Causes, signs and symptoms of coma, diagnosis and treatment
Coma called Ostrobothnian a condition characterized by loss of consciousness in humans, inhibition of the Central nervous system, disorder of the respiratory system and the cardiovascular system. Sometimes the term coma describes a degree of lowering of the functions of the Central nervous system, resulting in may start brain death. For brain death is not only a complete lack of consciousness, but also absence of reflexes, the disruption of all vital need of organs.
Causes of coma
The main reasons for the development of coma can be:
· Metabolic disorders in endocrine diseases, the excess or deficiency of hormones in the body, the use of certain hormonal drugs;
· Various intoxication in diseases of the liver, kidney, infectious diseases, poisoning;
· Lack of intake of oxygen and the development of hypoxia.
All these reasons are some of the most common, they differ in the mechanism of development, changes in the body and nervous system for the diagnosis and emergency care.
Signs of coma
Coma may develop (depending on its type) in a few minutes (immediately), hours (quickly), and then the day (gradually). In the disease there are 4 degrees of severity. These include precoma and four degrees.
· Precoma. Patients show confusion, lethargy, drowsiness. Some patients may develop the opposite, psychomotor agitation. Changes in the activities of the internal organs correspond to the nature of the underlying disease that caused the coma. The reflexes are preserved.
· Coma of the 1st severity. Patients develop significant stun, reaction to stimuli is inhibited. The person can still swallow water, liquid food, to perform simple movements, but contact has already been hampered. Reflexes can be strengthened or weakened depends on the type of coma.
· Coma 2nd degree. Patient contact is not available, there is deep sleep, stupor, rare chaotic motion of the limbs. The breathing is noisy, irregular, abnormal, involuntary defecation and urination. During the inspection there are pathological reflexes, no skin sensitivity, eyes narrowed.
· Coma 3rd degree. There is no consciousness,pain sensitivity, tendon reflexes, pupils dilated, reaction to light is absent. Patients is respiratory depression, blood pressure reduced, there is a decrease in body temperature.
· Coma 4-th degree. There is a deep disturbance of consciousness, absent reflexes, there is atony of the muscles, decrease in body temperature, blood pressure, spontaneous respiration stops and the patient should be immediately transferred to the respirator.
The symptoms of coma
Each type of coma has not only its causes, but also their distinctive features. There are also common manifestations of the disease. First and foremost, it is a violation of consciousness, changes in reflex activity, breathing and cardiovascular system. As already mentioned, has a coma of varying severity, which is determined by the scale of Glasgow. It takes into account all the signs: pain sensitivity, reaction to light of the pupils, eye opening, verbal and motor response, reflex activity. They all have their points, their sum is calculated the degree of comatose state.
Diagnosis of coma
For diagnostic search for the causes of the onset of pathological States carry out the following research:
· Analysis of blood or urine content of the drug;
· Determining the level of alcohol in the blood;
· Clinical analysis of blood and urine;
· Determining the level of glucose in the blood, the content of serum electrolytes, creatinine, urea nitrogen in the blood;
· The analysis on the content of thyroid hormones in the blood;
· Conduct liver function tests;
· Analysis of arterial blood gas;
· If there are neurological symptoms – lumbar puncture, CT scan of the head.
The treatment of coma
In some cases to determine the cause of coma is easy, sometimes it is necessary to conduct a number of tests for diagnosis. All coma patients are treated in intensive care units. Special attention is paid to treatment of the underlying disease that caused a coma.
All the patients try to maintain the normal operation of vital systems and organs, the therapy depends on the severity of the condition. Establish intravenous access, if necessary, connected to the artificialventilation, in addition to treating the underlying disease and the complications that arose in pathological coma.