You may have seen in a movie or on a TV show, someone lying on a bed, unconscious, not even moving. We call this state " coma ". Many people think that this is something like a deep sleep. But in fact, a coma is a very different and very serious medical condition. In this, even though a person is alive, there is no way to wake him up. So, to answer a lot of questions in your mind, let's talk about this coma today.
Simply put, what is a coma?
Think of a person in a coma as being like a TV that is turned on but has no channels. The TV is on, the lights are on, but there is nothing on the screen. Similarly, a person in a coma has their heart beating, breathing, and internal body processes going on, but their brain has no connection to the outside world.
Simply put, a coma is a prolonged state of unconsciousness . It is very different from deep sleep. We can wake someone up in deep sleep by making a noise or patting them on the body. However, a person in a coma cannot be awakened even by giving them pain. This condition is caused by severe damage to the brain.
What causes someone to go into a coma?
The main cause of coma is brain damage. This damage can take many forms. Some damage is temporary and can be treated . But some damage is permanent and can even lead to death. More than 50% of comas are caused by head injuries and problems with the blood circulation system in the brain.
Let's see what the main reasons are.
| Reason | Simple explanation |
|---|---|
| Head injuries (Trauma) | When you get hit in the head in an accident, your brain can swell or bleed. This swelling can put pressure on the brain and damage the part of the brain that controls consciousness (the Reticular Activating System - RAS). |
| Anoxic Brain Injury | Oxygen is essential for the brain. If the brain is deprived of oxygen for a few minutes, whether due to a heart attack, drowning, or strangulation, brain cells begin to die. |
| Stroke | A coma can occur when blood flow to a major part of the brain stops or when the brain swells due to bleeding. |
| Blood Sugar | Uncontrolled high blood sugar levels (hyperglycemia) or low blood sugar levels (hypoglycemia) can lead to a coma in diabetic patients. This usually resolves once blood sugar levels are controlled. |
| Infections | Infections that affect the brain or central nervous system, such as meningitis or encephalitis, can cause the brain to swell and cause coma. |
| Toxins | Liver or kidney disease can cause toxins (e.g. ammonia, urea) that should be removed from the body to accumulate in the body and damage the brain. Excessive drug or alcohol use can also be a cause. |
| Epilepsy/ Seizures | If you have continuous, unremitting seizures (Status Epilepticus), the brain does not have time to recover between seizures . This can also lead to a coma. |
How do you recognize a coma?
Only doctors can determine if someone is unconscious or in a coma. It is also very important to find the cause.
Doctors check these things:
- Level of responsiveness: See if the person responds when their name is called, when they are patted on the body, or when they are slightly painful (e.g., when a finger is pinched).
- Eye responses: When you open your eyes and shine a light on them, you see if the pupil gets smaller.
- Breathing pattern: Check to see if breathing is irregular, fast, or slow.
- Body posture: Check to see if limbs are unnaturally bent or stiff.
In addition to these tests, it is very important to ask the family about what happened before the incident. In addition, blood tests, urine tests, and tests such as a CT scan or MRI scan to check the condition of the brain are also done.
Doctors use a special scale to measure this condition. It's called the Glasgow Coma Scale (GCS) . It determines the level of unconsciousness by giving scores on things like eye opening, movement, and speech . The lower the score, the more serious the condition.
How do you treat a coma?
A coma is a medical emergency. If you see someone losing consciousness or are losing consciousness, call 911 immediately and get an ambulance. Getting them to a hospital, especially an Emergency Treatment Unit (ETU), as soon as possible can help minimize brain damage.
In the hospital, treatment is determined by the cause of the coma.
- Treating the cause: If it is an infection, antibiotics are given. If the brain is swollen, medication is given to reduce the swelling. If there is bleeding or a tumor in the brain, surgery may be necessary. If it is due to diabetes, blood sugar levels are controlled.
- Life Support: Patients in a coma are usually cared for in the intensive care unit (ICU) . If they have difficulty breathing on their own, they are connected to a ventilator .
- Supportive Care: When the patient is in a coma, it is very important to prevent other complications from developing.
- Nutrition: Because he is unable to eat or drink, he is given liquid food through a feeding tube.
- Skin care: Bed sores can develop from staying in the same position. To prevent this, turn the patient over every few hours.
- Muscles and joints: Lack of movement can cause muscles to become stiff and joints to become stiff. To stop this, physiotherapists come in and help you move your limbs.
Can you regain consciousness from a coma?
This is a problem that many people have. Recovery from a coma depends on the cause, the length of time in the coma, and the patient's overall health.
It's rare to find yourself suddenly opening your eyes and asking, "Where am I?" like in the movies. Recovery is a very slow, step-by-step process.
Usually, when the patient begins to regain consciousness, they first begin to respond to sounds or pain. Then, they gradually open their eyes. During the initial period of consciousness, many people may be confused and agitated . They may also behave differently than before. This is all part of the healing process. It can take months or years to fully recover. Some people may have permanent disabilities. They may need rehabilitation services such as physical therapy and occupational therapy to get back to normal.
Take-Home Message
- Coma is not a deep sleep, it is a serious medical condition caused by severe damage to the brain.
- If someone is found to be unconscious and unable to be revived, it should be considered an emergency and 1990 should be called immediately and taken to an Emergency Treatment Unit (ETU) .
- It is very important to treat the underlying cause of a coma and provide supportive care.
- Recovering from a coma is a slow process , and the support of family and the medical team is essential.
- Discuss any questions or concerns you have about your loved one's condition with your doctor . Don't rely solely on what you hear online or from others.
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