Coma Causes, Symptoms, Types, Complications, and Prevention

Coma: Types, Causes, Treatment & Prognosis

A coma is a medical emergency that requires prompt and proper treatment to prevent complications. With appropriate management, a comatose person can regain consciousness and live life independently, over time.

Therefore, it is crucial to understand the cause, symptoms, and prevention measures of coma to better manage such a critical health urgency. Keep reading to learn the coma definition, its symptoms, causes, treatment, and other relevant details.

What is a Coma?

A coma is a state in which a person is unconscious for a prolonged period and unresponsive to any kind of stimuli, including pain. Comas alter brain chemistry and can damage the brain. They differ from person to person and have different levels of severity.

This is considered a medical emergency. Hence, if you spot someone being unconscious and unresponsive, call for medical help immediately to prevent any kind of complications or untimely death.

What are the Different Types of Coma?

There are various types of comas, which are mentioned in the following:

1. Persistent Vegetative State: In a persistent vegetative state, the person is in a severe state of unconsciousness and unaware of their environment. They may progress to waking up, but no other higher brain function is noticed.
2. Diabetic: Poorly controlled diabetes can lead to ketoacidosis, which may eventually lead to coma, which is a life-threatening condition. This can lead to death if not treated properly.
3. Anoxic Brain Injury: This type of coma occurs when the brain doesn’t receive enough oxygen. There may be several causes behind it, such as choking, drowning, cardiac arrest, etc.
4. Medically Induced: This is a temporary coma used to prevent the brain from swelling after any kind of injury and allow the body to heal properly. A controlled dose of anesthetic medications is given to the patient, suppressing awareness.
5. Toxic-Metabolic Encephalopathy: This coma is caused by brain dysfunction, showing symptoms of confusion or delirium. This condition is usually reversible.

What are the Causes of Coma?

There are several causes that are responsible for a coma, and they include:

• Use of anesthetic medications during surgery and medically-induced comas
• Overuse of medical and non-medical drugs
• Extreme levels of blood sugar, either hyperglycemia or hypoglycemia, can cause diabetes-related coma
• Brain bleeds or intracranial hemorrhage
• Alcohol poisoning or intoxication
• Traumatic brain injuries, concussions and other types of head injuries
• Lack of blood flow to the brain due to a stroke
• Infections such as meningitis, encephalitis or sepsis
• Cerebral hypoxia (Lack of oxygen to the brain)
• Chemical poisoning, such as from carbon monoxide or certain pesticides
• Toxin poisoning
• Diseases causing liver or kidney failure
• Autoimmune disorders such as multiple sclerosis
• Electrolyte imbalances such as hypercalcemia or hyponatremia
• Seizures
• Increased intracranial pressure

Hence, people must stay alert and take care of their underlying medical conditions, if any, in order to reduce the risk of going into a coma.

What are the Symptoms of Coma?

A person is said to be comatose when they show the following coma signs:

• Their eyes are closed
• Irregular breathing
• Unresponsiveness
• No response to pain
• No response of limbs
   

Sometimes, they need to be ventilated, and sometimes they can breathe on their own.

What is the Treatment for Coma?

The first thing performed during the treatment of a coma is to minimize the brain damage as much as possible. The body functions are also supported, as a comatose patient cannot do it.

If the aetiology of the coma is known, then the patient is treated for the underlying medical condition. Sometimes medications are administered, and sometimes a surgery might be required to reduce the intracranial pressure.

Once the patient is stabilized, the other health concerns, such as infections and bed sores, are taken care of. A comatose patient also needs to be nutritionally adequate to speed up the recovery process.

What are the Complications of a Coma?

Even after being in a coma, the body of a comatose person still functions. However, some complications may arise, which include:

• UTI (urinary tract infection)
• Ventilator-associated Pneumonia (VAP)
• Bed sores
• Blood clots
• Muscle atrophy
• Delirium
• Tracheostomy

If a comatose person develops any complication, it dramatically affects their prognosis. For example, a blood clot could end up in a pulmonary embolism, and a bed sore could result in sepsis. Lastly, the coma can turn into a persistent vegetative state or brain death.

What are the Signs of Coming Out of a Coma?

There are 8 stages of a coma recovery process that are described below:

• Stage 1: The first stage is known as ‘No Response’. In this stage, the patient doesn’t respond to any stimuli.
• Stage 2: This is the ‘Generalized Response’ stage. The patient may react to pain or loud noises, but no specific responses.
• Stage 3: The third stage is the ‘Localized Response’ stage. Here, the responses are specific to the stimuli.
• Stage 4:In the ‘Confused-Agitated’ state, the patient may become agitated and frustrated. 
• Stage 5: In the fifth stage, the ‘Confused-Inappropriate’ stage, the patient may try to follow simple commands but cannot execute complex tasks.
• Stage 6:This is the ‘Confused-Appropriate’ stage, in which the patient can perform the activities of daily living but under supervision.
• Stage 7: In the ‘Automatic-Appropriate’ stage, the patient learns new tasks but has difficulty memorizing them.
• Stage 8: This is the ‘Purposeful-Appropriate’ stage, the last stage in which the patient has almost recovered fully and can manage the daily tasks independently.
   

How to Prevent a Coma?

You can prevent or reduce the risk of having a coma by following the tips mentioned below:

• Manage Chronic Diseases: Follow your healthcare provider’s advice on managing underlying chronic diseases to prevent complications in the future, such as coma.
• Consume a Balanced Diet: Many times, comas happen owing to nutritional and electrolyte imbalance. Therefore, it is essential to consume a healthy and balanced diet to rule out these probabilities.
• Wear Safety Gear: Head injuries account for a significant share of coma patients. Hence, people should wear safety equipment properly to protect themselves during an accident.
• Stay Active: Staying active to the optimum level affects your brain in a better way and delays or prevents the chances of leading to a coma.
• Quit Addiction and Substance Abuse: Substance abuse and addiction increase the risk of developing a coma.

A coma can be a severe medical emergency that can happen to anyone due to several health-related factors.