Someone in a coma often needs a feeding tube and some patients are unable to breathe on their own. In these cases, the patient needs a ventilator to keep breathing.
Routine treatment
Keeping them alive requires good basic care (such as turning and changing position to manage skin integrity), a feeding tube, intermittent antibiotics for infections and perhaps some ongoing mechanical ventilation support (such as oxygen at night).
While comas usually only last a few weeks, a vegetative state can continue for months or even years. The longer the person remains in this state, the bleaker their chances of making a recovery.
Because patients who are in a coma can't eat or drink on their own, they receive nutrients and liquids through a vein or feeding tube so that they don't starve or dehydrate. Coma patients may also receive electrolytes -- salt and other substances that help regulate body processes.
Comatose patients do not seem to hear or respond. Speaking may not affect their clinical outcome; time spent with them takes time away from other, more "viable" patients. Comatose patients may, however, hear; many have normal brain-stem auditory evoked responses and normal physiologic responses to auditory stimuli.
Someone in a coma will also have very reduced basic reflexes such as coughing and swallowing. They may be able to breathe on their own, although some people require a machine to help them breathe. Over time, the person may start to gradually regain consciousness and become more aware.
"Pulling the plug" would render the patient unable to breathe, and the heart would stop beating within minutes, he said. But if a patient is not brain dead and instead has suffered a catastrophic neurological brain injury, DiGeorgia said, he or she could breathe spontaneously for one or two days before dying.
Annie Shapiro (1913–2003) was a Canadian apron shop owner who was in a coma for 29 years because of a massive stroke and suddenly awakened in 1992. Apart from the patients in the true story Awakenings, Shapiro was the longest a person has been in a coma like state and woken up.
Use objects with pleasant tactile sensations and different textures such as soft toys, silk scarves or books. Put a bunch of flowers in the person's room or spray their favourite perfume.
In a coma, a patient is alive and there is some brain activity. Depending on the severity of the injury, recovery time varies and comas can be temporary or permanent. Patients in a coma might have brain stem responses, spontaneous breathing and/or non-purposeful motor responses.
Coma patients might feel pleasure and pain like the rest of us.
A coma is similar to a dream-like state because the individual is alive but not conscious. A coma occurs when there is little-to-no brain activity. The patient is unable to respond to touch, sound, and other stimuli. It is also rare for someone in a coma to cough, sneeze, or communicate in any way.
Severe brain injury is usually defined as being a condition where the patient has been in an unconscious state for 6 hours or more, or a post-traumatic amnesia of 24 hours or more. These patients are likely to be hospitalised and receive rehabilitation once the acute phase has passed.
An individual with post-coma unresponsiveness has regained a normal sleep/wake cycle and should be able to open and close their eyes, as well as react to loud noises. While these may appear to be signs of consciousness, they are actually the result of involuntary, autonomic responses.
Usually, coma patients have their eyes closed and cannot see what happens around them. But their ears keep receiving sounds from the environment. In some cases, the brains of coma patients can process sounds, for example the voice of someone speaking to them [2].
Someone in a coma needs intensive care in hospital. They may need help with breathing, they will be fed through a tube and they will receive blood and fluids through a drip inserted into the vein.
Comas may last from a few hours to years. Comas outwardly resemble a state of deep sleep, but are actually quite more complex.
As many as 15 to 20 percent of patients who appear to be in a coma or other unresponsive state show these inner signs of awareness when evaluated with advanced brain-imaging methods or sophisticated monitoring of electrical activity.
Yes, withholding and withdrawing life-sustaining treatment is legal in Australia so long as the law is complied with.
Doctors usually advise stopping life support when there is no hope left for recovery. The organs are no longer able to function on their own. Keeping the treatment going at that point may draw out the process of dying and may also be costly.
UNDERSTANDING COMA
Evidence of wakefulness comes gradually first with a response to painful stimulus. Moaning and groaning and withdrawing a limb are the first responses. Next, the command to blink the eyes is obeyed. Yet, there may still be confusion, agitation, fatigue and even agitation.
Brain death is not the same as coma, because someone in a coma is unconscious but still alive. Brain death occurs when a critically ill patient dies sometime after being placed on life support. This situation can occur after, for example, a heart attack or stroke.
Elaine Esposito (December 3, 1934 – November 25, 1978) held the record for the longest period of time in a coma according to Guinness World Records, having lost consciousness in 1941 and eventually dying in that condition more than 37 years later.
When someone is in a coma, they cannot interact with their environment. The brain is still working, however, and the degree of brain activity varies from patient to patient. New tools for mapping brain activity have helped doctors illuminate what is happening inside the brain, which informs their treatment and care.