Over time, the person may start to gradually regain consciousness and become more aware. Some people will wake up after a few weeks, while others may go into a
To end the coma, doctors begin reducing the medication that placed the patient in the coma in the first place. This allows the patient to wake up gradually. The goal remains to eventually withdraw the medication completely and change the ventilator to a mode that allows the patient to develop breathing on their own.
So, number one, first and foremost, the most important reason why your loved one is not waking up is simply because they have a brain injury, they have a stroke, or they have any other neurological conditions such as seizures, where they also get an anti-seizure medication, which often has a sedative effect.
Medically induced comas typically cause a number of health-adverse side effects. Often, patients temporarily lose the ability to breathe without the assistance of a mechanical ventilator. They usually also require nutritional help.
They cannot speak and their eyes are closed. They look as if they are asleep. However, the brain of a coma patient may continue to work. It might “hear” the sounds in the environment, like the footsteps of someone approaching or the voice of a person speaking.
Most people do come out of a coma
In some rare cases, a person might stay in a coma for several weeks, months or even years. Depending on what caused the person to go into a coma, some patients are able to return to their normal lives after leaving the hospital.
Studies show a very high overall mortality, ranging between 76% and 89%. 5, 6, 7 Of the surviving patients, only very few recover to a good outcome. The majority of the survivors do so with permanent disorders of consciousness or severe disabilities (see Table 1).
Recovery from coma is a gradual process, starting with the person's eyes opening, then responding to pain, and then responding to speech.
Some examples of early responses to watch for are: Localized response: These are appropriate movements by the patient in response to sound, touch, or sight. Turning toward a sound, pulling away from something uncomfortable, or following movement with the eyes are examples.
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.
A natural coma is due to brain injury, stroke, or seizures, whereas doctors induce an artificial coma to prevent brain damage. The time taken for a patient to recover from a natural coma is days to decades, whereas an artificial coma is induced for shorter periods.
The most common drugs used to induce a coma are propofol, pentobarbital, and thiopental. These drugs have a continuous effect on a patient, keeping them in a sustained state of unconsciousness that is necessary for healing to begin.
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.
Medically induced coma, performed on critically ill patients, has been used for a quarter of a century or more to put the brain in a state of temporary hibernation to allow time for the brain to recuperate. One of the greatest hazards associated with brain injury is intracranial hypertension.
The chances of someone recovering from a coma largely depend on the severity and cause of their brain injury, their age and how long they've been in a coma. But it's impossible to accurately predict whether the person will eventually recover, how long the coma will last and whether they'll have any long-term problems.
The majority of people (87 percent) who score a three or a four on the scale within the first 24 hours of going into a coma are likely to either die or remain in a vegetative state. On the other end of the scale, about 87 percent of those who score between 11 and 15 are likely to make a good recovery.
A drug-induced coma, better known as sedation in the medical field, is commonly used in medical, surgical and neurological intensive care units.
Level 4: confused - agitated. As the brain improves, it begins to “wake up” and may have difficulty controlling the level of response to the environment. This is called “agitation.” You will see the patient will have poor memory and be confused most of the day.
For surgery, patients need to be in an induced coma with anesthesia. The deep coma may impair their ability to breath adequately, necessitating the use of temporary mechanical ventilation for the duration of surgery. This is one way to use mechanical ventilation and this use is not necessary for life support.
Roving eye movements are typically slow, horizontal, bilateral conjugate deviations that are normally seen in light sleep. In comatose patients, these presence of these eye movements suggests a supranuclear (i.e., cortical) etiology (e.g., toxic-metabolic or other bilateral hemispheric etiologies).
Coma patients are monitored carefully through the following four stages of recovery before they can determine the full extent of their brain injury and prognosis.
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.
Some patients need to be sedated for hours, days or even weeks. If they are doing well - waking up, are strong enough, and breathing by themselves - then the breathing tube can usually be taken out. Everyone is different so please ask the ICU nurse or doctor how long your loved one is likely to be sedated for.
Nearly every coma patient who reaches the state of post-traumatic amnesia will make a functional recovery. In fact, patients who transition from a coma to a minimally conscious state within 8 weeks are most likely to transition to post-traumatic amnesia and regain higher functions.