This is a state of severe unconsciousness. The person is unaware of their surroundings and incapable of voluntary movement. With a persistent vegetative state, someone may progress to wakefulness but with no higher brain function. With persistent vegetative state, there is breathing, circulation, and sleep-wake cycles.
Typically, a coma does not last more than a few days or couple of weeks. 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.
Being comatose is being in a coma, unconscious and unable to communicate, often for long periods of time. A bad illness or unexpected accident or injury — especially to the head — can make you comatose and trapped inside a body that isn't working.
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.
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.
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.
People who do wake up from a coma usually come round gradually. They may be very agitated and confused to begin with. Some people will make a full recovery and be completely unaffected by the coma. Others will have disabilities caused by the damage to their brain.
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.
A coma doesn't usually last longer than several weeks. People who are unconscious for a longer time might transition to a lasting vegetative state, known as a persistent vegetative state, or brain death.
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.
Duration of coma
The longer a patient remains in a coma the poorer his or her chance of recovery and the greater the chance that he or she will enter a vegetative state (table 3). By the third day the chance of making a moderate or good recovery is reduced to only 7%, and by the 14th day is as low as 2%.
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.
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.
A person may appear fine, but will not able to speak or respond to commands. Spontaneous movements may occur, and the eyes may open in response to external stimuli. Individuals may even occasionally grimace, cry, or laugh.
Coma is a state of consciousness that is similar to deep sleep, except no amount of external stimuli (such as sounds or sensations) can prompt the brain to become awake and alert. A person in a coma can't even respond to pain. A wide range of illnesses, conditions and events can cause coma.
'Coma patients can be subdivided into several types,' said Dr Guger. 'People who are genuinely in a coma have no cognitive function and no motor responses – they cannot think and they cannot move. But some people may appear to be in a coma even though they are in fact conscious to some degree.
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.
The length of a medically induced coma varies from person to person, depending on the severity of their condition. "Some patients can recover very quickly, others can take weeks to months," says Dr. Pappadakis. Those expected to be comatose for weeks or months must have surgery called a tracheostomy.
Stage 4: Higher Level of Responsiveness
A patient at this stage may not be fully aware of their limitations. Family and friends might notice some personality changes at this stage as well. The recovery process is different for everyone, and some patients could stay in one stage longer than the other.
While trying to save your life, doctors may induce a coma. A medically induced coma effectively shuts down the patient's brain. As such, this medical course of action is a serious step in the treatment of individuals. Typically, doctors use the tactic to treat those who have suffered a serious traumatic brain injury.
With that said, everyone who goes into a coma has a unique experience. Some have reported remembering certain events that happened while they were in the coma, while many others have reported not remembering experiencing much of anything while unconscious.
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.