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Overview

Coma: Treatment, Procedure, Cost and Side Effects

What is the treatment?

Coma is also known as blackout, insensibility, knockout, swim, swoon, syncope.

How is the treatment done?

A coma is a prolonged state of unconsciousness. During a coma, a person is unresponsive to his or her environment. The person is alive and looks like he or she is sleeping. However, unlike in a deep sleep, the person cannot be awakened by any stimulation, including pain.Treatment for a coma depends on the cause. People close to the comatose patient should give doctors as much information as possible to help the doctors determine the cause of coma. Prompt medical attention is vital to treat potentially reversible conditions. For example, if there is an infection that's affecting the brain, antibiotics may be needed.

Glucose may be required in the event of a diabetic shock. Surgery may also be necessary to relieve the pressure on the brain due to swelling or to remove a tumor.Certain drugs may also help relieve the swelling. Medication may also be given to stop seizures if necessary.In general, treatment for a coma is supportive. People in comas are looked after in an intensive care unit and may often require full life support until their situation improves.Sometimes the cause of a coma can be completely reversed and the affected person will regain normal function. But if the affected person has suffered severe brain damage, he or she may sustain permanent disabilities or may never regain consciousness. The person may enter a persistent vegetative state or become brain dead.

Who is eligible for the treatment? (When is the treatment done?)

A coma is a serious medical emergency.Health professionals will start by ensuring the immediate survival of the patient and securing their breathing and circulation to maximize the amount of oxygen that reaches the brain.A doctor may administer glucose or antibiotics even before the results of blood tests are ready, in case the patient is in diabetic shock or has a brain infection.Treatment will depend on the underlying cause of the coma, for example, kidney failure, liver disease, diabetes, poisoning, and so on.If there is brain swelling, surgery may be needed to relieve the pressure.A coma is a medical emergency. Doctors will first check the affected person's airway and help maintain breathing (respiration) and circulation. Doctors may give breathing assistance, blood transfusions and other supportive care.

Emergency personnel may administer glucose or antibiotics intravenously, even before blood test results return, in case of diabetic shock or an infection affecting the brain.Treatment varies, depending on the cause of the coma. A procedure or medications to relieve pressure on the brain due to brain swelling may be needed.If the coma is the result of drug overdose, doctors will give medications to treat the condition. If the coma is due to seizures, doctors will administer medications to control seizures.Other treatments may focus on medications or therapies to address an underlying disease, such as diabetes or liver disease.

Who is not eligible for the treatment?

Comas are caused by an injury to the brain. Brain injury can be due to increased pressure, bleeding, loss of oxygen, or buildup of toxins. The injury can be temporary and reversible. It also can be permanent.More than 50% of comas are related to head trauma or disturbances in the brain's circulatory system. Problems that can lead to coma include:Trauma: Head injuries can cause the brain to swell and/or bleed. When the brain swells as a result of trauma, the fluid pushes up against the skull.Bleeding: Bleeding in the layers of the brain may cause coma due to swelling and compression on the injured side of the brain.

Stroke : When there is no blood flow to a major part of the brain stem or loss of blood accompanied with swelling, coma can occur.Blood sugar : In people with diabetes, coma can occur when blood sugar levels stay very high. That's a condition known as hyperglycemia. Hypoglycemia, or blood sugar that's too low, can also lead to a coma. This type of coma is usually reversible once the blood sugar is corrected.

Are there any side effects?

The signs and symptoms of a coma commonly include:Closed eyes, Depressed brainstem reflexes, such as pupils not responding to light,No responses of limbs, except for reflex movements,No response to painful stimuli, except for reflex movements,Irregular breathing.If a person does not face any of the signs then he or she is not in coma.

What are the post-treatment guidelines?

Although many people gradually recover from a coma, others enter a vegetative state or die. Some people who recover from a coma may have major or minor disabilities.Complications may develop during a coma, including pressure sores, bladder infections, blood clots in the legs and other problems During a coma, a person cannot communicate, so diagnosis is through the outward signs.These include: closed eyes, limbs that do not respond or voluntarily move, except for reflex movements, lack of response to painful stimuli, except for reflex movements.

How long these will take to develop, and how long they will continue, depend on the underlying cause.Before entering a coma, a person with worsening hypoglycemia (low blood sugar), or hypercapnia (higher blood CO2 levels), for example, will first experience mild agitation. Without treatment, their ability to think clearly will gradually decrease. Finally, they will lose consciousness.

How long does it take to recover?

In the longer term, healthcare staff will give supportive treatment on a hospital ward. This can involve providing nutrition, trying to prevent infections, moving the person regularly so they don't develop bedsores, and gently exercising their joints to stop them becoming tight.A person in a coma may become restless, or seize and need special care to prevent them from hurting themselves. Medicine may be given to calm such individuals. Patients who are restless may also try to pull on tubes or dressings so soft cloth wrist restraints may be put on. Side rails on the bed should be kept up to prevent the patient from falling.Coma has a wide variety of emotional reactions from the family members of the affected patients, as well as the primary care givers taking care of the patients. Common reactions, such as desperation, anger, frustration, and denial are possible. The focus of the patient care should be on creating an amicable relationship with the family members or dependents of a comatose patient as well as creating a rapport with the medical staff

What is the price of the treatment in India?

The chances of a person's recovery depend on the cause of the coma, whether the problem can be corrected, and the duration of the coma. If the problem can be resolved, the person can often return to his or her original level of functioning. Sometimes, though, if the brain damage is severe, a person may be permanently disabled/never regain consciousness.Comas that result from drug poisonings have a high rate of recovery if prompt medical attention is received. Comas that result from head injuries tend to have a higher rate of recovery than comas related to lack of oxygen.

Are the results of the treatment permanent?

No specific information is available.

What are the alternatives to the treatment?

It can be very difficult to predict recovery when a person is a coma. If the cause of the coma can be successfully treated, the person may eventually awaken with no permanent damage.They are likely to be confused at first, but then they usually remember what happened before the coma, and be able to continue their life. Typically, some rehabilitation therapy is necessary.If brain damage has occurred, long-term impairment may result. If the person awakens, they may need to relearn basic skills, and they may not remember what happened.

Safety: Condition Effectiveness: Medium Timeliness: Medium Relative Risk: Medium Side Effects: Medium Time For Recovery: Medium Price Range:

Popular Health Tips

Suffering From Thyroid? Things You Should Know!

LCPS, BAM&S
Integrated Medicine Specialist, Pune
Suffering From Thyroid? Things You Should Know!

Your thyroid is a small, butterfly-shaped gland situated at the base of the front of your neck, just below your Adam's apple. Hormones produced by the thyroid gland do everything from maintaining your heart rate to regulating your body temperature to controlling your body weight. 

Millions of people worldwide suffer from thyroid dysfunction and several don't know about it. This is primarily because people don't tend to link the common symptoms first with a thyroid disease. Some people suffer from mood swings, trouble with memory, weight gain or fatigue, all of which they look upon individually as a problem and hence not piecing together the puzzle of their real medical condition. Here are a few insights that'll help you cope:

How does the thyroid gland work: About 85% of the hormone produced by our thyroid gland is T4, which is an inactive form of the hormone. After T4 is made, a small amount of is converted into T3, which is the active form of thyroid hormone. T3 is then converted to free T3 or reverse T3. It is the free T3 that forms the base of thyroid functions. 

What is hypothyroidism: Hypothyroidism, or an underactive thyroid, accounts for 90% of all thyroid imbalances. The signs and symptoms of hypothyroidism develop slowly, often over a number of years, which is why it is often missed from regular treatment charts. For instance, fatigue and weight gain are often attributed to stress, lifestyle changes and natural ageing process. But as time goes by, some of the symptoms show a higher level of manifestation like muscle weakness, elevated blood cholesterol, thinning hair, puffy face, hoarse voice and slowed heart rate. 

If left untreated, hypothyroidism may lead to goiter (enlarged thyroid), increased memory problems, low blood pressure, decreased breathing and in extreme cases, unresponsiveness and coma
This disease may also occur in newborns, infants and children. Symptoms include excessive sleepiness, poor muscle tone and constipation. It is important to diagnose and treat it early, as in severe cases it may lead to mental and / or physical retardation. In children and teens, it can result in stunted growth, and delayed puberty.

What is hyperthyroidismIt's the opposite of hypothyroidism, which means in this case the thyroid overproduces hormones. Common symptoms include lack of sleep, weakness, irregular heartbeat, elevated blood pressure and hand tremors. While genetics are partially responsible for it, it is also triggered by autoimmune disorder. Hyperthyroidism can be treated with medication, radioactive iodine (not the first or best choice as it harms white cells too) and surgery. Keeping a focus on your calcium and sodium intake is crucial to curb the disorder.

Treatments: Conventional treatments rely mainly on drugs and surgery. Alternative treatments involve diet and lifestyle changes. Taking multivitamins, going gluten free, getting a good night sleep, and reducing stress is all said to help heal your thyroid gradually. If you wish to discuss any specific problem, you can consult an ayurveda.

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Popular Questions & Answers

Table of Content

What is the treatment?
How is the treatment done?
Who is eligible for the treatment? (When is the treatment done?)
Who is not eligible for the treatment?
Are there any side effects?
What are the post-treatment guidelines?
How long does it take to recover?
What is the price of the treatment in India?
Are the results of the treatment permanent?
What are the alternatives to the treatment?
Play video
Complications of Diabetes
Hello!

I m Dr. Shefali Karkhanis so I m practicing diabetes specialist at Thane, Mumbai.

Today I m going to give you an overview complications of diabetes. We all know the diabetes is basically a high blood sugar cause because of imbalance between the supply of insulin from the body and the demand the body has about the insulin. I m going to talk about complications of diabetes because diabetes is going to affect each and every cell of your body, right from your hair from top of your head to the nail in the bottom of your feet. So problem with diabetes is that all of these complications are generally silent. So you do not feel that there is a problem.

Let the complications will develop with time and it depends upon the duration of diabetes as well as the severity of the diabetes that means the longer that you have diabetes the more is a risk of you developing complications. Similarly, the higher the control of sugar the better is your risk of not developing complications that means if a person is having diabetes for about 10-15 years there is a definitely a risk that he has some of the other forms of complications with him.

But if he is been well controlled for all these ten years the risk reduces exponentially. On the other hand, if the patient is only diagnosed for the last 3-4 years but he has very high sugar or a very high fluctuating sugar he is more likely to develop complications very soon. Complications can be divided into 2 parts.one is acute and one is chronic. Acute complications include 1: very high blood sugar which will lead to acidosis, coma-like conditions and the person has to get hospitalized be on insulin etc. second is low sugar i.e. very low sugar wherein the patients feel he feels dizzy he feels kiddy he has shivers he was sweating he might even land into an unconscious state.

The treatment of these two is very simple. If the sugars are very high take him to a doctor, treat him insulin, and bring down the sugars, correct the acidosis and everything will be fine. If the patient is having low sugar before going to the doctor you can treat it. Just put in some powdered sugar or a paste of powdered sugar inside the mouth and the patient s blood sugar will slowly start increasing and you can he can be transferred to the hospital. The causes of hypoglycemia are one if the patient is taking erratically erratic medications.

If the patient is fasting at times. If the patient the dose is not adequate or he is taking multiple doses at a time or if the patient is just skipped a meal all together in spite of taking the medications. So any of these conditions you can get low sugar and the easiest thing to do is put sugar in the mouth. Do not give water to unconscious patient because it might cause other complications. Come into the long-term complications. Diabetes will affect major organs which get affected are your eyes, your heart your kidney your nerves as well as your blood vessels. In your eyes there is something called as retina. Retina is like the brain of the eye and you will there be small bleeding spots in the retina but the vision is 100% normal so you do not realize there is a spots inside. These aneurysms can be, this microhemorrhages can be diagnosed at an early stage by with an eye doctor and If it is diagnosed it can be treated and brought to normal immediately.

In the second stage these microhemorrhages become larger in size and there is a bleeding inside your eye and that is when you have vision disturbances but by then only oral medications is not going to help you so depending upon the damage you might require injections, lasers other procedures etc. The same thing happens with your heart. Your heart, the blood vessels to your heart gets affected because of diabetes and this will reduce the amount of blood supply to your heart making you more prone to develop heart attacks. In diabetic the heart attacks are many times silent so there might not be a lot of chest pain but there might be wake symptoms like small pain in the back or discomfort or heaviness or you just might feel breathless especially on walking especially on lying down. So all of these things will need to be addressed and you have to undergo a treadmill test regularly to ensure that your heart is fine. The second thing that happens in the heart is pumping capacity comes down so your heart does not pump as well as it used to.

Again this can be diagnosed with a simple noninvasive technique like an echo which can be done by any cardiologist and this will give you better idea about the condition of your heart. The third thing that gets affected is your kidneys. Now kidneys are like filters. So the holes are very very small because of diabetes these pores will start increasing in size and the protein in your body will start leaking into your urine. But there will be no signs no symptoms no problems what so ever. It is very simple again to diagnose it with a simple urine test called microalbumin and if this is positive that means your kidney damages is started and it can be reverted back to normal just with medications. A good control of diabetes as well as the good control of blood pressure will help your kidney a long way to run properly. Bu the time creatinine goes up it means there is extensive damage in both of your kidneys and then it is difficult to bring it back to normal. However it can still be controlled but at the end of the story probably you will end up in dialysis. So you have to start taking care of your kidneys right at the very beginning. The last is the nerves and the blood vessels.

fNow the nerves of your feet are most commonly affected so some people might have feelings like tingling, numbness, loss of sensation. There might be episodes where the chappal slips out and you don t realize it, there might be episodes there is a small little ulcer or a small bite but you know it doesn t pain. Then there can be loss of hair from your lower limb. All of this is a sign of nerves getting damages.

Secondly the blood supply starts getting hampered. So this is more common in patients who smoke or who have tobacco usage. This will lead to development of small ulcers and there is a higher risk of amputations in these patients. Every diabetes must check their sugars monthly, both fasting as well as the postprandial just to ensures that the sugars are well under control and hba1cthat is the average of the last two to three months this test must be performed at least once in six months if not 3 months.

Annually every diabetic patients must undergo a routine test to rule out any complications including their eyes including their heart including their kidneys as well as the blood supply to their feet and the blood supply and the nerve supply to their feet. So all of these tests are essential for every diabetic patients and I cannot stress this enough because diagnosed in the early stages everything can be reversible to a large extent. However the moment you wait for your symptoms to appear it is already too late. Remember diabetes is your life partner, it will not go away and there is no divorcing it so you have to control your sugars well and if you control them then you can lead not only a long life but a very healthy life also.

So please start taking care of your diabetes from today. if you have any other queries you can contact me via Lybrate. Thank you!
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