The difference between deep coma and shallow coma_The main difference between shallow coma and deep coma

Coma is a relatively serious condition. Generally speaking, patients will experience certain coma symptoms when they have brain lesions or their brains are damaged by impact. There are two types of coma symptoms: deep coma and shallow coma. Different measures should be taken for treatment and care for different comas. So, what are the differences between deep coma and shallow coma?

1. What is a deep coma?

Deep coma is the most serious disorder of consciousness. The pupil is dilated and fixed, the light reaction disappears, the physiological reflexes including tendon reflexes and brainstem reflexes disappear, the muscle tone decreases, and sometimes the pathological reflexes also disappear. Some patients experience decortication or decerebrate seizures.

There are obvious changes in vital signs, irregular breathing, large fluctuations in blood pressure, weak pulse, increased or decreased body temperature, and the person is in a dying state. (Gu Shanzhi)

2. What is a shallow coma?

Shallow coma is seen in various febrile diseases, poisoning, etc. When it develops to a certain extent, delirium tremens and coma will occur. Febrile diseases that are related to the brain include encephalitis, meningitis, rabies, etc.; pneumonia and typhoid fever that cause unconsciousness due to high fever; tetanus that causes unconsciousness after convulsions, etc. Poisoning, severe diabetes, severe liver disease, uremia with renal insufficiency, severe emphysema and pulmonary fibrosis, etc., which cause accumulation of metabolic products in the body and lead to unconsciousness. Poisoning by alcohol, carbon monoxide, hypnotic drugs, and the recent photochemical smog are also causes of confusion. Confusion caused immediately after trauma, but loss of consciousness caused by subdural hematoma after several days or weeks, is easy to misdiagnose, so special attention should be paid. Children suffering from acetonemia with diarrhea and vomiting and toxic bacillary dysentery may develop confusion.

Light coma means that there is a response to strong stimulation, but there may be less unconscious activity, and abdominal wall radiation disappears, but corneal radiation, light reflex, cough reflex, swallowing reflex, and tendon reflex exist. Inhibition is at the cortical level.

3. How to treat coma

1. First aid principles for coma

(1) All patients need to go to the hospital for further diagnosis and treatment, so they should be sent to the hospital as soon as possible. Staying at home or in the community for observation and treatment will be detrimental to the patients (Figure 2).

(2) Keep the patient's airway open, clear any foreign matter in the airway promptly, use an oropharyngeal tube for patients with greater respiratory resistance, or place the patient in a stable lateral position. This can prevent the pharyngeal tissue from falling and blocking the airway, and facilitate the drainage of secretions, preventing aspiration caused by the reflux of digestive tract contents. Therefore, the lateral position is the position that comatose patients must adopt before admission to the hospital.

2. Supportive therapy and symptomatic treatment

Supply oxygen, establish intravenous access, maintain blood pressure and water and electricity balance, provide respiratory support to those with abnormal breathing (mask airbag artificial respiration, endotracheal intubation, respiratory stimulants, etc.), give diazepam-like drugs to those with convulsions, and give dehydration drugs to patients with high intracranial pressure.

3. Treatment of the cause

Take targeted treatment measures based on the primary disease and cause of the coma, such as antibiotic treatment for infection, oxygen supply measures for hypoxic coma, and carbohydrate supplementation measures for hypoglycemia.