Coma tih hi eng nge ni? He hriatna hloh dinhmun khirh tak hi han sawi ila!

Mi pakhatin "coma-ah a lut" tih emaw, movie-a mi pakhat mit khap, che lo tak tak a hmuh emaw i hre tawh ngei ang. Hei hi a takah chuan natna khirh tak, nunna atana hlauhawm tak a ni. Chuvangin, vawiin hian coma hi eng nge ni tak tak, engvangin nge a lo awm tih leh eng nge kan tih theih tih te kan sawi dawn a ni.

Coma hi eng nge ni tak tak?

A awlsam zawngin, coma-a awm hian i rilru a buai tihna a ni a, i chhehvela thil thlengte i hre lo tihna a ni a, engti kawng mahin i chhang lo tihna a ni bawk . I taksa leh a mamawh i hre lo. A awlsam zawngin, coma tih awmzia chu i thluak hian hna a thawk tha lo tihna a ni .

Hetiang hian han ngaihtuah teh: thluak hi kan taksa control center ang a ni. Hei hi a thawk tha lo a nih chuan a thleng thin. Coma hi natna chi hrang hrang avanga lo awm thei a ni a, chu chuan thluak nasa takin a nghawng emaw, a tichhe thei emaw a ni. Coma zawng zawng hi a inang vek lo. Ṭhenkhat chu a thuk zawk , chu chu thluak hnathawh a tibuai nasa zawk tihna a ni.

Coma hi medical emergency a ni a . I awmna hmuna mi pakhat chu a rilru a buai a, a chhang thei lo a nih chuan 911 (or i awmna hmuna emergency number) chu call nghal rawh . Coma thlentu thil tam tak chu enkawl vat a ngai a ni. Tikhawtlai hian harsatna lian tak a thlen thei a, thihna thlengin a thlen thei.

Coma hi engtiang chiahin nge a awm?

Research awmsa atanga a lan dan chuan United States leh England ang ramah chuan kum tin mi 100,000 zingah coma vei thar 250 vel an awm thin. Mahse, heng chhut dante hi engtiang chiahin nge a dik tih erawh hriat chian lohna engemaw zat a awm. Hei hi chhan hrang hrang a awm a. A chhan lian tak pakhat chu coma thlentu natna thenkhat hi enkawl theih a nih avangin enkawl thuai theih a nih vang a ni. A châng chuan, hengte hi damdawi in an thlen hma pawhin first aider-te’n an enkawl thei a ni. A chhan dang chu coma ang maia lang thei, mahse a takah chuan a danglam thei dinhmun dang a awm vang a ni.

Coma hi thluak hnathawh tichhe thei damdawi lam harsatna nei apiangah a awm thei. Kum, mipa leh hmeichhia, chi leh sakhua thliar lovin tu pawh a nghawng thei a ni.

Coma a awm hian eng symptoms nge a neih?

Coma natna lanchhuahna lian ber pathum a awm a, chungte chu:

• Hriat lohna: Hei hi mut thuk tak ang a ni. Ka harh theih dan tur a awm lo .
• Mit chhanna tlakchham: Hei hian i mit a khar tihna a ni. Miin i mit tivar tum pawhin i chhang lo. A chang chuan mit chhungah reflex movement engemaw zat a awm thei bawk. Entîr nân, êng chhân lêt te, mit chhing te, leh i lu i hawi huna i mit tihher te. Mahse, coma hi a thuk hle a nih chuan heng reflexes te hi beisei angin a awm lo thei.
• Motor response tlakchhamna: 1.1.Chu chu tumruh taka movement i siam lo tihna a ni . A châng chuan reflexes engemaw zat i nei thei bawk. Mahse coma a thuk hle a nih chuan an bo thei bawk. Coma thuk zia chu i reflexes chi hrang hrang atang pawhin i hre thei bawk.

Heng symptoms te hi coma-ah hmuh tur ni mahse, a danglamna engemaw zat a awm thei. Mi thenkhat chuan motor response an thlak danglam thei bawk.

Glasgow Coma Scale (GCS) hi eng nge ni?

Khawvel pumah Glasgow Coma Scale (GCS) hi coma nasat dan tehna atana hman lar ber a ni. GCS-ah hian category lian pathum a awm a, category tinah score a ni. The maximum score is 15. Chumi awmzia chu i fimkhur tawk a, i chhehvel i hre chiang a, zawhna i hrethiam a, i chhang thei a, thupek i zawm thei tihna a ni.

A tlangpuiin score 8 emaw a aia tlem emaw chuan coma-ah i awm tihna a ni. Score a hniam poh leh coma a thuk zawk. Score hniam ber chu 3. GCS-in a tehna category pathumte chu:

• Mit chhanna (point 1-4) 1.1.
• Movement chhanna (point 1-6) 1.1.
• Thusawi chhanna (point 1-5) 1.1.

Coma awm chhan awm thei te chu engte nge ni?

Coma thlentu emaw, coma thlentu emaw chhan tam tak a awm. Eng nge an nih hi han thlir ila:

• Thisen sugar level inthlak danglamna pangngai lo: Hei hian zunthlum nena inzawm coma te pawh a huam tel. Thisen thlum hniam (hypoglycemia) leh thisen thlum sang (hyperglycemia) te hi a hlauhawm vek a ni.
• Damdawi leh damdawi lam kalphung: Surgery atan anesthesia, chubakah damdawi lam avanga coma te pawh a awm bawk.
• Damdawi lam leh damdawi lam ni lo ruihhlo hman.
• Zu ruih leh zu ruih ching.
• Lu hliam: Thil chi hrang hrang , concussions ang chi, accident-a lu a tlak avanga lo awm, a nih loh leh thil pawi zawk , traumatic brain injuries (TBI) ang chi te .
• Thluak thisen a chhuak.
• Thluak lama thisen kal tlem: Stroke chi hrang hrang, a bik takin ischemic stroke .
• Oxygen tlakchhamna (cerebral hypoxia) a awm.
• Thil tha lo: Entirnan , carbon monoxide , heavy metal, leh pesticide thenkhat.
• Infection: A bik takin thluaka infection encephalitis leh meningitis , chubakah nunna atana hlauhawm tak sepsis ang chi te.
• Kidney emaw liver emaw a thawk tha lo.
• Inflammatory conditions emaw immune system nena inzawm natna: Entirnan , ‘Multiple Sclerosis’ (MS) .
• Electrolyte imbalances: Sodium tlem lutuk (hyponatremia) emaw calcium tam lutuk (hypercalcemia) emaw ang chi dinhmun .
• Taksa lumna inthlak danglam dan pangngai lo: Taksa lum lutuk (hypothermia) leh sang lutuk (hyperthermia) te.
• Luruh chhunga pressure sang (Intracranial hypertension): Hei hi hydrocephalus ang chi natna avanga lo awm thei a ni.
• Seizures: A bik takin ‘Status Epilepticus’, chu chu epileptic condition awm reng a ni.

Tute nge coma risk sang zawk?

Damdawi lam dinhmun leh nunphung thenkhat chuan coma-a tlu lut theihna a tipung thei a ni. Chung zingah chuan:

• Metabolic conditions: Thisen sugar level tichhe thei dinhmun , Type 1 Diabetes leh Type 2 Diabetes complication awm lo, Diabetic Ketoacidosis (DKA) tih ang chi te.
• Hun rei tak chhunga natna: Thisen sang (hypertension) leh cholesterol sang (hyperlipidemia) ang chi thil . Chungte chuan thluaka thisen chhuah emaw, stroke emaw a thlen thei a ni.
• Ruihhlo leh zu hman: Ruihhlo eng pawh addiction, ruihhlo dan lo, opioid painkiller, mutna damdawi, zu ruih, opioid addiction, leh inhalant drug hman te.
• Safety gear hman loh: Helmet leh seat belt ang chi safety gear hman loh hian lu hliam leh concussion emaw TBIs ang chi condition a thlen thei a ni.
• Lung lam natna: Lungphun mumal lo ang chi thil.
• Hun rei tak chhunga natna dang: Epilepsy , hypothyroidism ang chi natna .

Coma avanga harsatna awm thei te chu engte nge ni?

Coma-a awm chuan mahni in enkawl thei lo. An che thei lo va, an ei thei lo va, an inbual thei lo va, heng zinga pakhat mah an ti thei lo. Hei hian darkar 24 chhung damdawi lam enkawlna an mamawh tihna a ni. Coma-a awm chuan zun chhuah theihna tura pui turin urinary catheter a mamawh mai thei. Thâwk lakna kawngah pawh ṭanpuina mamawh a awm fo a, chu chu mechanical ventilation an ti a ni., chu chu machine hmanga thawk thei tura siam an ni tihna a ni.

Coma emaw a kaihhnawih enkawlna avanga harsatna awm thei thenkhat chu:

• Hospital-a natna hrik kai: ventilator-associated pneumonia (VAP) leh catheter -associated urinary tract infection (CAUTIs) ang chi te .
• Pressure injuries/Bedsores: Kan taksa peng thenkhat chu hmun khata awm reng vangin a hliam thei.
• Tube hmanga chaw pek.
• Muscle atrophy a awm.
• Thrombosis: Hei hi ven nan hian thisen tithianghlimtu (anticoagulants) leh intermittent pneumatic compression (IPC) hmanrua te hman a ni. Hei hian stroke leh pulmonary embolism ang chi thil a veng thei a ni.
• Delirium (delirium) a awm.
• Thâwk chhuahna tur rilruah khur siam (Tracheostomy): Hei hi a tlangpuiin coma kar hnih aia rei a nih chauhvin a ngai a ni.

Engtin nge coma hi i hriat theih ang?

Coma awm chhan zawn – chu chu a hnuaia damdawi lam dinhmun hriatchhuah hi a ni – chu thil thleng thuai a ngai a ni . Coma hmuhchhuah hmasak ber pakhat chu neurological exam tih hi a ni . Chumi hnuah chuan doctor chuan Glasgow Coma Scale ang chi thil hmangin coma nasat dan a hre thei ang.

Neurological exam bakah hian doctor-te chuan test eng emaw zat an nei dawn a, coma awm chhan leh harsatna a nasat zia hriat theih a ni ang. Entirnan, lu hliam a awm tawh a nih chuan a chhan hriat a awlsam zawk. Tichuan test-naah chuan a chhiatna zau zawng chu a en ang. A chhan hriat a nih loh chuan coma awm chhan zawn leh a chhan nasat dan hriat chu thil inang deuh vek a ni.

He natna hi hriat theih nan eng test nge tih thin?

Coma hriat theihna tur leh a nasat dan hriat theihna tur test tam tak a awm a. Chung zinga ṭhenkhat chu:

• Thisen, zun leh cerebrospinal fluid (CSF) te laboratory test: Hengte hi coma thlentu tam tak hmuhchhuahna atan a tangkai hle. Thil tam tak an hmuchhuak thei a, chung zingah chuan thisen thlum harsatna, chi inthlauhna, taksa peng hrang hrang hnathawh that loh, toxins, leh natna hrik kai chhinchhiahna te pawh a tel.
• Diagnostic imaging: Heng test te hian i lu chhunga hliam emaw, chhiatna emaw awm leh awm loh "en" nan hmanraw hrang hrang an hmang thin. Imaging test hman tlanglawn ber chu computed tomography (CT) scan leh magnetic resonance imaging (MRI) scan te hi a ni .
• Electroencephalogram (EEG) hmanga chhut a ni: 1.1.He test hian i thluaka electrical activity awm chu a hmuchhuak a, a record bawk. Coma nasat dan hriat theih nan leh coma thlen thei dinhmun, epilepsy ang chi te hriatchhuahna kawngah a pui thei bawk.
• Electrocardiogram (ECG emaw EKG): He test hian coma thlen thei heart rhythm problem hriatchhuah emaw, paih chhuah emaw a pui thei a ni.

Heng bakah hian test dang pawh tih theih a ni. Hei hi coma awm dan, i dinhmun leh i hriselna chanchin a zirin a innghat ang. I hnaih ber tu emaw coma-a awm a nih chuan doctor hi eng test nge tih tih sawifiahtu tha ber a ni. Vawikhat i hriatna i neih leh chuan eng test nge tih a hrilh thei che a ni.

Engtin nge coma hi enkawl a nih? Tihdam theih a ni em?

Coma enkawl dan hi a chhan bulpuiah a innghat nasa hle . Coma awm chhan tam tak a awm avangin enkawl dan pawh a tam thei hle. Thil pakhat atana hnathawk chu thil dang tan a thawk lo thei (a nih loh leh dinhmun dang a tichhe thei bawk).

Chuvangin, i dinhmun bik emaw, i hnaih ber emaw dinhmun atana enkawlna tur leh rawtna awmte hrilh tur che chu doctor hi a tha ber a ni.

Emergency-a enkawlna hman tlanglawn tak tak

Coma awm chhan hriat hma hian doctor emaw enkawltu emaw enkawl tan theih tur enkawlna thenkhat a awm a. Heng enkawlnate hi damdawi lam dinhmun hriat tawhte nena inzawm a ni tlangpui a, a nih loh leh mi pakhatin a chhehvela evidence awmte atanga coma thlen thei tura a ngaih thilte nen a inzawm tlangpui bawk. Heng enkawlnate hian mi a ti nghet thei a, coma a na zual loh nan a pui thei a, coma atanga a chhuah tir vek thei bawk. Entirnan:

• Glucose emaw insulin: Hengte hian thisen sugar level tihsan emaw tihhniam emaw a pui thin. A hun taka glucose pek a nih chuan coma chu rang takin a let leh thei a ni.
• Drug overdose reversal drugs: Entirna atan ‘Naloxone’ . Hei hian opioid overdose avanga nghawng a neih chu a tidanglam thei a ni. Naloxone hian opioid overdose avanga a nghawng chu minute hnih atanga minute nga chhungin a tidanglam thei a ni.

Enkawlna avanga harsatna/side effects chungchangah chuan coma enkawlna hrang hrang a tam em avangin enkawlna atanga harsatna leh side effect lo awm thei tam tak a awm a ni. I doctor hi eng side effect emaw complication emaw a awm theih dan leh eng nge tih theih tih sawifiahtu tha ber a ni.

Coma-a awm hi eng ang nge ni?

Coma-a awm hian i rilru a buai tihna a ni tlangpui , chuvangin coma-ah i awm tih i hre lo. I chhehvela khawvel hriatna engmah i lantir lo. I dinhmun, i chhehvel, leh i taksa mamawhte chu tumruh takin i chhang lo. Coma thuk dan azirin reflexes engemaw zat i nei thei a, mahse hengte hi case hrang hrangah a inang lo ang.

Coma-a i awm lai hian i chhehvela thil thleng i hre thei em? I hre reng thei em?

HeiA chang chuan a thleng thei a, mahse coma chi leh i coma thuk danah a innghat. Coma-a awmte hian an chhehvela thil thleng an hre thei tih finfiahna a awm. Coma atanga dam tawh thenkhat chuan an bula thil thleng, inbiakna ang chi te chu an hrechhuak thei tawh a ni. Mahse, hei hi a danglam thei hle. Engtikah nge mi pakhatin hetiang hi a tawn ang tih chiang taka sawi a harsa hle.

Tin, coma hi a chang chuan hriat harsa tak a ni thei tih hriat reng a pawimawh bawk. Doctor-te chuan an training, an thil tawn leh an rorelna hmangin he natna hi an hmuchhuak a ni. Mahse case zawng zawng hi a inang vek lo. Hei hian coma chu thil dang vangin a dik lo thei tihna a ni a, a thuk zawng pawh a tlem thei tihna a ni. Tin, mi pakhat chu a tir lamah coma-ah a awm a, doctor-in a hriatna inthlak danglamna a hriat hmain a hriatna engemaw chen a lo harh leh thei bawk.

Factor tam tak a awm avangin he zawhna hi chhan a awlsam lo. Doctor hi nangmah emaw, i hnaih ber tu emaw chu coma-a i awm laia thil thleng kha a hriatchhuah leh hriatrengna hriat theihna tura puitu tha ber a ni. He zawhna hi a chhan kim thei lo mai thei a, mahse, chu hriatna chuan dam lehna kawng a nghawng dan leh a hnua thil thleng tur (a awm chuan) hriatthiamna atan a tlem berah a pui thei che a ni.

Coma hi eng chen nge a awm?

Coma hi hun rei lote chhung chauh a awm thei a, minute tlemte chauh a awm thei . A nih loh leh kar khat emaw kar hnih emaw chhung pawh a daih thei bawk . Vanduaithlak takin coma-a awm lai pawhin thihna a thleng thei bawk . Hei hi hliam na tak emaw, natna emaw avanga coma a awm emaw, coma a luh hnua damdawi lam pan vat loh emaw a nih chuan a thleng tam ber.

Coma hi kar tlemte aia rei a awm hi a tlem hle. Hei hi a chhan chu a rah chhuah tlangpui chu coma atanga harh emaw, hriatna tlahniam emaw, hriatna tlem emaw dinhmun danga inthlak emaw a nih vang a ni. Chungte chu:

• Vegetative State: Hetiang dinhmunah hian mi chu a harh a, mahse a chhehvel khawvel a hre lo. Tumruh taka nungchang engmah an lantir lo. An mit an meng a, an chhehvela khawvel chhanna ang maia lang thil an ti mai thei a, mahse a takah chuan an hre lo va, tumruh takin engmah an ti lo. Vegetative state chu rei tak a awm chuan persistent vegetative state (PVS) an ti bawk. (Mithiamte sawi dan chuan, thla thum tal accident awm lo, emaw, accident avanga thla sawm leh pahnih emaw chhunga awm thei vegetative state chu persistent anga ngaih a ni.)
• ‘Minimally Conscious State’: Hei hi mi pakhatin a chhehvel khawvel a hriat chian em emna leh tumruhna engemaw zat a lantir nana state a ni. Thupek awlsam tak tak an zawm thei a, sentence tawi te pawh an sawi thei bawk. Mahse heng thilte hi an ti chhunzawm zel thei lo. Heng thilte hi an tih theih loh chuan ‘Persistent Vegetative State’-ah an awm niin a lang.

‘Vgetative state’ hi coma nen inang mah se, coma a ni lo tak zet a ni. ‘Vgetative state’-a awmte chu coma-a awm tawh lo khawpin an dam leh tawh a ni. Mahse, an thluak hnathawh leh theihna erawh a la tlem hle.

Vegetative state atanga dam leh theihna chance a inang lo hle. Mi thenkhat chuan an hriatna famkim emaw, a then emaw an nei leh thin. Mahse mi tam tak chuan an ti lo. Mite chu kar tam tak, thla tam tak, kum tam tak chhung pawh vegetative state-ah an awm thei a ni. Amaherawhchu, mahni inenkawl thei lo an nih avangin damdawi lam enkawl reng reng an mamawh a ni. Vanduaithlak takin harsatna an tawk nasa hle. Vegetive state-a awm tam zawk chuan dam rei zawng an nei tlem hle.

Hetiang dinhmun atanga chhuah theihna chance engzat nge awm?

Coma atanga dam leh theihna chance a inang lo thei hle . Thil tam takin a nghawng a ni. Thil awmdan bik hrilh tur chea tha ber chu thil awmdan hre chiangtu doctor a ni. A tam zawkah chuan chu chu i hmangaih enkawltu doctor kha a ni.

Thutlukna i siam thei lo a nih chuan engtin nge i duhzawng i sawi chhuah?

Ngaihtuah teh, coma-a awm i nih chuan i damdawi lam enkawlna chungchangah thutlukna i siam thei lo vang a, i duhzawng chu tumah i hrilh thei lo vang. Vawi tam tak chu, chûng thu tlûkna siamte chu chhûngte emaw, hmangaih tak takte emaw siam a ngai ang.

Coma-a dah thei tur damdawi lam natna i nei emaw nei lo emaw pawh nise, i damdawi lam enkawlna chungchanga thutlukna i siam theih loh chuan i duhzawngte chu i hmangaih tak takte nen inbiakna neihpui a tha hle . He inbiakna hi nuam lo leh harsa tak niin a lang thei. Mahse, a tlai hmaa heng inbiakna te hi neih hian i thusawi theih loh chuan i duhzawng chu eng nge ni tih i hmangaih te hriat theih nan a pui ang.

Tin, i duhzawng leh thutlukna te chu ziakin i ziak tel bawk ang . Hei hi ‘Advance Directive’ emaw ‘Living Will’ emaw an ti tlangpui. Mahni in enkawl thei lo emaw, mahni hriselna atana thutlukna siam thei lo emaw i nih chuan eng nge thleng ang tih dan lama thil thleng chungchang a ni. Heng document te buatsaih nan hian ukil hnen atangin tanpuina i dawng thei ang. Mahse thenkhat chu nangmah ngeiin i buatsaih thei bawk (i awmna hmuna dan azirin notary sign tir i mamawh mai thei).

Coma hi ven theih a ni em?

Coma thlentu dinhmun tam tak chu ven theih a ni – a nih loh leh a hlauhawmna chu tihziaawm theih a ni . Coma-a i awm theihna tur venna emaw tihtlem emaw atana i tih theih pawimawh ber berte chu hetiang hi a ni:

• I natna rei tak enkawl dan: Zunthlum leh epilepsy ang chi natna enkawl dan tur i doctor thupek zawm hian nakin lawkah coma-a i tlu lut theihna a ti tlem thei a ni.
• A tul hunah invenna hmanrua vuah: Lu hliam, a bik takin concussion leh TBI (Traumatic Brain Injuries) te hi coma thlentu a ni fo. A remchan dan angin helmet leh seat belt ang chi invenna hmanrua bun hmangin inven rawh.
• Ei leh in inthlau (balanced diet) ei: Coma thlentu tam tak hi ei leh in nena inzawm a ni. Entirnan, chi (salt imbalances), ei leh in lama harsatna (nutritional deficiency) te. I ei leh in hian i circulatory system hriselna a nghawng bawk. Hei hian stroke ang chi natna avanga coma awm lo turin a pui thei a ni.
• Taksa chak taka awm la, i taksa rihna hrisel tak nei rawh: I taksa rihna leh i thawhrimna level hian i thluak tibuaitu, a bik takin coma thlentu dinhmunte chu a veng thei a, a tikhawtlai thei bawk.
• Ruihhlo leh damdawi ni lo hman loh te, zu in tlem te: Ruihhlo ngawlvei hian coma awm theihna a tipung nasa hle. Tin, doctor-in damdawi a pek ang chiah ei chuan coma ang chi complication leh side effects a awm theihna a ti tlem bawk.

Hmangaih coma-a awmte tan chuan hei hi thil hlauhawm tak a ni thei. I hmangaih tak chu coma-a a awm lai hian zawhna chhan loh tam tak i nei thei a. An dam leh dawn em tih te, eng chen nge a daih dawn tih te, an dam leh vek dawn em tih te i ngaihtuah mai thei. Zawhna leh rinhlelhna nena nun chu thil awlsam a nih loh laiin, zirchianna kalpui mek chuan mithiamte chu coma hnathawh dan leh enkawl dan tur an hriatthiam theih nan a pui mek a ni. Hei hian tunah leh nakin lawkah coma atanga dam lehna kawng a hawng dawn a ni.

A tawi zawngin, kan hriat reng tur thilte chu hetiang hi a ni (Take-Home Message):

Hei hian coma chungchang hriatna engemaw chen a pek che ka beisei. Hriat reng tur pawimawh tak takte chu:

• Coma hi medical emergency a ni. Mi hriat loh leh chhanna nei lo i hmuh chuan damdawi lam tanpuina zawng nghal rawh .
• Coma awm chhan tam tak a awm thei a , a then chu ven theih a ni.
• Lu (helmet, seat belt), natna khirh tak tak (zunthlum, thisen sang ang chi), leh damdawi laka inthiarfihlim a , coma hlauhawmna chu tihziaawm theih a ni
• Thutlukna siam thei lo dinhmunah i ding a nih chuan, i damdawi lam enkawl duhna chu i chhungte nen sawiho a pawimawh hle a, a theih chuan ziakin i ziak bawk ang
• Coma atanga dam leh theihna chance hi mi hrang hrangah a inang lo a , i doctor chuan hemi chungchang hi a tha berin a pe thei che a ni.

He thu hi i tan a tangkai ngei kan beisei. Hrisel takin awm rawh!

` Coma, hriat lohna, thluak, enkawlna, emergency, symptoms, hriselna