Information about your environment is normally passed from the brainstem into the rest of the brain. This feedback allows a person to be aware of and react to the environment. A coma is caused by a breakdown in this system.
Since the patient cannot speak,
the doctor will need to gather information from other sources. The doctor may need to speak to friends, family members, and people who witnessed the accident. This is important to help with diagnosis. The doctor will also need to know about the person’s medical history and any
alcohol use. It is important to provide honest information in order to help with treatment.
The doctor will test reflexes, listen to breathing, and examine the eyes. A physical exam will also be done including tests of the nervous system. In addition, the following tests may be done:
Blood tests—to check blood glucose levels, organ function and screen for infection and toxic substances
Urine test—to test for the presence of drugs
Imaging tests, such as:
—in cases where head and neck trauma may have occurred, a test that uses radiation to take pictures of structures inside the body
—a test that uses magnetic and radio waves to make pictures of the inside of the body, in this case the brain
—a type of x-ray that uses a computer to make pictures of the inside of the head
SPECT or Xenon—enhanced CT scan to test for blood flow and metabolic activity within the brain
Evoked potentials—a test for brain wave activity after stimulation of the sensory nerves (including the auditory nerves) of the body
Clinical findings of comatose patients can be rated according to the Glasgow Coma Scale (GCS). This scale assesses three different functions: eye opening, motor response, and verbal response. Scores can range from 15 to 3. A lower score indicates less responsiveness. Scores are interpreted as follows:
If a specific cause of the coma is suspected, supportive care may also include:
Glucose delivered through IV—in case low blood sugar is causing the coma
Naloxone—if a narcotics overdose is suspected
Thiamine (vitamin B1) may be given with glucose if
or malnutrition is suspected
In some cases, surgery may correct the cause of a coma.
If the coma persists after emergency care, ongoing care may be needed. Once the person is stabilized, treatment will focus on providing nutrition and preventing infections. The care staff will also work to prevent
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
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