First aid for collapse: what is important to know when providing assistance

The main reasons for the progression of the disease under study

If collapse occurs, emergency care is indicated in the following situations:

• acute bleeding, resulting in the loss of a large amount of blood,
• serious burns,
• viral diseases,
• intoxication with certain medications,
• stressful situations; depressive mood
• acute cardiovascular failure,
• diseases in the nervous system,
• endocrine pathology.

Treatment of arterial hypotension

First of all, it is necessary to treat the underlying disease, which is the cause of low blood pressure. For example, if indicated, heart valve replacement is performed, dyshormonal changes are corrected, or anemia is treated.

Patients with acute hypotension due to blood loss, dehydration, or shock require emergency treatment and hospitalization for intensive care.

Mild and moderate orthostatic collapse can be eliminated and treated on an outpatient basis, and in severe cases of this condition, hospitalization is indicated for the patient. Includes non-drug and drug treatments.

Non-drug treatment

1. Correct selection of physical activity regimen.
2. Discontinuation of drugs that cause hypotension.
3. Therapeutic gymnastics: strengthening the abdominal muscles and lower extremities.
4. Morning exercises followed by water procedures (contrast and fan showers in the morning).
5. Dynamic sports: skating, skiing, cycling, slow running, fast walking, rhythmic gymnastics, dancing, swimming, tennis.
6. Massage. General massage, massage of the collar area, hands, massage of the calf muscles, feet with hair brushes, Lyapko application rollers.
7. Recommendations for slowly changing posture when standing up (especially for older people).
8. Optimal temperature in the room.
9. Changing the diet with the introduction of foods rich in potassium and increasing the amount of salt.
10. Sleeping with the head of the bed elevated.

How does collapse occur?

The progression of the disease is quite acute. The condition is dangerous, and in the absence of timely emergency assistance in case of collapse, we can talk about serious and terrible consequences.

The main symptoms of the disease are:

• general weakness of the body and fatigue,
• dizziness,
• decrease in blood pressure,
• the skin becomes significantly lighter,
• decrease in temperature indicators,
• chills,
• facial features become sharper,
• dry mouth,
• loss of consciousness.

Help with collapse is urgently needed!

Pathogenesis of arterial hypotension

During the day, blood pressure changes depending on body position, breathing, stress, physical condition, medications taken, how much a person eats and drinks, and the time of day. Physiologically, BP is usually lowest at night and rises sharply upon awakening.

The human body has certain mechanisms to maintain blood pressure and blood flow at normal levels. These mechanisms are interconnected: the walls of the arteries, determining the level of blood pressure, send signals to the heart, arterioles, veins and kidneys to regulate blood flow. Blood pressure primarily depends on peripheral resistance of blood vessels and cardiac output.

Peripheral vascular resistance is the total resistance of the entire vascular system to the flow of blood that is ejected by the heart into the arteries. The muscle tissue in the walls of arterioles allows these blood vessels to dilate or contract. When the arterioles contract, their lumen narrows and the pressure increases. Conversely, when arterioles dilate, resistance to blood flow decreases, which leads to a drop in blood pressure. The degree of narrowing or dilation of arterioles can be regulated by nerves, hormones, and medications.

Symptoms

The disease occurs completely unexpectedly. Initially, weakness and dizziness occur, and the patient is thirsty. The skin becomes lighter than its normal state, profuse cold sweating appears on it, characterized by chills. The pulse becomes slower, the pressure decreases significantly, and shortness of breath is also observed. Among other things, you may notice deterioration in vision, the appearance of extraneous sounds in the ears, and the person may be worried about something. As the disease progresses, a person's thoughts become confused, his pupils dilate, and his heart beats much faster.

symptoms of collapse

What is arterial hypotension

Hypotension or hypotension is a long-term condition characterized by a systolic (upper) pressure level below 100 mm Hg. Art., and diastolic (lower) pressure - below 60 mm Hg. Art.

The criteria for hypotension are:

• blood pressure level < 100/60 mm Hg. Art. in persons under 25 years of age;
• blood pressure level < 105/65 mm Hg. Art. in older people

The following figures are considered to be the lower limit of the norm:

• during the day, blood pressure is 101/61 mm Hg. Art.;
• at night 86/48 mm Hg. Art.

Prevention and treatment

If you are wondering what is the sequence of first aid for collapse , then we offer you the following recommendations:

1. The pathology in question implies a phenomenon that requires immediate intervention by specialists. People who happen to be nearby when the disease progresses should change the position of the patient during collapse and put him on the bed, raise his legs and cover him with a warm blanket to prevent him from freezing.
2. In a short period of time, you need to find the cause of the decrease in pressure and get rid of it: stop heavy bleeding, give the person the necessary medications, and so on.
3. At this time, it is also necessary to provide for parenteral infusion of blood components or mixtures that serve as a replacement for blood.
4. In some particularly dangerous situations, it is necessary to carry out resuscitation measures to help save the patient’s life.

Prevention of this disease is reflected in properly selected treatment of those pathologies that can cause the development of collapse, in systematically undergoing a medical examination and taking into account the side effects of medications taken. Now you know the difference between collapse and fainting , and how to provide first aid.

Emergency care for collapse

To successfully relieve the syndrome, the following algorithm was developed:

1. Call an ambulance.
2. Place the victim on a hard surface (table, asphalt road) and raise his legs using a cushion of clothing (this will increase blood flow to the heart and brain).
3. Unbutton the collar of a tight-fitting shirt/blouse to facilitate breathing.
4. Open the windows and door to ventilate the room.
5. Since during collapse there is a decrease in body temperature, it is very important to warm the patient. If he is conscious, give him hot tea or coffee to drink; if not, wrap it in a warm blanket and put a heating pad on it.
6. Wet a cotton swab with ammonia and bring it to the nose, rub the patient’s temples and earlobes.
7. If possible, administer a solution of adrenaline and ephedrine.

NotaBene! In a collaptoid state, it is strictly prohibited:

• bring the patient to his senses by patting the cheeks;
• place a pill in the victim’s mouth or pour water into it if he is unconscious;
• giving heart medications - the popular nitroglycerin or validol, on the contrary, dilates blood vessels.

Clinical signs of orthostatic collapse

Clinical symptoms of orthostatic hypotension can vary in intensity, depending on the severity of the collapse; in total, there are 3 degrees.

Also, the symptoms of orthostatic collapse differ somewhat, depending on the situation in which fainting develops.

So, for example, with a sudden change in body position, the patient feels:

• sudden darkening of the eyes;
• flashing “flies” before the eyes;
• dizziness;
• feeling of “falling down”;
• cardiopalmus.

If vascular collapse is caused by a prolonged immobile position of the body, then the person experiences the following symptoms:

• increasing weakness in the legs, a feeling that the legs have become “wobbly”;
• nausea;
• ringing and buzzing in the ears;
• cardiopalmus;
• cold sweat;
• feeling of chilliness.

The listed clinical symptoms are characteristic of a mild degree of orthostatic collapse and usually quickly disappear when stepping from foot to foot, sitting on a chair, walking in place, and tensing the abdominal muscles.

Fainting

With degrees 2 and 3 of collapse, all of the listed symptoms end in loss of consciousness if the patient does not receive assistance in a timely manner. If you lose consciousness, involuntary urination may occur.

Before the patient loses consciousness, the following signs are observed (the lights last for several seconds):

• increasing pallor of the skin;
• sweat on the forehead and sweaty palms;
• sudden coldness of hands and feet;
• weak thread-like pulse when palpated.

In most cases, patients who feel the approach of fainting manage to somehow change their body position so as not to fall - sit on the floor, lean on the wall, etc.

Severe orthostatic hypotension is often accompanied by the development of a convulsive seizure, a sudden fall of the patient without any prefainting symptoms, and involuntary urination. Fainting in such situations lasts up to 5 minutes, and falls can lead to additional injuries - bruises, fractures.

Depending on the duration of the periods in which episodic disturbances of consciousness of the hypotonic type occur, the following are distinguished:

1. subacute – the period lasts from several days to several weeks. This period is typical for collapses caused by infectious diseases and long-term use of medications.
2. Chronic – orthostatic collapse occurs in the patient for more than 1 month. This duration of the condition is typical for diseases of the cardiovascular system, endocrine diseases, and pathologies of the nervous system.
3. Chronic progressive - lasts a year or more and is caused by unknown causes, the so-called idiopathic orthostatic collapse.

Classification

Conventionally, the following types of collapse can be distinguished:

• cardiogenic - develops as a result of a decrease in cardiac output (blood volume from the ventricles of the heart), which is observed, for example, with extensive myocardial infarction, heart rhythm disturbances;
• vasodilation – formed with a sharp decrease in vascular tone (vascular resistance), most often as a result of overheating of the body, an overdose of certain medications, or the course of severe infectious processes;
• hypovolemic – occurs when the volume of circulating blood decreases as a result of massive bleeding, repeated vomiting and diarrhea, deep and extensive burns;
• orthostatic.

Diagnostics

Orthostatic hypotension is detected if, after 2-5 minutes of quiet standing, the patient has the following symptoms:

• there is a decrease in systolic pressure (this is the first heard beat of the heart during the smooth deflation of air from the inflated cuff when measured with a tonometer) by 20 mm or more;
• a decrease in diastolic pressure (this is the level of cessation of heart sounds during the smooth deflation of air from an inflated cuff when measured with a tonometer) by 10 mm or more;
• orthostatic collapse, dizziness or other symptoms of decreased blood pressure when changing body position.

Possible complications

• Fainting is the main complication.
• Stroke (an acutely developing disorder of cerebral circulation, accompanied by damage to brain tissue and disruption of its functions) can occur as a result of fluctuations in blood pressure.
• Fall injuries – due to dizziness and fainting
• Damage to the central nervous system, particularly the brain.

Repeated collapses lead to severe brain hypoxia (lack of oxygen supply to the brain), worsening of concomitant neurological diseases, and the development of dementia (severe intellectual disorder, manifested by deterioration of cognitive activity, attention, memory).

Application therapy Lyapko

Lyapko applicators in various modifications (plates, rollers, application belts, application tapes) are an original, powerful device with many health-improving therapeutic capabilities. Their action is based on the principles of traditional Chinese medicine - superficial multi-needle acupuncture, as well as on the general physiological mechanisms of life.

Mechanisms of action of the applicator.

The high healing effect of Lyapko applicators is due to a combination of intense reactions:

• reflex-mechanical;
• galvano-electric;
• immunological.

The clinical effects of the multi-needle therapy method are manifested in analgesic, antispasmodic, anti-inflammatory, anti-edematous, neurotrophic and immunomodulatory effects. Also in the regulation of the functions of the autonomic nervous system, normalization of the processes of excitation and inhibition in the central nervous system.

Options for using Lyapko application devices at low pressure.

For hypotension, drowsiness, and weakness, the effect is effective in the morning and first half of the day. The session duration is 7–10 minutes for the applicator, 3–7 minutes for the roller.

In the morning, it is recommended to do a tonic massage, rolling the entire body with the “Large Roller M” or “Universal Roller M”. Rolling is carried out in the direction of the arrows, so the energy moves through the body (Fig. 1) or randomly, as you like.

Roll each arm, leg, then torso for one or two minutes. The use of rollers increases blood circulation, lymph flow, increases vascular tone, perfectly relieves fatigue, eliminates tension and muscle aches, pain, and increases vitality. After the massage, do a set of morning exercises, take a shower and you will feel rested and full of energy.

Fig.1

Application zones for hypotension (Fig. 2): main 1, 2, 3; auxiliary 0.4 (14); additional 7, 25, 28, 29, 31.

Fig.2

When blood pressure decreases (hypotension), act on zones 1, 2, 3 for a short time - 5-10 minutes, gradually involving the above and below zones 0, 4, 7, 14.

It is necessary to work for a short time (3-5 minutes) on the lumbosacral area, the adrenal gland area and complete the session with a 3-5 minute application of the feet and legs.

Options for using Lyapko application devices for hypotension.

Application to main, additional, auxiliary zones is possible simultaneously or in turn.

Flat applicators: “Romashka M”, “Large mat”, “Large needle massage mat”, “Chance 6.2x4”,

“Chance”, “Needle massage pillow”, “Quadro”, “Duet”, “Narodny”, “Insoles plus”.

Application rollers: “Face roller M”, “Universal roller M”, “Needle ball”.

Application belts: “Baby”, “Universal M”, “Magic ribbon “Health”. Application belts can be fixed to the main, additional zones, as well as to auxiliary zones - kidney zones (7), calves, feet (28,29,31). It is convenient to attach the “Health Magic Tape” to your feet.

Rolling in the palms, over the head, over the face with a “Needle Ball”, “Face Roller M”, “Universal Roller M” or pressing the face along massage lines with a small “Speck” applicator for 3 - 7 minutes gives a tonic effect, increases arterial pressure.

Psychosomatics of hypotension

Low blood pressure means that you are losing vitality, do not believe in yourself, in your strengths, capabilities, and are depressed. They have killed your ability to independently create your life and influence the world. You try to avoid responsibility and conflict situations. Lack of love in childhood. Defeatist mood: “Nothing will work out anyway.”

You need to live an active life, set realistic goals and achieve them, overcoming obstacles. Do not run away from life, but understand that any negative situation can become a source of accumulation of personal strength.

Reasons leading to the development of a collaptoid state

To date, the etiology of collapse has been well studied, which allows us to identify the main causes of its occurrence as a result of exposure to the body:

• infectious agents (causative agents of dysentery, botulism, meningoencephalitis, typhoid fever, influenza, and so on);
• massive blood loss (for example, as a result of injury, bleeding from a gastric or duodenal ulcer, from esophageal varices);
• severe burns;
• severe dehydration;
• toxins, poisons (especially cyanide, carbon monoxide, organophosphorus compounds);
• medications (most often antihypertensive, antiarrhythmic, b-blockers, as well as local anesthetics when released into the general bloodstream);
• various physical factors (too high or too low temperature, electric current, radioactive radiation):
• allergens (in case of development of an anaphylactic reaction);
• a decrease in venous tone, which leads to the development of orthostatic collapse (occurs after prolonged bed rest, a long-term serious illness, certain diseases of the endocrine system, and sometimes occurs in the postoperative period).

Almost everyone has encountered a condition (if not personally, then seen something similar in a film or read in literature) when a person who stood up quickly suddenly falls, “settles,” and becomes weaker. This is the so-called orthostatic collapse, which develops as a result of redistribution of blood flow, an increase in the vascular venous bed (due to decreased tone of the vein walls) and a significant decrease in the return of blood back to the heart.

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In addition to the listed pathological factors, various acute diseases or chronic diseases in the deteriorating stage play an important role:

• cardiovascular - acute myocardial infarction, pulmonary embolism, severe heart rhythm disturbances (including pacemaker dysfunction), dissecting aortic aneurysm, artificial heart valve dysfunction, acute myocarditis, pericarditis and others;
• severe pneumonia;
• acute pancreatitis and so on.

Does the presence of this condition affect the patient's overall prognosis?

It should be understood that orthostatic hypertension syndrome is not a separate disease, but usually develops against the background of one or another pathology and will always be an aggravating factor.
This condition can provoke the development of some dangerous complications. The most common are traumatic brain injuries due to falls. Another negative consequence may be encephalopathy, which occurs due to prolonged fainting, which can cause irreversible changes in the cerebral cortex, including dementia (dementia).

With proper treatment and implementation of preventive recommendations, the prognosis in most cases is favorable.