Coma

Consciousness is controlled by the Reticular Activating System (RAS) in the brainstem. Damage here often leads to coma.

What is a Coma?
A coma is a state of prolonged unconsciousness. The person is alive but cannot be awakened and fails to respond normally to painful stimuli, light, or sound.

The "Sleep" Myth: Unlike sleep, a person in a coma cannot be woken up. It is the brain's way of shutting down high-level functions to focus solely on keeping the heart and lungs working after a trauma.

🚑 MEDICAL EMERGENCY
Coma is a life-threatening emergency. Swift action is needed to preserve brain function.
Call 911 immediately if you find someone unconscious who cannot be roused.

Signs & Symptoms

Doctors look for specific involuntary reflexes to determine the depth of the coma:

• Closed Eyes: The patient appears to be sleeping.
• No Response: Limbs do not move voluntarily, though reflexes (twitching) may happen.
• Pupils: May not react to light (fixed pupils).
• Irregular Breathing.

Doctors check for "Posturing"—rigid body positions that indicate severe brain damage.

Common Causes

• Traumatic Brain Injury (TBI): Car accidents or blows to the head.
• Stroke: Lack of blood flow kills brain cells.
• Diabetes: Blood sugar that is too high (Hyperglycemia) or too low (Hypoglycemia).
• Lack of Oxygen (Anoxia): Drowning or heart attack resuscitation.
• Toxins: Overdose of drugs, alcohol, or carbon monoxide poisoning.

Diagnosis: The Glasgow Coma Scale

Doctors rate the severity of a coma using a point system called the Glasgow Coma Scale (GCS). The score ranges from 3 to 15.

Score	Severity
13 - 15	Mild Brain Injury (Concussion).
9 - 12	Moderate Injury.
8 or less	Severe Coma. (Doctors often say, "Less than 8, intubate," meaning the patient needs a machine to breathe).
3	Deep Coma or Death.

Understanding the Outcomes

Coma rarely lasts longer than a few weeks. Patients usually transition into one of these states:

State	Description
Vegetative State	The person may have open eyes and sleep-wake cycles, but has no awareness of surroundings.
Minimally Conscious	Occasional signs of awareness (e.g., following a finger with eyes or squeezing a hand on command).
Brain Death	Irreversible cessation of all brain activity. The person is legally dead, though machines may keep the heart beating.
Locked-In Syndrome	(Rare) The person is fully awake and aware but completely paralyzed and cannot speak or move.

Family Support & Complications

Since the patient cannot move, family and nursing care is vital to prevent secondary complications:

• Bedsores (Pressure Ulcers): The patient must be turned every few hours to prevent skin death.
• Muscle Contractures: Physical therapy (moving the limbs) helps prevent muscles from shortening and freezing in place.
• Infections: Pneumonia and bladder infections are common risks due to immobility and catheters.

Disclaimer: The content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician regarding any medical condition.