Death special: how does it feel to die?

Drowning In the UK, where the water is generally cold, 55 per cent of open-water drownings occur within 3 metres of safety and two-thirds of victims are good swimmers, suggesting that people can get into difficulties within seconds. Typically, when a victim realises that they cannot keep their head above water they tend to panic, leading to the classic "surface struggle". Studies with New York lifeguards in the 1950s and 1960s found that this stage lasts just 20 to 60 seconds. When victims eventually submerge, they hold their breath for as long as possible, typically 30 to 90 seconds. After that, they inhale some water, splutter, cough and inhale more. Water in the lungs blocks gas exchange in delicate tissues, while inhaling water also triggers the airway to seal shut. "There is a feeling of tearing and a burning sensation in the chest as water goes down into the airway. Then that sort of slips into a feeling of calmness and tranquillity", says marine survival expert Mike Tipton, describing reports from survivors. That calmness represents the beginnings of the loss of consciousness from oxygen deprivation, which eventually results in the heart stopping and brain death. Bleeding to death The speed of exsanguination, as bleeding to death is known, depends on the source of the bleed, says John Kortbeek, Chair of Advanced Trauma Life Support for the American College of Surgeons. People can bleed to death in seconds if the aorta, the major blood vessel leading from the heart, is completely severed, for example, after a severe fall or car accident. The average adult has 5 litres of blood. Losses of around 750 millilitres generally cause few symptoms. Anyone losing 1.5 litres - either through an external wound or internal bleeding - feels weak, thirsty and anxious, and would be breathing fast. By 2 litres, people experience dizziness, confusion and then eventual unconsciousness. "Survivors of haemorrhagic shock describe many different experiences, ranging from fear to relative calm," Kortbeek says. "In large part this would depend on what and how extensive the associated injuries were. A single penetrating wound to the femoral artery in the leg might be less painful than multiple fractures sustained in a motor vehicle crash." Fire Long the fate of witches and heretics, burning to death is torture. Burns inflict immediate and intense pain through stimulation of the nociceptors - the pain nerves in the skin. To make matters worse, burns also trigger a rapid inflammatory response, which boosts sensitivity to pain in the injured tissues and surrounding areas. As burn intensities progress, some feeling is lost but not much, says David Herndon, a burns-care specialist at University of Texas Medical Branch in Galveston. "Third-degree burns do not hurt as much as second-degree wounds, as superficial nerves are destroyed. But the difference is semantic; large burns are horrifically painful in any instance." Most people who die in fires do not in fact die from burns. The most common cause of death is inhaling toxic gases - carbon monoxide, carbon dioxide and even hydrogen cyanide - together with the suffocating lack of oxygen. One study of fire deaths in Norway from 1996 found that almost 75 per cent of the 286 people autopsied had died from carbon monoxide poisoning.

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Page 3: Explosive decompression? Electrocution?.

Published on 30 November 2007