When is unconsciousness a coma

They may need physiotherapy, occupational therapy, psychological assessment and support during a period of rehabilitation and may need care for the rest of their lives.

Patients can gradually come out of the coma, some progress to a vegetative state aka unresponsive wakefulness syndrome and others die. Some patients who have entered a vegetative state go on to regain a degree of awareness see Minimally Conscious State. The likelihood of significant functional improvement for coma patients diminishes over time. Publisher: David Bateman.

Brain Injury Australia braininjuryaustralia. Coma Science Group Belgium coma. ComaCare South Africa thebraininjurytrust. Brain Injury Resource Center www. This webpage may be helpful for diagnosticians and clinicians dealing with patients who have suffered TBI: headsafe. Please Help Us Help Those. This article covers the basics of understanding coma, various treatment options, and recovery.

Description Coma is a state of unconsciousness in which a patient does not react with the surrounding environment. Causes of coma Coma can happen for a number of reasons, such as: Intoxication eg drug abuse, overdose or misuse of medications Metabolic abnormalities Central nervous system diseases Acute neurologic injuries eg stroke, hernia, hypoxia, hypothermia Traumatic injuries caused by falls or vehicle collisions etc.

Initial treatment Initial treatment will depend on the cause of the coma and will be directed at preventing further damage to the brain. Prognosis outlook for recovery Comas can last from days to weeks while some severe cases have lasted several years. Search for:. The brain stem processes automatic, unconscious controls often called the vegetative functions of the body including heart rate, blood pressure, body temperature, and breathing.

If the intracranial pressure continues to increase without being treated, the brain will continue to swell until it pushes down through the opening at base of the skull. This damages the brain stem where the reticular activating system is located. This also damages the breathing and blood pressure control centers of the brain and can be the reason for death in the hours or days after injury. When the members of the medical trauma team are concerned about swelling of the brain, an intracranial pressure monitor may be placed inside the skull to read the pressure inside.

A small hole is drilled into the skull and the monitor tip is placed inside the skull. Or, surgeons may temporarily remove a portion of the skull to minimize the risk of further injury to the brain due to the pressure. Medications can be injected similar to providing a general anesthetic.

An induced coma is used to decrease intracranial pressure and to rest the brain. Hospital staff may ask family members and friends to be very quiet when visiting when there is a concern about high pressure spikes in the brain.

The lighting of the room may be kept low and the room kept cool. Coma usually evolves into the vegetative state or a higher level of consciousness within two to four weeks for those who survive. There have been improvements in taking pictures of the brain and measuring the electrical activity of the brain in the last five years. The results of new studies, and the well-documented reports of recovery months after the initial injury, challenge the long held view that people with long periods on unconsciousness cannot recover.

Cases of late recovery point to the remarkable plasticity of the human brain and its potential for long-term recovery. They are different stages. Individuals in VS generally do not follow people or objects with their eyes or remain visually focused on people or objects.

If a person can keep eye contact or follow movement with their eyes, it can often mean that the person is transitioning to MCS. Hospitals will start discharge planning as soon as life-threatening medical problems have resolved. People who are in a VS or MCS when they become stable medically despite the fact that they still may have tubes will need to leave the hospital.

There is no doubt that people who experience severe TBI need rehabilitation after their hospital stay. And chances are good that further recovery will occur. In some instances, a person who is VS or MCS may be admitted to a rehab hospital for a short stay weeks for family teaching and the development of needed rehab equipment.

At least one of the following criteria must be clearly evident on bedside examination: 1. Those observations are then used to fill out measurement scales. Different scales are used in different settings.

Two measurement scales that are important to life saving, establishing a prognosis, and tracking recovery are as follows:. The Glasgow Coma Scale is used at the scene of the accident, in the Emergency Department, and during the life saving hospital stay. It is a useful scale for doctors and nurses who want to track improvements in brain recovery or predict recovery. A sudden decline in being awake can mean that the brain pressure is changing for the worse or that there may be an area of bleeding in the brain that needs attention.

An increase in the number means that the brain is getting better. The Glasgow Coma Scale is rarely used after the initial hospital stay. This scale is most often used in the first year after brain injury. Skip to content. Understanding Stages of Coma. These tests include:. The first priority of treatment is to preserve brain life and function.

Antibiotics may be given right away, in case there is an infection in the brain. Medications for treating the underlying condition will be administered if the cause of the coma is known, as in the case of a drug overdose.

Surgery may be required to reduce swelling in the brain. A team of medical professionals will work with the comatose patient once they are stabilized. The team will also make sure to provide the patient with balanced nutrition during their coma. A coma usually does not last for more than four weeks. Some people may remain in a coma for much longer, however.

Long-term outcomes depend on what caused the coma and the site and extent of damage to the brain. The prognosis may be good for people whose comas are caused by a drug overdose. The severity of the brain damage dictates the long-term outcome. Some people emerge from a coma with physical, intellectual, or psychological problems. Patients who remain in a coma for more than a year are unlikely to come out of that state. Potential complications during a coma include infections, blood clots, and pressure sores.

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