A coma is a state of unconsciousness where a person is unresponsive and cannot be woken. It can result from injury to the brain, such as a severe head injury or stroke. A coma can also be caused by severe alcohol poisoning or a brain infection (encephalitis). People with diabetes could fall into a coma if their blood glucose levels suddenly became very low (hypoglycaemia) or very high (hyperglycaemia). Signs and symptoms of a coma patient: Inability to voluntarily open the eyes A non-existent sleep-wake cycle Lack of response to physical (painful) or verbal stimuli Depressed brainstem reflexes, such as pupils not responding to light Irregular breathing Scores between 3 and 8 on the Glasgow Coma Scale Causes: Traumatic brain injuries. These are often caused by traffic collisions or acts of violence. Stroke.  Tumors. Tumors in the brain or brainstem can cause a coma. Diabetes. Blood sugar levels that become too high (hyperglycemia) or too low (hypoglycemia) can cause a coma. Lack of oxygen. People who have been rescued from drowning or those who have been resuscitated after a heart attack might not awaken due to lack of oxygen to the brain. Infections. Infections such as encephalitis and meningitis cause swelling of the brain, spinal cord or the tissues that surround the brain. Severe cases of these infections can result in brain damage or a coma. Seizures. Ongoing seizures can lead to a coma. Toxins. Exposure to toxins, such as carbon monoxide or lead, can cause brain damage and a coma. Drugs and alcohol. Overdosing on drugs or alcohol can result in a coma. It's a presentation on Coma 2023.

1. COMA
Presented by the students of 10th Batch : Roll 1076 - 10100
IBN SINA Nursing Institute
1/1 – B, Kallayanpur, Dhaka - 1216
A presentation on

2. Definition of Coma
A coma is a state of unconsciousness where a
person is unresponsive and cannot be woken.
• It can result from injury to the brain, such as a severe
head injury or stroke. A coma can also be caused by
severe alcohol poisoning or a brain infection
(encephalitis).
• People with diabetes could fall into a coma if their
blood glucose levels suddenly became very low
(hypoglycaemia) or very high (hyperglycaemia).

3. Signs and symptoms of a coma patient:
 Inability to voluntarily open the eyes
 A non-existent sleep-wake cycle
 Lack of response to physical (painful) or verbal stimuli
 Depressed brainstem reflexes, such as pupils not
responding to light
 Irregular breathing
 Scores between 3 and 8 on the Glasgow Coma Scale

4. Causes:
Traumatic brain injuries. These are often caused by traffic collisions or acts of violence.
Stroke.
Tumors. Tumors in the brain or brainstem can cause a coma.
Diabetes. Blood sugar levels that become too high (hyperglycemia) or too low (hypoglycemia)
can cause a coma.
Lack of oxygen. People who have been rescued from drowning or those who have been
resuscitated after a heart attack might not awaken due to lack of oxygen to the brain.
Infections. Infections such as encephalitis and meningitis cause swelling of the brain, spinal
cord or the tissues that surround the brain. Severe cases of these infections can result in brain
damage or a coma.
Seizures. Ongoing seizures can lead to a coma.
Toxins. Exposure to toxins, such as carbon monoxide or lead, can cause brain damage and a
coma.
Drugs and alcohol. Overdosing on drugs or alcohol can result in a coma.

5. Diagnosis
• Perform a general examination and medical history check
• Make sure the patient is in an actual comatose state
• Assess the severity of the coma with the Glasgow Coma
Scale
• Check for levels of serum glucose, calcium, sodium,
potassium, magnesium, phosphate, urea, and creatinine
• Perform brain scans to observe any abnormal brain
functioning using either CT or MRI scans
• Continue to monitor brain waves and identify seizures of
patient using EEGs

6. GCS:
The Glasgow Coma Scale (GCS) is a clinical scale used to
reliably measure a person's level of consciousness after a brain
injury.
The Glasgow Coma Scale is used for people above the age of
two and composed of three tests: eye, verbal,
and motor responses. The scores for each of these tests are
indicated in the table below.

7. SCORING:

8. Pediatric scoring:
Children below the age of
two struggle with the tests
necessary for assessment of
the Glasgow Coma Scale.
As a result, a version for
children has been
developed.
Reference:
Wikipedia

9. Treatment:
Treatment for people in a coma will depend on the severity and cause
of the comatose state.
 Upon admittance to an emergency department, coma patients will
usually be placed in an Intensive Care Unit (ICU)
immediately, where maintenance of the patient's respiration and
circulation become a first priority.
 Stability of their respiration and circulation is sustained through the
use of intubation, ventilation, administration of intravenous fluids or
blood and other supportive care as needed.

10. Recovering from a coma:
A coma usually only lasts a few weeks, during which time the person may start to
gradually wake up and gain consciousness, or progress into a different state of
unconsciousness called a vegetative state or minimally conscious state:
 a vegetative state – where a person is awake but shows no signs of being aware of
their surroundings or themselves
 a minimally conscious state – where a person has limited awareness that comes
and goes
Some people may recover from these states gradually, while others may not improve
for years

11. Complications
Some people who recover from a coma
end up with major or minor disabilities.
Complications can develop during a
coma, including –
• pressure sores,
• urinary tract infections,
• blood clots in the legs and other
problems.

12. Conclusion:
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. They may
need physiotherapy, occupational therapy and psychological assessment and support
during a period of rehabilitation, and may need care for the rest of their lives.
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.

13. Thanks!
Do you have any questions?