Sudden death Sudden death, also known as sudden death, is a clinical syndrome that refers to the unexpected non-traumatic death of a person who seems to be healthy or whose condition has basically recovered or stabilized, which occurs suddenly within a short period of time and is often too late for treatment, and is a clinical emergency. The standard of “sudden death” is generally defined by the time between the appearance of symptoms and death, and the opinions are still not uniform. The World Health Organization (WHO) defines it as less than 6 hours. Since the peak of “sudden death” mostly occurs within one hour after the onset of the disease, cardiologists define death within one hour after the onset of the disease as the standard for “sudden death”, which generally does not exceed six hours. Most people die suddenly without obvious warning, either during normal activities or during quiet sleep. Some patients have a history of previous angina attacks, and the angina suddenly worsens, manifested by a gray face, profuse sweating, a drop in blood pressure, and especially frequent premature ventricular contractions, which are all precursors of “sudden death”. In addition, sometimes there are also symptoms that were not present before, such as obvious fatigue, palpitations, dyspnea, sudden changes in mental status, etc. Subsequently, due to cardiac arrest, and manifested as confusion, high cyanosis, spasms, fixed and dilated pupils, or several wheezing breathing and enter clinical death. If the above symptoms are not detected in time and cardiac resuscitation is not performed in time, the patient will enter irreversible biological death soon (about 4-6 minutes). The information provided by a large number of clinical cases shows that the cause of sudden death is mainly due to cardiac disorders, so it is also called “sudden cardiac death”. Coronary heart disease is the most common, followed by myocarditis, primary cardiomyopathy, rheumatic heart disease, primary ventricular fibrillation, cardiac arrest, and other cardiac disorders such as QT interval prolongation syndrome, premature ventricular contraction, ventricular tachycardia, mitral valve prolapse syndrome, congenital heart disease, etc., can cause the heart to suddenly stop contracting effectively, resulting in a severe shortage of blood supply to the whole body. Because of the short time, patients are usually not rescued in time and die. ”Sudden death” occurs mostly at home or at work, therefore, it is very important to save lives by immediate on-site rescue. Once a sudden death patient is found, he or she should be immediately laid flat on the bed or the floor, forbidden to move, and immediately perform cardiopulmonary resuscitation, that is, percussion of the precordial area, chest cardiac compressions, mouth-to-mouth artificial respiration, etc., and quickly ask the nearest hospital to come to the rescue. Only when the patient’s breathing and heartbeat are restored can he be escorted to the hospital in a proper manner to continue treatment. After cardiopulmonary resuscitation, combined with the patient’s clinical manifestations, drugs, synchronized direct current and other techniques can also be used to restore his heart rate, blood pressure and cardiopulmonary function as soon as possible, and to ensure the unobstructed airway and prevent infection. I. Cerebral hemorrhage Cerebral hemorrhage is a common disease in the elderly. It is caused by a sudden increase in blood pressure, resulting in the rupture of microvessels in the brain and causing bleeding. After a cerebral hemorrhage occurs, family members should provide the following emergency care: First, keep the patient sedated and in a lying position to avoid aggravating the condition due to vibration. To keep the patient’s airway open, tilt his head to the side to prevent blood and vomit from being inhaled into the airway. Quickly loosen the patient’s collar and belt to keep the room air circulating; pay attention to keeping warm when it is cold and cooling when it is hot; cover the patient’s head with cold towels because the blood vessels contract when they are cold, which can reduce the amount of bleeding. On the way to the hospital, the vehicle should be driven as smoothly as possible to reduce bumps and vibrations; at this time, the patient’s head should be slightly elevated and changes in condition should be noted at all times. 1. Drink more plain water to dilute the drug in the abdomen and discharge it from the urinary tract in time; 2. If the dose of the drug taken is large and has a certain degree of toxicity, stimulate the root of the tongue with your finger to induce vomiting immediately and go to the hospital at once. After inducing vomiting and gastric lavage, the patient can drink several glasses of milk; you can also take 100 grams of mung beans and 20 grams of licorice, decocted for 30 minutes and drink to detoxify; 3, if the corrosive agent is taken by mistake, you cannot induce vomiting and gastric lavage. Should immediately give the patient to drink a lot of milk, raw egg white, vegetable oil and quickly sent to the hospital for treatment. At the same time, don’t forget to bring the medicine and the box that the patient has mistakenly taken so that the doctor can take the correct symptomatic treatment in time. Third, carbon monoxide poisoning In daily life, the lack of preventive measures when using fire, heating and bathing at home is the main cause of carbon monoxide poisoning. Carbon monoxide is a colorless, odorless gas that is almost insoluble in water. After entering the body, the affinity with hemoglobin in the body is 300 times higher than that of oxygen, so that hemoglobin loses its ability and role in carrying oxygen, and has a toxic effect on tissue cells throughout the body, especially on the cerebral cortex. The initial stage of poisoning is just a headache, followed by dizziness, blurred vision, nausea, panic, weakness of the limbs, cherry red skin and mucous membranes and other symptoms. When people realize that carbon monoxide poisoning has occurred, it is often too late. This is because the cerebral cortex, which governs human movement, is the first to be damaged by paralysis, making it impossible for people to achieve purposeful, autonomous movement. At this point, the poisoned person is still conscious in his mind and wants to open doors and windows to escape, but his hands and feet are no longer at his disposal. Therefore, people who are poisoned by carbon monoxide are often unable to carry out effective self-help. When someone is found to have been poisoned by carbon monoxide, the rescuer must quickly follow the following procedures: Because the specific gravity of carbon monoxide is slightly lighter than that of air, it floats in the upper layers, and it is safer for rescuers to enter and evacuate the scene if they can creep. When entering the room is strictly prohibited to carry open flame, especially in the case of open gas suicide, the indoor gas concentration is too high, ring the doorbell, open the indoor electric lights generated by electric sparks can cause an explosion. After entering the room, you should quickly open all ventilation doors and windows, such as the source of gas can be found and can be quickly discharged should be controlled at the same time, such as turning off the gas switch, but never delay for this, because saving lives is more important. Then quickly carry the poisoned person out of the room full of carbon monoxide, transfer him/her to a ventilated and warm place to lie flat, untie the collar and belt to facilitate his/her breathing and smoothness. At the same time, call an ambulance and be ready to send the person to a hospital with a hyperbaric oxygen chamber for resuscitation. While waiting for the transport vehicle, the unconscious patient’s head can be tilted to the side to prevent vomit from being inhaled into the lungs by mistake, leading to asphyxiation. To wake up the patient, pinch the person’s middle point with a needle or fingernail. If the patient is still not breathing, mouth-to-mouth respiration should be started immediately. It is important to note that this type of artificial respiration is much less effective in patients with carbon monoxide poisoning than treatment in a hospital hyperbaric chamber. Therefore, patients with deep coma should not be based on local rescue, but should be sent to the hospital as soon as possible, but artificial respiration should never be stopped on the way to the hospital to ensure the oxygen supply to the brain and prevent irreversible brain nerve necrosis caused by hypoxia. Four, angina angina is an acute attack symptoms caused by coronary heart disease, due to atherosclerosis of the coronary arteries to narrow the myocardial blood vessels, blood flow is reduced, at this time, if encountered again exertion, exercise, emotional tension, straining to defecate and other situations that increase the burden on the heart, often triggered by angina. During an angina attack, the patient will suddenly feel a continuous crushing or suffocating pain under the sternum. The patient should immediately stop all activities, calm down, stand and rest on the spot, without lying down, so as not to increase the amount of blood return and thus increase the burden on the heart. Immediately take out the first aid medicine with you, such as a nitroglycerin tablet, chew it up and put it under the tongue, usually the pain can be relieved in about two minutes. If the effect is not good, 10 minutes later, you can take another piece under the tongue to increase the amount of medicine. However, it is important to note that it is not advisable to take more than three nitroglycerin tablets in a row, regardless of whether the angina is relieved, or if there is another attack. If the pain is severe or if you have isoamyl nitrite with you, you can crush it in a handkerchief and inhale it close to your nostrils, usually in 10-20 seconds after inhalation. Both of these drugs are fast-acting vasodilators. The effect of isoamyl nitrite is faster and stronger, but the time to maintain the effect is short, only 7-8 minutes; while nitroglycerin tablets can maintain the effect up to 30 minutes. Because of the strong vasodilating effect of isoamyl nitrite, transient hypotension may occur after the drug is administered. To prevent unpredictability, you should find a place to sit down and rest immediately after the medication takes effect. However, patients who have glaucoma at the same time should not take either of these drugs, otherwise they may cause severe eye pain, headache, blurred vision or even blindness due to increased intraocular pressure. For patients with coronary artery disease who have their first sudden onset of angina, they can be hidden in extreme panic due to the sudden and severe pain in the heart. This is very detrimental to the relief of angina pectoris. The panic will significantly accelerate the heart rate, thus increasing the burden on the heart. Patients with first-onset angina often do not carry emergency drugs with them, and in this case, there is no need to worry too much about the danger, most of the angina attack lasts less than 10 minutes, while those who have myocardial infarction have a history of frequent attacks. When there is no medicine, stopping the activity and resting in place and keeping a calm mind are the most effective first aid measures. E. Epilepsy Epileptic grand mal seizures, commonly known as “sheep epilepsy”, is one of the common diseases of the nervous system. The causes of epilepsy are complex: birth injury, cranial trauma, encephalitis, hypertensive encephalopathy, cysticercosis, etc. All of these can lead to epilepsy. Generally, epileptic patients have precursory autonomic symptoms before seizures, such as abnormal sensations, chest tightness, epigastric discomfort, fear, salivation, inaudible sounds, blurred vision, etc. Therefore, patients themselves should leave dangerous situations such as on the highway, by a pool of water, or in front of a fire as soon as possible before foreshadowing a seizure, and find a safe place to sit or lie down in time. The patient’s family members should also learn to observe the patient’s performance before a seizure so that they can take early precautions to prevent other unintentional injuries. Needle pricking or finger pinching of acupuncture points such as Renzhong and Hegu can sometimes stop seizures when the patient is not seized up. In petit mal seizures, the patient shows a brief loss of consciousness, usually only for a few seconds, no convulsive spasms, a white or red face, and the child shows spinning in place, etc., which is usually easily overlooked. The patient usually has limited epilepsy, with spasmodic convulsions in the hands, feet, face, etc. The actual fact is that you will be able to get a lot more than just a few of the most popular and most popular items. In the case of a grand mal seizure, the patient will have a spasmodic leg convulsion, tilt the head back, fall to the ground with a shout, the whole body muscles are tonic contraction, spasm, mouth closed, eyes rolled up, the rigid phase usually lasts for a few seconds to half a minute, turn to the clonic phase, the whole body muscles are rhythmic strong contraction, breathing recovery, with breathing mouth spraying white foam or blood foam, incontinence, a seizure lasts 2-3 minutes, more A seizure lasts for 2-3 minutes, and more than 7-8 minutes. When the patient is about to fall to the ground before a general convulsion occurs, the patient’s family or rescuer, if nearby, should immediately go forward to hold the patient and try to let him fall slowly to avoid injuries. At the same time, before the patient’s mouth is tightly closed, quickly roll the handkerchief, gauze, etc. into a roll and place it between the patient’s upper and lower teeth to prevent biting the tongue when the teeth are tightly closed. For those who have fallen to the ground and landed on their faces, they should be turned over to avoid airway obstruction. At this time, if the patient has closed the teeth, do not force sled open, otherwise the patient’s teeth will be loosened and fall off. Then the rescuer can untie the patient’s collar and trouser belt, so that it breathes freely. To prevent the patient from spitting out saliva or vomit inhalation of the trachea caused by asphyxiation, rescuers or family members should always guard the patient’s side, at any time to wipe away the patient’s spit. When the patient is convulsing, do not forcibly press the limbs to avoid ligament tears, joint dislocations, and even fractures and other injuries. Do not forcibly administer medication either. In the case of seizures, do not use needling or finger pinching to save the patient from further stimulation. Do not douse the patient with cool water. In a few patients, grand mal seizures can occur one after another and remain deliriously dazed during the interval, which is a continuous state of epilepsy. This is a critical condition of the disease, if not rescued in time, brain edema, brain herniation, respiratory and circulatory failure until the serious consequences of death. Once a persistent status epilepticus occurs, if luminal injections are available nearby, a larger dose of the drug can be given first, and then the patient can be taken to the hospital for resuscitation as soon as possible. When the patient’s whole body muscle convulsions and spasms stop and the patient enters a period of lethargy, the patient’s head should be quickly turned to the side, and the plugs between the upper and lower teeth should be removed, so that the saliva and vomiting in the patient’s mouth can flow out to avoid asphyxiation. At this time, the patient’s whole body muscles have been relaxed, the original forced position can be changed to side lying, so that the patient’s whole body muscles can be relaxed, saliva can easily flow out to prevent asphyxiation, while the tongue root is not easy to fall back and block the airway. And pay attention to the patient’s warmth and the quiet of the surrounding environment. After waking up, the patient often feels headache and body aches. Rescuers and family members should not describe the “scary” scene when the patient collapses and convulses, so as not to increase their mental burden. The patient’s diet should be light, avoiding oily, spicy and other stimulating foods. Hypertension Patients with hypertension have a sharp rise in blood pressure for a long or short period of time due to exertion, mood swings, trauma and other triggers, and their condition deteriorates rapidly. The patient first develops severe headache, vertigo, blurred vision, and if not treated in time, the condition will further deteriorate, followed by altered mental state, nausea, vomiting, abdominal pain, vomiting, abdominal pain, dyspnea, and palpitations. In severe cases, convulsions, coma, angina pectoris, heart failure, kidney failure, cerebral hemorrhage and other serious consequences occur. When hypertension patients with the above symptoms should immediately and absolutely bed rest, and take cardiac pain, buckle, blood pressure and other rapid antihypertensive drugs, and Valium 10 mg. Aminophylline, ephedrine and other stimulants or vasodilators are strictly prohibited. Call an ambulance at the same time and send to the nearest hospital for systematic treatment as soon as possible. Prevention: Patients with hypertension should adhere to medication treatment, and often go to the hospital to monitor changes in blood pressure and adjust the dose of drugs in a timely manner. Usually, work and rest should be reasonably arranged, not overworked, to ensure sufficient sleep. Quit smoking, alcohol and high-fat diet, and avoid large emotional fluctuations.