A friend of mine at a particular period in the year 2008 spent 3 months in the hospital in a state of coma. She was driving herself all the way from a seminar in another state when she was involved in the accidents. Her car crashed into another oncoming vehicle. Luckily, there were people around to save my friend's life. The other person in the car my friend hit had a bleeding head but was very well conscious.
Licence: CC-BY-SA 3.0 :: Source: Wikimedia :: Author: Aaron Cohen
As humans, we get sick one time or the other when exposed to pathogenic materials, overfeeding, extreme temperatures or newer environments. Some might be so critical as to get a bed rest for days or even weeks. Usually, with proper treatment, we get well and soon resume to our everyday life. However, being in a coma is a little bit different.
Being in coma is to be in a state of unconsciousness which can span from days to weeks and even years. It could be a permanent state or temporary phase. A person in comma can not respond to external stimulus such as being tickled, sounds, light including pain. It is like being in a deep sleep, but the person ca not be awakened by external stimulus, the person is totally unresponsive to his external environment and can not initiate voluntary motor movements. Involuntary movement and actions such as pumping action of the heart, contractions of the gastrointestinal tracts and sometimes breathing do not cease to function. An individual in a comma state is said to be comatose.
There are different causes of coma, all as a result of an injury to the brain. Injury might be as a result of trauma which causes the brain to swell and bleed. The targeted part of the brain in coma is the cerebral cortex, brain stem and its reticular activating system. The cerebral cortex is a large grey mass of the brain involved in sensation, intelligent processings The reticular activating system is a arrangement of connected nuclei in the central nervous system of vertebrate animals that function in the arousal, wakefulness and sleep transition. In trauma whereby there is bleeding, there is increased intracranial pressure shifting the brain and damaging the reticular formation of the brainstem.
Low oxygen level in the blood and blood sugar level are another cause of coma. The medical term for a low oxygen level in the body is hypoxia. The brain uses 20% of the total body oxygen making it the single most oxygen consuming organ of the body. This level is required to keep a person conscious, however, in events such as drowning, fire outbreak, carbon monoxide posing among other oxygen depriving incidents, a person goes into a state of coma. After cardiopulmonary resuscitation to save the lives of patient, they are often in a state of coma because the heart was unable to supply the brain oxygen.
Increased or decreased blood sugar can lead to coma as well. This depicts that a diabetic patient is more prone to having a coma. Infections and toxins can also lead to coma.However, coma can be temporary or even permanent. In some medical procedures, the state of coma is induced in patients.
Treatments given to a comatose patient depends on the primary cause and its severity. Coma resulting from imbalanced blood sugar is treated either by lowering or increasing the blood sugar until it reaches the normal homeostatic level. Coma result from intracranial pressure is treated by lowering the intracranial pressure. However, effectiveness depend on how much damage has been done to the brain tissues and how fast the body heals. The best treatment for comatose patients is however unknown.
When patients are in a state of coma, they still need to be cleaned, dressed and changed. Being in a state of coma does not stop the body from craving nutrients and energy. They still have to pass out waste product of metabolism and as well defecate. All care and personal treatment is done by the hospital nurses. A catheter is passed into the patient for collection of urine and a diaper for collection of solid waste. Food substances and metabolites are passed to the patient intravenously since they can not eat solid food.
Further reading:
Coma: Concise note
Coma: Full note
Coma: How it works!
