home Analyzes Vascular collapse: symptoms and emergency care for a life-threatening condition. Collapse (Collaptoid state, Vascular insufficiency) Collapse causes symptoms

Vascular collapse: symptoms and emergency care for a life-threatening condition. Collapse (Collaptoid state, Vascular insufficiency) Collapse causes symptoms

A collapse is a human condition characterized by acute vascular insufficiency caused by a sharp decrease in blood pressure due to a fall. vascular tone, an acute decrease in circulating blood volume or cardiac output.

The collapse is accompanied by a decrease in metabolism, hypoxia of all organs and tissues, including the brain, and suppression of vital functions. Unlike fainting, it takes a longer time and differs in the severity of the course.

Timely first aid for a collapse is often the only chance to save a person's life.

Causes of the collapse

The most common cause of collapse is significant blood loss due to a serious injury, burn, or rupture of an internal organ.

Also cause this acute condition can:

Sudden change in body position by the patient for a long time does not get up;
drug or food poisoning;
Heatstroke;
Heart rhythm disturbance due to thromboembolism, myocarditis or myocardial infarction;
Electric shock;
Exposure to strong doses of ionizing radiation;
A strong blow to the stomach;
Acute diseases of the abdominal organs (pancreatitis, peritonitis);
Anaphylactic reactions;
Diseases of the nervous and endocrine systems (syringomyelia, tumors, etc.);
Epidural (spinal) anesthesia;
Intoxication (poisoning with organophosphorus compounds, carbon monoxide, etc.);
Infections (pneumonia, typhoid and typhoid fever, influenza, food poisoning, meningoencephalitis, cholera).

Signs of collapse

Depending on the cause of the collapse, it can be sympathotonic, vagotonic and paralytic.

In the first case, there is a spasm arterial vessels, which leads to a redistribution of blood supply to such vital important organs like the heart and great vessels. A person's systolic pressure rises sharply, then it gradually decreases, but the number of heartbeats increases.

With vagotonic collapse, symptoms of a sharp decrease in blood pressure are noted, which occurs due to the rapid expansion of arterial vessels. As a result of this, circulatory failure and severe starvation of the brain occur.

With a paralytic form, the protective mechanisms of the body are depleted, which is accompanied by the expansion of small vessels.

The main signs of collapse:

Darkening in the eyes;
Sudden deterioration in well-being;
Dizziness;
Weakness;
Noise in ears;
Sharp headache;
Cold sweat;
Chills, chilliness, thirst;
pallor of the face;
Blueness of the skin of the hands and feet, as well as nails;
Unpleasant sensations in the region of the heart;
Sharpening of facial features;
Decrease in body temperature;
Rapid and shallow breathing;
Thready pulse (often not felt at all)
Sluggish reaction of pupils to light;
Tremor of fingers;
Seizures (sometimes);
Loss of consciousness (not everyone has this sign of collapse).

Depending on the condition or disease that led to the collapse, the total clinical picture takes on specific characteristics.

So, during a crisis caused by blood loss, a person often experiences excitation, sweating decreases sharply.

With peritonitis, toxic lesions and acute pancreatitis the main symptoms of collapse are combined with signs of general intoxication.

If the crisis is the result of an infectious disease, then it usually occurs during a critical drop in body temperature. At the same time, a person has pronounced hypotonia of muscles and moisture of the skin of the whole body.

Collapse in case of poisoning is often combined with nausea and vomiting, signs of dehydration of the body appear, and acute renal failure develops.

Orthostatic collapse, i.e. caused by a sharp change in the position of the body to a vertical one, it is quickly stopped by transferring the patient to the prone position.

First aid for collapse

A set of measures to help a person with a collapse should be carried out urgently and intensively, since delay can cost him his life. At the same time, it is important to differentiate acute vascular insufficiency from acute heart failure, since therapeutic measures in these cases are different.

So, you should know that a person with acute heart failure takes a forced position - he sits, while he is suffocating, and if you put him down, then shortness of breath increases even more. With vascular insufficiency in the supine position, the blood supply to the brain improves, and, consequently, the patient's condition. The skin integument in vascular insufficiency is pale, often with a gray tint, and in cardiac insufficiency it is cyatonic. In vascular, unlike cardiac, there are no characteristic congestion in the lungs, the boundaries of the heart are not displaced, neck veins collapsed, venous pressure is not increased, but, on the contrary, falls.

So, if a person has a collapse, first of all, you should call ambulance and then start resuscitation.

First aid for collapse:

Lay the patient on a flat hard surface, raise his legs (you can put a pillow) and tilt his head back a little to ensure blood flow to the brain;
Unfasten the collar and belt;
Open windows so that fresh air enters, if possible, inhale oxygen;
Wrap the victim, warm the legs with heating pads;
Give a sniff of ammonia or massage the earlobes, whiskey, dimple over upper lip;
Stop bleeding if the collapse is due to blood loss;
If there are no signs of life, do indirect massage hearts and artificial respiration.

Give the patient heart drugs that have a vasodilating effect (Nitroglycerin, Corvalol, No-shpa, Validol, etc.);
Hit on the cheeks to bring to life.

Collapse treatment

The primary task in the treatment of collapse is to eliminate its cause: stop bleeding, eliminate hypoxia, general detoxification, and stabilize the work of the heart.

Further treatment of collapse includes: stimulation of respiration, increase in venous and arterial pressure, activation of blood circulation, blood transfusion (if necessary) and activation of the central nervous system.

Many disorders of the cardiovascular system occur suddenly, against the background of relative well-being. One such acute life-threatening condition is vascular collapse. We will talk about the mechanisms of development, symptoms and emergency care for this pathology in our review and video in this article.

The essence of the problem

Vascular collapse is a form of cardiovascular insufficiency that develops against the background of a sudden decrease in the tone of arteries and veins. Translated from the Latin word collapsus, the term is translated as "fallen".

At the core pathogenetic mechanisms disease lies:

decrease in BCC;
decreased blood flow to the right side of the heart;
a sharp drop in pressure;
acute ischemia of organs and tissues;
inhibition of all vital functions of the body.

The development of collapse is always sudden, rapid. Sometimes from the onset of pathology to the development of irreversible ischemic changes only a few minutes pass. This syndrome is very dangerous, as it often leads to death. However, thanks to timely first aid and effective drug therapy the patient can be saved in most cases.

Important! The terms "collapse" and "shock" should not be confused. Unlike the first, shock occurs as a response of the body to superstrong irritation (pain, temperature, etc.) and is accompanied by more severe manifestations.

Causes and mechanism of development

There are many factors that influence the development of pathology. Among them:

massive blood loss;
sharp infectious diseases(pneumonia, meningitis, encephalitis, typhoid fever);
some diseases of the endocrine, nervous systems (for example, syringomyelia);
effect on the body of toxic and toxic substances(organophosphorus compounds, CO - carbon monoxide);
side effects of epidural anesthesia;
insulin overdose long-acting, ganglioblockers, agents for lowering blood pressure;
peritonitis and acute infectious complications;
acute violation of myocardial contractility in myocardial infarction, arrhythmias, dysfunction of the AV node.

Depending on the cause and mechanism of development, four types are distinguished.

Table: Types of collapse

Type of collapse	Description
	Caused by decreased cardiac output
	Provoked by a sharp decrease in circulating blood volume
	The cause of the acute condition is a sudden decrease
	Violation of the redistribution of blood with a sharp change in body position in space

Note! Orthostatic collapse at least once developed in most people on the planet. For example, many are familiar with mild dizziness, which develops with a sharp rise from bed in the morning. However, healthy people all unpleasant symptoms disappear within 1-3 minutes.

Clinical symptoms

A person develops:

a sharp rapid deterioration in well-being;
general weakness;
severe headache;
darkening in the eyes;
noise, buzzing in the ears;
marbled pallor skin;
respiratory disorders;
sometimes loss of consciousness.

Principles of diagnosis and treatment

Collapse is a dangerous and highly unpredictable state. Sometimes, with a sharp decrease in blood pressure, the count goes on for minutes, and the cost of delay may be too high. If a person has developed signs of acute insufficiency of the circulatory system, it is important to call an ambulance as soon as possible.

In addition, everyone should know the algorithm for providing first aid to patients with collapse. To do this, WHO specialists have developed a simple and understandable instruction.

Step one. Assessment of vital signs

To confirm the diagnosis, it is enough:

Conduct a visual inspection. The patient's skin is pale, with a marble tint. She is often covered in clammy sweat.
Feel the pulse on the peripheral artery. However, it is weak, filiform or not defined at all. Another sign of acute vascular insufficiency is tachycardia - an increase in the number of heartbeats.
Measure blood pressure. The collapse is characterized by hypotension - a sharp deviation of blood pressure from the norm (120/80 mm Hg. Art.) to the lower side.

Step two. First aid

While the ambulance is on its way, take urgent measures aimed at stabilizing the patient's condition and preventing acute complications:

Lay the victim on their back on a flat, hard surface. Raise your legs relative to the entire body by 30-40 cm. This will improve the blood supply to the heart and brain.
Ensure sufficient oxygen supply to the room. Remove the constraint respiratory movements clothes, open the window. At the same time, the patient should not freeze: if necessary, wrap him with a blanket or blanket.
Let the victim sniff a cotton swab dipped in ammonia (ammonia solution). If there is no medicine at hand, rub his temples, earlobes, and also the hole located between his nose and upper lip. These activities will help improve peripheral circulation.
If the cause of the collapse was bleeding from open wound, try to stop the bleeding by applying a tourniquet, finger pressure.

Important! If a person is unconscious, it is impossible to bring him to his senses with blows to the cheeks and other painful stimuli. Until he comes to his senses, do not give him food or drink. In addition, if the possibility of vascular collapse is not excluded, drugs that reduce blood pressure should not be given - Corvalol, Validol, Valocordin, No-shpa, Nitroglycerin, Isoket, etc.

Step three. First aid

Upon arrival of the ambulance, briefly describe the situation to the doctors, mentioning what assistance was provided. Now the victim must be examined by a doctor. After assessing vital functions and determining a preliminary diagnosis, the introduction of a 10% solution of caffeine-sodium benzoate in a standard dosage is indicated. For infectious or orthostatic collapse this is enough for a stable long-term effect.

In the future, urgent measures are aimed at eliminating the causes that caused vascular insufficiency:

With the hemorrhagic nature of the collapse, it is necessary to stop bleeding;
In case of poisoning and intoxication, the introduction of a specific antidote (if any) and detoxification measures are required.
In acute diseases (myocardial infarction, peritonitis, pulmonary embolism, etc.), life-threatening conditions are corrected.

If there are indications, the patient is hospitalized in a specialized hospital for further treatment and prevention of serious complications. There, depending on the causes of the disease, intravenous drip of adrenaline and norepinephrine (to quickly increase blood pressure), infusion of blood and its components, plasma, saline (to increase BCC), oxygen therapy are carried out.

Arterial-venous pressure falls, which in turn leads to inhibition of the vital functions of the body.

Collapse in Latin means "fallen", "weakened". Its development is sharp and rapid. Sometimes accompanied by loss of consciousness. This manifestation is quite dangerous, as it can lead to sudden death of a person. It happens that it takes only a few minutes after an attack to irreversible ischemic changes, sometimes - hours. However modern methods Treatments for some forms of collapse help prolong the life of patients with this disorder.

Causes of the collapse

Symptoms

Therapeutic measures

The information on the site is provided for informational purposes only and is not a guide to action. Do not self-medicate. Consult with your physician.

Vascular collapse is dangerous

Collapse is a condition caused by the rapid development of vascular insufficiency with a characteristic decrease in tone. blood vessels leading to a catastrophic decrease in the volume of circulating blood.

Due to the above reasons, the flow of venous blood to the heart is significantly reduced and the cardiac output of arterial, oxygenated blood is reduced, all this leads to metabolic disorders, brain hypoxia and inhibition of all vital body functions, that is, cardiac arrest occurs.

Types of collapse

There are several types of collapse, these are:

Toxic collapse - develops as a result of acute poisoning highly toxic substances (cyanide, carbohydrate oxide, etc.). In addition, a toxic collapse can be provoked by electric shock, radiation, sunstroke - that is, conditions that contribute to the disruption of the body's regulation of vascular function.
Infectious collapse - severe complication dangerous infectious diseases (rash or abdominal type of meningoencephalitis, severe influenza, botulism, etc.). This complication is caused by intoxication with endo- and exotoxins by microorganisms whose waste products affect the central nervous system and pre- and post-capillary receptors.
Hypoxic collapse occurs when a person breathes in air that is low in oxygen. If at the same time the barometric pressure is also lowered (for example, in the mountains), the human condition worsens almost immediately. The reason for such manifestations is the inability of the body to oxygen starvation, which leads to the expansion of the capillaries of the heart, and consequently, to a decrease in the volume of circulating blood, with all the ensuing consequences.
Orthostatic collapse - occurs when a person rises sharply, for example, when a person jumps out of a chair or, worse, out of bed. The development of orthostatic collapse can occur if a person stands in one place for a long time (it is because of this that frequent change guard of honor). This type of collapse often affects people who have recently arose from prolonged bed rest, as well as undergoing procedures such as evacuation of ascitic fluid and / or spinal and epidural anesthesia.
Hemorrhagic collapse - develops as a result of large blood loss caused by:

trauma with vascular damage;
bleeding due to aneurysm rupture;
stomach ulcer, etc.

Also, the development of hemorrhagic collapse can be facilitated by plasma loss, which is initiated by:

burns;
diarrhea;
indomitable vomiting;
taking diuretics, in large quantities.

Usually patients with hemorrhagic collapse are conscious, while it is noted:

pallor of the skin and visible mucous membranes;
the tips of the toes and hands, as well as the tip of the nose, acquire a bluish tint;
body temperature below 36°;
breathing is frequent and shallow;
pulse superficial, frequent;
systolic blood pressure is below 90.

Reflex collapse - occurs in patients with non-extensive myocardial infarction, accompanied by bradycardia and low systolic blood pressure (like hemorrhagic collapse). This condition is called a pain syndrome that accompanies myocardial infarction.

First aid

The role of first aid in case of collapse is difficult to overestimate, since this is exactly the case when delay is tantamount to death. Most often, even a team of doctors called in time and quickly arrived, if the patient was not given first aid, it remains only to ascertain death from collapse.

Usually the only chance for salvation, for a person who has developed a collapse, is the ability of the people around him to provide first aid.

So, the first pre-medical aid, with obvious signs collapse:

Lay the victim down on a flat, hard surface.
Don't put anything under your head.
Raise your legs to 45°.
Unfasten all buttons, cuffs and waistbands. If the victim is wearing tight clothing, remove or even tear (cut) it.
Ensure inflow fresh air, opening the doors and windows, if the patient, in a dense ring, was surrounded by people, ask them to move away.
Cover the victim with a warm light blanket or warm light clothing.
If possible, cover the victim with hot heating pads or bottles of hot water, after wrapping them with something so as not to cause a burn and not aggravate the already difficult situation of a person.
Rub the earlobes, temples and dimple over the patient's upper lip with warm hands.
Give a sniff of ammonia.
Do not irritate or frighten a person who is already so frightened by his condition, but speak calmly with him, assuring that everything will be fine.

What Not to Do

A non-medical person, even if there are all signs of collapse, may not determine what is happening to a person, however, all adults should know the following:

A person whose systolic (upper) pressure is below 100 (one hundred) is strictly forbidden to give no-shpu, corvalol, valocardin, validol and nitroglycerin.

In addition, when the victim is unconscious, it is impossible:

Try to pour water into his mouth, or any drops.
Shake to bring the fainting person to his senses.

Treatment

The first thing that doctors begin to do, with a diagnosed collapse, is to try to restore normal circulation blood in circulatory system the patient, for which a dropper with Ringer's solution or saline is placed.

The amount of transfused liquid is individual and is determined by the following factors:

What condition is the victim in?
how pale the patient's skin is;
is there a separation of urine;
whether the blood pressure rises during the drip infusion;
how the heart rate changes.

Perhaps, if the pressure does not rise, vasopressors (mezaton or norepinephrine) will be added to saline or Ringer's solution. These pharmacological forms are very effective, and after no more than 2 hours, and more often earlier, the pressure returns to normal.

Prednisolone may also be prescribed (to "spur" the body's defenses).

There are other drugs used in diagnosed collapse, but they are all prescribed individually, administered under the strict supervision of doctors and / or nurses, and in no case can be used by the patient or his relatives, on their own.

Read also

The other day I experienced a collapse on myself. It's good that in the past a doctor figured out what to do. Very well written. Thank you for the article!

Unexpected vascular collapse: how not to be confused with fainting, help for the arrival of an ambulance

One of acute forms vascular insufficiency is called collapse. It occupies an intermediate position between fainting and state of shock. It is characterized by a drop (collapse means fallen) pressure, dilatation of the veins and arteries with the accumulation of blood in them.

It happens with infections, allergies, blood loss, adrenal insufficiency, or under the action of strong antihypertensive drugs. Treatment requires emergency hospitalization and the introduction of drugs that increase systemic pressure.

Causes of acute vascular collapse

The following can lead the patient to a collaptoid state:

sharp pain;
trauma;
blood loss, general dehydration;
acute infectious processes;
low cardiac output (heart attack, cardiomyopathy, narrowing of the valve openings);
severe allergic reactions;
intoxication with internal (diseases of the kidneys, liver, intestines, acute inflammation) or external (various poisoning) entry of toxic substances into the blood;
the introduction of drugs for general or spinal anesthesia, barbiturates, an overdose of sleeping pills, drugs, medications for the treatment of arrhythmias, hypertension;
decreased synthesis of catecholamines in the adrenal glands;
drop in blood sugar or its sharp increase.

Determining the cause of the collapse is not difficult if it arose against the background of an already existing disease. With sudden development, it is the first manifestation emergency conditions(For example, ectopic pregnancy bleeding from a stomach ulcer). In the elderly, acute vascular insufficiency often accompanies myocardial infarction or pulmonary embolism.

And here is more about the use of the drug Isoket.

Deficiency symptoms

The first signs of collapse are sudden general weakness, yawning, dizziness. Then quickly join:

cold clammy sweat;
a feeling of fear, anxiety and excitement, giving way to apathy and lethargy;
pale skin with a marbled pattern;

Cold clammy sweat

visual impairment;

noise in ears;

nausea;

change of consciousness;

frequent and shallow breathing;

irregular contractions of the heart;

decrease in body temperature

Arterial pressure decreases as the severity of the vascular reaction increases, but its values must necessarily be correlated with the initial indicators, in hypertensive patients at a pressure of 100/70 mm Hg. Art. the condition can be quite severe, and for hypotension this is considered a variant of the norm. Systolic and pulse pressure falls more often, diastolic changes depending on the cause of the collapse.

Heart sounds are normal or louder than usual, with poisoning or low cardiac output they are muffled, rhythm disturbances are noted. The pulse is rapid, thready, arrhythmic, in severe attacks it may slow down or cease to be determined.

How to distinguish collapse from fainting

Collapse in its clinical manifestations is a severe variant of the fall in vascular tone. With it, unlike fainting, the primary process is the expansion of arteries and veins with the accumulation of blood in them. As a result, the volume of blood circulating in the bloodstream and returning to the heart decreases. The consciousness of patients remains intact until the transition of the collapse into severe form accompanied by impaired cerebral blood flow.

With fainting, a spasm of cerebral vessels occurs, and even with mild form patients lose consciousness. It is also important to distinguish collapse from shock. In the latter case, heart failure joins, gross violations metabolic processes and neurological disorders. It should be noted that the border between these states (fainting, collapse, shock) is often rather conditional, they can pass into each other as the underlying disease progresses.

Types of collapses

Depending on the causes and the leading mechanism of development, several types of vascular collapses have been identified:

orthostatic - with a sharp change in body position in case of ineffective regulation of arterial tone (recovery from infections, taking antihypertensive drugs, a rapid decrease in body temperature, pumping fluid out of the cavities, indomitable vomiting);
infectious - a decrease in the tone of the arteries occurs under the influence of bacterial or viral toxins;
hypoxic - happens with a lack of oxygen or low atmospheric pressure;
dehydration - it leads to loss of fluid during severe infections with diarrhea and vomiting, excessive excretion of urine during forced diuresis, diabetes with high hyperglycemia, with internal or external bleeding;
cardiogenic - associated with myocardial damage during a heart attack, myocarditis, cardiomyopathy;
sympathicotonic - blood loss or dehydration, neuroinfection, proceeds with vascular spasm at normal pressure, frequent pulse;
vagotonic - strong pain, stress, anaphylaxis, a drop in blood sugar or a lack of adrenal hormones. A sharp difference between systolic and diastolic pressure, bradycardia;
paralytic - severe diabetes, infectious processes, depletion of compensation reserves, paralytic vasodilation with a sharp decrease in blood circulation.

According to the severity of the patient's condition is:

light - the pulse increases by a third, the pressure is at the lower limit of the norm, the pulse (difference between systolic and diastolic) is low;
moderate - heart rate increased by 50%, pressure about 80-60 / 60-50 mm Hg. Art., urine output decreases;
severe - consciousness changes to a state of stupor, lethargy, the pulse is increased by%, maximum pressure below 60 mm Hg. Art. or not determined, anuria, intestinal motility stop.

Features of vascular insufficiency in children

IN childhood common cause of collapse are infections, dehydration, intoxication and oxygen starvation with diseases of the lungs, heart, nervous system.

Minor external influences can lead to vascular insufficiency in premature and debilitated children. This is due to the physiological inferiority of the mechanisms of regulation of the tone of arteries and veins, the predominance of vagotonia, the tendency to develop acidosis (shift of the blood reaction to the acid side) in this category of patients.

Chills, pallor of the skin, coldness of the hands and feet, an increase in the pulse, which becomes threadlike, are noted. Then the blood pressure decreases, the peripheral veins lose their tone, against the background of the preservation of consciousness, children lose their reaction to the environment, convulsive syndrome is possible in newborns.

Emergency care before the ambulance arrives

Collapse is treated only in a hospital, so emergency care should be called as soon as possible. All the time before the arrival of the doctor, the patient must be in a horizontal position with raised legs (put a blanket or clothes rolled into a roller).

It is necessary to ensure the supply of fresh air - unbutton the collar, loosen the belt. If the attack occurred indoors, then you need to open the windows, while covering the victim with a warm blanket. Additionally, you can attach a warm heating pad or bottles of non-hot water on the sides of the body.

To improve peripheral circulation, rub hands, feet, auricles are pressed into the hole between the base of the nose and the upper lip. You should not try to seat the patient or give him medication on his own, since the most common remedies (Corvalol, No-shpa, Validol, especially Nitroglycerin) can significantly worsen the condition, turn the collapse into shock. For external bleeding, a tourniquet should be applied.

Watch the video about first aid for fainting and vascular collapse:

Medical therapy

Before transporting the patient to the hospital, the introduction of vasoconstrictors - Cordiamin, Caffeine, Mezaton, Norepinephrine can be used. If the collapse occurred against the background of loss of fluid or blood, then the introduction similar drugs is carried out only after the restoration of the volume of circulating blood with the help of Reopoliglyukin, Stabizol, Refortan or saline solutions.

IN severe cases and in the absence of peptic ulcer apply hormonal preparations(Dexamethasone, Prednisolone, Hydrocortisone).

Inhalation of humidified oxygen is indicated for patients with hypoxic collapse, poisoning carbon monoxide, severe infections. In case of intoxication, infusion therapy- the introduction of glucose, isotonic solution, vitamins. In case of bleeding, transfusion of blood or plasma substitutes is used.

Patients with heart failure additionally receive cardiac glycosides; in case of arrhythmia, it is necessary to restore the rhythm with the help of Novocainamide, Kordaron, Atropine (with blockade of conduction, bradycardia). If the collapse develops against the background of a severe attack of angina pectoris or a heart attack, then intravenous administration neuroleptics and narcotic analgesics, anticoagulants.

Forecast

With the rapid elimination of the cause of the collapse, it is possible to completely restore normal hemodynamic parameters and recover the patient without consequences. With infections and poisoning, adequate and timely therapy is also often quite effective.

The prognosis is more severe in patients with chronic, progressive diseases of the heart, digestive organs, pathology of the endocrine system. In such patients, repeated, repeatedly recurring collaptoid conditions are especially dangerous. Due to the age characteristics of the body, collapse is most dangerous for children and the elderly.

Prevention

Prevention of acute vascular insufficiency consists in:

timely diagnosis and treatment of infections, intoxications, bleeding, burns;
taking potent medications to reduce pressure only on medical advice, under the control of hemodynamic parameters;
correction of violations of metabolic processes;
maintaining the recommended blood glucose levels.

At acute infections With high temperature body is important bed rest, slow transition to vertical position, sufficient drinking regimen especially with fever, diarrhea and vomiting.

And here is more about the use of the drug Sidnopharm.

Collapse is an acute vascular insufficiency, it happens with infection, poisoning, blood loss, dehydration, heart disease, endocrine pathology. The difference from fainting is the absence of an initial loss of consciousness. Manifestations - a decrease in pressure, severe weakness, lethargy, pallor and cooling of the skin, sticky sweat.

It is difficult to tolerate in childhood and old age. First aid consists of giving horizontal position, a quick call to a doctor, providing access to fresh air. For treatment, vasoconstrictors, hormones, infusion solutions and plasma substitutes. A prerequisite for a favorable outcome is the elimination of the cause of the collapse.

Sudden heart failure (collapse, shock). . At the same time, the pressure in the vascular bed drops sharply.

vascular collapse; drop in blood pressure below 100 mm Hg. Art. (systolic index)

vascular collapse. Some patients experience increased pain in the heart, severe weakness, fainting with bradycardia, and collapse.

What affects vascular tone, how dangerous are pressure changes in the vessels? . The most severe conditions occur with shock or collapse, which.

vascular collapse; hypertrophic form cardiomyopathy; kidney or liver failure.

We will publish information shortly.

Collapse

Collapse is a human condition characterized by acute vascular insufficiency caused by a sharp decrease in blood pressure due to a drop in vascular tone, an acute decrease in circulating blood volume or cardiac output.

Timely first aid for a collapse is often the only chance to save a person's life.

Causes of the collapse

The most common cause of collapse is significant blood loss due to a serious injury, burn, or rupture of an internal organ.

Also cause this acute condition can:

A sharp change in the position of the body by a patient who does not get up for a long time;
drug or food poisoning;
Heatstroke;
Heart rhythm disturbance due to thromboembolism, myocarditis or myocardial infarction;
Electric shock;
Exposure to strong doses of ionizing radiation;
A strong blow to the stomach;
Acute diseases of the abdominal organs (pancreatitis, peritonitis);
Anaphylactic reactions;
Diseases of the nervous and endocrine systems (syringomyelia, tumors, etc.);
Epidural (spinal) anesthesia;
Intoxication (poisoning with organophosphorus compounds, carbon monoxide, etc.);
Infections (pneumonia, typhus and typhoid fever, influenza, food poisoning, meningoencephalitis, cholera).

Signs of collapse

Depending on the cause of the collapse, it can be sympathotonic, vagotonic and paralytic.

In the first case, a spasm of arterial vessels occurs, which leads to a redistribution of the blood supply to such vital organs as the heart and large vessels. A person's systolic pressure rises sharply, then it gradually decreases, but the number of heartbeats increases.

With a paralytic form, the protective mechanisms of the body are depleted, which is accompanied by the expansion of small vessels.

The main signs of collapse:

Darkening in the eyes;
Sudden deterioration in well-being;
Dizziness;
Weakness;
Noise in ears;
Sharp headache;
Cold sweat;
Chills, chilliness, thirst;
pallor of the face;
Blueness of the skin of the hands and feet, as well as nails;
Unpleasant sensations in the region of the heart;
Sharpening of facial features;
Decrease in body temperature;
Rapid and shallow breathing;
Thready pulse (often not felt at all)
Sluggish reaction of pupils to light;
Tremor of fingers;
Seizures (sometimes);
Loss of consciousness (not everyone has this sign of collapse).

Depending on the condition or disease that led to the collapse, the overall clinical picture acquires specific features.

So, during a crisis caused by blood loss, a person often experiences excitation, sweating decreases sharply.

With peritonitis, toxic lesions and acute pancreatitis, the main symptoms of collapse are combined with signs of general intoxication.

Collapse in case of poisoning is often combined with nausea and vomiting, signs of dehydration of the body appear, and acute renal failure develops.

Orthostatic collapse, i.e. caused by a sharp change in the position of the body to a vertical one, it is quickly stopped by transferring the patient to the prone position.

First aid for collapse

So, you should know that a person with acute heart failure takes a forced position - he sits, while he is suffocating, and if you put him down, then shortness of breath increases even more. With vascular insufficiency in the supine position, the blood supply to the brain improves, and, consequently, the patient's condition. The skin integument in vascular insufficiency is pale, often with a gray tint, and in cardiac insufficiency it is cyatonic. In vascular, unlike cardiac, there are no characteristic congestion in the lungs, the boundaries of the heart are not displaced, the cervical veins are collapsed, venous pressure is not increased, but, on the contrary, falls.

So, if a person has a collapse, first of all, you should call an ambulance, after which you should start resuscitation.

First aid for collapse:

Lay the patient on a flat hard surface, raise his legs (you can put a pillow) and tilt his head back a little to ensure blood flow to the brain;
Unfasten the collar and belt;
Open windows so that fresh air enters, if possible, inhale oxygen;
Wrap the victim, warm the legs with heating pads;
Give a sniff of ammonia or massage the earlobes, whiskey, dimple above the upper lip;
Stop bleeding if the collapse is due to blood loss;
If there are no signs of life, perform chest compressions and artificial respiration.

Give the patient heart drugs that have a vasodilating effect (Nitroglycerin, Corvalol, No-shpa, Validol, etc.);
Hit on the cheeks to bring to life.

Collapse treatment

The primary task in the treatment of collapse is to eliminate its cause: stop bleeding, eliminate hypoxia, general detoxification, and stabilize the work of the heart.

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Vascular collapse: symptoms and emergency care for a life-threatening condition

The essence of the problem

decrease in BCC;
a sharp drop in pressure;

Causes and mechanism of development

massive blood loss;

Table: Types of collapse

Clinical symptoms

A person develops:

Neurologist, 4.5 years of experience. Hello everybody. I won't recommend anything specific. Write your questions, we'll figure it out. But my dears: no matter how detailed you ask your question and no matter how we answer you in a timely manner, it’s better to make an appointment with me (I now live and work in Moscow) or my colleagues for an appointment. It is very difficult to give specific recommendations without seeing the whole picture.

Therapist. Elderly people often turn to me for help, everyone needs help. But most people are to blame for the fact that the last 20 years have introduced a sedentary lifestyle. What can I advise: buy a complex of vitamins and do not read more about recipes traditional medicine. Strong drugs only as a last resort and only under the supervision of a doctor.

Phlebologist with 8 years of experience. I myself believe that all vascular problems are due to an incorrect lifestyle. Go in for sports and do not eat any fast food and you will feel great.

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Vascular collapse

The essence of the problem

The basis of the pathogenetic mechanisms of the disease is:

decrease in BCC;
decreased blood flow to the right side of the heart;
a sharp drop in pressure;
acute ischemia of organs and tissues;
inhibition of all vital functions of the body.

The development of collapse is always sudden, rapid. Sometimes only a few minutes pass from the onset of pathology to the development of irreversible ischemic changes. This syndrome is very dangerous, as it often leads to death. However, thanks to timely first aid and effective drug therapy, the patient can be saved in most cases.

Important! The terms "collapse" and "shock" should not be confused. Unlike the first, shock occurs as a response of the body to superstrong irritation (pain, temperature, etc.) and is accompanied by more severe manifestations.

Causes and mechanism of development

There are many factors that influence the development of pathology. Among them:

massive blood loss;
acute infectious diseases (pneumonia, meningitis, encephalitis, typhoid fever);
some diseases of the endocrine, nervous systems (for example, syringomyelia);
the effect on the body of toxic and poisonous substances (organophosphorus compounds, CO - carbon monoxide);
side effects of epidural anesthesia;
overdose of long-acting insulin, ganglionic blockers, agents for lowering blood pressure;
peritonitis and acute infectious complications;
acute violation of myocardial contractility in myocardial infarction, arrhythmias, dysfunction of the AV node.

Depending on the cause and mechanism of development, four types of cardiovascular insufficiency are distinguished.

Table: Types of collapse

Note! Orthostatic collapse at least once developed in most people on the planet. For example, many are familiar with mild dizziness, which develops with a sharp rise from bed in the morning. However, in healthy people, all unpleasant symptoms disappear within 1-3 minutes.

Clinical symptoms

Symptoms of vascular collapse are pronounced. It is difficult to confuse it with other cardiovascular diseases (Thursday also Age changes of cardio-vascular system).

A person develops:

a sharp rapid deterioration in well-being;
general weakness;
severe headache;
darkening in the eyes;
noise, buzzing in the ears;
marble pallor of the skin;
respiratory disorders;
sometimes loss of consciousness.

Principles of diagnosis and treatment

In addition, everyone should know the algorithm for providing first aid to patients with collapse. To do this, WHO specialists have developed a simple and understandable instruction.

Step one. Assessment of vital signs

To confirm the diagnosis, it is enough:

Conduct a visual inspection. The patient's skin is pale, with a marble tint. She is often covered in clammy sweat.
Feel the pulse on the peripheral artery. However, it is weak, filiform or not defined at all. Another sign of acute vascular insufficiency is tachycardia - an increase in the number of heartbeats.
Measure blood pressure. The collapse is characterized by hypotension - a sharp deviation of blood pressure from the norm (120/80 mm Hg. Art.) to the lower side.

Step two. First aid

While the ambulance is on its way, take urgent measures aimed at stabilizing the patient's condition and preventing acute complications:

Lay the victim on their back on a flat, hard surface. Raise your legs relative to the entire torso. This will improve the blood supply to the heart and brain.
Ensure sufficient oxygen supply to the room. Remove clothing that restricts breathing, open a window. At the same time, the patient should not freeze: if necessary, wrap him with a blanket or blanket.
Let the victim sniff a cotton swab dipped in ammonia (ammonia solution). If there is no medicine at hand, rub his temples, earlobes, and also the hole located between his nose and upper lip. These activities will help improve peripheral circulation.
If the cause of the collapse was bleeding from an open wound, try to stop the bleeding by applying a tourniquet, finger pressure.

Important! If a person is unconscious, it is impossible to bring him to his senses with blows to the cheeks and other painful stimuli. Until he comes to his senses, do not give him food or drink. In addition, if the possibility of vascular collapse is not excluded, drugs that reduce blood pressure should not be given - Corvalol, Validol, Valocordin, No-shpa, Nitroglycerin, Isoket, etc.

Step three. First aid

Upon arrival of the ambulance, briefly describe the situation to the doctors, mentioning what assistance was provided. Now the victim must be examined by a doctor. After assessing vital functions and determining a preliminary diagnosis, the introduction of a 10% solution of caffeine-sodium benzoate in a standard dosage is indicated. With an infectious or orthostatic collapse, this is enough for a stable long-term effect.

In the future, urgent measures are aimed at eliminating the causes that caused vascular insufficiency:

With the hemorrhagic nature of the collapse, it is necessary to stop bleeding;
In case of poisoning and intoxication, the introduction of a specific antidote (if any) and detoxification measures are required.
In acute diseases (myocardial infarction, peritonitis, pulmonary embolism, etc.), life-threatening conditions are corrected.

Thus, vascular collapse is a serious and often life-threatening condition. It requires timely diagnosis And early start therapy, because the unproven (or rendered incorrectly) first health care significantly worsens the prognosis for the patient (Thurs. also Cardiovascular system: the secrets and mysteries of the human "motor").

Reasons for the development of collapse

Disturbances in the blood supply to tissues and organs and their function occur as a result of collapse - acute vascular insufficiency with a drop in vascular tone, a decrease in the contractile function of the heart and a decrease in the volume of circulating blood. Distinguish:

traumatic collapse (due to severe injuries),
hemorrhagic (due to blood loss),
burn,
cardiogenic (due to myocardial damage),
infectious-toxic,
anaphylactic collapse, etc.

Taking into account the fundamental pathogenetic mechanism for the development of shock, there are also

hypovolemic collapse (due to a decrease in circulating blood volume),
cardiogenic (due to dysfunction of the heart and decrease in cardiac output),
vascular, (caused by decreased vascular tone)
and mixed collapse (with a combination of these causes).

At the same time, it is important to remember that with a collapse of any nature, it is hypovolemia that is the main link in pathogenesis, which determines medical tactics and help with collapse.

Causes of hypovolemic collapse

The cause of the disease can be acute external and / or internal bleeding as a result of injury or disease, plasma loss during thermal burns. A similar mechanism is observed in collapse due to uncompensated fluid loss with profuse vomiting and diarrhea, in diabetes insipidus and diabetes mellitus, etc. A sudden decrease in circulating blood volume due to loss of blood, plasma or body fluids leads to a decrease in venous return to the heart, a decrease in cardiac output and a decrease in blood pressure, which, as you know, depends on the minute volume of the heart and the value of peripheral resistance.

The activation of the sympathoadrenal system that occurs with symptoms of hypovolemic collapse is defensive reaction organism, aimed at maintaining the constancy of blood pressure. At the same time, tachycardia develops due to stimulation of beta-receptors of the heart and vasoconstriction due to stimulation of alpha-adrenergic receptors of the vessels of the kidneys, lungs, liver, skin, and muscles. Due to centralization, normal blood flow is maintained in the vessels of the heart and brain. However, if vasoconstriction persists, the decrease in tissue perfusion leads to irreversible damage to the cells of the ischemic organs.

Causes of cardiogenic collapse

Cardiogenic collapse develops due to a decrease in myocardial contractility (most often with acute infarction myocardium, less often - with myocarditis or poisoning with cardiotoxic substances), with severe tachycardia and bradycardia, as well as with morphological disorders (rupture interventricular septum, acute valvular insufficiency, critical aortic stenosis).

Insufficient filling of the heart cavities may be based on pericardial tamponade, pulmonary embolism, tension pneumothorax (obstructive shock). All these factors lead to a decrease in the minute volume of the heart, depending on its mechanical pumping function, heart rate (HR), filling of the heart cavities and the function of the heart valves. A decrease in cardiac output and a drop in blood pressure lead to activation of the sympathoadrenal system and centralization of blood flow.

Causes of vascular collapse

The pathogenesis of vascular collapse is based on relative hypovolemia - the normal volume of circulating blood is insufficient to adequately fill the ventricular cavities. With an infectious-toxic (septic) collapse under the influence of bacterial toxins, oxygen uptake by tissues decreases and arteriovenous shunts open, peripheral resistance decreases, as a result of which blood pressure falls. In order to maintain a normal level of blood pressure, the body reacts with a hyperdynamic circulation reaction - an increase in stroke volume and heart rate. In the future, an increase in the permeability of the capillary wall, deposition of blood and an increasing decrease in the volume of circulating blood with a decrease in venous return to the heart, as well as the development of heart failure, lead to the manifestation of the hypodynamic stage of septic shock.

In anaphylactic collapse, relative hypovolemia is due to the vasodilating effect of histamine and other mediators of allergy, as well as an increase in capillary permeability under their influence. The accumulation of blood in the capillaries and veins leads to a decrease in venous return and a decrease in the stroke volume of the heart, a drop in blood pressure and a decrease in capillary perfusion.

How to provide emergency assistance in case of collapse?

Emergency care must comply with the requirements of emergency therapy, i.e., funds should be immediately applied that give an effect immediately after their introduction. Delay in the treatment of such a patient can lead to the development of severe microcirculation disorders, the appearance of irreversible changes in tissues and be the direct cause of the patient's death. Since in the mechanism of shock development essential role play a decrease in vascular tone and a decrease in blood flow to the heart, therapeutic measures should primarily be aimed at increasing venous and arterial tone and increasing the volume of fluid in the bloodstream.

First of all, the patient is laid horizontally, that is, without a high pillow (sometimes with raised legs) and oxygen therapy is provided. The head should be turned to the side to avoid aspiration of vomit in case of vomiting.

Relief drugs for incipient collapse

Taking drugs by mouth with symptoms of collapse, of course, makes no sense. In collapse, only intravenous infusion of drugs may be of benefit, as a disorder of tissue circulation impairs absorption. medicinal substances administered subcutaneously or intramuscularly, as well as taken orally.

As an emergency, rapid infusion of fluids that increase the volume of circulating blood is shown: colloidal (for example, polyglucin) and saline solutions in order to increase blood pressure to 100 mm Hg. Art. Isotonic sodium chloride solution is quite suitable as an emergency aid for collapse, but when transfusing very large volumes, pulmonary edema may develop. In the absence of signs of heart failure, the first portion of isotonic sodium chloride solution (400 ml) is administered by jet. If shock is caused by acute blood loss not exceeding 30% of its total volume, the same therapy is carried out; with greater blood loss, if possible, blood is transfused or blood-substituting fluids are administered.

With cardiogenic collapse, this cannot be done due to the danger of pulmonary edema. Preference is given to pressor amines. In anaphylactic collapse and shock resistant to fluids (if there are no signs of ongoing internal bleeding), pressor amine therapy is also indicated.

Alpha-adrenergic agonist Norepinephrine acts not only on blood vessels, but also on the heart, having positive ino- and chronotropic effects (strengthens and speeds up heart contractions). Norepinephrine is injected intravenously at a rate of 1-8 µg/kg/min. In the absence of a dispenser, they act as follows: 150–200 ml of 5% glucose solution or isotonic sodium chloride solution with 1–2 ml of 0.2% norepinephrine solution are poured into the dropper and the clamp is set so that the injection rate is 16–20 drops per minute. Checking blood pressure every 10-15 minutes, if necessary, double the rate of administration. If interruption for 2 to 3 minutes (with a clamp) of the drug does not cause a second drop in pressure, you can stop the infusion while continuing to control the pressure.

Dopamine as an emergency aid for collapse has a selective vascular effect. It causes vasoconstriction of the skin and muscles, but dilates the vessels of the kidneys and internal organs. Dopamine is administered intravenously by drip at an initial rate of 200 µg/min. In the absence of a dispenser, the following scheme can be used: 200 mg of dopamine is diluted in 400 ml of isotonic sodium chloride solution, the initial rate of administration is 10 drops per minute, if there is no effect, the rate of administration is gradually increased to 30 drops per minute under the control of blood pressure and diuresis.

Additional emergency measures for collapse

Since shock can be caused by various causes, along with the introduction of fluids and vasoconstrictors, measures must be taken against further exposure to these causal factors and development of pathogenetic mechanisms leading to hypovolemia. With tachyarrhythmias, the means of choice is electropulse therapy, with bradycardia, electrical stimulation of the heart. In true cardiogenic shock, it is sometimes possible to improve the prognosis by timely systemic thrombolysis.

What to do when different types collapse?

In emergency care for hemorrhagic collapse, measures to stop bleeding (tourniquets, tight bandages, tamponade, etc.) come to the fore. Pathogenetic treatment is thrombolysis for thromboembolism of the branches of the pulmonary artery, drainage of the pleural cavity for tension pneumothorax, pericardiocentesis for pericardial tamponade. Pericardial puncture can be complicated by damage to the myocardium or coronary arteries with the development of hemopericardium and fatal arrhythmias, therefore, if there are absolute indications, this procedure can only be performed qualified specialist in a hospital setting.

Local anesthesia (novocaine blockade of the injury site) is indicated as emergency care for hemorrhagic collapse. In traumatic, burn shock, when adrenal insufficiency occurs due to stress, it is necessary to use prednisolone, hydrocortisone.

What to do with infectious-toxic collapse. Antibiotics are prescribed for emergency care.

As an emergency for anaphylactic collapse, the volume of circulating blood is also replenished with saline or colloidal solutions (500-1000 ml), but the main treatment is Adrenaline at a dose of 0.3-0.5 mg subcutaneously with repeated injections every 20 minutes, additionally used glucocorticoids (intravenous hydrocortisone or prednisolone, or betamethasone).

As an emergency for hemolytic collapse (due to transfusion of incompatible blood), therapy includes the introduction of alkaline solutions and early stimulation of diuresis to prevent acute renal failure, which naturally complicates hemolysis.

All therapeutic measures are carried out against the background of absolute rest for the patient, who is laid with a low head position. The patient is subject to emergency hospitalization in the intensive care unit of a multidisciplinary hospital or a specialized department. Transportation of the patient is carried out, if possible, by a specialized ambulance, in which all necessary medical measures are continued.

Clinical picture of collapse

The clinical picture of shock is due to a critical decrease in capillary blood flow in the affected organs. On examination, the characteristic face of a patient in a state of shock attracts attention. It is also described by Hippocrates (Hippocratic mask): "... The nose is sharp, the eyes are sunken, the temples are depressed, the ears are cold and tight, the earlobes are turned, the skin on the forehead is hard, stretched and dry, the color of the whole face is green, black or pale, or lead" . Along with the noted signs (a haggard earthy face, sunken eyes, pallor or cyanosis), the low position of the patient in bed, immobility and indifference to the environment, barely audible, "reluctant" answers to questions attract attention. Patients complain of severe weakness, dizziness, chilliness, blurred vision, tinnitus, sometimes a feeling of melancholy and fear. Often drops of cold sweat appear on the skin, the extremities are cold to the touch, with a cyanotic skin tone (the so-called peripheral signs of shock). Breathing is usually rapid, shallow, with depression of the function of the respiratory center due to increasing hypoxia of the brain, apnea is possible. There is oliguria (less than 20 ml of urine per hour) or anuria.

The greatest changes during collapse are observed in the cardiovascular system: the pulse is very frequent, weak filling and tension (“threadlike”). In severe cases, it is not possible to probe it. The most important diagnostic sign and the most accurate indicator of the severity of the patient's condition is a drop in blood pressure. Both the maximum and minimum, and pulse pressure are reduced. We can talk about shock with a decrease systolic pressure below 90 mm Hg. Art. (later it decreases to 50 - 40 mm Hg or is not even detected when measured with a cuff); diastolic blood pressure drops to 40 mm Hg. Art. and below. In individuals with previous arterial hypertension the picture of collapse can be observed at higher rates of blood pressure. A steady increase in blood pressure with repeated measurements indicates the effectiveness of the ongoing emergency care in case of collapse.

Features of the course of collapse

With hypovolemic and cardiogenic collapse, all the described signs are sufficiently pronounced. In hypovolemic shock, unlike cardiogenic shock, there are no swollen, pulsating jugular veins. On the contrary, the veins are empty, collapsed, it is difficult, and sometimes impossible, to obtain blood during the puncture of the cubital vein. If you raise the patient's hand, you can see how the saphenous veins immediately fall. If you then lower your hand so that it hangs down from the bed, the veins fill very slowly.

With cardiogenic collapse, the jugular veins are filled with blood, signs of pulmonary congestion are revealed. With an infectious-toxic collapse, the clinical features are fever with amazing chills, warm, dry skin, and in advanced cases, strictly defined skin necrosis with its rejection in the form of blisters, petechial hemorrhages and pronounced marbling of the skin.

With anaphylactic collapse, in addition to circulatory symptoms, other manifestations of anaphylaxis are noted, in particular:

skin and respiratory symptoms (itching, erythema, urticaria, angioedema, bronchospasm, stridor),

A distinctive feature of anaphylactic collapse, which develops as a result of the total expansion of the arteries, including the skin, is warm skin.

The diagnosis of collapse is made on the basis of a characteristic clinic. diagnostic criteria are a drop in blood pressure, apathy and drowsiness, pallor, cyanosis, marble coloration of the skin, their high humidity, cold extremities, respiratory disorders (dyspnea), oliguria.

The differential diagnosis of collapse is with acute heart failure. Distinguishing features include:

position of the patient in bed (low in shock and semi-sitting in heart failure),

its appearance (with shock, a hippocratic mask, pallor, marbling of the skin or gray cyanosis, with heart failure - more often a cyanotic puffy face, swollen pulsating veins, acrocyanosis),

breathing (with shock it is rapid, shallow, with heart failure - rapid and increased, often difficult),

expansion of the boundaries of cardiac dullness and signs of cardiac stagnation (moist rales in the lungs, enlargement and tenderness of the liver) in heart failure and a sharp drop in blood pressure during shock.

Causes of the collapse

Among the main reasons for an unexpected drop in vascular tone are:

Symptoms

The clinical picture is pronounced. Together, the symptoms can immediately identify the pathology, without confusing it with other diseases of the heart and blood vessels.

Sudden and rapid deterioration of well-being;
Severe and sharp headache;

One of the symptoms of cardiovascular collapse is a severe and severe headache.

Note that a distinction is made between vascular and cardiac collapses. The first is less dangerous for the patient's life, but it also requires an adequate response.

Therapeutic measures

At the slightest sign collapse should immediately seek qualified help. Compulsory hospitalization required further therapy underlying disease causing atony.

And yet, in order to avoid relapse, it is necessary to undergo a course of treatment for the underlying disease that causes collapse.

Staying at home and hoping that everything will pass by itself will not work. Also, do not independently increase the pressure by taking over-the-counter medications. The appointment should be made by a cardiologist based on the results of a qualitative diagnosis. Rapid response and timeliness of provided therapeutic care- the key to saving human life!

How does acute vascular insufficiency develop?

The collapse is characterized by a decrease in vascular tone, which is accompanied by a relative decrease in the volume of blood circulating in the body. In simple words, the vessels dilate in a short period of time, and the blood available in the bloodstream becomes insufficient for the blood supply to the vital organs. The body does not have time to quickly respond to a change in vascular tone and release blood from the blood depots. acute vascular insufficiency, collapse develops acutely and rapidly.

If the collapse is accompanied by a critical violation of the blood supply to the brain, then there is a faint, or loss of consciousness. But this does not happen in all cases.

With the development of collapse, the state of health worsens, dizziness appears, pallor of the skin and mucous membranes, cold sweat may appear. Breathing becomes frequent and superficial, the heartbeat quickens, blood pressure decreases.

Cardiovascular collapse: first aid

As a rule, collapse develops against the background of a weakening of the body after serious illnesses, infections, intoxications, pneumonia, with physical and mental overstrain, with a decrease or increase in blood sugar levels. If the collaptoid state or fainting lasts more than 1-2 minutes, then any serious illness should be suspected here and an ambulance doctor should be called.

First aid for cardiovascular collapse and fainting should be as follows: eliminate potential hazards (electric current, fire, gas), make sure the patient has free breathing or ensure it (unfasten the collar, belt, open the window), pat on the cheeks and splash your face with cold water.

If such conditions occur repeatedly, their duration and frequency increase, then it is necessary to carry out a complete clinical examination to determine their cause.

Fainting, collapse and shock are frequent "companions" of vascular insufficiency, they are all due to sharp drop HELL. Fainting is the mildest form. The severity of the manifestations of collapse is predetermined by the form in which the underlying disease proceeds. Shock is the most severe condition of this triad. It is not at all easy to stop the pathological process without special knowledge.

Acute vascular insufficiency is a condition in which the general or peripheral circulation is disturbed, accompanied by low blood pressure and impaired blood supply to organs and tissues. This disorder is caused by a mismatch between blood supply and the metabolic needs of the brain. There is a decrease in cardiac output or a decrease in systemic vascular resistance, which leads to a drop in blood pressure. Acute heart failure manifests as syncope, collapse, or shock. These pathological conditions require an immediate response from others: literate urgent Care in syncope, collapse and shock can be crucial for a person with impaired peripheral circulation.

This article is devoted to the causes and symptoms of syncope collapse and shock, as well as first aid for these manifestations of acute vascular insufficiency.

Fainting: causes, symptoms and emergency care

Fainting- this is a sudden short-term disturbance of consciousness caused by cerebral hypoxia. This is the most common and rather mild form of acute vascular insufficiency. The causes of fainting can be overwork, fear, pain, negative emotions, a sudden change in body position, prolonged standing, the use of appropriate medications, internal bleeding, angina pectoris. Other heart conditions can also be the cause of fainting.

Fainting is usually preceded by weakness, nausea, dizziness, tinnitus. Also, the clinical symptoms of fainting are numbness of the extremities, darkening of the eyes, yawning, sweating. Unconscious state most often occurs in the upright position of the patient. He slowly sinks to the ground, his face turns pale, the pupils constrict, the reaction to light is lively, the skin is pale and moist, the pulse is weak, blood pressure is lowered, breathing is rare, shallow. Loss of consciousness usually lasts from a few seconds to several minutes. At the height of fainting, especially with its protracted course (more than 5 minutes), the development of seizures, involuntary urination.

When providing first aid for symptoms of fainting, it is necessary to eliminate the factor contributing to the occurrence of this pathological condition. If a person feels general weakness, nausea, yawning, sweating, it is necessary to help to sit down with his head down. Give an influx of fresh air, give a sniff of cotton wool soaked in ammonia, vinegar, cologne, rub whiskey with these products, warm your feet with heating pads or rub them with something hard. If the patient has lost consciousness, he is laid on his side to prevent the tongue from falling into the larynx. To provide emergency care for symptoms of fainting, unfasten the belt and collar, spray the face with water, rub with a towel dipped in cold water, give to inhale vapors of ammonia, vinegar, cologne. After the return of consciousness, hot strong tea or coffee should be given. If after measures taken consciousness is not restored, it is necessary to call an ambulance. After fainting of any intensity, you should definitely consult a doctor. Hospitalization is indicated for syncope in patients with cardiovascular or nervous diseases, frequent fainting, with fainting after physical activity and etc.

The most typical causes of sudden loss of consciousness should be purposefully identified. For diagnosis, ECG, EchoCG, Holter, blood Hb, and serum troponin T are used.

Vascular collapse: main symptoms, causes of development and first aid

Collapse- this is a sharp vascular insufficiency that occurs due to a change in the volume of circulating blood, a drop in vascular tone, redistribution of blood, etc. At the same time, the flow of venous blood to the heart decreases, cardiac output decreases, arterial and venous pressure drops, tissue perfusion and metabolism are disturbed, hypoxia of the brain occurs, vital functions are inhibited. Compared to fainting, collapse takes longer and is more severe.

The cause of vascular collapse is severe infections, intoxication, internal bleeding, the use of drugs, a critical decrease in body temperature, adrenal insufficiency, fluid loss during profuse urination. Also, the cause of the development of collapse can be overheating of the body.

The severity of manifestations of collapse depends on the underlying disease and the degree of vascular disorders. The degree of adaptation (for example, to hypoxia), age (in the elderly and children early age collapse is more severe) and the emotional characteristics of the patient. Relatively mild degree collapse is sometimes called the collaptoid state.

In most cases, the pathological condition develops acutely, suddenly. The first clinical symptom of collapse is severe weakness, dizziness, and tinnitus. Patients often feel chilliness, cooling of the extremities. Consciousness is obscured, the patient is indifferent to the environment, often complains of a feeling of melancholy and depression, convulsions are possible. Also, symptoms of vascular collapse are blanching, and then blue of the skin and mucous membranes. Tissue turgor decreases, the skin can become marble, the face is earthy, covered with cold sticky sweat, the tongue is dry.

One of the main symptoms of collapse is rapid pulse weak filling on the radial arteries. Arterial pressure is sharply lowered (systolic below 80 mm Hg. Art.). In severe cases, diastolic pressure cannot be determined, the amount of urine excreted decreases (oliguria) almost to a complete cessation (anuria). Sometimes the body temperature drops, patients complain of cold and chilliness.

To provide emergency care for collapse, it is necessary to lay the patient on his back, in a horizontal position with his legs slightly raised. If possible, it must be warmed, overlaid with heating pads, sprinkled on the face and chest with water, rub hands and feet. Providing first aid for collapse, the patient should be allowed to inhale ammonia, open the window. In the absence of ammonia, massage the earlobes, temples, dimples above the upper lip. With absence external signs life, artificial respiration and indirect heart massage should be done.

It is important to remember that while assisting with collapse, before examining the patient by a doctor, you cannot give the patient water and give any medication, try to bring him to his senses with the help of slaps.

After the examination, the doctor may prescribe a subcutaneous injection of 1-2 ml of cordiamine or 1 ml of a 10% caffeine solution. In the case of bradycardia, 0.5 ml of a 0.1% solution of atropine is administered. After the return of consciousness, the patient should not immediately rise.

In a hospital, depending on the cause and symptoms of collapse, detoxification therapy is carried out during first aid - 400-800 ml of hemodez, reopoliglyukin are administered intravenously. To maintain heart function 1-2 ml of 1% mezaton solution, 1 ml of 0.2% norepinephrine solution, 1-2 ml of cordiamine, 1-2 ml of 10% caffeine solution. Additionally, 60-90 mg of prednisolone is administered intravenously, and with the development of acidosis, intravenously up to 200 ml of a 4% solution of sodium bicarbonate.

Shock: main symptoms and first aid

Shock- this is a serious condition that occurs as a result of a strong impact and is caused by a sharp violation of the mechanisms of regulation of all life processes. Basically, this is a state of deep depression of blood circulation, central nervous system, respiration and endocrine system. Differentiate shock traumatic, toxic-infectious, cardiogenic, allergic, anaphylactic, etc. There are two phases of shock (according to I.P. Pirogov): erectile and torpid.

In the short-term erectile phase that follows an injury (stress, strong tension), the main symptom of shock is the patient's excessive mobility. As a rule, a person in a state of such a shock is verbose, his pulse is quickened, his blood pressure is elevated. In a more protracted torpid phase with preserved consciousness, the clinical symptom of shock is the patient's apathy, his indifference to the environment. The skin and mucous membranes are pale, with a cyanotic tint, reflexes are depressed, blood pressure is lowered, the pulse is weak, the body temperature is lowered.

The diagnosis of "shock" is made if the patient has the following symptoms: lowering blood pressure and tachycardia (in the torpid phase); anxiety (erectile phase) or blackout (torpid phase); respiratory failure; decrease in the volume of urine excreted (oligonuria and anuria); cold, moist skin that is pale cyanotic or marbled.

Assistance and treatment are carried out in a specialized institution.

Prior to the arrival of a doctor, it is necessary to provide a person in a state of shock with emergency care. To do this, you need to release the victim from under the rubble, extinguish burning clothes, etc. In case of external bleeding, it is necessary to take measures to stop it - apply a sterile pressure bandage to the wound or (in case of arterial bleeding) apply a hemostatic tourniquet or twist from improvised materials above the wound . If a fracture or dislocation is suspected, temporary immobilization of the limb should be provided. The oral cavity and nasopharynx of the victim are freed from vomit, blood, foreign bodies; if necessary, carry out artificial respiration. If the victim is unconscious, but breathing and cardiac activity are preserved, then during first aid in case of shock, to prevent the flow of vomit into the respiratory tract, the victim is laid on his stomach, and his head is turned to the side. The victim, who is conscious, can be given inside painkillers (analgin, pentalgin, sedalgin). It is important to deliver the victim to a medical facility without delay. In all cases anaphylactic shock adrenaline is preferred. When providing first aid for symptoms of shock in a medical facility, use 2 ml of a 2% solution of suprastin - carefully intravenously or 1-2 ml of a 2.5% solution of diprazine intramuscularly, heparin 10,000 IU, 0.25% solution of droperidol 2 ml, sodium oxybutyrate 20% solution 10 ml, 0.5% solution of sibazon 2 ml. Systolic blood pressure must be maintained at 100-110 mm Hg. Art. Additionally, cordiamine, caffeine, camphor are administered, and in case of severe bronchospasm - intravenously 10 ml of a 2.4% solution of aminophylline with 10 ml of a 40% glucose solution. It is also recommended to use intravenously 30-60 mg of prednisolone hemisuccinate with 5% glucose solution. It is advisable to limit yourself to a minimum set of drugs.

Remember! It is necessary to provide assistance with fainting, collapse and shock clearly and competently, strictly following the algorithms described above.

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One of the acute forms of vascular insufficiency is called collapse. It occupies an intermediate position between fainting and shock. It is characterized by a drop (collapse means fallen) pressure, dilatation of the veins and arteries with the accumulation of blood in them.

Read in this article

Causes of acute vascular collapse

The following can lead the patient to a collaptoid state:

sharp pain;
trauma;
blood loss, general dehydration;
acute infectious processes;
low cardiac output ( , );
severe allergic reactions;
intoxication with internal (diseases of the kidneys, liver, intestines, acute inflammation) or external (various poisonings) entry of toxic substances into the blood;
the introduction of drugs for general or spinal anesthesia, barbiturates, an overdose of sleeping pills, drugs, medications for the treatment of arrhythmias, hypertension;
decreased synthesis of catecholamines in the adrenal glands;
drop in blood sugar or its sharp increase.

Determining the cause of the collapse is not difficult if it arose against the background of an already existing disease. With sudden development, it is the first manifestation of emergency conditions (eg, ectopic pregnancy, bleeding from a stomach ulcer). In the elderly, acute vascular insufficiency often accompanies myocardial infarction or pulmonary embolism.

Deficiency symptoms

The first signs of collapse are sudden general weakness, yawning, dizziness. Then quickly join:

With fainting, a spasm of cerebral vessels occurs, and even with a mild form, patients lose consciousness. It is also important to distinguish collapse from shock.. In the latter case, heart failure, gross metabolic disorders and neurological disorders join. It should be noted that the border between these states (fainting, collapse, shock) is often rather conditional, they can pass into each other as the underlying disease progresses.

Types of collapses

Depending on the causes and the leading mechanism of development, several types of vascular collapses have been identified:

orthostatic- with a sharp change in body position in case of ineffective regulation of arterial tone (recovery from infections, taking antihypertensive drugs, a rapid decrease in body temperature, pumping fluid out of the cavities, indomitable vomiting);
infectious- a decrease in the tone of the arteries occurs under the influence of bacterial or viral toxins;
hypoxic- happens with a lack of oxygen or low atmospheric pressure;
dehydration- it leads to fluid loss in severe infections with diarrhea and vomiting, excessive urine output with forced diuresis, diabetes mellitus with high hyperglycemia, with internal or external bleeding;
cardiogenic- is associated with myocardial damage during a heart attack, cardiomyopathy;
sympathicotonic- loss of blood or dehydration, neuroinfection, proceeds with vascular spasm at normal pressure,;
vagotonic- severe pain, stress, anaphylaxis, a drop in blood sugar or a lack of adrenal hormones. The sharp difference between , ;
paralytic- severe diabetes, infectious processes, depletion of compensation reserves, paralytic vasodilation with a sharp decrease in blood circulation.

According to the severity of the patient's condition is:

easy- the pulse increases by a third, the pressure is at the lower limit of the norm, the pulse (the difference between systolic and diastolic) is low;
moderate- heart rate increased by 50%, pressure about 80-60 / 60-50 mm Hg. Art., urine output decreases;
heavy- consciousness changes to a state of stupor, lethargy, the pulse is increased by 80 - 90%, the maximum pressure is below 60 mm Hg. Art. or not determined, anuria, intestinal motility stop.

Features of vascular insufficiency in children

In childhood, infections, dehydration, intoxication and oxygen starvation in diseases of the lungs, heart, and nervous system are a common cause of collapse.

Signs of the onset of a collaptoid reaction are a deterioration in the child's condition - against the background of the underlying disease, there is a sharp weakness, lethargy up to adynamia (low motor activity).

Emergency care before the ambulance arrives

Watch the video about first aid for fainting and vascular collapse:

Medical therapy

Before transporting the patient to the hospital, the introduction of vasoconstrictors - Cordiamin, Caffeine, Mezaton, Norepinephrine can be used. If the collapse occurred against the background of loss of fluid or blood, then the introduction of such drugs is carried out only after the restoration of the volume of circulating blood with the help of Reopoliglyukin, Stabizol, Refortan or saline solutions.

In severe cases and in the absence of peptic ulcer, hormonal drugs are used (Dexamethasone, Prednisolone, Hydrocortisone).

Inhalation of humidified oxygen is indicated for patients with hypoxic collapse, carbon monoxide poisoning, and severe infections. With intoxication, infusion therapy is carried out - the introduction of glucose, isotonic solution, vitamins. In case of bleeding, either plasma substitutes are used.

Patients with heart failure additionally receive cardiac glycosides; in case of arrhythmia, it is necessary to restore the rhythm with the help of Cordarone, Atropine (with conduction blockade, bradycardia). If the collapse develops against the background of a severe attack of angina pectoris or a heart attack, then intravenous administration of neuroleptics and narcotic analgesics, anticoagulants is carried out.

Forecast

Prevention

Prevention of acute vascular insufficiency consists in:

timely diagnosis and treatment of infections, intoxications, bleeding, burns;
taking potent medications to reduce pressure only on medical advice, under the control of hemodynamic parameters;
correction of violations of metabolic processes;
maintaining the recommended blood glucose levels.

In acute infections with high body temperature, bed rest, a slow transition to a vertical position, and sufficient drinking regimen are important, especially with fever, diarrhea and vomiting.

It is difficult to tolerate in childhood and old age. Emergency care consists in giving a horizontal position, quickly calling a doctor, providing access to fresh air. For treatment, vasoconstrictors, hormones, infusion solutions and plasma substitutes are administered. A prerequisite for a favorable outcome is the elimination of the cause of the collapse.