Asphyxia

A Asphyxia is the name for oxygen deficiency in the organism. It occurs as a result of trauma or illness.

What is asphyxia?

The causes of asphyxia are severe trauma such as spills or swimming accidents. Obstruction of the airways, heart failure and respiratory paralysis also play a role as causes.
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Asphyxia is a condition of a lack of oxygen in the cardiovascular system and tissues. Asphyxia is a serious disruption of the cardiovascular system. Literally translated from ancient Greek is the meaning of the term "stopping the pulse". Weak and superficial breathing is a sign of poor circulation.

An insufficient amount of the breathing gases oxygen and carbon dioxide is exchanged. Too little oxygen is carried by the blood cells in the arteries. The adequate supply of the tissues is no longer guaranteed: As a result, the oxygen partial pressure decreases. This process takes place both in the arteries and in the entire tissue. The asphyxia becomes visible: mucous membranes and skin turn blue (cyanosis).

To make matters worse, the carbon dioxide that is not exhaled collects in the blood and tissue. The consequence of this is a clouding of consciousness. This can go as far as a coma and lasts until the causes of the oxygen deficiency are eliminated. If there is an accumulation of carbon dioxide content, this is registered by the brain stem. There is a very strong fear of suffocation.

causes

The causes of asphyxia are severe trauma such as spills or swimming accidents. Obstruction of the airways, heart failure and respiratory paralysis also play a role as causes. In the event of a spill, there is sudden, strong compression of the chest. The resulting pressure presses the blood out of the chest into the head and neck.

As a result, blue-red discoloration occurs on the neck and head. There is bleeding under the skin. The eyes are bloodshot. The brain is also undersupplied with oxygen. Cerebral haemorrhage and cerebral edema occur. The strong external force often leads to further serious injuries to the internal organs. Immediate resuscitation and extensive first aid should be provided. The mortality from asphyxia is high.

With strangulations, the windpipe is narrowed. The result is asphyxia. In the case of swimming accidents with drowning, asphyxia occurs. If the water temperature is below 28 degrees Celsius, the body temperature of 37 degrees cannot be maintained without risk, as the core body temperature drops due to the release of energy to the environment. Muscle tremors occur in order to warm the core body temperature.

With the muscle tremors cramps occur at the same time, coordinated powerful swimming movements can no longer be performed. Mental control over the situation decreases at the same time. Lack of oxygen leads to an undersupply of the brain and tissue, while massive amounts of water are swallowed. There is a desperate attempt to breath while coughing and gasping, unconsciousness and respiratory arrest.

The obstruction of the airways results in asphyxia. The causes of asphyxia in the unconscious are the tongue falling back due to the lack of muscular control. Cancer sores in the larynx and trachea can block the airways. The lower airways can also be affected by an obstruction: Here, the increased mucus production in chronic obstructive bronchitis leads to asphyxia.

In bronchial asthma, in addition to the increased mucus production, there is also a spasm of the bronchial muscles. With COPD, too, there is an obstruction of the airways and thus asphyxia. An allergic reaction to insect bites, nuts or fruit can quickly lead to obstruction of the airways and to asphyxia.

In heart failure, too little blood is pumped into the circulation in terms of the unit of time. As a result, there is an insufficient supply of oxygen in the arterial blood vessels and tissues and asphyxia. The respiratory paralysis results in asphyxia. In central respiratory paralysis, the respiratory center in the brain is affected. The control of inhalation and exhalation is disturbed or has come to a standstill.

Triggers for this are poisoning by drugs such as narcotics and barbiturates, a cerebral infarction, a traumatic brain injury, general hypothermia of the tissue or non-traumatic bleeding into the brain substance. In peripheral respiratory paralysis, the respiratory muscles are affected: the supplying nerves themselves or the neuromuscular conduction are disturbed.

Curare or botulin are powerful neurotoxins that cause peripheral respiratory paralysis. Other possibilities are infectious diseases such as whooping cough, tetanus, polio or rabies. In advanced stages, degenerative muscle diseases such as spinal muscular atrophy can lead to paralysis of the respiratory center and thus to asphyxia.

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Symptoms, ailments & signs

The symptoms of asphyxia are shortness of breath, a fast heartbeat, cyanosis, and convulsions. In asphyxia, the regulation of inhalation and exhalation is disturbed. There is a shortened duration of inhalation and massive problems with inhalation. The organism tries to breathe in more oxygen with the help of the diaphragm, auxiliary respiratory muscles and intercostal muscles.

Because of the disturbed inhalation, a wheezing sound can be heard. If a foreign body has been breathed in or food is stuck in the esophagus, the body tries to free itself with massive coughing or gagging. There is general restlessness, tremors, sweating, panic and death attacks.

The strong stimulus of the sympathetic nervous system is also responsible for the initially existing accelerated heartbeat and high blood pressure as an attempt to ensure the supply of the organism under the conditions. The existing imbalance of inhalation and exhalation, or the accumulation of carbon dioxide in the tissues, leads to cyanosis. The skin and mucous membranes are discolored bluish. At the same time, the insufficient supply of oxygen to the brain leads to a clouding of consciousness.

course

Asphyxia is a life-threatening emergency which, if left untreated, leads to respiratory arrest, cardiac arrest and death.

Complications

In the worst case, asphyxia leads to death. Those affected mainly suffer from shortness of breath and the resulting panic. In addition, breathing in and out is usually no longer possible in the usual way. Most patients try to breathe more oxygen during asphyxia, which often leads to gasping and panic.

The affected person may suffer from dizziness and headaches from the lack of oxygen, and in some cases they may faint. The shortage of oxygen causes tremors and sweating. Often the patient is scared to death. If the asphyxia is not treated, the lack of oxygen usually results in damage to the organs and extremities. These turn blue.

Above all, the brain is damaged, so that consequential damage and mental impairments cannot be avoided. The longer the lack of oxygen, the more the organs are destroyed. The treatment of asphyxia is usually carried out by the emergency doctor and is designed to stabilize the patient and restore normal breathing.

Various complications can arise here, depending on the cause of the asphyxia. If there is a foreign body or water in the lungs, an incision in the trachea is necessary. If the asphyxia is left untreated, death will result.

When should you go to the doctor?

Asphyxia is a medical emergency and must be treated immediately. If there is an acute danger to life as a result of a swimming accident or a burial, an emergency doctor must be called. Signs of asphyxia are symptoms such as shortness of breath, coughing or gagging and an accelerated heartbeat, but also panic attacks and fear of death. If these symptoms occur, urgent action is required.

The ambulance service must take care of the person affected and bring them to the hospital for further treatment. Until professional help arrives, first aiders must carry out appropriate first aid measures in order to save the life of the person concerned. Depending on the cause, external wounds should be closed and breathing and circulation stabilized. If the person concerned can be addressed, the legs should be positioned upwards.

Sometimes it is also necessary to calm the injured person to prevent hyperventilation and a general worsening of the situation. If you react early to asphyxia, the chances of recovery are usually good. In most cases, however, the affected person has to undergo lengthy treatment and extensive rehabilitation measures.

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Treatment & Therapy

Asphyxia is always associated with a serious disturbance of the cardiovascular system. If there is an opportunity to survive the asphyxia, the measures aim to help the organism to find its way back to normal. As part of first aid, the following measures must be taken immediately: The unconscious are brought into a stable lateral position.

The head is overstretched to prevent the airway from being blocked by vomit or the tongue falling back. If no breathing can be determined, mouth-to-mouth resuscitation or chest compressions are started. The subsequent measures are ventilation with oxygen using a mask or intubation and monitoring of parameters such as arterial blood pressure, electrocardiogram, control of the breathing rhythm, measurement of the saturation level of oxygen and carbon dioxide.

In the event of spills and severe traumatic brain injuries, in addition to asphyxia, attention must also be paid to potentially life-threatening injuries and blood loss of the internal organs. External wounds can be satisfied with first aid measures. Paramedics and emergency physicians have additional options for expertly intervening on the way to the clinic in order to stabilize breathing and circulation. If there are further internal injuries or broken bones, immediate emergency surgery in the clinic is indicated.

The casualty in the water is brought ashore as soon as possible. Stable lateral position or resuscitation are necessary. A large gush of water may be vomited. The body temperature must be stabilized and raised, as must the circulation. If the blood pressure is low, the circulation must be stabilized. If the person concerned can be addressed, the legs can be put up.

While sitting as upright as possible - possibly supported - a glucose solution can be drunk in small sips with the head straight ahead. Causes of the low blood pressure are medically clarified and remedied, if possible. Neurotoxins such as drugs in high doses or narcotics can paralyze the respiratory center. Once the basic functions of breathing and circulation are restored, the body is detoxified and, if necessary, readjusted with medication.

In some degenerative muscle diseases such as spinal muscular atrophy, the development of heart muscle weakness, paralysis of the respiratory center and death result. When staying at high altitudes, such as mountain climbing, the person concerned must, as far as he can, descend into deeper areas so that breathing stabilizes. If he does not have the strength to do this, mountain rescue is activated.

In order to avoid a lack of oxygen and unconsciousness in rooms at events, good ventilation and a limitation of the number of participants must be ensured. The cough reflex is so strong that foreign bodies are coughed up. If they are too big, they have to be surgically removed. A tracheotomy may be necessary beforehand.

The lack of oxygen can cause permanent damage to the brain. These can extend into a vegetative state. If the sleep-wake rhythm, respiratory, circulatory and digestive functions are maintained, spasticity - for example tetraspasticity - can persist. The need and extent of rehabilitation is determined.

These rehabilitation measures aim to re-initiate learning functions and to integrate them into what is already there. Permanent damage can affect the central and peripheral nervous system, for example speech and swallowing functions or perception.

Outlook & forecast

Asphyxia is a medical emergency that results in the death of the patient without immediate medical attention. Difficulty breathing and loss of consciousness are symptoms. In this state, the person concerned is no longer able to help himself. He is inevitably dependent on first aid from other people.

They must immediately call an emergency doctor and follow the instructions for first aid. If the patient is alone in this condition, he is very likely to die within the next few minutes. If he is denied immediate help or if ventilation is not adequately ensured, then likewise.

The chances of recovery depend on the cause of the asphyxia, the time of adequate intensive medical treatment and the age and general health of the patient. If the patient has previous illnesses and is of old age, the risk of lifelong impairments and dysfunction increases.

The faster an adequate supply can be guaranteed and the healthier the patient is, the better the chances of recovery are. When making a prognosis, the time in which the organism was not supplied with oxygen is essential. A few minutes are enough to cause permanent impairment. The consequential damage caused by asphyxia is often irreparable. However, individual improvements can be achieved with various therapy options.

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prevention

Spills can be avoided by following the safety rules at work and in the home; not in the case of natural disasters. When warnings are issued, it is obvious that an attempt is being made not to be in these areas.

The risk of Sudden Infant Death Syndrome is reduced if the baby is breastfed and raised in a smoke-free environment. A bedroom temperature of 16-18 degrees, sleeping in a sleeping bag on your back without a hat and removing nests protect you from overheating.

An air-permeable, but firm mattress also helps regulate body heat. Swimming accidents can be avoided if the bathing rules are observed. This also includes not going into too cold waters or into unfamiliar waters with cold currents. Break-ins in ice also belong in this category. After several days of severe frost without a thaw, the ice thickness should be sufficient to prevent ice breaking.

Adolescents should be informed that games of fainting are not a desirable way of testing their limits. In the case of circulatory weakness, the circulation is stabilized through a healthy, varied diet, sufficient drinking and exercise such as hiking, swimming or cycling. Getting enough sleep is important. Hot baths or saunas should be avoided.

Some drugs have the side effects of acting on the respiratory center. Whenever possible, the benefit and risk of the drug should be weighed against the risk of the disease it is being taken for.To avoid altitude sickness, the climber has to slowly acclimate himself. During a tour it has to climb a little more than it descends in order to slowly gain altitude.

Nobody will be able to avoid choking. There have been emergencies with swallowed eggs - of course, the food should be chewed sufficiently. There should be no crumbs, feathers or small parts in bed that can be breathed in while sleeping. It goes without saying that everything is done in the vicinity of small children to prevent the swallowing and breathing of small parts lying around or that have to be detached.

Aftercare

Asphyxia can be countered by avoiding general life risks. Miners and swimmers in bodies of water are affected by the state of suffocation. You should follow the usual security measures and not take unnecessary risks. This means that the responsibility for avoiding renewed asphyxia falls mainly on the patient himself.

Doctors, on the other hand, can only react acutely and treat possible consequential damage as part of follow-up care. Early detection examinations, as we know them with tumor diseases, are not possible. Rehabilitation measures mostly deal with relearning general skills. The language and nerve centers are often disturbed.

Mental intelligence is severely restricted as a result of the lack of oxygen. After the state of suffocation, there is no immunity to relapsing the disease. People of old age as well as men and women with previous illnesses suffer disproportionately from the consequences of asphyxia.

Since, unlike young people, their ability to regenerate is only developed to a limited extent, they often become a need for care. They can no longer cope with everyday life alone. Service providers and close family members are included in the aftercare. Regular check-ups follow. Medicines are intended to alleviate consequential damage and must be adjusted from time to time.

You can do that yourself

Asphyxia is life-threatening and must be treated immediately by a doctor. However, the patients themselves are usually unconscious or at least unable to act. First aiders must notify the emergency doctor immediately if they suspect asphyxia. In addition, a number of other first aid measures are required to increase the victim's chances of survival.

Asphyxia often occurs after swimming accidents and spills. In the event of swimming accidents, the person concerned must be taken out of the water immediately. In addition to the emergency doctor, if available, the lifeguard or other supervisory staff should also be informed, as these people usually have qualified training as first aiders.

Unconscious people should first be brought into the stable side position. Since the airways could be blocked by the tongue that has fallen back or vomit, the unconscious head must be hyperextended. If the patient is no longer able to breathe independently, mouth-to-mouth resuscitation should be carried out and chest compressions should also be started. Furthermore, it is extremely important to wrap the unconscious in a blanket in order to normalize the body temperature.

If the person concerned survives the asphyxia, permanent damage to the brain can remain due to the lack of oxygen, which among other things affects the learning function or the ability to speak. The patient can actively promote his convalescence by starting the recommended rehabilitation measures as soon as possible and following them consistently.