2-3 days due to the activation of hematopoiesis. With a loss of more than 1 liter, not only the venous receptors are irritated, but also the alpha receptors of the arteries. This causes excitation of the sympathetic nervous system and stimulates the neurohumoral response - the release of a large amount of catecholamines by the adrenal cortex. At the same time, the amount of adrenaline exceeds the norm at once, the amount of norepinephrine is 5-10 times.

Under the influence of catecholamines, first the capillaries, and then the larger vessels, spasm. The contractile function of the myocardium is stimulated, tachycardia occurs. The liver and spleen contract, ejecting blood from the depot into the vascular bed. Arteriovenous shunts open in the lungs. All of the above allows you to provide the necessary amount of blood with vital important organs, maintain blood pressure and hemoglobin levels. Subsequently, the neuro-reflex mechanisms are depleted, and vasodilation comes to replace angiospasm. The blood flow in all vessels decreases, and erythrocyte stasis occurs. Metabolic processes in tissues are even more disrupted, metabolic acidosis develops. All of the above forms a picture of hypovolemia and hemorrhagic shock.

The severity of hemorrhagic shock is determined taking into account the pulse, blood pressure, urine output and laboratory parameters (hematocrit and hemoglobin content in the blood). Under the influence of aldosterone, arteriovenous shunts are opened in the kidneys, as a result the blood is "dumped" without passing through the juxtaglomerular apparatus, which leads to a sharp decrease in urine output up to anuria. Due to hormonal changes, plasma does not leave the vessels into the interstitial tissues, which, along with the deterioration of microcirculation, further aggravates tissue metabolism disorders, aggravates acidosis and provokes the development of multiple organ failure.

The listed violations cannot be completely stopped even with immediate replacement of blood loss. After the restoration of the BCC, a decrease in blood pressure persists for 3-6 hours, impaired blood flow in the lungs - within 1-2 hours, impaired blood flow in the kidneys - within 3-9 hours. Microcirculation in tissues is restored only in 4-7 days, and complete elimination of the consequences takes many weeks.

Symptoms and diagnosis of acute blood loss

Symptoms of acute blood loss include sudden weakness, increased heart rate, decreased blood pressure, pallor, thirst, dizziness, lightheadedness, and fainting. In severe cases, shortness of breath, intermittent breathing, cold sweats, loss of consciousness and marbled skin are possible. As well as clinical signs there are laboratory indicators to assess the amount of blood loss. The number of erythrocytes decreases below 3x10¹² / l, hematocrit - below 0.35. However, the listed figures only indirectly indicate the degree of acute blood loss, since the test results reflect the real course of events with some "lag", that is, with massive blood loss in the first hours, the tests may remain normal. This is especially common in children.

Considering the above, as well as the nonspecificity of signs of acute blood loss (especially mild or moderate), it is necessary to pay special attention to external signs. With external bleeding, establishing the fact of blood loss is not difficult. In case of internal bleeding, indirect signs are taken into account: hemoptysis with pulmonary hemorrhage, vomiting of "coffee grounds" and / or melena with pathology of the esophagus, stomach and intestines, tension of the anterior abdominal wall and dullness during percussion in the sloping parts of the abdomen with damage to parenchymal organs, etc. Examination data and anamnesis complement the results instrumental research... If necessary, X-ray, MRI, ultrasound, laparoscopy and other studies are performed, consultations of a vascular surgeon, abdominal surgeon, thoracic surgeon and other specialists are prescribed.

Treatment of acute blood loss

Treatment tactics depend on the volume of acute blood loss and the patient's condition. With a loss of up to 500 ml, special measures are not required, the restoration of the BCC occurs independently. With a loss of up to 1 liter, the issue of volume replenishment is resolved differentially. With tachycardia no more than 100 beats / min, normal blood pressure and diuresis, infusions are not indicated, in case of violation of these indicators, plasma substitutes are transfused: saline, glucose and dextran. Decrease in blood pressure below 90 mm Hg. Art is an indication for drip infusion of colloidal solutions. With a decrease in blood pressure below 70 mm Hg. Art. produce jet transfusions.

With an average degree (up to 1.5 liters), transfusion of plasma substitutes is required in a volume that is 2-3 times higher than the amount of BCC loss. Along with this, blood transfusion is recommended. In severe cases, transfusion of blood and plasma substitutes is necessary in a volume that is 3-4 times higher than the amount of BCC loss. With massive blood loss, it is required to transfuse 2-3 volumes of blood and several volumes of plasma substitutes.

Criteria for adequate recovery of the BCC: pulse no more than 90 beats / min, stable blood pressure 100/70 mm Hg. Art., hemoglobin 110 g / l, CVP 4-6 cm. water. Art. and diuresis more than 60 ml / h. In this case, one of the most important indicators is diuresis. Restoration of urination within 12 hours from the onset of blood loss is one of the primary tasks, since otherwise the renal tubules become necrotic and irreversible renal failure develops. To normalize diuresis, infusion therapy is used in combination with stimulation with furosemide and euphyllin.

Acute blood loss - treatment in Moscow

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Blood loss

Blood loss is a process that develops as a result of bleeding. It is characterized by a combination of adaptive and pathological reactions of the body to a decrease in blood volume in the body, as well as a lack of oxygen (hypoxia), which was caused by a decrease in the transport of this substance by blood.

The development of acute blood loss is possible in cases where there is damage to a large vessel, due to which a fairly rapid drop in blood pressure occurs, which can drop to almost zero. Also, this condition can occur with a complete rupture of the aorta, pulmonary trunk, lower or upper vein... Even despite a slight loss of blood, a sharp, almost instantaneous drop in pressure occurs, anoxia (lack of oxygen) of the myocardium and brain develops. And this, in turn, leads to death. The general picture of blood loss consists of signs of acute death, damage to a large vessel, an insignificant amount of blood in various body cavities, and some other signs. For acute blood loss, there is no characteristic exsanguination of the internal organs of the body, and with massive blood loss, a gradual outflow of blood from the vessels can be observed. At the same time, the body loses half of the available blood. In a matter of minutes, the pressure drops, the skin becomes "marbled", there are sharp, pale, limited spots that appear later than in other types of death.

The main link in the course of blood loss is a decrease in the volume of circulating blood. The first reaction to this condition is a spasm of small arterioles and arteries, which occurs as a reflex in response to irritation of certain areas of the vessels and an increase in the tone of the autonomic nervous system. Due to this, with blood loss, if its course develops slowly, further maintenance of normal blood pressure is possible. Vascular resistance increases in proportion to the severity of blood loss. As a result of a decrease in the volume of circulating blood, the minute volume of blood circulation and venous flow to the heart decrease. As compensation, the force of the heart rate increases, and the amount of blood in his ventricles decreases. The transferred blood loss leads to a change in the functional state of the heart muscle, ECG changes, conduction is disturbed, arteriovenous shunts open, while part of the blood passes the capillaries and immediately passes into the venules, the supply of blood to muscles, kidneys and skin deteriorates.

The body independently tries to compensate for the lack of blood in case of blood loss. This is provided due to the fact that the interstitial fluid, as well as the proteins contained in it, penetrate into the bloodstream, as a result of which the original volume can be restored. In cases where the body cannot cope with compensating the volume of circulating blood, as well as when arterial pressure lowered for a long time, acute blood loss becomes irreversible, which can last for hours. This condition is called hemorrhagic shock. In the most severe cases, thrombohemorrhagic syndrome may develop, which is caused by a combination of an increased content of procoagulants in the blood and slow blood flow. The irreversible condition differs in many respects from acute blood loss and is similar to the terminal stage of traumatic shock.

The volume of lost blood is not always associated with the clinical picture of blood loss. With a slow outflow of blood, a blurred clinical picture is possible, symptoms may be absent. The severity of blood loss is detected primarily based on the clinical picture. If blood loss proceeds quickly and in a large volume, compensatory mechanisms may not have time to turn on, or may not be fast enough. At the same time, hemodynamics deteriorates, oxygen transport decreases, due to which the accumulation and consumption of oxygen by tissues decreases, the contractile function of the myocardium is disrupted due to oxygen starvation of the central nervous system, the minute volume of blood circulation decreases, due to which oxygen transport deteriorates even more. If this circle is not broken, the victim will face certain death. Some factors can increase the body's sensitivity to blood loss: concomitant diseases, ionizing radiation, shock, trauma, overheating or hypothermia, overwork and some other circumstances. Women are more resilient and tolerate blood loss more easily, while the elderly, infants and newborns are extremely sensitive to blood loss.

Blood loss is latent and massive. The former are characterized by a deficiency of hemoglobin and erythrocytes. With massive blood loss, the volume deficit leads to dysfunction of the cardiovascular system, even having lost only one tenth of the total blood volume in case of massive blood loss, the patient has a great threat to life. Absolutely fatal blood loss is one third of the total blood volume circulating in the body.

By the volume of blood lost, blood loss can be divided:

Low blood loss - less than 0.5 liters of blood. Low blood loss, as a rule, is tolerated without any clinical symptoms and consequences. Pulse, blood pressure remain normal, the patient feels only slight fatigue, has a clear consciousness, the skin has a normal shade.

Average blood loss is characterized by a blood loss of 0.5-1 liter. With it, severe tachycardia develops, blood pressure decreases domm. rt. Art., breathing remains normal, nausea, dry mouth, dizziness develops, fainting is possible, severe weakness, twitching of individual muscles, a sharp decline in strength, a slow reaction.

With a large blood loss, the lack of blood reaches 1-2 liters. Blood pressure decreases domm. rt. Art., pronounced increased respiration, tachycardia, severe pallor of the skin and mucous membranes, cold sticky sweat is released, the patient's consciousness is clouded, he is tormented by apathy, vomiting and nausea, excruciating thirst, pathological drowsiness, weakening of vision, darkening in the eyes, tremor of the hands.

With massive blood loss, there is a lack of blood in the volume of 2-3.5 liters, which is up to 70% of the total circulating blood volume. Blood pressure drops sharply and reaches 60 mm, the pulse is threadlike up to 150 beats per minute, on the peripheral vessels it may not be felt at all. The patient shows indifference to the environment, his consciousness is confused or absent, there is a deathly pallor of the skin, sometimes with a blue-gray tint, cold sweat is released, convulsions may occur, eyes sink.

Fatal blood loss occurs when there is a shortage of more than 70% of the body's blood. It is characterized by a coma, agony, blood pressure may not be detected at all, the skin is cold, dry, the pulse disappears, there are convulsions, dilated pupils, and death.

The main goal in the treatment of hemorrhagic shock is to increase the volume of circulating blood, as well as to improve microcirculation. In the early stages of treatment, the transfusion of fluids, such as glucose solution and saline solution, is established, which allows for the prevention of empty heart syndrome.

Instant arrest of blood loss is possible when the source is available without anesthesia. But in most cases, patients must be prepared for surgery, while various plasma substitutes are introduced.

Infusion therapy, which is aimed at restoring blood volume, is carried out under the control of venous and blood pressure, hourly urine output, peripheral resistance and cardiac output. Replacement therapy uses canned blood preparations, plasma substitutes, as well as their combinations.

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Tip 1: How much blood can a person lose without danger to life

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Danger of blood loss

Blood is the most important substance in the human body, one of the main functions of which is to transport oxygen and other essential substances to the heart and tissues. Therefore, the loss of a significant amount of blood can significantly disrupt the normal functioning of the body or even lead to death.

The volume and nature of blood loss

Doctors say that the degree of danger of blood loss for a person's life in a particular case depends not only on its volume, but also on the nature of the bleeding. So, the most dangerous is rapid bleeding, in which a person loses a significant amount of blood for a short period of time, not exceeding several tens of minutes.

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Why do you need blood

Blood has a high heat capacity and thermal conductivity, which allows it to retain heat in the body and, when overheated, remove it outward - to the skin surface.

The loss of more than 30% of circulating blood is considered massive, more than 50% is life threatening.

Function of the circulatory system

In addition to transporting various nutrients and oxygen from one organs to another, with the help of blood circulation in the body, metabolic products and carbonic acid are transferred to those organs through which waste products are removed: kidneys, intestines, lungs and skin. Blood also performs protective functions - white blood cells and proteins contained in plasma are involved in neutralizing toxins and absorbing microbes that enter the body. Through blood endocrine system regulates all vital functions and processes, since hormones produced by the glands internal secretion are also transported by the bloodstream.

A rapid decrease in the amount of blood is dangerous for humans, for example, in the case of open wound causing a sharp drop in blood pressure.

How much blood is in the human body

Currently, the amount of blood circulating in the human body is determined with sufficient high degree accuracy. For this, a method is used when a metered amount of a substance is injected into the blood, which is not immediately removed from its composition. After it is evenly distributed over the entire circulatory system after some time, a sample is taken and its concentration in the blood is determined. Most often, a colloidal dye, harmless to the body, is used as such a substance, for example, Congo-mouth. Another way to determine the amount of blood in the human body is the introduction of artificial radioactive isotopes into the blood. After some manipulations with blood, it is possible to count the number of erythrocytes into which the isotopes have penetrated, and then by the value of the radioactivity of the blood and its volume.

If excess fluid is formed in the blood, it is redistributed to the skin and muscle tissues, and also excreted through the kidneys.

Blood loss: types, definition, acceptable values, hemorrhagic shock and its stages, therapy

What is blood loss is best known in surgery and obstetrics, since they most often encounter a similar problem, which is complicated by the fact that there was no single tactics in the treatment of these conditions, and there is no. Every patient requires individual selection optimal combinations remedies because blood transfusion therapy is based on the transfusion of donor blood components compatible with the patient's blood. Sometimes it is very difficult to achieve the restoration of homeostasis, since the body reacts to acute blood loss with a violation of the rheological properties of blood, hypoxia and coagulopathy. These disorders can lead to uncontrollable and fatal reactions.

Acute and chronic blood loss

The amount of blood of an adult is approximately 7% of its weight, in newborns and infants this figure is twice as high (14-15%). It also rises quite significantly (on average by 30-35%) during pregnancy. Approximately 80-82% takes part in blood circulation and is called circulating blood volume(BCC), and 18-20% is in reserve in the depositing authorities. The volume of circulating blood is noticeably higher in people with developed muscles and not burdened with excess weight. In obese, oddly enough, this indicator decreases, so the dependence of the BCC on weight can be considered conditional. The BCC also decreases with age (after 60 years) by 1-2% per year, with menstruation in women and, of course, during childbirth, but these changes are considered physiological and, in general, do not affect the general condition of a person. Another question is if the volume of circulating blood decreases as a result of pathological processes:

• Acute blood loss caused by traumatic effects and damage to a large-diameter vessel (or several with a smaller lumen);
• Acute gastrointestinal bleeding associated with existing human diseases of ulcerative etiology and being their complication;
• Blood loss during operations (even planned), resulting from a surgeon's mistake;
• Bleeding during childbirth, leading to massive blood loss, is one of the most severe complications in obstetrics, leading to maternal mortality;
• Gynecological bleeding (rupture of the uterus, ectopic pregnancy, etc.).

Blood loss by the body can be divided into two types: acute and chronic, and the chronic is better tolerated by patients and does not pose such a danger to human life.

Chronic (hidden) blood loss is usually caused by persistent but minor bleeding (tumors, hemorrhoids), in which the compensatory mechanisms that protect the body have time to turn on, which does not happen with acute blood loss. With latent regular blood loss, as a rule, the BCC does not suffer, but the number of blood cells and the level of hemoglobin drops noticeably. This is due to the fact that it is not so difficult to replenish the blood volume, it is enough to drink a certain amount of liquid, but to produce new shaped elements and the body does not have time to synthesize hemoglobin.

Physiology and not so

The loss of blood associated with menstruation is a physiological process for a woman, it does not have a negative effect on the body and does not affect its health, if it does not exceed the permissible values. The average blood loss during menstruation fluctuates within ml, but it can reach dom, which is also considered the norm. If a woman loses more blood than this, then you should think about it, because a monthly blood loss of about 150 ml is considered abundant and one way or another will lead to anemia and in general can be a sign of many gynecological diseases.

Childbirth is a natural process and physiological blood loss will take place, where values ​​of about 400 ml are considered an acceptable norm. However, everything happens in obstetrics, and it should be said that obstetric bleeding is quite complex and can very quickly become uncontrollable.

Pregnancy complicated by late toxicosis or other pathology, fatigue, prolonged and intense pain in the prenatal period and in childbirth, often combined with injuries, contribute to the transition of physiological processes into pathophysiological changes, can cause dangerous blood loss and very quickly form a clinical picture of hemorrhagic shock, and this is already life-threatening condition.

Successfully completed childbirth and cry healthy baby give no reason to calm down. IN postpartum period(early) for the first 2 hours, the doctor closely monitors hemostasis, since the real stop of bleeding will occur only after the third hour.

Of course, any deviations in the hemostatic system require urgent measures in the form of adequate fluid therapy.

Struggle for quantity

The human body "notices" acute blood loss quickly and in order to protect itself, it just as quickly begins to rebuild blood circulation and put into action the defense system, which consists of complex mechanisms compensation for the disturbed constancy of the internal environment.

Regardless of where the source of bleeding is localized, the clinical and pathological manifestations will be the same. And the start of these disorders will be given by an increasing decrease in the volume of circulating blood, after which circulatory and hemodynamic disorders begin to develop, which are very life-threatening. This suggests that not so much the body suffers from the fact that anemia develops (a drop in the number of red blood cells and hemoglobin levels), but from the fact that there is not enough blood.

Each person reacts to the loss of the same volume of blood in his own way, and this primarily depends on:

1. Blood flow rates;
2. The state of human health at the time of blood loss;
3. The presence of chronic diseases;
4. Age (old people and children do not tolerate blood loss);
5. Climatic conditions and even weather, because high temperatures contribute to the aggravation of the condition.

To this it should be added that blood loss is very poorly tolerated by pregnant women, especially those suffering from toxicosis.

Some argue that the loss of 10-15% of the circulating blood volume does not affect a person in any way and does not cause harm. However, this statement is true only for healthy people who will tolerate 25% of the loss remarkably, because their body is able to quickly turn on the compensatory mechanism. In patients weakened by infection, emaciated, or have already suffered blood loss in the recent past, even a slight bleeding threatens with serious consequences.

Changes in the body with blood loss

The human body is designed in such a way that in any critical situation it tries to fight itself and turn on protective functions. So in the case of hypovolemia. However, it should be borne in mind that the result of this struggle is highly dependent not only on the amount of blood lost, but also on the rate of blood loss. In any case, in response to acute blood loss, pathophysiological changes quickly begin to form, which are initially worn compensatory and protective character to save life. Until a certain point, the body succeeds in this even with hemorrhagic shock.

The liver begins to actively produce essential proteins, hematopoiesis is activated, mobilized lymphatic system, which helps to increase the synthesis of albumin. But it should be borne in mind that in this state, a number of biochemical transformations unusual for the body occur, leading to acidosis, a change in blood pH, a decrease in total oxygen consumption, which can be aggravated in adverse events. With further deepening of hypovolemia, you can get a clinic of hemorrhagic shock.

In acute blood loss, many organs and systems are involved in the process:

• Circulatory disorders and intensive treatment in the form of massive infusion therapy can lead to respiratory failure;
• A decrease in renal blood flow in an unfavorable development of events results in renal failure;
• Massive blood loss is fraught with impaired liver function.

Acute blood loss is an urgent condition, therefore, the life of a person who finds himself in a similar situation, for the most part depends on the timely provided first aid and further treatment.

Who and how assesses the degree of blood loss?

Visual assessment and simple examinations even with initial examination give the doctor reason to assume a critical condition due to hypovolemia(decrease in BCC), which is eloquently indicated by signs of blood loss, expressed in changes:

To determine the degree of blood loss, the listed indicators should be assessed promptly in order to adequately qualify the loss and begin to replenish it in a timely manner. For this, the doctor, relying on generally accepted criteria, assumes the severity of the patient's condition on the basis of objective data:

• You can think of low blood loss with a slight decrease in blood pressure and a barely noticeable increase in heart rate. True, it shows some pallor, but the body temperature remains normal, exactly, like the clarity of consciousness;
• The average degree of blood loss is characterized by a moderate decrease in blood pressure and an increase in heart rate, the patient breaks through a cold sweat and, as with fainting, the skin turns pale. To this extent, a short-term loss of consciousness is possible;
• Large blood loss is characterized by rather pronounced symptoms and is characterized by a noticeable drop in blood pressure (below 100 mm Hg) and an increase in heart rate (above 120 beats / min). Pale (to cyanosis) skin, rapid breathing, cold clammy sweat, blurred vision and blurred consciousness indicate blood loss up to 40% of the circulating blood volume, which can reach up to 2 liters;
• Massive blood loss is even easier to recognize by bright clinical manifestations: HELL is critical (up to 60 mm Hg), pulse is fast, threadlike, respiratory function is impaired until the appearance of Cheyne-Stokes respiration, facial features are pointed, cyanosis, confused consciousness. In such cases, blood loss of up to 70% of the BCC can be assumed;
• With fatal blood loss (over 70%), all symptoms of a coma with a transition to agony are observed. BP is below 60 mm. rt. Art., with a tendency to decrease to 0, the pulse is practically not palpable, the state of all body systems indicates the approach of death.

How to find out the amount of blood loss?

Looking at a person losing consciousness, one can hardly tell at once how much blood has gone, therefore, there are methods for determining blood loss, which are divided into:

1. Indirect, providing, mainly, a visual assessment of the patient's condition (pulse, blood pressure, condition of the skin, central nervous system, breathing, etc.);
2. Direct when certain actions are performed (weighing napkins during surgery, weighing a patient, laboratory research).

The use of these methods makes it possible to divide hypovolemia into 3 degrees of blood loss:

• 1 degree - blood loss up to 25% of the initial BCC (the patient's condition changes slightly, this degree is not characterized by bright symptoms);
• Grade 2 - blood loss of 30-40% of the initial BCC is considered large and has a pronounced clinical picture;
• Grade 3 - massive blood loss (loss of more than 40% of the initial BCC).

Of course, in emergency cases at the prehospital stage, it is not possible to use direct methods for diagnosing hypovolemia, however, indirect methods can be used, where it is recognized as a good indicator. Algover shock index(the ratio of the pulse rate to the level of systolic pressure). It has been noticed that a certain degree of hemorrhagic shock corresponds to a certain volume of lost blood. For example:

• 1 degree of shock - about 500 ml of blood;
• 2 degree of shock - about 1 liter of blood;
• 3 degree of shock - 2 liters or more.

In stationary conditions, the patient urgently undergoes laboratory tests:

Determination of BCC using indicators (radioactive isotopes of iodine and chromium) is an analysis of the second stage.

Weighing wipes or counting blood collected in an aspirator is used when surgical interventions, both emergency and planned.

Hemorrhagic shock

Hemorrhagic shock is considered to be the result of an acute decrease in circulating blood volume by 40-50%, although in weakened people it can develop with less blood loss. The development of the clinic and the degree of hemorrhagic shock are influenced by two indicators:

1. The absolute amount of blood lost;
2. The rate of outpouring.

The body tolerates slow bleeding better, even if the blood loss is profuse (compensatory mechanisms are activated).

The classification of hemorrhagic shock is based on the various aforementioned indicators and provides for certain stages of its development. There are 3 stages of hemorrhagic shock about domestic medicine:

• Stage I - compensated reversible shock;
• Stage II - decompensated reversible shock;
• Stage III - irreversible shock.

Stages of hemorrhagic shock according to the western classification:

It is not necessary for every patient to go through all stages. A stepwise transition occurs at a speed that directly depends on many indicators, where the main ones are:

1. The initial state of the patient;
2. Reactivity of functional systems;
3. The amount of blood loss;
4. The intensity of the bleeding.

With compensated shock, the volume of lost blood is compensated by the mechanisms of adaptation and self-regulation, therefore the patient's condition is satisfactory, he is conscious, however, may be somewhat agitated. The skin is pale, the limbs are cold. The pulse is weak, but blood pressure not only remains normal, but may even rise slightly. Diuresis decreases.

For decompensated reversible shock, deeper circulatory disorders are characteristic, which, due to spasm of peripheral vessels, do not allow compensating for a small cardiac output; blood pressure decreases. In the future, there is an accumulation of vasodilators with the development of arterial hypotension.

At this stage, all the classic signs of hemorrhagic shock are clearly and clearly manifested:

• Coldness of the extremities;
• Pallor of the skin;
• Tachycardia;
• Acrocyanosis;
• Dyspnea;
• Muffled heart sounds (insufficient diastolic filling of the heart chambers and deterioration of the contractile function of the myocardium);
• Development of acute renal failure;
• Acidosis.

Distinguishing decompensated hemorrhagic shock from irreversible is difficult, since they are very similar. Irreversibility is a matter of time, and if decompensation, despite treatment, lasts more than half a day, then the prognosis is very poor. Progressive organ failure, when the function of the main organs (liver, heart, kidneys, lungs) suffers, leads to irreversible shock.

What is infusion therapy?

Infusion therapy does not mean replacing lost blood with donor blood. The slogan "drop by drop", which provides for complete replacement, and sometimes even more than, has long since disappeared into oblivion. Transfusion donated blood- a serious operation involving the transplantation of foreign tissue, which the patient's body may not accept. It is even more difficult to deal with blood transfusion reactions and complications than with acute blood loss, therefore whole blood and do not overflow. In modern transfusiology, the issue of infusion therapy is solved in a different way: blood components are transfused, mainly fresh frozen plasma, and its preparations (albumin). The rest of the treatment is complemented by the addition of colloidal plasma substitutes and crystalloids.

The task of infusion therapy in acute blood loss:

1. Restoration of the normal volume of circulating blood;
2. Replenishment of the number of red blood cells, as they carry oxygen;
3. Maintaining the level of coagulation factors, since the hemostatic system has already responded to acute blood loss.

It makes no sense for us to dwell on what the doctor's tactics should be, since this requires certain knowledge and qualifications. However, in conclusion, I would also like to note that infusion therapy foresees different ways its implementation. Puncture catheterization requires special care of the patient, therefore, you need to be very careful about the slightest complaints of the patient, since there may also be complications here.

Acute blood loss. What to do?

As a rule, first aid in case of bleeding caused by injuries is provided by people who are nearby at that moment. It happens that these are just passers-by. And sometimes a person has to do it himself, if trouble caught him far from home: fishing or hunting, for example. The very first thing to do is to try to stop the bleeding with the help of available tools or by finger pressure on the vessel. However, when using a tourniquet, remember that it should not be applied for more than 2 hours, so a note is placed under it indicating the time of application.

Besides stopping the bleeding, first aid is to carry out transport immobilization, if there are fractures, and to make sure that the patient falls into the hands of professionals as soon as possible, that is, it is necessary to call a medical team and wait for her arrival.

Emergency care is provided by medical professionals, and it consists in:

• Stop the bleeding;
• Assess the degree of hemorrhagic shock, if any;
• Replenish the circulating blood volume by injecting blood substitutes and colloidal solutions;
• Conduct resuscitation measures in case of cardiac and respiratory arrest;
• Transport the patient to the hospital.

The sooner the patient gets to the hospital, the more chances he has for life, although even in inpatient conditions it is difficult to treat acute blood loss, since it never leaves time for reflection, but requires quick and clear action. And, unfortunately, he never warns about his arrival.

Video: acute massive blood loss - lecture by A.I. Vorobyov

Hemoglobin dropped sharply to 47 g / l. They had an operation - they removed the stomach cancer, but the hemoglobin did not rise. What can be done to raise hemoglobin?

Hello! A decrease in hemoglobin is associated with both the tumor and the operation performed, and it can be raised with the help of iron preparations or transfusion of blood components, since it is almost impossible to do this only with nutrition. It is worth noting, however, that drug treatment may also not be as effective as we would like, since iron absorption may be impaired. Treatment can be prescribed by a therapist who should be contacted with this issue.

Every person at a conscious age thinks about death. What awaits us after death? Does the other world exist? Are we purely biological beings, or does each of us still have a certain soul, which after death goes to another world? One of the many questions that arise in the mind is the unknown. Does a person experience anguish, pain, or, on the contrary, all sensations before leaving for another world dull?

The issues considered have worried people from the moment they appeared and are still worrying. Scientists continue to study this mysterious phenomenon, but only a few questions can be answered.

Feelings of dying people

The physical sensations of a dying person will depend primarily on what led him to death. He can experience both severe pain and pleasant sensations.

As for psychological perception, at the moment of dying, most people instinctively feel fear, panic and horror, try to "resist" death.

According to biology, after the heart muscle stops contracting and the heart stops, the brain continues to function for about five minutes. It is believed that in these last minutes in the mind of a person there is a pondering of his life, vivid memories emerge, and a person, as it were, “sums up” his existence.

Death classification

Biological scientists divide death into two categories:

• Natural;
• Unnatural.

Natural death proceeds according to the laws of normal physiology and arises from the natural aging of the body or in the case of underdevelopment of the fetus in the womb.

Unnatural death can occur for the following reasons:

• Due to various serious and (oncological, cardiovascular, etc.);
• Mechanical impact:, electric shock;
• Chemical attack: or;
• Unspecified - a completely healthy-looking person dies suddenly from a latent disease or an abrupt acute form disease.

From a legal point of view, death is subdivided into:

• Nonviolent;
• Violent.

Nonviolent death occurs with old age, a prolonged course of the disease, and in other similar cases. Violent death includes murder and suicide.

Death stages

To better understand what a person may experience at the time of death, you can consider the stages of the process, highlighted with medical point view:

• Preagonal stage. At this moment, a failure occurs in the blood circulation and respiration system, as a result of which hypoxia develops in the tissues. This period lasts from several hours to several days;
• Terminal pause. At this moment, the person stops breathing, the functioning of the myocardium fails;
• Agonal stage. The body is trying to return to life. At this stage, the person periodically stops breathing, the heart works weaker and weaker, which is why there are failures in the functioning of all organ systems;
• Clinical death. Respiration and blood circulation stop. This stage lasts about five minutes, and it is at this moment with the help of a person that you can return to life;
• Biological death - a person finally dies.

Important! Only people who have experienced clinical death are the only ones who can accurately tell what sensations are possible in a dying person.

Soreness with various deaths

Does it hurt to die of cancer

Cancer is one of the most common causes of death. Unfortunately, no cure for malignant carcinoma has yet been discovered, and stage 3 and 4 cancer is an incurable disease. All that doctors can do in this situation is to reduce the patient's pain with the help of special analgesics and slightly prolong a person's life.

A person with a cancer does not always experience pain at death. In some situations, before the death of a cancer patient, he begins to sleep a lot and ultimately plunges into a coma, after which he dies without feeling any physical ailment, that is, directly in sleep. In a different situation, the stages of dying of an oncological patient are as follows:

• Before death, the patient may experience migraines, see hallucinations and lose memory, which is why he does not recognize his loved ones;
• Speech disorders occur, it is more difficult for the patient to say related sentences, he can carry awkward phrases;
• The person may develop blindness and / or deafness;
• As a result, the motor functions of the body are disrupted.

However, this is only a general average picture of how a person with cancer feels before dying.

If we consider directly specific types of cancerous tumors, then the localization of carcinoma in the liver makes a person die in agony due to multiple bleeding. Death from lung cancer also causes significant pain due to the fact that the patient begins to choke, vomit blood, after which an epileptic seizure occurs, and the patient dies. In the case of the patient, he also feels excruciating pains in the abdomen, in addition to this, he is tormented headache... Laryngeal cancer patients also feel pain before they die. With this localization, a person also experiences strong pain in the corresponding area.

Important! Do not forget that the described symptoms are eliminated by doctors with the help of special analgesics, and before death - with narcotic drugs, therefore, in some cases, an almost complete reduction in pain can be achieved until it disappears.

Thus, the question “does it hurt to die of cancer?” Is most likely to be answered negatively, since modern medicine has all the means to help reduce the patient's pain.

Does it hurt to die of old age?

According to medical research, people in old age feel relief at death. Only 1/10 of the respondents feel fear before death. Just before passing away, old people feel discomfort, pain, and complete apathy to all. When dying, people begin to see hallucinations, they can "talk" with the dead. As for the physical sensations, dying is painful only due to difficulty breathing.

Most old people can die in their sleep, and this death is not associated with severe pain and physical suffering.

Does it hurt to die from?

The physical sensations of a person dying due to taking an excessive amount of a drug depends primarily on the type of drug and the individual characteristics of the body. In fact, death occurs due to the development of the strongest intoxication of the body, and before death, a person may experience pain due to abdominal cramps. In addition, he experiences dizziness, nausea and vomiting.

An exceptional case will be a person who has taken an excessive dose of a potent sedative, since the consequences of such an act will be the onset of a deep coma and the shutdown of all instinctive defense mechanisms. In view of this, a person departs to another world directly in a dream and does not feel pain.

Does it hurt to die from a stroke?

Since it can occur in different areas of the brain, a person's feelings before death can also be different. If the motor center has been affected, weakness or paralysis may occur in an individual limb.

The general picture of a person's feelings about death is usually as follows:

• He hears incomprehensible voices or sounds;
• Sleepy;
• Confused consciousness;
• Strong headache;
• General weakness.

Some survivors may also die in their sleep or fall into a deep coma.

Does it hurt to die from a heart attack?

In the heart, due to a failure in blood circulation, sudden pressure drops occur, which is felt by a person as severe pain in the area behind the sternum. In addition, the blood supply to all organs is disrupted, which also causes painful sensations - in particular, blood stagnates in the lungs and edema of the latter occurs. The patient has difficulty breathing and general weakness organism. In the first minutes, when the blood stopped flowing to the brain and hypoxia began, the person will also feel a severe headache.

However, as a rule, during such an attack, a person can lose consciousness almost immediately, since the organs are not supplied with blood in a normal manner. Without medical assistance, a person in this state can live no more than 5 minutes, while not feeling pain.

Does it hurt to die from a bullet?

It all depends primarily on the place where the bullet hit and its caliber. If a bullet pierced the brain, then very often death occurs almost instantly, and the organ turns off faster than a person could feel anything. In other situations, as a rule, at first, a person feels a sharp jolt, then some kind of warmth in the body, and only after that - severe pain. A few minutes later, a painful shock occurs, when the pain is no longer felt due to the included defense mechanisms of the body, and the person loses consciousness. With no medical care, he dies from blood loss, but there is no physical suffering.

Does it hurt to die from falling?

Death from falling from a great height occurs almost instantly - after a few seconds or minutes. Feelings largely depend on the posture in which the person landed and on the surface on which he fell. In the case of landing on the head, death occurs instantly, and the only thing that can be experienced in this case is psychological panic during the flight.

Fall deaths result from multiple fractures, rupture of internal organs, and large blood loss. In the first seconds after a fall, a person experiences severe pain from a blow, then weakness occurs due to developing hypoxia and loss of consciousness.

Does it hurt to die from blood loss?

The time of death in this case depends on the caliber of the damaged vessels. In particular, if the walls of the aorta are destroyed, a person dies almost instantly, without experiencing pain.

Losing a lot of blood, a person does not feel pain. When bleeding, he first experiences dizziness, heaviness in the body and weakness. Gradually, a strong thirst is added to these feelings. In the end, due to insufficient blood supply, the person can pass out and die.

Does it hurt to die from the cold?

In severe frost conditions, a person can die for a long time, but they will not experience pain. Being in the cold for a long time, a person first experiences strong tremors and aches in the body. Gradually, he also begins to lose memory and the ability to recognize the faces of loved ones. Then there is a strong weakness and, as a rule, people just fall into the snow. The slowed down speed of blood flow in the brain at the same time provokes hallucinations. Severely narrowed capillaries on the skin can suddenly widen their lumen to generate a surge of warmth, which is why people often try to take off their clothes at this moment because of the feeling of "heat". After that, the person loses consciousness and dies as if "in a dream."

Does it hurt to die of AIDS?

Since death in this case does not arise from AIDS itself, but from the disease that the body cannot cope with, the feelings before death can vary. Most often it is cytomegalovirus, cirrhosis of the liver, tuberculosis, developing against the background of AIDS. However, death can also occur from common bronchitis.

Physical sensations will completely depend on the disease that the body cannot overcome. It hurts a person to die only if he is sick with serious diseases of internal organs. For example, if death occurs from tuberculosis, the patient will experience severe pain in the chest area, breathing and heartbeat may be disturbed, and also occur. In the case when death occurs due to cirrhosis of the liver, the patient may experience excruciating pain in the abdomen and right hypochondrium.

Conclusion

Summing up the above, we can say that it hurts people to die rather psychologically. Only in some cases, before death, a person suffers from severe pain. More often than not, people find it difficult to accept the very fact of dying.

Video

Acute blood loss is a process that occurs against the background of bleeding. In acute blood loss, the patient experiences rapid blood loss in a short period of time. It is accompanied primarily by a sharp decrease in blood pressure, as well as symptoms such as shortness of breath, tachycardia and depression of consciousness. The cause of blood loss can be both disease and trauma, which led to damage to the vessel.

How does blood loss in the body manifest?

Basically, acute blood loss develops in case of damage to a large vessel or rupture of the upper or inferior vein, pulmonary column, aorta. This leads to a rapid drop in blood pressure, which in the most critical cases can drop to zero. Against the background of an almost instantaneous decrease in blood pressure, the patient develops a lack of oxygen (anoxia) of the myocardium and brain, which ultimately leads to death.

Depending on how quickly the patient loses blood, his general condition changes. The faster this happens, the more severe the condition. In this case, it is almost impossible to predict a positive course for the patient.

The response of each organism to acute blood loss is individual. The younger the patient and the stronger his health, the higher the chances of a positive prognosis.

It's important to know! For each individual patient, the risks of blood loss will differ. For example, for a healthy adult patient, the loss of 10% of the BCC (circulating blood volume) will not lead to significant changes.

In a patient with chronic diseases, blood loss in the same volume will require mandatory replenishment of the BCC. Also, blood loss in patients with different body constitutions will be accompanied by various consequences.

The patient's condition can also be affected by the weather at the time of injury. This is explained by the fact that in the hot period the blood loss will be much more significant than in cold weather, since in the heat the vessels expand, which speeds up the process.

Attention! Acute blood loss is a medical emergency. It is important to understand that if you do not provide timely assistance to the patient, then soon hypovolemia (BCC deficiency) will begin to develop. In extreme cases, the lack of adequate measures to prevent this process will lead to death.

Signs of rapid blood loss

The general signs of blood loss are influenced by the amount of blood that the patient has lost. The degree of blood loss is measured in percentage of BCC, since it is not advisable to measure the amount of blood in milliliters, taking into account the individual differences of each individual patient.

By severity, acute blood loss is divided into 4 degrees:

• Small. The BCC deficit is insignificant - from 10 to 20%. Pulse: up to 100 beats per minute. The patient's mucous membranes and skin are pale or pink, systolic blood pressure (systolic blood pressure) is normal or slightly lowered, at least 90-100 mm Hg. Art.
• Average. BCC deficiency is 20-40%. Pulse - up to 120 beats per minute. The patient develops shock of the II degree. The skin and lips are pale, the body is covered with drops of cold sweat, the palms and feet are cold. Oliguria begins to develop due to insufficient production of urine by the kidneys. The SBP level reaches 85-75 mm Hg. Art.
• Big. BCC deficiency is 40-60%. Pulse - up to 140 or more beats per minute. Shock of the III degree develops. The skin is clearly pale, grayish, covered with sticky cold sweat. The systolic blood pressure drops to 70 mm Hg. Art. and below.
• Massive. BCC deficit - 60% or more. Pulse on peripheral arteries disappears. The skin is sharply pale, cold and moist. The subungual bed and lips of the patient are gray. BP is not determined. The patient's heart rate can only be determined on the hip and carotid arteries. Arrhythmia is observed.
• Deadly. BCC deficit: more than 70%. The skin is cold, dry; pupils are dilated. The patient has convulsions, agony, coma. Blood pressure and pulse are not determined, death occurs.

Classification of conditions for blood loss

Blood loss can be divided by type:

• wound, traumatic, operating;
• pathological;
• artificial.

Also, the condition characteristic of a patient with acute blood loss can be divided into different degrees according to the rate of development of pathology:

• chronic (more than 5% of the BCC per hour);
• acute (less than 7% BCC per hour);
• subacute (from 5 to 7% of the BCC per hour).

Hemorrhagic shock

The result of a sharp decrease in the BCC by 40-50% of the total amount of blood is called hemorrhagic shock. For patients with poor health, this figure may differ slightly downward. The degree of hemorrhagic shock and the development of the clinical picture are influenced by:

• the rate of hemorrhage;
• the absolute amount of blood loss.

Due to the fact that during slow bleeding, even with significant blood loss, the body triggers compensatory mechanisms, it is easier to tolerate than rapid blood loss.

Physiological processes

Blood loss is not necessarily pathological. In some cases, for example, during menstruation, this process cannot cause significant harm to the body. We are talking about those cases when the blood loss is within the permissible limits. During menstrual cycle the female body loses an average of 50 to 80 ml.

In some cases, this figure can reach 100-110 ml and this will also be the normal course of menstruation. A violation indicating the possible presence of gynecological diseases can be considered a blood loss of more than 150 ml. Such profuse discharge inevitably leads to anemia.

Another natural process for which the loss of blood by the female body is inevitable is childbirth. Within normal limits, the amount of lost blood should not exceed 400-500 ml.

It is worth noting that in obstetric practice, complex bleeding occurs frequently and can become uncontrollable. This process poses a threat to a woman's life.

The following factors can provoke hemorrhagic shock during childbirth:

• preeclampsia (late toxicosis) and other pathologies during pregnancy;
• fatigue;
• trauma;
• painful sensations in the prenatal period.

Symptoms Indicating Blood Loss

Symptoms of acute blood loss include:

• severe weakness;
• dizziness;
• thirst;
• rapid pulse;
• light-headedness;
• fainting;
• lowering blood pressure;
• pallor.

In more complex cases, the patient has the following manifestations of the pathological condition:

• complete loss of consciousness;
• cold sweat;
• periodic breathing;
• dyspnea.

It's important to know! With extensive blood loss, the number of erythrocytes in the blood drops to 3x10¹² / l and below.

But this figure cannot indicate that the patient has an acute blood loss, since in the first hours laboratory tests can be false, similar to normal indicators. Therefore, it is important to pay more attention to the external signs of acute blood loss.

Diagnosis with external bleeding is not difficult. However, if there is a suspicion of the presence of internal bleeding, then such indirect clinical signs will help to confirm this:

• hemoptysis (characteristic of pulmonary hemorrhage);
• vomiting (vomit resembles coffee grounds);
• melena (with bleeding of the digestive tract);
• tense abdominal wall.

When making a diagnosis, examination, laboratory tests and anamnesis data are supplemented with instrumental and instrumental studies. To do this, you may need to run:

• radiography;
• laparoscopy.

Consultation of the following specialists is required:

• abdominal;
• vascular surgeon;
• thoracic surgeon.

Treatments for Acute Blood Loss Condition

Treatment of a patient with blood loss is selected individually. For example, with a blood loss of no more than 500 ml, compensation for the BCC level is not required, since the body is able to replenish this amount on its own. When it comes to more significant blood loss, then this issue is resolved depending on how much blood the patient has lost and in what condition he is. If the pulse and blood pressure remain within the normal range, then no specific therapy may be required. However, in case of changes in these indicators, the patient may be prescribed a transfusion of plasma substitutes:

• dextran;
• glucose;
• saline solution.

A patient with blood pressure below 90 mm Hg. Art. prescribe drip infusion of colloidal solutions. If the patient's blood pressure drops to 70 mm Hg. Art. and below, then in this case, jet transfusions are made.

A patient who has medium degree blood loss (the volume of lost blood does not exceed one and a half liters), it is necessary to transfuse plasma substitutes in an amount exceeding the loss of BCC by 2-3 times. You will also need a blood transfusion, the volume of which should be from 500 to 1000 ml.

A patient with a severe degree of blood loss needs blood transfusion, plasma substitutes in an amount that will exceed the loss of general blood circulation by 3-4 times.

For a patient with massive blood loss, a blood transfusion will be required in such a volume so that he can exceed the BCC loss by 2-3 times, as well as an increased volume of plasma substitutes.

One of the most important criteria for adequate recovery of the BCC is diuresis, as well as the restoration of normal blood pressure and pulse (90 beats per minute).

A vein opened along the length begins to bleed rapidly and heavily; in the absence of professional or at least first aid (depending on the number and length of cuts), death occurs within a short time as a result of blood loss.

To make suicide more effective, it is often performed in the bathroom, in warm water. After making the cuts, the hand is dipped in water to prevent blood from clotting, especially for short cuts.

After the procedure, immediately before death, severe dizziness begins and the person simply loses consciousness from a lack of blood and oxygen in the lungs. If done correctly, death is guaranteed.

How does a person feel when they die in different ways?

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In such a situation, a person is able to hold his breath for up to 90 seconds, after which he begins to cough and opens his mouth. Water thus blocks the airways and a burning sensation in the chest. This is followed by a feeling of calm due to lack of oxygen, which subsequently leads to cardiac arrest, as well as brain death.

Death by fire

In the Middle Ages, the fate of burning in a fire befell many people. In a fire, the flame scorches the victim's eyebrows and hair. A large amount of smoke clogs the airways. In this case, severe pain is felt due to the stimulation of pain nerves in the skin. Burns cause a rapid inflammatory response that increases the painful sensations of the injured and surrounding areas of the body.

However, most of the victims who die in fires do not die from burns, but from the effects of toxic gases. Carbon monoxide together with a lack of oxygen are the main reasons for the death of people in the fire.

Depending on the size of the fire, carbon monoxide causes drowsiness and headaches. Over time, a person loses consciousness and this entails irreparable consequences.

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Decapitation

This method of execution was widely used in the Middle Ages. If the executioner executing the sentence was experienced, then this method of death was considered the most painless. The defeat of the spinal cord led to a loss of sensitivity, and after 7 seconds, oxygen ceased to be supplied to the head.

However, there were cases in history when the sentence was carried out by an inexperienced executioner or a not too sharpened weapon was used for this. In particular, in order to kill Mary Stuart in 1587, the executioner had to finish the job with a knife.

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Blood loss

Due to blood loss, a person can die in a few seconds. In particular, this applies to cases when the aorta, the main blood vessel, is affected. If veins or small arteries were affected, then death occurs slowly - within a few hours.

There are about 5 liters of blood in the body of an adult. If 750 ml is lost, dizziness begins and the person feels severe weakness. If 1.5 liters are lost, then a person has a constant feeling of thirst. Loss of more than 2 liters leads to loss of consciousness and death.

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Falling from height

Death as a result of falling from a height occurs in the first seconds or minutes after landing. The falling speed can reach 200 km / h. The exact cause of death depends on the surface the body lands on. If grouped incorrectly, it can even be fatal to hit the surface of the water. Hard contact results in lung bruising, fractured ribs, or damage to large blood vessels.

Those who survived falls from great heights report that time slows down very much during flight. At the same time, the instinct of self-preservation is manifested and the person puts his arms and legs forward, trying to prevent a fall. This results in multiple fractures of the limbs.

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Fatal electric shock

The consequence of electric shock is cardiac arrest, which is ultimately fatal. Very high voltage leads to instant loss of consciousness and arrhythmias.

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Hanging

When suffocating, the rope acts on the trachea and blocks the artery that supplies blood to the brain. Lack of oxygen leads to loss of consciousness and death. Using a longer rope causes the victim to break the neck.

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Lethal injection

Lethal injection was developed in 1977 as an alternative painless method of taking life. At the same time, in order to limit the physical suffering of the sentenced person, anesthetic may also be administered to him. A large dose of potassium chloride is used as a poison, which leads to instant cardiac arrest.

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Uncontrolled decompression

This is an unexpected drop in air pressure in a closed space, for example, due to depressurization of the aircraft cabin. If the rate of pressure drop is greater than the rate at which air is expelled from the lungs, this is called explosive decompression. Decompression, which occurs quickly, but not faster than the air leaves the lungs, is called rapid decompression. Finally, a slow or gradual decompression occurs so slowly that it is not subjectively detected until signs of hypoxia appear.

In 1971, an accident occurred with the crew of the Soyuz-11 spacecraft. Depressurization occurred during the entry into the layers of the atmosphere. After landing, the entire crew was found dead from strangulation.

Uncontrolled decompressions are the result of human error, material fatigue, technical failure, or external influences leading to damage to the sealed enclosure.

What does a person feel when he dies from:

1. Drowning.

As a rule, when the victim realizes that he will soon disappear under the water, panic and floundering on the surface begins. Struggling to breathe, they cannot call for help. This stage lasts from 20 to 60 seconds.

2. Heart attack.

Most common feature- chest pain that can be prolonged or come and go. This is how the struggle of the heart muscle for life and its death from oxygen deprivation is manifested. The pain can radiate to the jaw, throat, back, abdomen and arms. Other signs include shortness of breath, nausea, and cold sweats.

Most victims are slow to seek help, waiting an average of 2 to 6 hours. It is more difficult with women, as they are more likely to experience symptoms such as shortness of breath, which radiates pain or nausea to the jaw, and do not respond to them. Delay can cost your life. Most people dying of heart attacks simply didn't make it to the hospital. Often the actual cause of death is cardiac arrhythmia.

Approximately ten seconds after the cardiac muscle stops, the person loses consciousness, and a minute later he is dead. In hospitals, a defibrillator is used to make the heart beat, clear arteries, and inject drugs to bring them back to life.

3. Fatal bleeding.

Death can occur within a few hours if another artery or vein is damaged. In this case, the person would go through several stages. The average adult has 5 liters of blood. The loss of one and a half liters causes a feeling of weakness, thirst and anxiety and shortness of breath, and two - dizziness, confusion, the person falls into unconsciousness.

4. Death by fire.

When the area of ​​the burn increases, the sensitivity decreases slightly, but not completely. Third-degree burns do not damage as much as second-degree wounds, as the superficial nerves are destroyed. Some victims with severe burns reported that they did not feel pain while they were still in danger or rescuing others. Once the adrenaline and shock gradually subside, pain quickly sets in.

Most of those people who die in fires actually die from poisonous carbon monoxide poisoning and lack of oxygen. Someone just doesn't wake up.

The rate of onset of headaches and drowsiness, unconsciousness depends on the size of the fire and the concentration of carbon monoxide in the air.

5. Decapitation.

The most advanced decapitation technology is the guillotine. Officially adopted by the French government in 1792, it was recognized as more humane than other methods of deprivation of life.

Perhaps it is really fast. But consciousness is not lost immediately after the spinal cord is severed. A study in rats in 1991 showed that the brain stays alive for another 2.7 seconds by consuming oxygen from the blood in the head; the equivalent number for humans is roughly 7 seconds. If a person unsuccessfully falls under the guillotine, the time of pain sensation can be increased. In 1541, an inexperienced man made a deep wound in the shoulder rather than the neck of Margaret Paul, Countess of Salisbury. According to some reports, she jumped from the execution site and was chased by the executioner, who struck her 11 times before she died.

6. Death by electric shock.

If the tension is high, then unconsciousness occurs almost immediately. The electric chair was supposed to cause instant loss of consciousness and painless death by passing current through the brain and heart.

7. Fall from height.

8. Hanging.

The method of suicide and the old-fashioned method of execution is death by strangulation; the rope puts pressure on the trachea and arteries leading to the brain. Unconsciousness may occur for 10 seconds, but it will take longer if the loop is not positioned correctly. Public hanging witnesses have often reported victims “dancing” in pain in a noose for several minutes! In some cases, after 15 minutes.

In England, in 1868, the "long fall" method was adopted, involving a longer rope. The victim reached a speed during the hanging that broke her neck.

9. Lethal injection.

Each drug is supposed to be injected into lethal dose redundant to ensure a quick and humane death. However, witnesses reported convulsions and an attempt by the convict to sit during the procedure, that is, the administration of drugs does not always give the desired result.

10. Explosive decompression.

When external pressure air suddenly decreases, the air in the lungs expands, tears fragile tissues involved in gas exchange. The situation is aggravated if the victim forgets to exhale before decompression or tries to hold his breath. Oxygen begins to leave the blood and lungs.

Experiments on dogs in the 1950s showed that 30 to 40 seconds after the pressure was released, their bodies began to swell, although the skin prevented them from "tearing". At first, the heartbeat increases, then sharply decreases. Bubbles of water vapor form in the blood and travel through the entire circulation, obstructing blood flow. After a minute, the blood ceases to effectively participate in gas exchange.

The survivors of decompression accidents are mostly pilots whose aircraft have depressurized. They talked about severe chest pain and inability to breathe. After about 15 seconds, they fainted.

Facts about how a person feels when they die

What does a person feel when he dies? When does he understand that his consciousness is leaving him? Will something unexpected happen the moment our life comes to an end? These questions have plagued philosophers and scientists for centuries, but the topic of death continues to excite everyone to this day, reports NewScientist.com.

How quickly people drown is determined by several factors, including the ability to swim and the temperature of the water. In the UK, where the water is constantly cold, 55 percent of open water drowning occurs within 3 meters of shore. Two-thirds of the victims are good swimmers. But a person can get stuck in seconds, says Mike Tipton, a physiologist and expert at the University of Portsmouth in England.

When victims eventually submerge, they do not inhale for as long as possible, usually 30 to 90 seconds. After that, a certain amount of water is inhaled, the person coughs and inhales more. Water in the lungs blocks gas exchange in thin tissues, there is a sudden involuntary contraction of the muscles of the larynx - a reflex called laryngospasm. There is a bursting and burning sensation in the chest as water passes through the respiratory tract. Then comes a feeling of calm, indicating the onset of loss of consciousness from a lack of oxygen, which will ultimately lead to cardiac arrest and brain death.

2. Heart attack

Hollywood Heart Attack - Sudden heart pain and immediate fall, of course, happens on a few occasions. But a typical myocardial infarction develops slowly and begins with mild discomfort.

3. Fatal bleeding

How soon death from bleeding occurs depends on the wound, says John Courtbeek at the University of Calgary in Alberta, Canada. People can die from blood loss within seconds if the aorta is ruptured. It is the main blood vessel leading from the heart. This can be caused by a serious fall or a car accident.

4. Death by fire

Hot smoke and fire scorch the eyebrows and hair and burn the throat and airways, making it impossible to breathe. Burns cause severe pain through excitation of the pain nerves in the skin.

Execution is one of the quickest and least painful ways to die, if the executioner is skilled, his blade is sharp and the condemned sits motionless.

6. Death by electric shock

Most common reason death from electric shock - arrhythmia leading to cardiac arrest. Unconsciousness usually follows after 10 seconds, says Richard Trochman, a cardiologist at Onslaught University in Chicago. A study of deaths from electric shock in Montreal, Canada found that 92 percent died from arrhythmias.

Whether this is actually the case is a moot point. John Wixvoe, a biophysicist at the University of Nashville, Tennessee, argues that thick, insulating skull bones would prevent sufficient current from flowing through the brain, and prisoners could die from warming up of the brain, or from suffocation from paralysis of the respiratory muscles.

7. Fall from height

This is one of the fastest ways to die: a top speed of about 200 kilometers per hour is reached when falling from a height of 145 meters or more. A study of fatal falls in Hamburg, Germany found that 75 percent of the victims died within the first seconds or minutes after landing.

The causes of death depend on the place of landing and the position of the person. People are unlikely to reach the hospital alive if they fall headlong. In 1981, 100 fatal jumps from the Golden Gate Bridge in San Francisco were analyzed. It has a height of 75 meters, the speed when colliding with water is 120 kilometers per hour. These are the two main causes of instant death. As a result of a fall, a massive lung contusion, a ruptured heart, or damage to the main blood vessels and lungs from broken ribs. Landing on your feet can significantly reduce injuries and can be life-saving.

The method of suicide and the old-fashioned method of execution is death by strangulation; the rope puts pressure on the trachea and arteries leading to the brain. Unconsciousness may occur for 10 seconds, but it will take longer if the loop is not positioned correctly. Public hanging witnesses have often reported victims "dancing" in pain in a noose for several minutes! In some cases, after 15 minutes.

9. Lethal injection

Lethal injection was developed in Oklahoma in 1977 as a humane alternative to the electric chair. The state medical auditor and the chairman of anesthesiology agreed to administer almost three drugs at once. First the pain reliever thiopental is injected to avoid any feeling of pain, then the paralytic agent panzuronium is given to stop breathing. Finally, potassium chloride almost immediately stops the heart.

10. Explosive decompression

Death due to exposure to vacuum occurs when the vestibule is depressurized or the spacesuit ruptures.

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How quickly does death occur after opening the veins in the wrist?

Come in and chat - you won't be bored!

I don't know why you need it, but still. It is painless. It only hurts at the autopsy itself, and then you will simply slowly faint. No need to open anything! What nonsense?

it is very painful for a long time and excruciatingly not only for the body and soul too. sin

Listen, if you're going to open it, then congratulations, you're a suicide suicide. And so yes.

Another thing is worse. If the pressure drops, it can stop flowing out.

Kidneys, brain will refuse, gangrene of extremities will begin.

Not soon. And it's not a fact that the blood won't clot. Opening veins is not so and just right

it may not come at all))) firstly, you need to be able to do it)) and secondly, even having managed to cut the veins is not a fact, as mentioned above, that the blood will not coagulate, you will stay alive anyway, but the tendons will be damaged - 100%, and this is a guaranteed injury and the hands will no longer work. Consider an armless living disabled person.

I'll open it now, I'll mark it

as 2 liters of blood flow out, you will grunt

until a certain amount of blood flows out. unpleasant thing

After opening the veins, how long does death occur on average?

Evgeniy Konchik at the elbows on both hands

Questions on the topic

and how long does it take for death if yes

I'm not afraid of her, I saw the mutilated corpses, I know that I myself will turn into minced meat. I'm not afraid of death in the least. Think of assassins pumped up with hashish and throwing themselves at the enemy, remember suicide bombers with a smile on their faces detonating bombs! I do not understand the fear of death. I never understood people who cling to life with all their might: there is nothing wrong in the cemetery. Take cancer patients, for example. Most of them are looking for any chance to survive. Nonsense. Are there really so many freaks around.

couple of hours. if on the wrists, then a few hours longer. if on the bends of the elbows and on the legs at the ankles, plus under the knees, then even faster, but no less painful. in general, cyanide is recommended for this business - they say it also hurts, but very quickly. happiness to you!

Not an exact question. Please clarify. The place of the autopsy at least.

Physics. It depends on where to cut if it is on the wrists for a relatively long time, you can get scared, neighbors will come running to sober up and save you. If the neck, then even the blade does not have time to fall to the floor, it will darken in the eyes, but the instinct of self-preservation will work, you grab the neck and again not a quick death. There are a lot of factors, so 2 minutes or 10 minutes is very individual and depends on the preparation and severity of the cut.

Suicide methods or How to get out of the water

In search of a quick and painless way (2nd version of the article title)

Don Rumata Estor.

Usually, ideas about methods of suicide are taken from cliches, stereotypes imposed from the outside, everyday ideas, opinions of those who themselves do not know anything about it, and describes attempts to commit suicide, relying only on information obtained from the media, feature films and literature. without knowing the most complex structure of the human body.

On the other hand, even if you perfectly study physiology, pathological physiology, anatomy, physics and biochemistry, there will still be no guarantees of obtaining the desired suicide result. After all, the reaction of an individual complexly arranged organism to this or that effect is unpredictable.

However, this also applies to attempts only to "scare" others with the so-called "manipulative" suicide. In actions where the main goal is to simulate suicide, and not to take life, it is also almost impossible to foresee everything. For example, the hopes of the manipulator for the effect produced, as well as timely detection and rescue may not be justified and they may be discovered too late, or they will react to what is happening in a completely different way than he expected. And extra seconds and delay in providing assistance can lead to serious consequences and even probable death, which the manipulator did not count on at all.

However, there are other consequences as well. For example, for those who attempted suicide (including for the purpose of manipulating others), being in the intensive care unit is not a picture from a television series, where relatives sympathizing with him are sitting around the patient and the medical staff is fussing around. The picture is rather the opposite. To prevent inappropriate behavior and motor excitement of suicides, which can occur under the influence of many factors, as well as to prevent subsequent attempts at suicide and possible aggressive actions against staff or other patients, involuntary examination by a psychiatrist is often used, on the recommendation of which such patients are undressed, fixed (tied ) to the bed by the arms and legs. To prevent aspiration (so that the patient does not choke with vomit, since he is lying on his back and cannot turn), a tube is placed in the trachea through which he breathes.

At the same time, naturally, the patient is not able to ask for anything or complain about pain. Of course, if a person is tied, then he cannot eat and go to the toilet on his own, in order to solve this problem, catheters are installed in bladder, a probe into the stomach and rectum, or put a diaper on it. Thus, after a suicide attempt, pipes are placed in almost all natural openings of the human body, giving a person a very unsightly appearance, as well as depriving him of many of the joys of life. Relatives are not allowed into intensive care at all, so you can not count on sympathy and help from your relatives.

After the patient's condition has stabilized, he may be involuntarily transferred from the intensive care unit to a psychiatric hospital for compulsory treatment... And there are already waiting for special chambers with enhanced supervision, which also do not look at all like a five-star hotel on the seashore. In general, it is better not to get there.

The first thing that awaits those who have decided to die by drinking “200-300 of any pills” are extremely unpleasant procedures of detoxification therapy. The bodies of such people, when found, appear for all to see in a puddle of their own feces and vomit (the body is thus trying to remove the dangerous contents from the stomach and intestines). To begin with, an ambulance team that arrived at the scene, in front of relatives, neighbors and onlookers, performs gastric lavage at the suicide lying on the left side, inserting a rubber tube (probe) through the mouth into the stomach, gradually pouring tens of liters of water there, and a laxative is administered through a tube. In a hospital, this extremely unpleasant procedure for the introduction of sorbents can be repeated several times. Gastric lavage and the introduction of sorbents are carried out in all cases. If the patient is in a coma, the probe is left in the stomach. Often the toxic effect of drugs leads to the fact that people resemble insane, who cannot tell anything about themselves, do not remember anything.

In case of poisoning with respiratory disorders, tracheal intubation is performed (a tube is installed through the mouth into the trachea for adequate breathing), with laryngeal edema and the impossibility of intubation, a tracheotomy is performed (an incision is made on the neck through which the tube is inserted into the trachea), and then artificial ventilation is performed.

The conventional wisdom is that if you exceed a certain dose of pharmacological drugs (tablets, solutions, etc.), it will lead to death. We will not dwell on the specifics of the effect of various groups of drugs, but let us explain that, in order to commit suicide, take into account weight, somatic and psychological state, individual characteristics of the body, resistance to the drug used, the effectiveness of the drug (s) (the effectiveness of the effect of the same drug on different patients may differ tens of times), their interaction (drugs may not increase pharmachologic effect each other, but, on the contrary, reduce), the method of administration (none of which guarantees anything), their influence on the individual unique organism of the suicide due to the physiological resistance to the poisoning of the organism itself, concomitant diseases, as well as a huge number of other factors are impossible. The interweaving of these extremely complex factors makes it completely impossible to accurately predict the result in each specific case. In no case will it be possible to deceive and predict the reaction of the body.

Even pharmacologists, chemotherapists, toxicologists, resuscitators and other highly qualified specialists with knowledge and extensive experience cannot always choose the right dosage of medicinal drugs in order to cure patients from various diseases or remove any symptom, due to the fact that the body of each person is unique ...

Therefore, poisoning with any drugs cannot be a reliable method of suicide.

By the way, poisoning may not develop immediately, but several hours after taking the pills. Even for mild poisoning, this process is very unpleasant, it is typical for it the appearance of apathy and lethargy, muscle relaxation, gait disturbance, a feeling of heaviness in the epigastric region, nausea and vomiting. After a while, anxiety appears. There is irritation to loud noises, light, pain during urination, as well as prolonged abdominal pain and diarrhea (diarrhea).

Poisoning of moderate severity is characterized by depression of the nervous system, respiratory and cardiac disorders. There is a spasm of the muscles of the face with forced grimaces, cramps in the limbs. Shortness of breath may occur. With prolonged respiratory failure and hypotension (low pressure in the vessels), the appearance of cyanosis, that is, cyanosis of the skin, is noted.

Severe poisoning is characterized by various complications, among which, in addition to severe damage to the nervous, respiratory and cardiovascular systems, severe toxic damage to the liver and kidneys is revealed, symptoms of hepatic and renal failure appear, which can lead to further life on hemodialysis (method of extrarenal blood purification in acute and chronic renal failure). Moreover, these consequences may not appear immediately, but 3-6 days from the moment of poisoning. In addition, it is not always possible with delayed consequences to save a person from death, at a time when he himself is already passionately desirous of this salvation.

Also, the use of some drugs can make serious adjustments to the work of the cardiovascular system, create serious interruptions in the work of the heart, and in some cases stop it (which, by the way, does not mean death). But already the treatment of damage to the cardiovascular system is a difficult task, and it is not a fact that after what happened, it is successful. And then such an attempt may end in disability.

Of course, in some cases, this can lead to the most painful death. As we said above, all people have different functional characteristics of the body, the reaction of the body is different, and, accordingly, the rate of dying is also different. How does a person die? This is often a lengthy, multi-phase process. Usually the suicide understands everything, has changed his mind for a long time, wants salvation, but the countdown has already started, death is approaching inexorably, bringing mental and physical suffering.

Strong respiratory depression begins (choking, which is completely unpleasant), breathing becomes shallow, groaning and wheezing, and later acquires a periodic character. The skin turns pale, covered with clammy, cold sweat. Cyanosis appears. Cardiac activity in this case weakens, and blood pressure drops. At this stage, mild, but prolonged, excruciating seizures often occur. As a result, death, which in the overwhelming majority of cases is not instantaneous, can occur 2-3 days in agony or coma (in a state of deepest depression of consciousness, accompanied by a violation of the body's reaction to the environment, including to stimuli, as well as a violation of the most important functions the body, including the pelvic functions - urination and defecation). According to scientists, a person in a coma feels severe pain, continuing to be in an altered state of consciousness. Something even then understands. Time stretches out. For a person who has been comatose for five minutes, it may seem like years have passed. All this is accompanied by excruciating symptoms of dying.

If a person still has not died, but does not regain consciousness for a long time, then bedsores will form due to prolonged lying on his back. Depending on the period of unconsciousness, such bedsores can reach cm in diameter and reach the bones.

If in the end the suicide survives, then the relative recovery, on average, can be observed only after a very long time. However, even after the disappearance of acute phenomena, as possible consequences, there are long-term headaches, mental disorders (often with hallucinations), memory and speech disorders, as well as severe hormonal, vegetative disorders and the acquisition of other serious chronic diseases.

As an illustration, we will give only one, far from the most severe, example of poisoning (according to Professor A.V. Dobronravov):

"Observation of poisoning drug... Vladimir S., complained of a sharp pain in the neck, stiff neck and occipital muscles, inability to bend the head. I accepted it the day before. tablets of the drug. After that, he fell into a drowsy state. In the morning I felt a significant malaise, lethargy, a sharp headache. During the examination by the doctor, the patient developed a pronounced convulsive tonic syndrome with symptoms of opisthotonus (the patient convulsively bends back from head to feet). The severity of the syndrome reached such a degree that the patient himself had to bend his head by the hair to the chest. All this was accompanied by significant pain syndrome with groans and painful crying. There was a strong sense of fear. On examination: confused consciousness, inadequate motor and emotional reactions. After 5 minutes, the convulsive seizure was arrested, the patient in a state of drug-induced sleep was hospitalized with a diagnosis of drug poisoning. In the hospital, the condition was not worsening, the convulsions did not recur. Later, during the clinical examination after 2 months, a number of serious chronic diseases were revealed, which were the consequences of a suicide attempt, which led to the patient's disability. "

A fall, even from a very high altitude, does not always end in death, and even more so does not guarantee a quick death. In the event of a fall, it is completely impossible to foresee a huge number of factors, such as the trajectory of the fall, the direction and strength of the wind, obstacles on the way, and, of course, a lot of other defining aspects. It is widely known that even in plane crashes associated with helicopters and airplanes, when falling due to an unopened parachute, violations of the rules of climbing in mountaineering, as well as technologies in industrial mountaineering, many survive. But, naturally, in most such cases, these people remain deeply disabled.

In addition, in case of severe injuries of the limbs due to a fall from a height, they have to be amputated, and in case of damage to internal organs, complex operations to remove them must be performed, which, of course, cannot but affect the further life of a person, his quality of life, and professional capabilities. Scars from such injuries and operations are significant cosmetic defects that disfigure the skin and remain for life.

Treatment of bone fractures takes a long time, often up to several months, while a person lies motionless, and weights of skeletal traction are suspended from his arms and legs.

Spinal fractures are also very common in falls from a great height and are accompanied by spinal cord injuries. In this case, the sensitivity and motor functions of the arms and legs are disturbed, up to their complete loss. Also, if the spinal cord is damaged, a person is not able to independently control his physiological functions (urination, i.e., does not hold urine, and defecation, i.e., does not hold feces). There is currently no medical opportunity to repair a severely damaged spinal cord, so these disorders remain for life, making a person a disabled person, bedridden, defecating under himself.

After landing, multiple fractures of the bones of the limbs, pelvis, spine and head make further independent movements impossible and make it impossible to call for help. Such victims can lie motionless for several days before they die, experiencing the full range of pain sensations and comprehending their erroneous act. All this is aggravated by the fact that a fully conscious person can see, for example, the road and people passing by, but cannot call for help or crawl due to the severe nature of the injury.

A head hit does not mean fatal brain damage and death. In some people, who are not very good at thinking about their own actions, the brain can hide so much in the spaces of the cranium that you can't even get out of a machine gun. Resuscitation departments of the N.V. N.V. Sklifosovsky Research Institute of Neurosurgery. N.N. Burdenko, as well as other departments, accept a large number of such victims. It is also necessary to remind that in our time veterans of the Great Patriotic War live with bullets and shrapnel in their heads, many of whom have passed their bright life as invalids. And immediately after the war there were thousands of them. But they are honored and respected - they lost their health for the sake of Victory, for the sake of the Motherland, for us. Why do you want to acquire a disability? After all, if you avoid the most terrible thing - death, then severe brain damage, as well as the consequences of a shot in the head, will remain for life. This rash step with a high degree of probability can lead to disability or even to a plant (vegetative) state.

In addition, if death does not occur immediately (and this, as mentioned above, cannot be predicted), then even weeks of terrible suffering and torment, as you understand, will not be able to return the damaged brain to its place. Nerve cells are not restored, this damage is permanent! So it's best not to joke with weapons and the like.

Bullet and stab wounds to the heart

Even if a bullet hits the heart, no one guarantees a lethal outcome. The vast experience of military field surgery during the Great Patriotic War shows that such injuries did not always end in death, even in an extremely difficult wartime situation, given the level of development of medicine. And now such wounds are often healed with timely hospitalization. But of course, problems with the cardiovascular system remain a suicidal person for the rest of his life. And not only with her. Such actions can with a high degree of probability damage the lung, spine, and other internal organs... Therefore, if you do not like the prospect of being unable to get out of bed due to paralyzed limbs, or you do not want to spend your whole life in an oxygen mask, then leave the weapon in place! Getting straight into the heart with a scalpel is not easy even for a professional who does not have the appropriate amount of practical experience. Why is that? Firstly, all people are different, "by eye" it is not always possible to determine exactly where the heart of a particular person is located. Secondly, the heart is a very mobile muscle due to its systolic contractions, during which it not only changes its shape and volume, but also its spatial configuration.

In order to damage the heart, considerable physical effort is required, which has to be exerted even during an autopsy (when the heart muscle is relaxed). A suicidal person will not be able to do this any more.

We are not saying that all heart injuries are curable, but the fact that there is no 100% mortality guarantee is a fact.

I also advise you to think about the fact that even if you accidentally manage to fatally damage your heart, death in most cases does not occur immediately. Consciousness lasts from several hours to several days. But you can no longer help yourself, although you will passionately desire to live.

This is more a way of attracting attention than a way of taking your own life, but in any case, it entails very serious consequences.

Sometimes suicides under the influence of alcohol or drug intoxication, or in a state of passion, in which the euphoria is intensified by the release of adrenaline, begin to randomly cut cuts. An agitated state makes it impossible to control one's actions and assess the degree of damage inflicted on oneself.

Trauma to the veins is rarely fatal, but when trying to cut the veins in the hands, tendons and muscles are almost always damaged, which leads to impaired movement in the hand and fingers, followed by disability (paralysis of the hand).

In addition, due to cuts in veins and contamination of wounds, inflammation can develop, which leads to the most severe painful conditions of the body, including blood poisoning or gangrene and, as a result, amputation.

It is important to note the social consequences of such actions. It is clear that the scars on the hands remain with the suicide forever. And it is their presence that can be decisive in life, for example, in employment. In this case, you will only have to blame yourself - well, personnel officers do not like people from whom you do not know what to expect! Problems may also arise from these defects when entering educational institutions: at any medical examination, these cuts will be visible. These scars can also interfere in personal life, receiving a negative assessment, for example, future mother-in-law, father-in-law, father-in-law and mother-in-law, as well as numerous other relatives of the second half. After all, we love to condemn, even for the weakness that was long ago. This can bring additional problems when starting a family or continuing a family life, as well as in romantic acquaintances. After all, it is clear that a potential groom or bride, seeing such "beauty", may begin to distance themselves and try not to get involved with the owners of such scars. And it happens that even during a divorce, one of the spouses, when determining with whom the children will live, pointing to old cuts in his hands, tries, sometimes successfully, to win the court over to his side, arguing that the spouse cannot take over responsibility for children, since they are not even able to answer for themselves. So, you should not embark on this path, where you will find many problems, and not a way to solve them!

Cutting carotid artery

To get to the carotid artery, you need qualified knowledge in topographic anatomy vessels of the neck, as well as professional use of a scalpel. But even if the carotid artery can be cut completely, the ambulance will most likely have time to get you to the hospital for treatment.

At the same time, it is worth paying attention to the amazing structure of the human body, which protects more important organs for survival, even to the detriment of less important ones.

In the event of an artery being cut, this precise rescue mechanism is triggered. For the brain to maintain vital functions (its brainstem parts), the remaining second carotid artery, together with the vertebral arteries, is sufficient. Only for the cerebral cortex, which is in conditions of hypoxia (with insufficient supply of oxygen to the brain), this may turn out to be irreparable, since the dead nerve cells of the brain, alas, will not recover. The result, most likely, will turn out to be completely different from what a person wants, thirsting for his death. The defeat of half of the cerebral cortex will lead the suicide to mental disability, and in more severe cases - to a "plant" existence. But even if after the most difficult treatment and recovery occurs, then the cosmetic defect on the throat will remind you of this all your life.

A very well-known, but also far from always reliable method of suicide. Quite often, attempts at hanging remain without a fatal ending, but with very serious and grave consequences, since in this case again it is impossible to take into account all the variety of accompanying factors.

Let us recall that when hanging there is a certain sequence of violations of the functions of the vital systems of the body. During the first 2-3 minutes after hanging, there is a holding of breath, erratic movements, anxiety, attempts to escape. In corpses, it is very often found that the fingers are pinched by the loop, which indicates a failed attempt at self-rescue. In an instant, realizing all the horror of what is happening, the person with the last bit of strength tries to get out of the loop. Moreover, he does this also at the level of reflexes, which, of course, are outside the sphere of conscious control. And I must say that he often manages to free himself, or with the help of others.

It is also impossible to calculate the reliability of this method, as well as to control your rescue actions. We do not set ourselves the task of considering the aspects that affect the likelihood of completing an attempted hanging by death, but we dare to assure you that several tens of percent of suicides remain alive, but with the severe consequences described above. However, it happens that manipulative attempts (that is, not aiming at death) end in death. And there are also many such cases.

After strangulation (squeezing the neck with a noose) for more than 6-7 minutes, the rescued from death has pronounced convulsions. In addition, suicides can exhibit extremely aggressive behavior towards others.

Subsequently, the victims for a long time have increased fatigue, headache, dizziness, which leads to disruption of performance for many months.

The most severe post-asphytic consequences of hanging (i.e., the consequences of depriving the brain of oxygen as a result of squeezing the neck with a noose) include brain damage, namely, decreased vision, hearing, stuttering, epileptic seizures, as well as a persistent memory disorder: in the first months after hanging, it is sharply reduced, over time it may improve slightly, but full recovery almost never happens. With incomplete restoration of the functions of the central nervous system, the state of disorientation (impaired coordination of movements and spatial perception) and memory disorders persists almost constantly, which leads to persistent disability of varying degrees. In fact, a change in character is revealed in a large part of the rescued after the fact: people become hot-tempered, do not understand jokes, and cannot stand noise. And, of course, if a person spent a long time in the loop and his brain was experiencing hypoxia, then due to the death of some of the brain cells, dementia may develop for the rest of his life.

So you should not look for additional life problems in this way.

Household gas poisoning

Propane ("household gas") is practically non-toxic to the human body. Its danger is that it can ignite and explode. In this case, not only the apartment, but also the whole entrance can catch fire and explode. And the residents of this entrance, or even the whole house, including the elderly and children, can suffer and die. This will no longer be suicide, but an act of terrorism, and you are not a suicide, but a suicide bomber.

Another property of "household gas" that is dangerous for humans is the displacement of oxygen by propane, since it is heavier than air. A person who has survived the effects of gas on his body will suffer from hypoxia (lack of oxygen). Mortality with this method is low, but posthypoxic encephalopathy (disruption of the activity of the cerebral cortex due to insufficient oxygen supply) is a frequent phenomenon. The consequence of posthypoxic encephalopathy is the development of deep, irreversible personality changes. In other words, a person has every chance of becoming more than just a person with disabilities, and a disabled person with a severe mental disability.

Carbon monoxide poisoning (as well as car exhaust)

Another rather rare method of suicide, which, of course, also gives absolutely no guarantees.

It is impossible to control the process of suicide in case of carbon monoxide (CO) poisoning. The body itself will seek salvation without being interested in the desire for "personality". In case of CO poisoning, hypoxia of the cerebral cortex first of all develops. During the period of time in which the cortex is turned off, but the subcortex is not, the body makes an attempt to escape. Successful or not - how lucky. Even with an exposure (time of exposure to human organs) at 14 hours (the case is described in the literature), there is no certainty about the onset of a lethal outcome. In case of CO poisoning, as in cases of poisoning with other gases, after long-term treatment, suicides retain signs of post-hypoxic and toxic encephalopathy, which can lead to severe mental disability due to the death of brain cells due to oxygen starvation.

But if this method is fatal, then, most likely, this death will not be easy. The onset of death from carbon monoxide poisoning on the spot does not always occur, often already in the hospital, after long, difficult treatment.

Caustic poisons or self-immolation

Attempts to die with the help of caustic poisons (acids and alkalis) in their pain sensations can only compete with attempts at self-immolation. As for self-immolation, I would like to dispel the myth that a person dies from pain shock instantly, or at least very quickly. In fact, for the development of shock, it takes several hours, and sometimes several days, during which a person suffers from terrible unimaginable pains, which are almost impossible to drown even with narcotic analgesics. If a person survives such massive burns, then he will have huge scars on the skin, covering several areas of the body. Such scars, due to their density and inability (unlike the skin) to stretch, subsequently complicate movement in the joints. Disability in such cases is almost inevitable. The cosmetic consequences of such actions are also obvious. Most likely, this will lead to complete disfigurement.

As for those who nevertheless decide to drink acid or alkali, the result will be terrible internal burns of the gastrointestinal tract, the infliction of which is accompanied by the most severe pain, uncontrolled vomiting. Immediate death from these actions is extremely unlikely, and even after the first sip, it is almost impossible to make the second. On the contrary, the consequences of chemical burns of the esophagus are very likely: in addition to pain and other sufferings, there are also widespread cicatricial narrowing of the esophagus, which does not allow a person to eat through oral cavity... In order to prevent suicides from dying of hunger, they undergo surgery and put a gastrostomy tube - a "hole" in the stomach through which food is directly poured into the stomach. Believe me, such a food intake procedure does not bring either moral or aesthetic satisfaction to both the suicidal person and those around him. Perhaps in a few months (if the body fully recovers), doctors will be able to try a very expensive esophageal plastic surgery, in which a fragment of a person's own intestines is used. But no one gives a 100% guarantee of the success of this operation, so the possibility of eating food in the above-described way for the rest of your life is not excluded.

I must say that this method of suicide is strange already in that there are more chances to drown by accident than to end life in this way on purpose.

The fact is that when drowning attempts, various consciously uncontrolled reflex mechanisms of self-rescue, which we described above, come into play. Almost all drowned people have hemorrhages in the muscles of the neck, chest and back. This is the result of a strong muscle tension of a drowning man trying to escape, which clearly confirms a person's awareness of the horror of everything that happens to him while making a desperate attempt to escape. It is these mechanisms that often nullify all attempts to drown yourself. However, all this does not in any way negate the grave consequences of the very attempts to take away one's life in this way: first of all, it is hypoxia (oxygen starvation) in a person who was drowning, with all the ensuing consequences (see CO poisoning). But even if such an attempt will lead to death, then one must understand that it does not come quickly. The drowning period lasts 5-6 minutes and proceeds very scary in severe suffocation. So use swimming to get positive emotions, not to settle scores with your life, which you have alone.

It is very rare for individuals to have a desire to commit suicide with explosives. At the same time, they completely do not take into account the well-known fact that even in the zone of direct influence of the factors of a nuclear explosion, people survived. The history of war has accumulated a lot of examples of the survival of people in the immediate vicinity of the explosions of shells: the most powerful howitzer, mortar shells and even aerial bombs fall into the trenches and dugouts, the military is blown up by mines; Of course, all this leads to losses, but it must be borne in mind that even according to military statistics, for one killed there are from 3 to 10 wounded. These data indicate a small fraction of the likelihood of killing yourself with this method.

Moreover, a person who wants to end his life in this way does not have the slightest chance to accurately calculate the combination of power, direction of the explosion, shock wave and many other related factors. There are much more opportunities to get a concussion, injury, trauma and other injuries, from which you will have to lie helplessly, bleeding, and die for a long time. After all, for example, one limb can be torn off, and in this case, it will take a long time to die from blood loss, experiencing a painful shock. In case if health care will be provided, the chance to remain deeply disabled is simply enormous.

It should also be taken into account that in preparation for committing suicide in this way, you will have to get, store, transport explosives or ammunition. So, the most likely alternative to suicide in this case can be a temporary detention center, lawyers, court, expert examinations, checks for involvement in similar cases, interrogations and appeals, and as a result - imprisonment.

It should be noted not only the physical consequences of suicidal attempts, but also the social ones. We have already mentioned some of them earlier. And now you can talk about possible others. First, if you are hospitalized after a suicide attempt, you will almost certainly be examined by a psychiatrist and then registered. I would like to note that those people who come to the doctor for help themselves, without having difficult mental illness, in the overwhelming majority of cases are not registered. But suicides, as people who pose a danger to themselves, on the contrary, are subject to mandatory registration. Upon admission to a medical institution, you will never be treated as a mentally healthy person, because there will be a record of suicide in the medical history. The attitude of medical personnel to such patients is usually, to put it mildly, specific.

Accounting will also mean that for a very long time the suicide will be limited in rights - he will not be able to obtain a driver's license, drive vehicles, and will not be able to obtain a permit to acquire and store weapons. In addition, due to the lack of a certificate from a psychiatric dispensary, he will not be able to enter a prestigious university, receive Good work in public service, and sometimes in commercial organizations.

Accordingly, you foolishly lose many of the benefits that our life provides. And there will be no one to blame except himself for allowing momentary weakness to prevail over sanity.

100% reliable way to die

It's very sad to see how healthy people succumbing to fleeting weakness under the influence of imposed stereotypes, they are looking for a “reliable”, “proven” and even “painless” method of suicide. This is reminiscent of futile attempts to find the "elixir of youth." For those who want to commit suicide “safely”, the same thing happens.

A reliable, quick and even painless method of suicide simply does not exist in reality.

Not. However, there is still one "reliable" way! It is very ancient and extremely effective. This way is to live your priceless life, and overcoming adversity with honor and dignity, eventually die of old age with the knowledge that you have completed your life task, remembering the most joyful moments of life that filled you with faith in a wonderful future. endowed with the ability to overcome obstacles in your life path, which only made your immortal soul stronger. Try it - you will definitely succeed!

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Petr Rozumny, forensic scientist

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