Coma is a condition that is characterized by a reduction in the level of consciousness in which a person appears to be sleeping, does not respond to stimuli in the environment and does not demonstrate knowledge about himself. In this situation, the brain continues to produce electrical signals capable of maintaining vital functions, such as the heartbeat, for example.
This condition can happen due to several situations such as traumatic brain injury, caused by strong blows to the head, infections and even the excessive consumption of drugs and alcohol, in this case, it is called alcoholic coma.
Coma can be classified using the Glasgow scale, in which a trained doctor or nurse assesses the person's motor, verbal and ocular abilities at the moment, which can indicate the person's levels of consciousness and thus prevent possible sequelae and establish the best treatment. See more how the Glasgow scale is applied.
Possible causes
The causes of the coma are not yet fully understood, but some conditions can cause a person to fall into a coma, which may be:
- Toxic effect of any medication or substance, through the excessive use of illicit drugs or alcohol; Infections, such as meningitis or sepsis, for example, that can decrease the person's levels of consciousness due to the involvement of various organs; Cerebral hemorrhage, which is characterized by bleeding in the brain due to the rupture of a blood vessel; Stroke, which corresponds to the interruption of blood flow to some region of the brain; Head trauma, which is an injury to the skull caused by concussion, cuts or bruises and which, when there is an impairment in the brain, is called a traumatic brain injury; Lack of oxygenation in the brain, due to severe lung disease or excessive carbon monoxide inhalation, such as car engine smoke or home heating system, for example.
In addition, the coma may be the result of hyperglycemia or hypoglycemia, that is, due to health problems that cause sugar levels to rise or fall a lot, and also by hyperthermia, which is when body temperature is above 39 ℃, or hypothermia, which is occurs in situations where that temperature drops below 35 ℃.
And yet, depending on the cause of the coma, the person can reach brain death, in which the brain no longer emits electrical signals to the body. Know the difference between brain death and coma.
How the treatment is done
The treatment for the coma depends on the causes of this condition, and the recovery of consciousness is a process that happens gradually, in some cases with rapid improvement, but in more severe cases, the person can remain in a vegetative state, in which the person can even waking up, but remains unconscious and unaware of time, himself and events. Learn more about the vegetative state.
In situations where the person is no longer at risk of death and the causes of the coma are already controlled, the ICU team of doctors and nurses aims to provide care that helps prevent bed sores, hospital infections, such as pneumonia in case of breathing by apparatus, and ensure the progress of all body functions.
Most of the time, the person needs to use a tube for feeding and for urine elimination, in addition to having to undergo physical therapy, to keep the muscles and breathing in good condition.
In addition, it is recommended to have the support and presence of the family, as studies show that hearing is the last sense that is lost, so even if the person does not react and does not understand exactly what the family member is saying, the brain can recognize the voice and the words of affection and react in a positive way.
Main types
The coma can be divided into three types, depending on the cause that led to the appearance of this condition, such as:
- Induced coma: also called sedation, it is the type of coma that occurs by administering medications in the vein that reduce brain function, being indicated by doctors to protect the brain of a person with traumatic brain injury, reducing swelling and preventing the increase in intracranial pressure, or to keep the person breathing through devices; Structural coma: it is the type of coma that arises from an injury in some structure of the brain or nervous system, due to a traumatic brain injury, because of a car or motorcycle accident, or because of brain injuries caused by stroke; Non-structural eating : occurs when the person is in a coma due to intoxication due to the use of medications, drugs or alcohol in excess, but it can also appear in people with very decompensated diabetes, leading to a malfunction of the brain and consequently to the with the.
There is also the Locked-in syndrome, also called Incarceration syndrome, which can lead to coma, however, in this case, despite the paralysis of the body's muscles and it is not possible to speak, the person remains aware of everything what happens around you. See more what is incarceration syndrome and how treatment is done.
