Asphyxia

Asphyxia (apnea is a condition that occurs due to a sudden lack of oxygen in the body. There are mechanical asphyxia and toxic. Emphasize traumatic asphyxia, and asphyxia of the fetus and newborn.
Mechanical and toxic asphyxia. Mechanical asphyxia develops as a result of termination or sharp restriction of access of air to the lungs (drowning, pulmonary edema, cereals, inhaled foreign bodies, such as vomit with alcohol intoxication). Toxic asphyxia develops as a result of exposure to chemicals, sharply oppressing breathing center (morphine)violating the respiratory function of blood (nitrites, carbon oxide), respiratory enzymes (cyanide compounds)that paralyzes the respiratory muscles (muscle relaxant). Asphyxia cause some poisonous substances suffocating and toxic effects.
The clinical picture asphyxia on the foreground there is shortness of breath with progressive respiratory distress until its termination. During shortness of breath quickens the pulse, increased arterial and venous pressure, develops dizziness, darkening in the eyes. Then the heart rate slows down, lost consciousness, there convulsions. Later comes the stop breathing. By this time arterial and venous pressure decreases, the pupils dilate. As the result of a sharp reduction in oxygen content and accumulation in the body of carbon dioxide blood gets dark red colour; at this time, you may encounter fibrillace ventricular heart.
Treatment. When mechanical asphyxia first of all it is necessary to eliminate the cause of the cessation of air inhaled: remove a foreign body from the mouthto dissolve the loop, squeeze the neck (at povecanom), remove liquid from the respiratory tract (drowning). Then immediately begin conducting artificial respiration. The most appropriate use for this special devices. If no effective is artificial respiration mouth-to - mouth or mouth to the nose (see CPR). To reduce venous pressure, it is advisable to leave Vienna 200-400 ml of blood. In atrial ventricular are defibrillation, when stopping - heart massage and other activities (see the Revival of the body). Treatment of toxic asphyxia - see Poisoning (morphine, carbon monoxide, etc.).

Asphyxia (asphyxia; from the Greek. negative prefix a -, and sphygmos - the beating of the heart, pulsation) - choking; pathological process that occurs as a result of sharp deficiency in the body of oxygen and characterized by severe disorder of breathing and circulation until full stop. Depending on the reasons which have caused asphyxia, she may develop acute or more slowly, with a gradually increasing signs of oxygen starvation.
There are mechanical and toxic asphyxia. Mechanical A. develops as a result of the termination of access of air to the lungs (hanging, suffocation, drowning, inhaled amniotic fluid or foreign bodies, compression of the chest and abdomen, swelling of the larynx, closing holes mouth and nose, congestion in the pleural cavity large amounts of exudate, blood or air, pulmonary edema, and so on). Toxic A. occurs when exposed to different chemicals, sharply oppressing breathing center (morphine), exclude the activity of the respiratory muscles (curare and similar substance)violates the respiratory function of blood (carbon oxide, nitrites) and the activity of tissue respiratory enzymes (cyanide compounds).
Asphyxia may also develop from exposure to toxic agents (S) suffocating or General toxic action, the lack of oxygen in the air we breathe, in various diseases associated with lesions of the Central and peripheral nervous system (injury or bleeding in the field of suffering brain damage stray nerves, polio and other) and in diseases of the cardiovascular system. Despite the fact that each cause of A., has specific features (presence strangulation furrows for the hanging, the liquid in the respiratory tract when drowning, carboxyhemoglobin in blood carbon monoxide poisoning, methemoglobin when poisoning cyanide, nitrite, aniline, and so on), there are General signs of asphyxia.
As a rule, first in the clinical picture revealed respiratory disorders in which distinguish four stages: inspiratory wheezing; expiratory dyspnea, terminal pause and agonal breath, followed by its termination. The nature of any shortness of breath according to D. P. Kosorotov, is determined by the period in which the breath - breathe in or out, there came the closing of the respiratory tract. If this happened after exhalation, shortness of breath prevail breaths, and Vice versa. The first phase in respiratory distress depends on the deficiency in the body of oxygen; further exerts its action and excessive accumulation of carbon dioxide.
During the inspiratory shortness of breath, pulse quickens, arterial and venous pressure rises, there are dizziness, blackouts. During the expiratory dyspnea pulse usually slows down, there may be loss of consciousness, often marked convulsive twitching of muscles of the trunk and extremities, passing in the tonic and clonic convulsions. In connection with the fall of the excitability of the respiratory centre due to oxygen starvation and accumulation in the body of carbon dioxide comes stops breathing, then decreases blood pressure and heart stops activities. With the beginning of asphyxia eyes narrowed, and then expanding; by the time not breathing or more before ocular reflexes fade.
From the first minutes of asphyxia develops severe hypoxia, which by the end of the period of dying reaches extreme proportions. This is evidenced by a sharp decrease in the blood oxygen saturation, at the time of extinction of the corneal reflexes constituting 19-24%, and by the time of cessation of cardiac activity falling to a 13 - 19%. Already in the first minute of asphyxia saturation of arterial blood oxygen is reduced to 68-64% (source 97 - 98%), by the end of the second - to 48-46%, by the end of the third - to 38-24%. On 4 - 5 minutes of dying blood contains as little oxygen as it is not always possible to quantify. In the hypercapnia blood becomes dark red colour, the coagulation it falls, pH decreases.
One of the serious complications asphyxia, is fibrillace ventricular heart.
The treatment should be aimed at eliminating oxygen starvation. Therefore, if there are obstacles for the passage of air into the lungs to fix (remove foreign body, dismiss squeeze the neck loop, remove the liquid from the respiratory tract when drowning, and so on). Then move to the respirator (see), which should start as early as possible by air or by a mixture of air with oxygen. The most effective is the use of special devices. In their absence, it is better to hold artificial respiration mouth-to mouth or mouth to the nose, than manual (type Sylvester or Schaefer), as when blowing air into the lungs is not only the gas in them, but reflex stimulation of the respiratory centre.
Because asphyxia always increased venous pressure, it is advisable to bloodletting from Vienna. If he not only stopped breathing and cardiac activity, i.e. came clinical death, along with artificial respiration should be indirect or direct heart massage in combination with fractional injection into the artery small amounts of the blood with adrenalin and glucose. When gistologicescoe asphyxia along with other therapies good results were obtained from croweley - total or partial. At occurrence of ventricular fibrillation of the heart should be defibrillation (see the Revival of the body).