A coma is a state of deep unconsciousness from which a person cannot be aroused. A person in a coma cannot react to events in his environment.
Normally, information from a person’s surroundings is passed from the brainstem into the cerebrum. This feedback allows a person to be conscious of and react to his environment. When this system breaks down and a person is no longer able to respond, a coma can result.
Age: 5 years or younger, 15-24 years old, and 75 years or older
Traveling in a vehicle at a high rate of speed or at night
Lack of sleep
A previous head injury
Symptoms of a coma include the following:
No response to outside stimuli, such as:
Spontaneous body movements, such as:
Eyes opening and closing
Since the patient cannot speak,
information from friends, family members, and witnesses is important when diagnosing the cause of a coma. The doctor will want to know about the person’s medical history, as well as any
alcohol use. It is important to provide honest information in order to help with treatment.
The doctor will test reflexes, listen to breathing, examine the eyes, and perform neurological and physical exams. In addition, the following tests may be done:
Blood tests—to check blood glucose levels, organ function and screen for infection and toxic substances
Urine test—to test for the presence of drugs
Imaging tests, such as:
—in cases where head and neck trauma may have occurred, a test that uses radiation to take pictures of structures inside the body
—a test that uses magnetic and radio waves to make pictures of the inside of the body, in this case the brain
—a type of x-ray that uses a computer to make pictures of the inside of the head
SPECT or Xenon—enhanced CT scan to test for blood flow and metabolic activity within the brain
Evoked potentials—a test for brain wave activity after stimulation of the sensory nerves of the body
Comas are rated according to the Glasgow Coma Scale (GCS), which assesses three different functions: eye opening, motor response, and verbal response. Scores can range from 15 to 3. A lower score indicates a person is less responsive. Scores are interpreted as follows:
15-13—mild brain injury
12-9—moderate brain injury
8 or less—a severe brain injury
A coma is a medical emergency. Any unconscious person should be taken to the emergency room immediately.
Oxygen and intravenous fluids will be given, and the person’s vital signs monitored closely. He may be put on a
. Doctors will work quickly to determine the cause of the coma, and further treatment will depend on the cause.
Usually, glucose is given by IV in case low blood sugar is causing the coma. Naloxone can also be given by IV if a narcotics overdose is suspected. Thiamine (vitamin B1) may be given with glucose if
or malnutrition is suspected. In some cases, surgery may correct the cause of a coma.
Once the person is stabilized, treatment will focus on providing adequate nutrition and preventing infections and
The following can help decrease your risk of coma:
Wear a seatbelt. Make sure infants and small children are securely fastened in a child safety seat.
Children aged 12 years and under should ride in the back seat of a vehicle.
Wear an appropriate helmet while biking, rollerblading, or playing contact sports.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a