Coma is a deep state of unconsciousness where the affected individual is alive but is not able to react or respond to external stimuli.
Sometimes, comatose patients are totally unaware of their states and environments; sometimes they are partially or fully aware but cannot communicate. There is lack of consciousness, self-awareness, sleep-wake cycle and purposeful movements in a comatose patient. But the basic life support functions, like breathing and blood circulation are retained.
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. Coma may appear slowly in conditions where there are preceding medical or neurological problems, including the secondary brain swelling that surrounds a pre-existing lesion.
The outcome of coma ranges from full recovery to death. Whether a person recovers, and to what extent, depends upon the cause of the coma and the type and extent of brain damage. It is very important to know that the outcome may remain unknown for many months.
Most comas last no longer than four weeks. However, some people in a coma shift to a persistent vegetative state, which can last for years, depending on the medical circumstances and the cause.
Initial emergency treatment of a comatose patient focuses on stabilizing the vital signs. This may rapidly reverse the coma. After emerging from a coma, many people can recover fully; some require lifelong physical and occupational therapy, while others may recover only basic functions.
Causes of Coma
Head injury or certain serious illnesses or their complications may cause a coma.
The most common causes of coma include:
- Severe head injury
- 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 or skull
- Alcohol or drug intoxication
- Brain inflammation and infection
Symptoms of Coma
The main symptom of coma is unconsciousness.
Symptoms of coma include-
- Unconsciousness. The patient may appear to be in a deep sleep.
- The patient is unresponsive to external stimuli- strong tactile (painful), or verbal stimuli.
- The patient may exhibit spontaneous body movements- shake or jerk abnormally, or the eyes may move.
- Inability to open the eyes.
- Breathing may be affected in severe coma.
- A coma does not have a sleep-wake cycle.
Treatment for Coma
Currently, there are no medicines that will shorten the duration of coma.
Diagnosis and treatment of coma begin simultaneously.
The Glasgow coma scale is used to determine whether the patient is improving, deteriorating, or remaining the same. It is a simple way of measuring the depth of coma based upon observations of eye opening, speech and movement.
Initial emergency treatment of a comatose patient focuses on stabilizing the vitals. In some cases of severe coma, the patient may require life-saving resuscitative measures. Once the comatose patient is medically stable, it is important to diagnose and treat the underlying cause of coma.
- A detailed history from the family members and friends is very important and can help determine the exact cause of coma.
- Glucose may be administered intravenously if the blood sugar level is low.
- If the coma is suspected to be induced due to a narcotic overdose, naloxone (narcan) may be given intravenously to reverse the situation.
Currently there are no medicines that will shorten the duration of coma. In fact, some medicines actually deepen the state of unconsciousness. For a patient in prolonged coma, the treatment goal is-
- Preventing infection like pneumonia or bedsores
- Providing balanced nutrition
- Physical therapy may prevent permanent muscle contractions and bone deformities.
If doctors think the coma is not likely to reverse quickly, they may insert an endotracheal tube to aid respiration and may administer oxygen.
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.
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Dr. Trupti Shirole. (2014, September 25). Coma - Causes Symptoms Treatment FAQs. Medindia. Retrieved on Mar 31, 2023 from https://www.medindia.net/patients/patientinfo/coma.htm.
Dr. Trupti Shirole. "Coma - Causes Symptoms Treatment FAQs". Medindia. Mar 31, 2023. <https://www.medindia.net/patients/patientinfo/coma.htm>.
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Dr. Trupti Shirole. 2021. Coma - Causes Symptoms Treatment FAQs. Medindia, viewed Mar 31, 2023, https://www.medindia.net/patients/patientinfo/coma.htm.
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Hi my elder brother[28 years] is in Comma from last 2 years due to head injury by Road Accident. He is opening eyes and nothing else. His operation was held in New Delhi AIIMS india shunt placed in this brain by the Doctors.
Can You pls suggest me any way to get back my bro in our life as earlier. Pls suggest me any treatment that will be effected in this condition ?? and pls Pray for My brother pls pls pls.
my wife is in coma for 6 days but after coming out of coma she forgot most of the things but after one week she recognised my family friends but she is not looking like a normal person how long will it take to come to normal life
Hi I am 12th studying student ,, and have a question - According to my Book for acquiring the features of a living being one must possess consciousness and should have the capacity to grow and reproduce . So can a person in Coma be called a living being who dont have consciousness . Some1 please answer......
Please Dear All! Guide me, Who is best Doctor of Comatose in Pakistan???? which hospital have best treatment facility of Coma?????
My mom passed away last year from multiple things but she had an anurisum on her heart and had to undergo open heart surgery. She lived for 10 days and wasn't getting any better. I know when she was in a state of coma she could hear me. I really miss her. I lost my bf...last year aug 26 2012
Hi Karly23, it's really sad that you had to lose you loved ones. I can understand your state of mind. Wish you all the luck in future. God Bless!