4 signs of sudden death, catching them early may save lives

Audit expert: Wang Xin

Deputy Chief Physician, Department of Cardiology, Jilin People's Hospital

A few days ago, news of two cases of sudden death made everyone tremble in their hearts. One was a 33-year-old COVID-19 victim who was diagnosed with sudden cardiac death. The other was an employee of a certain company who unfortunately died suddenly just one hour after starting work.

Source: Beijing News Network

Source: Jiupai News

Sudden death occurs from time to time. According to statistics from the National Center for Cardiovascular Diseases in 2020, about 550,000 people die from sudden cardiac death in my country each year. So, what is sudden death? What are the signs of sudden death? How to rescue in an emergency? This article will give you the answers.

What is sudden death?

Sudden death, as the name suggests, is sudden death. It refers to the sudden death of a healthy or seemingly healthy patient due to a natural disease within a short period of time. More precisely, it refers to the death of a patient within 6 hours of onset. 6 hours is the recognition standard in my country, which is the same as the regulations of the World Health Organization. In other countries, there are also 12 hours and 24 hours recognition standards. It is currently recognized that those who die within 1 hour of onset are mostly sudden cardiac death. Sudden death can occur at any age, including infants, children, teenagers, young adults, and the elderly.

The key to judging sudden death lies in its three characteristics: sudden, accidental and natural death. Sudden means rapid and short; accidental means unexpected; natural death refers to death caused by various diseases, rather than death from external factors of the patient's body, such as drowning, electric shock, hanging, poisoning, hypothermia, hyperthermia, violence, blood loss, trauma, anesthesia, surgery and other unnatural causes.

Sudden death itself is not a disease. Clinically, sudden death can be divided into two categories, namely sudden cardiac death and non-cardiac sudden death. Sudden cardiac death is also called sudden cardiac death, which is mainly caused by sudden death due to some reason of the heart. Among patients with sudden cardiac death, 80% of adult deaths are related to acute coronary syndrome. These patients die from acute myocardial ischemia. After the occurrence of acute coronary syndrome, the sudden myocardial ischemia causes the patient's heart electrical activity to become disordered, and then malignant arrhythmias occur, mostly ventricular fibrillation. At this time, if the patient does not receive timely cardiopulmonary resuscitation or resuscitation fails, sudden death will occur.

Heart disease may lead to sudden cardiac death Source: Pixabay

Non-cardiac sudden death, also known as non-cardiac sudden death, refers to the sudden death of a patient due to diseases other than heart disease. Common major clinical diseases include pulmonary infarction, bronchial asthma, cerebral hemorrhage, acute hemorrhagic necrotizing pancreatitis, severe electrolyte imbalance, etc.

Once cardiac arrest occurs, tissues and organs throughout the body will be damaged to varying degrees, and the brain is the most seriously affected. Although it only accounts for 2% of the body's weight, the brain's oxygen consumption accounts for 20%-30% of the body's oxygen consumption. If cardiac arrest lasts for more than 4-6 minutes, brain tissue will be permanently damaged, and brain death will occur and be irreversible if it lasts for more than 10 minutes. Most limb replantations within 6 hours at room temperature will be successful, but for brain tissue, this time can only be calculated in minutes and seconds.

Why does sudden death also happen to young people?

In the early morning of November 27, 2019, 35-year-old actor Gao Yixiang fainted during the recording of a program and died after being sent to the hospital.

On December 29, 2020, a female employee of a shopping website suddenly felt severe abdominal pain on her way home from get off work, fainted and died after failed rescue efforts. She was only 23 years old.

On the afternoon of February 4, 2022, an employee of a certain website suddenly became unwell and died in the evening after being sent to the hospital. He was only 25 years old.

When sudden death occurs, age cannot separate us from death.

The high-intensity work and fast pace of modern society have brought excessive fatigue and long-term work pressure to young people. On the one hand, high-intensity work consumes a lot of mental and physical energy, which will make the body tired. Excessive fatigue will also increase the activity of the human sympathetic nerves, increase blood pressure, and increase the burden on the cardiovascular system. On the other hand, long-term work pressure will always keep people's mental state in a tense state, and eventually lead to electrolyte disorders in the body. Finally, unhealthy living habits such as staying up late for a long time will disrupt the body's normal 24-hour rhythm, leading to dysfunction of various organs in the body, arrhythmia, or heart failure, and the probability of sudden death will suddenly increase.

Source: pixabay

Many young people believe that exercise is good for health and that they should exercise more often to relieve work fatigue. However, this common sense is not necessarily correct. Going to the gym when you are sleep deprived and physically tired will actually increase the burden on your body. This is because the body's response to exercise is similar to the state of the body under stress. Both can cause sweating, increased heart rate, increased blood pressure, and heavier breathing.

Source: Shangguan News

When people are under stress, the adrenaline and cortisol released by the brain help us get through difficult times, but they also bring corresponding side effects, such as anxiety, headaches, indigestion, heart disease, insomnia, weight gain, memory and attention disorders, etc.

For people who are under long-term stress, this bad state will exist for a long time. After intense exercise in a short period of time, the cortisol in the body will continue to increase, making the body's condition worse. In the huge consumption, the body can no longer bear the extra pressure and will inevitably explode at some point. The reasons mentioned above will make young people a high-risk group for sudden death.

Sudden death is so dangerous, is there any way to predict it? Before sudden death occurs, the body will send out a series of warning signals. If these warning signals can be taken seriously, a life may be saved.

Physical signs before sudden death:

Chest pain: The typical symptom of acute myocardial infarction is chest pain. Although chest pain does not necessarily mean acute myocardial infarction, once chest pain occurs, the first thing to think of is the occurrence of heart disease.

Dyspnea: Acute left heart failure, severe asthma, pneumothorax, etc. can all cause dyspnea, which can quickly endanger life.

Panic: sudden increase in heart rate. When an acute myocardial infarction occurs, the heart rate suddenly exceeds 120 beats/minute. If it is ventricular tachycardia, it indicates that ventricular fibrillation may occur at any time. Ventricular fibrillation is a type of cardiac arrest and a malignant arrhythmia that occurs when the heart is acutely ischemic. Once ventricular fibrillation occurs, the patient's heart loses its pumping function and blood circulation stops. More than 80% of cardiac arrests occur within a few minutes of ventricular fibrillation. If the heart rate suddenly drops below 60 beats/minute, especially below 50 beats/minute, it may be a serious slow arrhythmia, such as atrioventricular block. Especially when the heart rate slows down during an acute myocardial infarction, it is also a dangerous signal of sudden death.

Sudden coma: that is, "no matter how you call, the person cannot be awakened", which means complete loss of consciousness. It can be seen in cardiac arrest caused by various reasons, acute cerebrovascular disease, craniocerebral injury, hypoglycemia, acute poisoning, etc.

Symptoms leading to sudden death, how to provide first aid?

In his book First Aid Guide to Saving Lives at Critical Moments, Mr. Jia Dacheng (a well-known senior first aid expert at Beijing Emergency Center and a member of the Health Communication Professional Committee of the Chinese Medical Doctor Association) summarized the four basic steps of judgment-calling for help-compression-defibrillation:

judge

First, determine whether the patient has lost consciousness and stopped breathing. Pat the patient's shoulders gently and call out loudly on both sides of the patient's ears: What's wrong with you? Or give some simple instructions: Open your eyes! The voice should be low and clear. If the patient does not respond, it means that he has lost consciousness. Immediately spend 5-10 seconds to observe whether the patient's chest and abdomen are rising and falling to determine whether he is breathing. If they rise and fall, it means that he is breathing. Otherwise, it means that he has not breathed. If he has lost consciousness and stopped breathing, it means that his heart has stopped.

Call for help

Dial 120 immediately, ask someone to get an AED nearby, and then perform chest compressions immediately.

If there is only one rescuer on the scene, immediately turn on the speakerphone and perform chest compressions while talking on the phone. If an AED is available immediately on the scene, then the AED should be used for rescue.

Source: hippopx.com

Press

When doing cardiopulmonary resuscitation, the focus is on chest compressions. The purpose is to ensure blood supply to the brain tissue. To ensure the effect, chest compressions must be pressed down 5-6 cm and the compression frequency must be maintained far higher than the normal heart rate, reaching 100-120 times per minute, so as to ensure that blood can effectively reach organs throughout the body.

Defibrillation

Use an AED to defibrillate the patient's heart as soon as possible. The purpose of using an AED is to stop the irregular heartbeat through electric shock, which is a key part of rescue. The success rate of cardiac resuscitation without AED is extremely low, but if an AED is used in time, the success rate of resuscitation will be greatly improved. After defibrillation, cardiac compression should be continued, and then whether to continue defibrillation should be determined based on the patient's condition.

Source: Wikipedia

In my country, an average of 1,500 people die suddenly every day, or one person dies suddenly every minute, but less than one percent of them are saved. Many people do not have time to wait for the arrival of the ambulance, and a few minutes of rescue can determine a person's life or death. Therefore, the popularization of AED is not only the popularization of first aid equipment, but also the promotion of a new concept of first aid: first aid is not only the patent of professionals, but also needs to be carried out as soon as possible by eyewitnesses on the scene with the assistance of professional equipment.

Don't let the regret of your loved ones leaving become a permanent pain in your life. The popularization of first aid knowledge requires the public's extensive attention and everyone's participation.