Coma in adults: symptoms, causes, treatment
Experience 13 year
Doctor of the highest category. Member of the European Respiratory Society and the Russian Respiratory Society
A coma is a life-threatening pathology of consciousness caused by damage to brain tissue. Patients lose any contact with the world around them. Coma can occur due to metabolic (intoxication caused by metabolic products or chemicals) or organic (deformation of brain areas) causes.
The key symptom is unconsciousness, with the patient's pupils unresponsive even to strong stimuli. CT scans, MRI scans and laboratory tests of blood plasma are used to diagnose the condition. The treatment is aimed at combating the cause of the coma.
Symptoms and signs of coma in adults
As it was mentioned above, the main symptom of coma is the absence of any mental activity in the patient. Other symptoms of coma depend on the cause that has caused the damage to the brain structures.
- Body temperature. A coma, which is caused by overheating, is accompanied by an increased body temperature (up to 43 degrees) and dryness of the skin. Intoxication caused by alcoholic drinks and sedatives is associated with hypothermia (temperature up to 34 degrees).
- Respiratory rate. Slow breathing is a sign of a hypothyroid coma (lack of thyroid hormones). Deep breathing is common in patients with pneumonia, brain cancer and renal failure.
- Blood pressure, heartbeat. A decreased heartbeat indicates that a person has fallen into a coma due to an acute illness of the heart muscle. Arterial hypertension is seen in patients who have fallen into a comatose state due to a stroke. Low blood pressure indicates diabetic coma, intoxication with sedatives, heart attack.
- Skin colour. Skin turns a cherry colour if a person has been poisoned by carbon monoxide. Cyanotic fingertips indicate a decreased concentration of oxygen in the blood plasma. Pale skin is typical in patients who have lost a lot of blood.
- Eye contact with the environment. In a mild coma, a patient may make different sounds, suggesting a favourable prognosis. As the coma worsens, the ability to make sounds is gone.
Causes of occurrence
Why do people fall into a coma? The main reasons for this condition in adults are:
- organic factors (stroke, gunshot wound, trauma, brain haemorrhage);
- internal chemical compounds. These are products of metabolism, caused by organ diseases;
- external chemical compounds. The CNS can be poisoned by an overdose of drugs, sedatives, or neurotropics.
The causes mentioned above explain how comas occur. A factor that combines signs of organic and chemical causes is particularly worth highlighting. This is an increase in pressure inside the skull. Such pathology is seen in head injuries and neoplasms in the nervous system.
The main risk factor is alcohol and drug use. An overdose of ethyl alcohol or drugs can put a person into a coma. People with heart, brain or other important organ diseases are also at risk. For example, if someone has diabetes, he or she may suffer from a hypoglycaemic coma.
The most dangerous complication that a coma can lead to is death of the patient. There is also a chance that a person will come out of a coma but will be disabled. The prognosis depends on how badly the brain tissue is damaged and what the pathology is caused by.
When should you see a doctor?
If a person falls into a coma, it is important to see a doctor immediately. First of all, such a patient will need the help of a resuscitator, who will try to get the patient out of a pathological state quickly. If resuscitation measures have no effect, the patient must be treated.
The choice of the specialist who will treat the patient depends on the reason that caused the state of consciousness. You can receive qualified medical help at our clinic. We have specialists who understand how to deal with people who have fallen into a coma. The choice of the doctor who will treat the coma depends on the cause that led to the development of the pathology.
Preparation for a doctor's appointment
No special preparation is needed. You should call an ambulance as soon as possible to take a person into a coma to a hospital.
Diagnosis of coma in adults
The following methods are used to diagnose comas of levels 1, 2, 3.
CT. It is one of the most informative ways of radiological diagnostics. The advantages of this procedure include the following:
- fast scanning;
- it is possible to obtain thinly sliced images (up to 0.1 cm) without increasing the radiation load on the patient;
- increased resolving capacity, which allows obtaining clear images of internal organs.
MRI. It is a modern diagnostic method that allows a doctor to obtain cross-sectional images of soft tissues and organs in different perspectives.
Blood tests. It is performed to establish the concentration of hormones in the blood plasma.
The therapy aims to maintain the patient's vital functions, preventing brain death. The doctor also deals with the underlying problem that caused the abnormality. Medical personnel maintain airway patency and normal blood flow. In the intensive care unit, the patient is connected to an ALV device, if necessary.
The patient is given anti-seizure medication and glucose injections. The patient's body temperature is then normalised. If the person is poisoned, the stomach is flushed.
It is impossible to treat comas at home. Therapy must be conducted in a hospital, since special equipment, medications, and round-the-clock care are needed to maintain the patient's vital functions.
Myths and dangerous treatment misconceptions
From Hollywood movies, people might have the impression that a level 1 coma is a kind of holiday. In movies, a post-coma patient looks refreshed and rested. In reality, however, this is not the case. Many patients never fully recover after waking up from a coma. It is not uncommon for a person to be left disabled for life.
Preventive measures are aimed at the timely treatment of diseases that can lead to a comatose state. If a person has had a stroke, he/she should periodically see a doctor to monitor his/her health condition.
It is also necessary to give up alcohol and drug use. People who suffer from alcoholism and drug addiction are at risk. They are unable to control the amount of alcohol and drugs they take, so they risk being overdosed and falling into a coma.
It is extremely important to look after your health. The recommendations of doctors and other specialists must not be ignored.
If there are any contraindications for engaging in serious sports, they should be avoided. Physical activity is allowed, but it is important to observe the extent of it. In some cases, only light gymnastics, fitness and any other sporting activity with minimal stress is allowed.
Any deviation from the general rules (especially for those who are at risk) can lead to undesirable consequences. It is important not only to keep this in mind, but also to follow all recommendations.
If you have any questions or do not know whether you are allowed to exercise excessively, it is better to consult a specialist.
The best measure against any pathology, regardless of its type or severity, is prophylaxis. Each person's health is in his or her own hands. Doctors and other professionals can only guide you towards the right path.
How to call a resuscitation doctor?
If you decide to apply to our clinic for medical help, call our emergency number - +7 (495) 229-00-03. Our team of specialists will arrive at the indicated address to transport the patient to a medical centre and provide him/her with first aid.
All our specialists are highly qualified and have extensive medical experience. All diagnostic measures are carried out promptly. This is also due to the availability of modern equipment. Our doctors choose the best method of treatment, taking into account the specifics of the disease and the patient's organism.
Our clinic is located at: Moscow, Central Administrative District, 2nd Tverskoy-Yamskoy Lane, 10. The nearest metro station is "Mayakovskaya'' (5 minute walk).
Remember that if a person falls into a coma, he or she needs immediate professional medical help. The slightest delay can lead to death.