Doctor's Notes on Coma
A coma is a deep state of unconsciousness in which individuals do not consciously respond to stimuli in their environment. Causes of coma include head trauma/injury, bleeding (hemorrhage) into the brain or skull (such as from high blood pressure, aneurysm, or a tumor), swelling of the brain (cerebral edema) (such as from infections, traumatic injuries, and problems with the flow of cerebrospinal fluid), lack of oxygen to the brain (which may be due to heart arrhythmias, lung disease, anemia, or toxins), poisons, and endocrine disorders such as hypothyroidism or diabetes.
The main symptom of a coma is unconsciousness with no conscious response to external stimuli. The patient may appear to be in a deep sleep. Other symptoms of coma may include
- spontaneous body movements such as shaking or jerking abnormally, and
- the eyes may move.
- In severe cases, basic body functions such as breathing may be affected.
What is the treatment for coma?
Treatment varies with the cause of the coma; however, a coma is a medical emergency and EMS plus Emergency medical caregivers should determine what emergency treatments should be done. For example, many coma patients may need breathing assistance and/or blood circulation support. Other coma symptom treatments considered may include the following:
- Reduction of brain swelling – surgery to relieve pressure on brain tissue
- Drug overdoses – suicide attempts with prescribed medications that may be reduced or neutralized
- Use of illegal/recreational drugs – drug reversal medications
- Low glucose level – monitored glucose administration
- Sepsis – IV antibiotics
- Medical conditions – for example, seizure-preventing drugs
Coma treatments should be done by experienced medical caregivers.
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REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.