Collapse

The life-threatening condition of the person at which there is a falling of blood pressure and worsens blood supply of vitals, call a collapse. This state is shown by emergence at the person of sharp weakness and pallor, cooling of extremities and pointedness of features.

Also the collapse is meant as one of forms of acute vascular insufficiency at which there is a sharp falling of a vascular tone or bystry reduction of volume of the circulating blood bringing to:

• To oppression of the vital functions of an organism;
• To reduction of a venous inflow to heart;
• To falling of venous and arterial pressure;
• Brain hypoxias.

It is important to define correctly the reason which served to emergence of a state and the nobility how to give first aid at a collapse as it can help to save life to the person before transportation in medical institution.

Collapse reasons

Acute infections to which number carry an encephalomeningitis, belly and a sapropyra, pneumonia, etc. can be the possible reasons of a collapse. Also the state arises against the background of acute blood loss, at diseases of nervous and endocrine system, exogenous intoxications coming owing to poisoning with organophosphorous connections or carbon monoxide.

In medical practice many cases when the collapse came at the orthostatic redistribution of blood arising owing to overdose of such medicines as hypotensive drugs, ganglioblokator, insulin, etc. are registered.

The collapse can develop owing to a complication of a syndrome of the small cordial emission arising in the period of an acute myocardial infarction at tachycardia, deep bradycardia and dysfunction of a sinus node.

The collapse of cardiovascular system can be caused:

• The Pubertalny period at girls;
• Sharp change of position of a body at the bed patient;
• High temperature of the environment;
• Strong blow by electric current;
• Organism dehydration;
• Strong dose of ionizing radiation.

As the collapse reasons spinal and peridural anesthesia, acute diseases of abdominal organs also act.

Symptoms of a collapse

The patient suddenly has a feeling of the general weakness, a chill, dizzinesses, a fever, unquenchable thirst, body temperature decreases. Symptoms of a collapse are such manifestations as:

• Pointedness of features;
• Cooling of extremities;
• Pallor of integuments and mucous membranes (sometimes with a tsiatonichny shade);
• All body, or only forehead and whisky, are covered cold then;
• Weakness of pulse;
• Decrease in the ABP.

At inspection of the patient usually reveal that his heart is not expanded with deafs, sometimes arrhythmic, tones, the breath which is speeded up and superficial, the diuresis is lowered. At a blood analysis comes to light that its volume is reduced, the hematocrit is raised, a metabolic decompensated acidosis.

The patient has a desire to lay down or sit down with low located head, he does not test suffocation despite an asthma, his consciousness is kept or darkened, characteristic to this state full indifference to the events around.

Symptoms of a collapse is also sluggish reaction of pupils to light, spasms and a tremor of fingers of hands.

Types of a collapse

In medicine conditionally allocate three types of a collapse:

• Hypovolemic;
• Cardiogenic;
• Vazodilyatatsionny.

Developing of a hypovolemic collapse is caused by organism dehydration, strong blood loss or plazmopotery because of which blood volume in vessels sharply decreases.

The cardiogenic collapse arises against the background of:

• Heart failure;
• Acute disorder of cordial activity;
• Sharp reduction of cordial emission.

The Vazolidatsionny collapse is characteristic of serious infectious and toxic conditions, a deep hypoxia, a hyperthermia, a hypocapny, an endocrinopathy, develops at the wrong use of medicines and at surplus of the kinin, a histamine and adenosine in blood conducting to the general peripheric vascular resistance.

Collapse: first aid and treatment

Depending on the reason which served to emergence of a state it is necessary to provide in a short space of time at a collapse first aid to the patient. If the state was served by bleeding – it is necessary to stop it, poisoning with toxic substances – to remove them from an organism, applying specific antidotes.

Then it is necessary to bring the patient to medical institution where to him will appoint adequate treatment of a collapse – will carry out a transfusion of blood substitutes, applying saline solutions, Haemodesum, Polyglucinum and реополиглюкин, if necessary and strictly to destination can apply blood components.

Then, at treatment of a collapse, to the patient enter struyno intravenously 60-90 mg of Prednisolonum if the effect of its use insufficient, is added:

• 10% caffeine solution – 1-2 ml;
• 1% Phenylephine hydrochloride solution – 1-2 ml;
• 0,2% Noradrenaline solution – 1 ml;
• Cordiaminum – 1-2 ml;
• 10% Sulfocamphocainum solution – 2 ml.

At a metabolic acidosis to the patient intravenously enter or 8,4% (50-100 ml), or 4,5% (100-200 ml) hydrosodium carbonate solution. If emergence of a collapse was served by the syndrome of small cordial emission caused by arrhythmia usually appoint antiarrhythmic drugs, intravenously kapelno enter divorced 25, 100 or 200 mg of dopamine in isotonic solution of sodium chloride or 5% glucose solution, and also render the emergency electrocardiostimulation.

Collapse call a state at which there is a deterioration in blood supply of internals and falling of blood pressure that threatens human life. Most important at development of a state to define what served its emergence as the subsequent treatment of a collapse has to be directed to elimination of the reason. Further, depending on indications and a type of a collapse, the doctor appoints adequate drug treatment, can appoint a transfusion of blood substitutes and apply electrocardiostimulation.