Coma

Coma

Description of coma

Coma – a state of deep unconsciousness, from which a person is very difficult to deduce. Man, being in a coma can not react to events around.

Causes of coma

Information about the events surrounding, usually, transmitted from the brain stem to the rest of its parts. This connection allows a person to feel and respond to the environment. Coma causes a disturbance in the system.

The causes of coma can be:

• Severe head trauma, most often resulting from road accidents, violence or falls;
• Brain Diseases, such as:
  • Encephaloma;
  • Brain hemorrhage or stroke;
  • Infections of the brain;
• The lack of oxygen in the brain, which can cause:
  • Very high blood pressure;
  • Very low blood pressure or shock;
  • Cardiac arrest;
  • Severe cramps;
• Severe illness, such as:
  • Dangerous infections;
  • Severe acute liver or kidney failure;
  • High levels of carbon dioxide;
  • Carbon monoxide poisoning;
  • The toxicity of poisons, medication, consumption of alcohol or drugs;
  • Abnormal hormone levels, eg, thyroid or adrenal glands;
  • Abnormal blood composition, such an imbalance of sodium and calcium;
  • Very low or very high blood sugar;
  • Very low or very high body temperature;
  • Acute shortage of nutrients;
  • Hepatic failure;
  • Renal failure;
  • Hereditary metabolic diseases.

Risk factors for coma

Risk factors for coma include:

• Serious illness;
• Diabetes;
• Liver Disease, renal or cardiovascular disease;
• The trend towards the emergence of blood clots;
• Exposure to toxic substances (such, carbon dioxide);
• Cancer and cancer chemotherapy.

Risk factors for brain injury:

• Age: 5 years and younger, 15-24 year, and 75 and older;
• Paul: male;
• In a car at high speed or at night;
• Lack of sleep;
• Previous head injury.

Signs coma

Symptoms of a coma include the following:

• The lack of response to stimuli, such as:
  • Pain;
  • Sounds;
  • Touch;
• Spontaneous body movements:
  • Twitch;
  • Tremor;
  • Opening and closing the eye;
  • Irregular breathing.

Diagnosis of coma

Because the patient can not speak, the doctor will have to collect information from other sources. The doctor may need to talk with your friends, family, and people, who witnessed the accident. This is important for diagnosis. Doctors also need to know about the history of human disease, About, whether he took drugs, alcohol or drugs. It is important to provide accurate information, to assist in the treatment of.

The doctor will check reflexes, breathing, eye examination. It will also make medical inspection, including inspection of the nervous system. Also, there may be assigned some tests:

• Blood tests – to check the level of glucose in the blood, organ function and the presence of infection and toxic substances;
• Analysis of urine – to check for drug use;
• Taking pictures of internal organs, for which the following procedures:
  • X-rays of the neck – in cases, when suspected head and neck injuries;
  • MRT – test, which uses magnetic and radio waves, to make images inside of the body, in this case the brain;
  • CT – type of X-ray, wherein the computer is used, to make pictures of the inside of the head;
  • SPECT – enhanced computed tomography, to examine the blood flow and metabolism in the brain;
• Electroencephalogram (EEG) – test, which records the activity of the brain by measuring electrical current therethrough;
• Poyasnichnaya puncture – removal of a small amount of cerebrospinal fluid, to check her blood pressure, the presence of blood and infection;
• Evoked potentials – test brain activity following stimulation of nerves, responsible for the senses (including auditory nerves).

Clinical manifestations of comatose patients can be evaluated according to the Glasgow Coma Scale (GCS). This scale assesses three different functions: Opening Eyes, motor response, and verbal response. Results may vary from 15 to 3. A low score indicates a less responsive. The results are interpreted as follows::

• 15-13 – mild brain injury;
• 12-9 – mild brain injury;
• 8 or less – severe brain injury.

Treatment of coma

Coma is a medical emergency. Any person is unconscious it should be immediately sent to the emergency department.

Emergency treatment

Physicians should work quickly, to quickly determine the cause of coma. This will determine the further treatment. Supportive care may include:

• Monitoring of vital functions;
• -Therapy;
• Introduction of fluids directly into the bloodstream through the IV;
• Respiratory care, to maintain breathing.

If you know the specific cause of the coma, maintenance treatment may also include:

• Glucose drip – when, if the cause of the coma is a low blood sugar level;
• Naloxone – if there is a suspected drug overdose;
• Thiamin (Vitamin B1) It can be administered with glucose, if alcoholism or malnutrition is suspected.

In some cases, eliminate the cause coma can surgery.

Further treatment of coma

If coma persists after emergency, the patient may need a permanent care. Once the patient is stabilized, Treatment is focused on providing nutrition and the prevention of infections. Medical staff also take care of prevention of bedsores.

Prevention of coma

To reduce the risk of coma:

• It is necessary to wear seat belts. Check, that infants and small children are securely fastened in a child car seat;
• Children under the age of 12 years old must ride in the back seat of the car;
• Wear an appropriate helmet while riding a bike, roller skates, when engaging in contact sports, when skiing, snowboarding, and riding a motorcycle;
• Wear mouth guards during sports;
• Do not abuse alcohol or drugs;
• If you have diabetes, you need to see your doctor regularly and take appropriate measures to control blood sugar;
• If you are ill or taking medications, you need to visit a doctor for examination.