Suffocation is a pronounced lack of air, an extreme manifestation of shortness of breath, accompanied by a feeling of fear of death. It is caused by diseases of the respiratory tract, cardiovascular pathology, chest injuries and other conditions. Asphyxiation is diagnosed on the basis of clinical data, its causes are established using radiation diagnostics, functional examination, and endoscopy. When providing emergency care, it is necessary to ensure adequate ventilation of the respiratory tract. Further treatment depends on the cause of this condition.
The most common causes of attacks of pronounced shortness of breath are respiratory diseases. Most often, suffocation develops with bronchial asthma. Attacks of difficulty breathing due to primary bronchial hyperreactivity are the main clinical manifestation of this disease, develop upon contact with allergens and physical stress, are provoked by respiratory infections and psycho-emotional stress.
The feeling of lack of air occurs at any time, often at night and in the morning. The number and severity of seizures can vary throughout the day. Shortness of breath is accompanied by a feeling of tightness in the chest, wheezing, unproductive cough. Light suffocation resolves on its own, medications are used to stop a severe episode of shortness of breath. With inadequate treatment, the attack is sometimes delayed - an asthmatic status is formed.
Suffocation caused by narrowing of the airway is common in a number of different conditions. The clinical picture of the bronchospastic state resembles an attack of bronchial asthma. However, bronchospasm in other nosologies is secondary, develops against the background of acute pathological processes or exacerbation of chronic diseases. The main causes of secondary bronchoconstriction are:
Less commonly, episodes of bronchospasm are found in cardiovascular insufficiency, thrombosis and pulmonary embolism, endocrine diseases (hypoparathyroidism, hypothalamic syndrome, Addison's disease). Inhalation of dust, irritants, poisoning with phosphorus compounds, taking beta-blockers can also provoke suffocation.
Violation of the integrity of the pleura, accumulation of air (pneumothorax) or fluid (hemothorax) in its cavity cause collapse of the lung, displacement of the mediastinum to the healthy side. The pulmonary excursion is limited, the main vessels are compressed. The severity of suffocation depends on the amount of pathological contents of the pleural cavity. Shortness of breath is accompanied by pain in the chest, dry cough.
Foreign body aspiration is a fairly common cause of sudden difficulty in breathing in young children. Children tend to take various small objects into their mouths, which, when frightened, crying or laughing, enter the respiratory tract and can cause suffocation. Adults usually aspirate foreign objects in violation of chewing and swallowing functions or in a state of alcoholic intoxication.
Clinical manifestations of aspiration depend on the size, shape and properties of the object that has entered the airways. Large foreign bodies of the larynx and trachea can stop the flow of air into the respiratory tract and lead to the death of the victim within a few minutes. A foreign object often partially blocks the lumen of the upper respiratory tract, less often foreign bodies of the bronchi are detected.
The victim develops a painful reflex cough, inspiratory dyspnea. Auxiliary muscles are included in the act of breathing. There is a retraction of the intercostal space, the epigastric region during inspiration. Breathing becomes stridorous, the skin becomes bluish.
Other common causes of choking in childhood are conditions leading to laryngospasm and acute laryngeal stenosis. Laryngospasm is a sudden involuntary contraction of the muscles of the larynx and is usually detected in children under 3 years of age against the background of spasmophilia. It can be caused by inflammatory diseases of the lungs, instillation of certain drugs into the nose. In adults, laryngospasm is rare, observed with eclampsia, tetany, inhalation of irritants.
Suffocation comes on suddenly. It provokes stress, crying, fear. Breathing becomes noisy. The patient turns pale, gasps for air with an open mouth. The head is thrown back, the neck muscles are tense. There comes a short-term cessation of breathing, which ends with a long whistling breath. Seizures may be repeated. Prolonged respiratory arrest is accompanied by convulsions and can be fatal.
Acute laryngostenosis is observed in infectious and inflammatory processes, tumors and injuries of the larynx. Other causes of narrowing of the lumen of the organ include Quincke's edema in the larynx, volumetric formations of neighboring organs, some diagnostic and therapeutic manipulations. Asphyxiation develops in stages, goes through the stages of sub- and decompensation, in the absence of adequate assistance, ends with the death of the patient from asphyxia.
Asphyxiation in case of inhalation injury appears due to thermal burns of the respiratory tract and poisoning by combustion products. Such injuries in victims during a fire aggravate the course of burn disease and cause high mortality. The presence of burns in the face and neck indicates the possibility of inhalation damage to the respiratory tract. The pronounced difficulty in breathing is preceded by a change in the timbre of the voice, coughing up soot.
The main toxic products of combustion - carbon monoxide, cyanides, phosgene and chlorine - are manifested by suffocation, tightness and pain in the chest. There are signs of intoxication. The victim is disturbed by excruciating headaches, nausea, vomiting. In severe cases, hallucinations and delusions join, up to a complete loss of consciousness.
Diagnostic search is carried out by pulmonologists together with otorhinolaryngologists. Fire victims are being examined by surgeons. An asthma attack is diagnosed by characteristic clinical manifestations. With the help of a survey, the frequency of occurrence of episodes of shortness of breath and provoking factors are established. To determine the cause of the pathological condition, the following are used:
Asphyxiation is a medical emergency, the main goal of which is to restore airway patency. As pre-medical measures, it is necessary to ensure the flow of fresh air - open the window, free the patient from tight clothing, take the victim out of the fire to the street. A foreign object in the respiratory tract should be tried to be removed using the Heimlich maneuver.
The choice of tactics of etiopathogenetic treatment depends on the immediate cause of suffocation. For burn patients, therapeutic bronchosanations are relevant, and cardiotropic drugs are prescribed for patients with cardiovascular pathology. In the treatment of diseases of the respiratory system accompanied by suffocation, the following groups of drugs are most often used:
If necessary, oxygen therapy, respiratory support is provided. Epinephrine is given for anaphylaxis. Patients with allergic diseases are prescribed antihistamine and antileukotriene drugs, allergen-specific immunotherapy is performed. Infectious and inflammatory lesions of the bronchopulmonary system are treated with antibiotics.
With the ineffectiveness of conservative measures, the impossibility of tracheal intubation, patients with laryngeal obstruction are subjected to a tracheostomy. To evacuate exudate or air from the pleural cavity, thoracocentesis is performed, if necessary, drainage is installed. Operatively, tumors of the organs of the chest cavity are radically removed.