| What
is Coma? |
|
A coma is a deep
state of unconsciousness where the affected individual is
alive but is not able to react or respond to life around
him/her.
|
| Can
a patient in Coma be aware of what is happening around him? |
|
Sometimes
comatose patients are totally unaware of their states and
environments; sometimes they are partially or fully aware but
cannot communicate
|
| Is
it a disease? |
|
Coma
is not a disease. It is a symptom of a disease or a response
to an event, such as a severe head injury, seizure or
metabolic problem.
|
| When
will he /she wake up? |
|
No
one can tell you when he/she will wake up. You can only WAIT
and SEE. Furthermore, head injured persons rarely wake up all
at once.
|
| How
long does it last? |
|
Most
comas last no longer than four weeks. Some people in a coma
shift to a persistent vegetative state,
|
| What
happens in a comatose patient? |
|
There
is
Lack of consciousness
Lack of self-awareness
Lack of sleep-wake cycle
Lack of purposeful movements
|
| Can
coma be caused by anything other than Head injury? |
|
Head
injury or certain serious illnesses or their complications may
cause a coma. The most common causes of coma include: Severe
head injury Seizures Metabolic disturbances, such as low or
high blood sugar Tumors or other structural lesions leading to
high pressure within the skull Bleeding in the brain Alcohol
or drug intoxication
|
| Can
I do something to prevent Coma? |
|
Many of the head injuries
that cause comas can be prevented through safety practices,
such as wearing seatbelts in cars and helmets on bicycles and
motorcycles. Routine doctor visits will lessen the chances of
coma in patients with diabetes, seizure disorders or other
conditions that may lead to coma.
|
| What
are the tests to be done for a comatose patient? |
|
Vital signs (temperature, pulse, respiratory rate and blood
pressure) and inquires about the patient's medical history and
the circumstances under which the coma occurred. · Blood to
be tested for levels of electrolytes, glucose, calcium,
magnesium, arterial blood gases, and liver and kidney
function. · Check the patient's heart with an
electrocardiogram or the patient's brain with an
Electroencephalography (EEG). An EEG may also be used to
provide repetitive sensory stimulation so that the doctor can
determine nerve response (evoked potentials or EPs). · If
increased pressure within the skull is evident or suspected,
the doctor may request a Computerized Tomography Scan (CT
scan) or Magnetic Resonance Imaging (MRI) of the brain. · In
some instances, a spinal tap is performed; this involves using
a needle to withdraw fluid from around the spine for testing.
|
| Does
a normal CT or MRI rule out brain injury? |
|
Some
lesions in the brain may have the same texture as surrounding
tissue and might not be identified in a CT. It may not show on
the MRI also until it evolves fully and hence might not be
seen immediately.
|
| What
is the immediate treatment for Coma? |
|
Initial
emergency treatment of a comatose patient focuses on
stabilizing the vital signs. This may rapidly reverse the
coma.
|
| What
else has to be done? |
|
The
specific cause of the coma has to be treated.
1. A complementary treatment goal is
. to prevent infection and,
· as possible, maintain the patient's physical state
· preventing pneumonia · preventing bedsores
· providing balanced nutrition.
· Physical therapy may prevent permanent muscle
contractions
and bone deformities.
2. If doctors think the coma is not likely to reverse quickly,
they may insert an endotracheal tube to aid respiration and
may administer oxygen
|
| Can
surgery help in treating comatose patients? |
|
In
the case of a coma that results from a head injury, doctors
may perform surgery to drain excess fluid from the head and
relieve pressure on the brain.
|
| What
is the vegetative state? |
|
People
who wake and sleep but have no meaningful interaction with the
world around them are said to be in PERSISTENT VEGETATIVE
STATE
|
| What
is the prognosis in vegetative coma? |
|
The
prognosis for regaining full mental faculties once the
vegetative state has supervened is almost negligible. Most
instances of dramatic recovery, when investigated carefully,
yield to the usual rules for prognosis, but it must be
acknowledged that rare instances of awakening to a condition
of dementia or paralysis after months or years in this state
have been documented.
|
| What
is the Glasgow Coma scale? |
|
A
number scale called the Glasgow Coma Scale is often used to
describe the responses of people in coma. There is nothing
magic about this scale; it just attaches numbers to the
responsiveness of the head injured person in terms of eye
opening, speaking, and moving his/her extremities. People are
usually no longer considered to be in coma if they open their
eyes, speak, or can obey simple commands.
|
| Can
a person in coma move? |
|
People
who are in coma cannot obey commands. They may move, however,
in response to touch or pain, or even on their own.
|
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