Written by Elif Gulce Batgi
Coma is a prolonged state of unconsciousness that occurs as a result of permanent or temporary disruption of the brain’s function. These disruptions affect consciousness and cause unconsciousness, inability to stay awake, and unresponsiveness to stimuli, such as pain, sound, and light.
Derivation of the word “coma” can help us to understand what coma is. The word “coma” is derived from the Greek word “Koma” which means “deep sleep” (1). A person in a coma is still alive, but unable to respond to the sounds of voices, other sounds, or any kind of activity near them. Also, they are unable to move at will. Vital functions such as breathing and blood circulation are impaired. They are given medication or other kinds of interventions, such as airway pressure or mechanical ventilation.
Occurrences of comas can be associated with different variables. An injury to the head hurts the brain, a stroke, an overdose because of medicine or other types of drugs, infections including the brain, brain damage caused by a lack of oxygen for too long, chemical imbalances, and seizures are causes of a coma (2). When one of these occurs; if they damage the part which helps a person to stay awake and conscious and cause this part to stop working the person will stay unconscious.
(Image Credit: https://www.wrshlaw.com/blog/personal-injury/how-to-represent-a-coma-patient-in-a-claim/.)
There are three types of stages of coma and levels of awareness: Persistent vegetative state, and minimally conscious state. and brain death. A person in a persistent vegetative state is alive but unable to respond to the things going on surrounding them and move at will. They lose such abilities but retain non-cognitive function and normal sleep patterns (3). A minimally conscious state occurs when someone comes out of a vegetative state (1). They have limited abilities to respond to stimuli or requests. However, it is hard to keep conscious for long periods. Brain death is another level of awareness that is not reversible. Doctors will perform a medical examination to see if the brainstem and cerebrum are functioning (1).
Diagnosing a coma is not easy as it is though. An individual who might be in a coma is tested before diagnosis. Physical exams such as checking reflexes, muscle tone, blood pressure, and signs of bruises on the skin, determining the person’s response to painful stimuli, observing pupil size, and observing breathing patterns and heart rhythm will be conducted (1). Brain scans can be also used to locate the areas that might be injured. Computerized tomography (CT) scans, magnetic resonance imaging (MRI), and electroencephalography (EEG) are some examples of scans.
The recovery process of the coma depends on the severity and cause of the injury, the individual’s age, and how long they have been in the coma. Some people may recover gradually, whereas others’ process lasts for years (4). Some people can get out of the coma without any damage, whereas some of them might need physiotherapy, occupational therapy, and psychological assessment and support during a period of rehabilitation (4). However, it is not possible to predict whether the individual will eventually get out of the coma, how long it will last, or will the individual have any long or short-term problems.
References:
Cafasso, J. (n.d.). Coma: Types, causes, treatments, prognosis, and more. Healthline. https://www.healthline.com/health/coma#treatment.
What is a coma? (n.d.). Nemours KidsHealth - the Web's most visited site about children's health. https://kidshealth.org/en/kids/coma.html?ref=search.
Coma and persistent vegetative state. (n.d.). Cleveland Clinic. https://my.clevelandclinic.org/health/articles/6007-coma--persistent-vegetative-statev Coma. (2017, October 18). nhs.uk. https://www.nhs.uk/conditions/coma/.
Comments