The term collapse defines a severe pathological condition of a child, in which a significant decrease in the tone of the smooth muscles of the walls of arterial vessels develops, as a result of which the level of systemic blood pressure decreases. This condition requires emergency care, as it can lead to a sharp deterioration in the functional state of all organs and systems, which is a consequence of impaired blood flow in them. First of all, against the background of collapse, the central nervous system suffers, since neurocytes (cells of the nervous system) are very sensitive to oxygen starvation.
Reasons
A sharp and pronounced decrease in the tone of the smooth muscle structures of the walls of arterial vessels is a polyetiological pathological condition, the development of which can be caused by several causes. The most common of these in children are:
- A significant increase (hyperglycemia) or decrease (hypoglycemia) in blood sugar levels.
- Insufficiency of the functional activity of the adrenal glands, which produce hormones that increase the tone of the smooth muscles of the artery walls (glucocorticosteroids, adrenaline, norepinephrine).
- Poisoning of the body associated with exogenous (from outside) intake of various toxins.
- Severe course of infectious pathology with severe intoxication of the child’s body.
- Somatic pathology with damage to internal organs, heart, endocrine glands in the stage of decompensation.
Girls in puberty may develop vascular collapse, which can be triggered by exposure to psycho-emotional stress factors.
Clinical picture
The development of collapse is characterized by the manifestation of a fairly characteristic clinical picture with the following symptoms:
In general, the severity of the child’s condition is determined by the severity of the decrease in systemic blood pressure. The lower it is, the worse the condition and the more pronounced the clinical picture of collapse.
Pre-hospital assistance
When the first clinical signs of collapse appear in a child, you should immediately call an ambulance. Before the arrival of medical specialists, assistance is provided at the prehospital stage, which includes several activities:
Further measures require intravenous or intramuscular administration of drugs, which is performed by medical specialists already in the ambulance. After the child is hospitalized, care at the hospital stage necessarily includes an objective diagnosis of the causes of collapse.
Collapse– one of the most complex forms of acute vascular insufficiency. This problem requires immediate professional attention. Everyone should know how to provide emergency assistance during a collapse. During an attack, minutes can count. And due to the fact that the first aid algorithm is very simple, remembering it will not be difficult.
How to understand that this is a collapse and a person needs first aid?
The collapse comes suddenly. The amount of blood flowing to the brain sharply decreases, causing the patient’s well-being to suddenly deteriorate. The faster the signs of collapse are recognized, the greater the likelihood that the unpleasant consequences of the disease will be avoided.
So, emergency assistance for collapse may be required when the following symptoms occur:
- sudden darkening of the eyes;
- pallor;
- weak but rapid pulse;
- nausea;
- vomit;
- fog;
- cold sweat;
- headache;
- blurred vision;
- decrease in body temperature;
- fainting;
- absent look.
Emergency care for collapse, fainting, shock
Of course, a person without a medical education will not be able to help a patient get out of a state of collapse. And yet there are some actions that will help alleviate the patient’s condition during an attack:
- The patient should be carefully placed on a hard surface.
- The patient's legs should be elevated and secured in this position. This will help ensure blood flow to the heart and brain.
- A mandatory step in emergency care for collapse is to ensure an influx of fresh air.
- Remove or unfasten outer clothing that makes breathing difficult.
- Give a cotton swab with ammonia to smell, if you have one on hand. If not, you can simply rub your temples, earlobes, and the hollow above your upper lip with gentle massage movements.
- If collapse is a consequence of severe blood loss, you need to try to stop the bleeding.
Lecture No. 11 Acute vascular insufficiency.
Acute respiratory failure. Comatose states.
Fainting(syncope) – a sudden short-term loss of consciousness.
Reasons: acute pain, fear, stuffiness, anxiety, physical and mental stress, infectious diseases, internal bleeding, heart defects. The mechanism of fainting is associated with a sudden movement of blood into the large vessels of the abdominal cavity.
Clinic:
Fainting has three periods:
1st period - pre-syncope state lasting from several seconds to 1-2 minutes. Characterized by dizziness, nausea, lightheadedness, darkening of the eyes, ringing in the ears, a feeling of increasing general weakness and an imminent fall with loss of consciousness.
2nd period - actual fainting or syncope, lasting 6 - 60 s. Loss of consciousness due to low blood pressure, weak labile pulse, shallow breathing, pale skin, general muscle hypotension. The eyes are closed, the pupils are dilated. With deep fainting, clonic or tonic-clonic twitching and involuntary urination are noted.
The 3rd period is postsyncopal, lasting several seconds. Consciousness, orientation in oneself, place, time, amnesia of the second period are restored. Expressed anxiety, general weakness, tachycardia, increased breathing.
Emergency care for acute vascular insufficiency (fainting).
severe weakness, dizziness, noise in the head, ringing in the ears, nausea, numbness of the limbs, pallor of the skin, loss of consciousness.
Target : restore the patient's consciousness within 5 minutes.
| Actions | Rationale |
| 1) Call a doctor. | To provide qualified medical care |
| 2)Give it a horizontal position with the foot end raised. | |
| 3) Unfasten tight clothing, ventilate the room, provide access to fresh air. | Reduce brain hypoxia |
| 4) Spray your face and chest with cold water, pat your cheeks, call your name loudly, let them smell ammonia, rub your temples. | Increase blood flow to the head |
| 5) Measure blood pressure, calculate pulse, respiratory rate, take an ECG. | Condition monitoring |
| 6) Give humidified oxygen, inject subcutaneously 2 ml of cordiamine or 1 ml of 1% mesatone solution. | Reduce hypoxia, improve heart function, increase vascular tone |
| 7) Warm the patient (apply heating pads to the arms and legs). When consciousness is restored, give hot tea to drink. |
Intravenous infusion system, syringes for IV, IM and SC administration of drugs, tourniquet, ECG machine;
Prednisolone, adrenaline, saline solution 500 ml.
After restoration of consciousness, normalization of pulse and blood pressure, the patient is provided with physical and mental rest for 1-2 hours.
Collapse
A form of acute vascular insufficiency, accompanied by a decrease in circulating blood volume, a sharp decrease in blood pressure without loss of consciousness.
Reasons: severe intoxication, infections, pneumonia, peritonitis, sepsis, etc. Mechanism: a sharp decrease in the tone of arterioles and veins as a result of dysfunction of the vasomotor center and the direct impact of pathogenic factors on the peripheral nerve endings of blood vessels. Signifies vascular paresis and increases the capacity of the vascular bed, which leads to stagnation and accumulation of a significant part of the blood in some vascular areas and a decrease in blood flow to the heart.
Clinic. Develops acutely, suddenly. First, severe weakness, dizziness, tinnitus appear, often a “veil” appears before the eyes, chilliness, and cold extremities. Consciousness is preserved, but patients are inhibited, indifferent to their surroundings, answer questions in monosyllables, with difficulty, and almost do not react to external stimuli. The skin and mucous membranes are initially pale, then bluish with a gray tint; profuse cold, sticky sweat. The facial features become sharper, the gaze is dull and indifferent. The pulse is frequent, small, absent or difficult to detect. Blood pressure is sharply reduced. The amount of urine decreases sharply or is absent. Body temperature is reduced.
Emergency care for collapse.
severe weakness; dizziness; lethargy; pale skin; hypotension; cold sweat. Goal: normalize the patient’s blood pressure within 5-10 minutes.
| Actions | Rationale |
| Call a doctor | To provide qualified medical care |
| Lay horizontally without a pillow, calm down, lower the head end of the bed, raise the foot end | Increase blood flow to the head |
| Cover with a blanket, apply heating pads to your feet, give hot tea to drink | Warm the patient |
| Ventilate the room, give access to fresh air, give humidified oxygen, inject subcutaneously 2 ml of cordiamine or 1 ml of 1% mesatone solution, if ineffective intravenous prednisolone 60-90 mg. . | Reduce hypoxia, increase vascular tone, improve heart function |
| Measure blood pressure, calculate pulse, respiratory rate | Condition monitoring |
| Take an ECG and connect it to a cardiac monitor | Condition monitoring |
Prepare equipment, instruments, medicines:
Intravenous infusion system, syringes for IV, IM and SC administration of drugs, tourniquet, ECG machine, cardiac monitor, defibrillator, Ambu bag;
Prednisolone, adrenaline, mesaton, dopamine, strophanthin, lasix (amp.), solution of polyglucin, rheopolyglucin, saline solution in 500 ml bottles, sterile.
The body's reaction to the extremely strong influence of exo- and endogenous factors, accompanied by a decrease in circulating blood volume, impaired microcirculation, hypoxia, leading to severe changes in vital organs.
Depending on the etiological factor, there are different types of shock:
Hypovolemic (hemorrhagic, traumatic, dehydration)
Cardiogenic
Anaphylactic
Infectious-toxic
Shock phases: erectile (excitement) and torpid (depression).
Torpid phase Shock severity is divided into three degrees.
At first degree There is a sharp pallor of the skin and mucous membranes, weak sweat. Pulse 90-100 per minute, satisfactory quality, systolic blood pressure within 90-60 mm Hg. Art., clear consciousness. Diuresis is normal.
In the second degree- moderate or severe condition, severe pallor, cyanosis, adynamia, rapid pulse, threadlike, systolic blood pressure - 60-40 mm Hg. Art., confused consciousness. Diuresis is reduced to 400 ml per day.
In the third degree - a state of extreme heaviness, limbs cold to the touch, wet. Systolic blood pressure is within 50-40 mm Hg. Art. or not determined. Confusion or coma. Anuria.
Clinic. Depends on the type of shock (hypovolemic, cardiogenic, anaphylactic, infectious-toxic.); phases shock (erectile, torpid).
In short erectile phase agitation and an inadequate behavioral reaction may occur (the patient may refuse treatment or leave the room, etc.). The skin may be hyperemic, covered with red spots, hot to the touch; in some cases, tachypnea, expiratory shortness of breath, tachycardia, and a short-term increase in blood pressure occur.
IN torpid phase the face becomes mask-like, there is a weak reaction to the environment, a sharp disturbance in pain sensitivity, frequent and shallow breathing. The skin is pale or earthy-gray in color, covered with sticky cold sweat, and the extremities are cold. The pulse is frequent, thread-like. Blood pressure is reduced. Superficial veins collapse and the nail beds become pale and cyanotic. Bronchospasm with cough, expiratory shortness of breath, wheezing or symptoms of gastrointestinal damage - nausea, vomiting, abdominal pain, gastrointestinal bleeding may appear. In most cases, severe general weakness is noted; adynamia; confusion; lethargy; tachycardia; hypotension; oliguria and/or anuria.
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.
Collapse is accompanied by a decrease in metabolism, hypoxia of all organs and tissues, including the brain, and inhibition of vital functions. Unlike fainting, it lasts longer and is more severe.
Timely first aid in case of collapse is often the only chance to save a person’s life.
Causes of collapse
The most common cause of collapse is significant blood loss due to serious injury, burn or rupture of an internal organ.
This acute condition can also be caused by:
- A sharp change in body position by a patient who does not stand up for a long time;
- Drug or food poisoning;
- Heat stroke;
- Heart rhythm disturbances 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 collapse, it can be sympathotonic, vagotonic and paralytic.
In the first case, a spasm of arterial vessels occurs, which leads to a redistribution of blood supply to vital organs such as the heart and large 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 observed, which occurs due to the rapid expansion of arterial vessels. As a result, circulatory failure and severe starvation of the brain occurs.
With the paralytic form, the body's defense mechanisms are depleted, which is accompanied by dilation of small vessels.
Main signs of collapse:
- Darkening in the eyes;
- Sudden deterioration in health;
- Dizziness;
- Weakness;
- Tinnitus;
- Severe headache;
- Cold sweat;
- Chills, chilliness, thirst;
- Paleness of the face;
- Blueness of the skin of the hands and feet, as well as nails;
- Unpleasant sensations in the heart area;
- Sharpening of facial features;
- Decreased body temperature;
- Rapid and shallow breathing;
- Thread-like pulse (often it cannot be felt at all);
- Sluggish reaction of pupils to light;
- Tremor of fingers;
- Cramps (sometimes);
- Loss of consciousness (not everyone experiences this sign of collapse).
Depending on the condition or disease that led to the collapse, the overall clinical picture acquires specific features.
Thus, during a crisis caused by blood loss, a person often experiences agitation and sweating sharply decreases.
With peritonitis, toxic lesions and acute pancreatitis, the main symptoms of collapse are combined with signs of general intoxication.
If the crisis is a consequence of an infectious disease, then it usually occurs during a critical decrease in body temperature. In this case, a person experiences pronounced hypotonia of the muscles and moisture in the skin of the whole body.
Collapse during poisoning is often combined with nausea and vomiting, signs of dehydration appear, and acute renal failure develops.
Orthostatic collapse, i.e. caused by a sharp change in body position to a vertical one, it is quickly stopped by transferring the patient to a lying position.
First aid for collapse
A set of measures to assist a person in case of collapse must be carried out urgently and intensively, since delay can cost him his life. It is important to differentiate acute vascular failure from acute heart failure, since therapeutic measures in these cases are different.
So, you should know that a person with acute heart failure is in a forced position - sitting, while he is suffocating, and if he is laid down, the shortness of breath intensifies even more. With vascular insufficiency, lying down improves blood supply to the brain, and, consequently, the patient’s condition. The skin in case of vascular insufficiency is pale, often with a gray tint, and in case of cardiac insufficiency it is cyatonic. With vascular, unlike cardiac, there are no characteristic congestion in the lungs, the boundaries of the heart are not displaced, the neck veins are collapsed, venous pressure is not increased, but, on the contrary, decreases.
So, if a person collapses, you should first of all call an ambulance, and then begin resuscitation measures.
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 the windows to allow fresh air to flow in and, if possible, inhale oxygen;
- Wrap up the victim and warm his feet with heating pads;
- Give ammonia to sniff or massage the earlobes, temples, dimple above the upper lip;
- Stop bleeding if collapse is due to blood loss;
- If there are no signs of life, perform chest compressions and artificial respiration.
- Give the patient heart medications that have a vasodilator effect (Nitroglycerin, Corvalol, No-shpa, Validol, etc.);
- Hit the cheeks to bring them to their senses.
Treatment of collapse
The primary task in treating collapse is to eliminate its cause: stopping bleeding, eliminating hypoxia, general detoxification, stabilizing heart function.
Further treatment of collapse includes: stimulation of breathing, increase in venous and blood pressure, activation of blood circulation, blood transfusion (if necessary) and activation of the central nervous system.
There are so many different diseases in the modern world that sometimes you don’t even suspect what problem will overtake you at the next stage of life. There are diseases that pose a great danger to our body, and sometimes to our lives. In some cases, with serious complications, collapse may occur and emergency care will be needed urgently to save a person’s life.
What is collapse
In many diseases, a disruption may occur in the functioning of the autonomic nervous system, which is responsible for regulating vascular tone. In such situations, acute
During collapse, pressure drops as paresis of small vessels occurs. The volume of blood moving through them decreases sharply, and blood flow slows down. This leads to the fact that the brain ceases to receive the necessary amount of oxygen and nutrients. The same goes for the heart muscle.
In this condition, blood supply throughout the body is disrupted, which leads to metabolic disorders. Not only neuro-reflex disorders can lead to vascular insufficiency, but also toxic substances of a protein nature. This usually happens during infectious diseases, such as pneumonia, typhus, during a heart attack or severe blood loss.
Types of collapse
Depending on the clinic and pathogenesis, collapse is divided into three types:
- Sympathotonic. This form of collapse is accompanied by increased tone of the sympathetic nervous system, which leads to spasm of the arteries throughout the body. Systolic pressure in such situations is normal or slightly elevated, and diastolic pressure is high. If such a collapse is observed, emergency care is required urgently so as not to develop more serious complications.
- Vagotonic collapse. In this state, the parasympathetic system comes into tone. The arteries, on the contrary, dilate, diastolic pressure decreases, and bradycardia is observed. The cause of this condition is fear, fainting, hypoglycemic coma.
- Paralytic. Most often it happens when the mechanisms that are responsible for regulating blood circulation are severely depleted. The vessels dilate, the pressure drops, and collapse occurs; emergency care comes down to normalizing, first of all, blood pressure.
Causes of collapse
Many reasons can cause a condition such as collapse:
If collapse occurs as a result of the above reasons, emergency care will depend on them. In each case the steps will be different.
Signs of collapse
As a rule, recognizing collapse is not difficult. Its manifestations are usually clear and bright, so it is almost impossible to confuse it with other diseases. The main symptoms of collapse include the following:
Providing emergency assistance in case of collapse should be carried out immediately in order to bring the person out of this state as quickly as possible.
Symptoms of collapse in children
The child’s body is much more sensitive to any malfunction in its functioning, so the onset of collapse can be accurately recorded. The symptoms are usually the following:
In such situations, emergency assistance for collapse in children is urgently required.
First aid for collapse
It may happen that your loved one needs help with collapse. No one is immune from this, so every person should have basic skills in providing it. Although the rendering algorithm is voluminous, anyone can remember it.
- Call an ambulance.
- In the event of such an attack, the patient must be placed on his back on a flat surface.
- Unfasten the top buttons on the clothing, if any.
- It is advisable to open the window in the room to allow more fresh air to enter.
- The legs can be raised slightly to increase blood flow to the head.
- Since there is a decrease in body temperature, the patient must be warmed with a heating pad.
- Place a swab soaked in ammonia to your nose.
- Introduce 0.1% solution of “Adrenaline”, 0.5% solution of “Ephedrine”.
- If the collapse is caused by severe bleeding, then it must be stopped.
- Provide the patient with complete rest.
- In case of cardiac arrest, it is necessary to perform chest compressions in combination with artificial respiration.
We looked at what constitutes collapse. algorithm for its implementation - these issues were also touched upon by us, but there are other points that must be taken into account.
Prohibited during collapse
If you need to provide first aid to a person in case of collapse, this does not mean that all means are good. There are things you shouldn't do:
- Under no circumstances should a patient be given heart medications, as they dilate blood vessels.
- During this time, you should not try to pour a little water into your mouth or stuff a pill.
- It is also not recommended to resort to slapping to bring a person to his senses.
Most often, minutes count in such situations, so even before the ambulance arrives, competent emergency care should be provided for fainting and collapse.
Drug therapy during collapse
The ambulance that arrives will certainly take the patient to the hospital. Help will be provided within its walls, but with the use of medications. First of all, intravenous infusions of sodium chloride are prescribed. The amount of the drug is determined according to the patient's condition. The doctor pays attention to the following signs:
As additional therapy the following is prescribed:
- Anti-inflammatory drugs, for example, Metipred, Prednisolone.
- Vasopressor drugs are administered intravenously.
- To quickly relieve spasms, Novocaine is administered.
After the patient’s condition returns to normal, treatment of the disease that provoked the collapse begins. You must always remember: if your loved one collapses, the emergency care you provide can save a life. That is why everyone should know the list of necessary actions during such a situation. Health to everyone, may such situations never happen in your life.