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What are the complications of a coma?

Some people who recover from a coma may have major or minor disabilities. Complications may develop during a coma, including pressure sores, bladder infections, blood clots in the legs and other problems. Overview of coma and impaired consciousness.

What is a coma?

A coma is a state of prolonged unconsciousness that can be caused by a variety of problems — traumatic head injury, stroke, brain tumor, drug or alcohol intoxication, or even an underlying illness, such as diabetes or an infection. A coma is a medical emergency. Swift action is needed to preserve life and brain function.

How do doctors assess coma severity?

Doctors will consider a variety of factors when assessing a coma’s severity. One of the most common tools a doctor might use is the Glasgow Coma Scale (GCS). The Glasgow Coma Scale is a simple test that gauges the degree of impaired consciousness in acute medical and trauma patients.

Can a coma last more than a month?

However, a coma rarely lasts over a month. Instead, individuals who remain unconscious for prolonged periods typically progress to a wakeful but unconscious state called post-coma unresponsiveness. In the next section, we will discuss post-coma unresponsiveness and additional states of consciousness that may occur after a coma.

What is a coma in medical terms?

A coma is a medical emergency. Doctors will first check the affected person's airway and help maintain breathing and circulation. Doctors might give breathing assistance, intravenous medications and other supportive care. Treatment varies, depending on the cause of the coma.

How to know if you are in a coma?

Speaking loudly or pressing on the angle of the jaw or nail bed while watching for signs of arousal, such as vocal noises, eyes opening or movement. Testing reflexive eye movements to help determine the cause of the coma and the location of brain damage.

How does a coma test work?

This measures the electrical activity inside the brain through small electrodes attached to the scalp. Doctors send a low electrical current through the electrodes, which record the brain's electrical impulses. This test can determine if seizures might be the cause of a coma.

Why do doctors need to rely on physical clues?

Because people in a coma can't express themselves , doctors must rely on physical clues and information provided by families and friends. Be prepared to provide information about the affected person, including: Details about how the affected person lost consciousness, including whether it occurred suddenly or over time.

What to check for in a coma exam?

The exam is likely to include: Checking the affected person's movements and reflexes, response to painful stimuli, and pupil size. Observing breathing patterns to help diagnose the cause of the coma. Checking the skin for signs of bruises due to trauma.

What to do if you are in a coma?

If you are with a person who develops signs and symptoms of a coma, call 911 or your local emergency number immediately . When you arrive at the hospital, emergency room staff will need as much information as possible from family and friends about what happened to the affected person before the coma.

Can you give antibiotics to a diabetic in a coma?

Emergency personnel might administer glucose or antibiotics intravenously, even before blood test results return, in case of diabetic shock or an infection affecting the brain. If the coma is the result of drug overdose, doctors will give medications to treat the condition.

What happens when you go into a coma?

Some people who recover from a coma end up with major or minor disabilities. Complications can develop during a coma, including pressure sores, urinary tract infections, blood clots in the legs and other problems. By Mayo Clinic Staff.

What are the symptoms of a coma?

Symptoms. The signs and symptoms of a coma commonly include: Closed eyes. Depressed brainstem reflexes, such as pupils not responding to light. No responses of limbs, except for reflex movements. No response to painful stimuli, except for reflex movements. Irregular breathing.

How long does a coma last?

A coma seldom lasts longer than several weeks. People who are unconscious for a longer time might transition to a persistent vegetative state or brain death.

How to tell if you are in a coma?

The signs and symptoms of a coma commonly include: 1 Closed eyes 2 Depressed brainstem reflexes, such as pupils not responding to light 3 No responses of limbs, except for reflex movements 4 No response to painful stimuli, except for reflex movements 5 Irregular breathing

What causes a coma?

Causes. Many types of problems can cause a coma. Some examples are: Traumatic brain injuries. These are often caused by traffic collisions or acts of violence. Stroke. Reduced or interrupted blood supply to the brain (stroke), can result from blocked arteries or a burst blood vessel. Tumors.

Why do people go into a coma after a heart attack?

Blood sugar levels that become too high (hyperglycemia) or too low (hypoglycemia) can cause a coma. Lack of oxygen. People who have been rescued from drowning or those who have been resuscitated after a heart attack might not awaken due to lack of oxygen to the brain. Infections.

What is a coma?

Share on Pinterest. A coma is a state of deep unconsciousness. A person who is experiencing a coma cannot be awakened, and they do not react to the surrounding environment. They do not respond to pain, light, or sound in the usual way, and they do not make voluntary actions. Although they do not wake up, their body follows normal sleep patterns. ...

What happens to a person in a coma?

Without treatment, their ability to think clearly will gradually decrease. Finally, they will lose consciousness.

How long does a coma last?

Levels of consciousness and responsiveness will depend on how much of the brain is functioning. A coma often lasts for a few days or weeks. Rarely, it can last for several years. If a person enters a coma, this is a medical emergency. Rapid action may be needed to preserve life and brain function.

Why is coma different from sleep?

Coma is different from sleep because the person is unable to wake up. It is not the same as brain death. The person is alive, but they cannot respond in the normal way to their environment.

What are the symptoms of a coma?

Symptoms. During a coma, a person cannot communicate, so diagnosis is through the outward signs. These include: closed eyes. limbs that do not respond or voluntarily move, except for reflex movements. lack of response to painful stimuli, except for reflex movements.

How to determine if you have carbon monoxide poisoning?

These will be taken to determine: 1 blood count 2 signs of carbon monoxide poisoning 3 presence and levels of legal or illegal drugs or other substances 4 levels of electrolytes 5 glucose levels 6 liver function

Can you wake someone from a coma?

If the cause of the coma can be successfully treated, the person may eventually awaken with no permanent damage. They are likely to be confused at first, but then they usually remember what happened before the coma, and be able to continue their life. Typically, some rehabilitation therapy is necessary.

What is critical condition?

As one doc told me, critical condition, by definition, requires care in a critical care or intensive care unit. In general, it’s the worst condition (other than, obviously, DOA) a patient can be in, with a high risk of death within the next 24 hours.

What does it mean to be upgraded to serious?

Being upgraded to "serious" means there is a lower likelihood of death within 24 hours, but the patient still requires close observation. So, you’re definitely thought to be better off in "serious" condition than in "critical" condition, but you’re not ready to go run a marathon, or for that matter shuffle to the bathroom.

What happens when you are in a coma?

While in a coma, a person is unresponsive and cannot wake up, even when stimulated. In nearly every coma, no matter what triggered it, the same event occurs: the brain swells, pushes up against the skull, and damages the Reticular Activating System, (RAS) the part of the brain stem that controls arousal from sleep.

What are the symptoms of a coma?

Some neurological reflexes that a doctor may look for in coma patients include: 1 Pupillary reactivity. The pupils should shrink in response to a light being shone in the eyes. 2 Oculocephalic response. The eyes should turn to the right when the individual’s head is turned to the left, and vice versa. 3 Gag reflex. The individual should gag or cough if a cotton swab or endotracheal tube is placed down their throat.

What happened to Sharat's son?

“My son Sharat suffered a severe traumatic brain injury 23 years ago leaving him with Aphasia and right sided weakness from his vision,hearing to his limbs. The lockdown in June was a great challenge for him as his caregivers stopped coming, no gym workouts and no outings for a coffee.

What is the Glasgow Coma Scale?

The Glasgow Coma Scale is a simple test that gauges the degree of impaired consciousness in acute medical and trauma patients. It can indicate the severity of a TBI and is used to predict the outcome of an injury.

How long does a coma last?

Lack of speech or other forms of communication. No purposeful movement. An actual coma rarely lasts over four weeks. Instead, most patients who remain unconscious for long periods have progressed to the next stage of consciousness.

How long does it take to recover from a coma?

In fact, patients who transition from a coma to minimal consciousness within eight weeks are the most likely to reach this state and regain higher functions.

What to do after a coma?

After a person emerges from a coma and regains consciousness, occupational and physical therapy exercises and other cognitive rehabilitation exercises will be crucial in their recovery. These activities are great ways to engage neuroplasticity and help their brain heal.

What is the urgency message for patients in the wake of a motor vehicle accident?

Urgent message: Patients presenting to urgent care in the wake of a motor vehicle accident have self-selected their treatment setting. However, it is imperative to maintain vigilance for potentially serious and even life-threatening injuries that may not be apparent.

Why is it important to describe the details of an accident?

This is an important part of the evaluation, as it provides a context for their physical complaints and may give clues to the correct diagnosis.

What are the risks of a chest injury?

Direct trauma, rapid deceleration, and other mechanisms may lead to chest wall injuries, including rib fractures, cardiovascular contusion, aortic injury, pulmonary contusions, lacerations, or pneumothorax.#N#Risk factors for severe thoracic injury include high speed, no seat belt use, extensive vehicular damage, and steering wheel deformity. Inquiring about contact with the steering wheel, chest pain, palpitations, or trouble breathing is also important to the history. A complete visual inspection should be done, looking for a paradoxical movement of the chest wall, and identifying all wounds on the chest and back. The exact location, appearance, number, and type of wounds should be noted and well documented.#N#Auscultation for absent or diminished breath sounds may indicate a pneumothorax or hemothorax.#N#Palpation of the chest wall should be done carefully, feeling for subcutaneous emphysema or bony crepitus.#N#An electrocardiogram should be performed in all patients with anterior chest trauma, pain and tenderness directly over the mid-anterior chest, and in those patients with a history or active signs and symptoms suggestive of cardiac disease, as well as in the elderly. Findings concerning for cardiac contusion include unexplained persistent tachycardia, new bundle branch block (with right BBB being the most common), or dysrhythmia. These patients should be admitted for cardiac monitoring.

How to tell if you have an epidural hematoma?

Epidural hematomas present in 5% to 10% of patients with severe head injuries. A brief loss of consciousness at the time of the accident or an alteration in behavior may be the only clue to an epidural or subdural hematoma. Other signs and symptoms, such as headache, dizziness, unsteady gait, lack of awareness of surroundings, nausea, and vomiting may develop gradually.#N#The classic presentation is a patient who loses consciousness from the initial concussion, gradually recovers over a few minutes, and enters the “lucid interval” where they may be neurologically intact. Accumulation of blood form the lacerated artery may compress the brain and cause a shift, leading to a declining level of consciousness and eventually a second loss of consciousness with herniation and death. There can be a very short window of opportunity to intervene; this is considered a true emergency.

What percentage of TBI patients have post traumatic headaches?

Post-traumatic headaches are estimated to occur in 25% to 78% of patients with a mild traumatic brain injury (TBI); in the United States, 45% of TBIs are caused by MVAs. 1,2 The differential diagnoses of these headaches range from benign etiologies such as post-concussive syndromes, tension, or migraine, to more serious and potentially life-threating ones such as epidural hematomas, subdural hematomas, or injuries of the carotid or vertebral arteries.#N#It is incumbent upon us to seek out details that may cause concern in the history and exam.#N#The post-MVA headaches that we see most commonly in the urgent care center are tension headaches, which can be related to simple cervical strains. Often, these present as a persistent throbbing headache; unfortunately, this is nonspecific and odes not rule out a more serious cause which can present in a delayed fashion. Therefore, the examiner should look for concerning physical signs, such as extensive bruising and hematomas of the scalp, as well as a hematoma or bruit over the lateral neck.

Is post-concussive syndrome a traumatic head injury?

Post-concussive syndrome is a common sequela to traumatic head injuries, and may present with headaches, dizziness, inability to concentrate, or irritability that many persist for several weeks following the injury. This can be a diagnosis of exclusion, as these patients may need neuroimaging and further testing initially to rule our intracranial bleeding. Treatment is supportive with reassurance and education.

Can a patient die from blunt cardiac injury?

While most patients with blunt cardiac and pulmonary injury will die in the field, some life-threatening injuries, such as transection of the aorta, may have a delayed presentation.#N#Patients with a history of a rapid deceleration injury should be evaluated with a chest x-ray and possibly a chest CT, especially if the patient has persistent pain or dyspnea. In patients who appear clinically stable without a concerning mechanism of injury, further evaluation may not be necessary with the exception of obtaining an ECG.#N#However, if the symptoms are severe or if there are worrisome findings on the chest x0ray, such as multiple rib fractures, hemo-pneumothorax, pulmonary contusion, or a wide mediastinum, the patient should be transferred to the ED for further evaluation.

What is clinical incident?

A clinical incident is an unpleasant and unplanned event that causes or can cause physical harm to a patient. These incidents are harmful in nature; they can severely harm a person or damage the property. For example—

What is clinical risk management?

Clinical risk management, a subset of healthcare risk management, uses incident reports as essential data points. Risk management aims to ensure the hospital administrators know their institution performance and identify addressable issues that increase their exposure.

What is an incident in healthcare?

An incident is an unfavourable event that affects patient or staff safety. The typical healthcare incidents are related to physical injuries, medical errors, equipment failure, administration, patient care, or others. In short, anything that endangers a patient’s or staff’s safety is called an incident in the medical system.

Why is incident reporting important?

Improving patient safety is the ultimate goal of incident reporting. From enhancing safety standards to reducing medical errors, incident reporting helps create a sustainable environment for your patients. Eventually, when your hospital offers high-quality patient care, it will build a brand of goodwill.

Why is reporting important in healthcare?

Reporting can also make healthcare operations more economically effective. By gathering and analyzing incident data daily, hospitals’ can keep themselves out of legal troubles. A comprehensive medical error study compared 17 Southeastern Asian countries’ medical and examined how poor reporting increases the financial burden on healthcare facilities.

What are near miss incidents?

#2 Near Miss Incidents 1 A nurse notices the bedrail is not up when the patient is asleep and fixes it 2 A checklist call caught an incorrect medicine dispensation before administration. 3 A patient attempts to leave the facility before discharge, but the security guard stopped him and brought him back to the ward.

How much of healthcare is wasted?

Even the World Health Organisation (WHO) has estimated that 20-40% of global healthcare spending goes waste due to poor quality of care. This poor healthcare quality leads to the death of more than 138 million patients every year. Patient safety in hospitals is in danger due to human errors and unsafe procedures.