Providing first aid to a victim in a coma
Coma is a severe unconscious state, characterized by a violation of the most important functions of the body, the absence of reflexes and suppression of consciousness. Coma can occur instantly or develop over several hours. The mechanism of its occurrence is swelling of the brain against the background of hypoxia as a result of infection, trauma or the influence of other pathological processes. Symptoms of coma in a person are lack of consciousness and reaction to any stimuli. Treatment of a comatose state is carried out exclusively in the intensive care unit. The main therapy is aimed at preventing the death of brain tissue and maintaining the vital functions of the body. Let's consider the symptoms, treatment and methods of providing first aid to a victim in a coma.
Factors that can provoke this condition:
- craniocerebral injuries and electric shocks;
- stroke, epilepsy;
- sharp fluctuations in blood sugar;
- infections of the central nervous system or brain;
- hypoxia, asphyxia, cardiac arrest;
- dehydration, loss of electrolytes;
- severe degree of body intoxication;
- induction into a coma according to medical indications (state of artificial coma).
Depending on the depth of unconsciousness, the following types of coma are distinguished: I degree (mild), II degree (moderate), III degree (deep), IV degree (terminal). Classification is based on various clinical symptoms.
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Hyperglycemic coma
Hyperglycemic coma is the most severe complication of diabetes, which develops as a result of increased insulin deficiency and reduced utilization of glucose in the blood. Symptoms are frequent and loud breathing, tachycardia, lowering of blood pressure, sharp smell of acetone from the mouth. Without timely and qualified treatment of hypoglycemic coma, the patient may die. We will talk about pre-medical care later.
Renal coma
Develops gradually. The main symptoms of this condition include: dry skin, swelling in the lower back and lower limbs, the smell of urine from the patient, puffiness of the face, low blood pressure, narrow pupils and high tendon reflexes. Involuntary twitching of individual muscle groups is also possible.
Hypertensive coma
Arises as a result of a sharp increase in intracranial pressure. Coma develops due to compression of some parts of the brain and is accompanied by bradycardia, vomiting, rapid breathing, and high blood pressure. During the consultation, the doctor will tell you how to help the patient in such a condition and in what position it is necessary to transport the victim in a coma.
Coma symptoms of varying severity
Precoma lasts from a few minutes to 3-5 hours. The condition is characterized by confusion, preservation of all reflexes and impaired coordination. Periods of excitation alternate with periods of complete inhibition. It is important to know how a coma differs from an unconscious state.
Coma of mild degree. The main symptoms are lethargy, retardation, the patient does not respond well, consciousness is confused.
Coma of moderate severity. The patient does not respond to pain, light, sounds and is in a stupor. BP decreases, heart rate accelerates, pupils are narrowed. Occasionally, chaotic motor activity of the limbs and involuntary defecation may be observed.
Deep coma. The patient has enlarged pupils, shallow breathing, low blood pressure, no swallowing reflexes.
Terminal coma. The patient is on artificial lung ventilation and parenteral nutrition. Complete absence of reflexes, critical drop in blood pressure, pupils do not react to light. In most cases, this stage ends in death.
Diagnostics
When making a diagnosis, it is important to interview the people surrounding the patient and differentiate coma using the Glasgow scale. After a thorough examination, the doctor will prescribe blood tests (general, biochemistry, and hormones), urinalysis, liver tests, spinal tap, brain CT, head MRI, and encephalogram. After receiving the results, a course of drug therapy will be prescribed. Treatment of diabetic comas is carried out according to a special scheme.
Treatment of diabetic comas
Coma treatment is carried out in the intensive care unit. The primary task of doctors is to stabilize the patient's condition and maintain his vital functions. Further treatment will depend on the results of the tests.
Features of therapy for various types of coma:
- antibiotic therapy - in the presence of inflammation;
- anticonvulsant drugs - for epilepsy;
- anticoagulants - for acute ischemic disease;
- detoxification of the body - in case of any poisoning;
- insulin therapy with signs of ketoacidotic coma.
During the coma period, it is very important to pay attention to the care of the patient: this includes prevention of bedsores, skin treatment, feeding and proper nutrition.
Vegetative state after coma
Vegetative state (apalic syndrome) - a state after coming out of a coma, when the patient is disoriented in space. The patient has preserved periods of sleep and wakefulness, cardiorespiratory function and reflexes. But there is no understanding of oneself and one's surroundings.
The vegetative state after a coma develops due to damage to the cerebral hemispheres, the causes of which can be injuries, infections, ischemia.
Forecast
Prognosis depends on the degree of brain damage and root causes. In medical practice, the patient's chances of coming out of a coma are assessed as follows: with precoma and coma of the first degree - the prognosis is favorable; with coma II and III - doubtful, but there is a chance for recovery; IV degree coma in most cases ends in death.
If you still have questions, make an appointment with our specialists. The doctor will help solve health-related issues and tell you what actions are necessary in the event of a hypoglycemic coma. Take care of your health now.
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