Coma Meaning in Medical
Coma meaning is a medical emergency situation when a person experiences an unconscious state within a certain period of time. This unconsciousness is caused by decreased activity in the brain that is triggered by several conditions such as severe brain injury, alcohol poisoning, or brain infection (encephalitis).
In addition to not being aware of the circumstances surrounding, people who experience coma generally also can not respond to sound or pain. Basic body reflexes (such as coughing and swallowing) in coma patients will be greatly reduced. Most patients are able to breathe spontaneously, but some need a breathing apparatus.
The awareness level of the coma depends on how large the part of the brain is still functioning, and this situation usually changes over time. When gradually conscious, the patient will begin to feel pain, begin to realize the circumstances around, and finally able to communicate. Opportunities to recover from coma are highly dependent on the cause of the coma itself. But people who are comatose for months to years have very little chance of survival.
Causes of Coma
The following are some conditions that may cause commas, including:
- Severe head injury.
- Infections of the brain, such as meningitis and encephalitis.
- Poisoning, for example due to carbon monoxide.
- Alcohol overdose and / or
- Lack of oxygen.
- Tumors in the brain.
- Liver failure (hepatic coma).
Diagnosis of Coma
Physical examination will be done as a doctor first step to diagnose coma, for example:
- Check the pupil size.
- Examining reflexes and movements, such as movement of the eyes or sounds that may be released by the patient.
- Check for signs of head injury.
- Check the patient’s breathing patterns.
- Examine the patient’s reaction to pain.
Before further examination to determine the cause of coma, doctors will usually ask information to the family, friends, or the people closest to the patient who knows the condition before experiencing a coma. Some of the things that doctors will ask include:
- A patient’s medical history, such as whether he has had a stroke.
- Signs of loss of consciousness are seen and how the sufferer loses consciousness, such as whether slowly or suddenly.
- The symptoms before the patient had a coma, such as headache, seizures or vomiting.
- The use of drugs before coma.
- Behavior of the patient before experiencing a coma.
To better ascertain the cause of coma while helping doctors find the right treatment, more detailed examination may be required, for example:
- Blood examination. Thyroid, glucose, and patient electrolyte levels will be examined. The goal is to know the existence of coma triggers, such as overdose of alcohol or drugs, carbon dioxide poisoning, and liver organ disorders.
- Electroencephalography or EEG. Examination performed by measuring electrical activity in the brain aims to determine whether coma triggered by seizures.
- MRI and CT Through this scan, a picture of the condition of the brain can be seen clearly by doctors, both brain structures and brainstem. Here doctors can see if coma is caused by tumors, strokes, or bleeding in the brain.
Scanning CT scans use electromagnetic wave radiation, while MRI uses powerful radio and magnetic waves.
- Lumbar puncture. The purpose of this examination is to determine the presence of infection in the nervous system.
The level of awareness of a comatose person can be determined by an assessment called the Glasgow Coma Scale (GCS). There are three things that are measured on this scale. Each thing has points that will be added up. The sum is then used to determine the level of awareness of a person in a coma.
- Eye opening. In this category, point 0 means the patient is unresponsive and unable to open his eyes spontaneously. Point 4 as the highest means that the patient can open the eyes spontaneously.
- Verbal responses to orders. In this category, point 0 means that the patient is not responding. Point 5 as the highest point implies that the patient is conscious and able to speak.
- The movement’s response to the command. Point 0 is defined as the absence of a response. Point 6 as the highest means the patient is obedient to the command.
Physicians who handle comatose patients will add up the Glasgow Coma Scale (GCS) score to determine the level of patient awareness and what treatment needs to be given. Most people who are in a coma have a total GCS score of less than or equal to 8. The lower the total value obtained, the brain damage experienced may be more severe.
Treatment of Coma
Treatment of coma depends on the cause of the coma itself. For example, a doctor will administer a seizure control medication if coma is caused by a seizure. Doctors will also give antibiotics if coma occurs due to infection of the brain. Glucose can also be given to overcome diabetic shock.
In addition to the above experiments, surgery can also be done to reduce swelling in the brain. If needed, support aids, such as a breathing apparatus or blood transfusion will be paired to a coma patient. In conclusion, coma treatment can be performed appropriately if the diagnosis is also accurate. The patient’s conscious opportunity is highly dependent on treatment outcomes and the duration of the coma.
For example, coma caused by head injury and drug overdose have a higher chance of cure than coma due to lack of oxygen. But if the head injury suffered by sufferers is severe enough to damage the brain, it is not impossible that the patient will be difficult to conscious or disabled when he was aware.
When a person’s time to wake up from a coma can not be predicted by a doctor. But the longer the coma progresses, the conscious chance for the sufferer will generally become thinner, especially if the coma lasts more than one year.
Recovered from a Coma
The recovery of consciousness of people who experience coma usually does not occur suddenly, but gradually. There are some patients who can recover completely from a coma without experiencing a slight defect. Some others realize, but with brain function or body decreased, even paralysis.
Patients with disability after coma should receive further treatment through a variety of therapies by experts, such as physiotherapy, psychotherapy, and occupational therapists.