How to judge whether a coma can be awakened

Coma is a symptom caused by brain disease or trauma. Comatose patients generally lose consciousness. The possibility of a patient waking up varies depending on the degree of coma. For example, for a patient in a mild coma, waking up is a relatively simple matter, but for a patient in a deep coma, the possibility of waking up is relatively small. Here is some information about the symptoms of coma.

1. How to determine whether a comatose patient has begun to wake up or has already woken up?

After treatment, some manifestations of severe impaired consciousness in patients with severe impaired consciousness may undergo reversible changes, which can be used to determine that the patient may show signs of awakening.

(1) Patients in a mild coma respond to general external stimuli, open their eyes when called, speak slurredly, and have spontaneous limb movements.

(2) Patients in moderate coma respond to stimuli such as pain, sound, and light. Strong pain stimuli may cause defensive reflexes, signs of limb positioning, eye movements, and increased sensitivity of corneal reflex and pupil light reflex.

(3) It is very unlikely that patients in a deep coma will wake up. Even if subtle changes begin to appear in nerve reflexes and vital signs (blood pressure, pulse, respiration), it is difficult for them to escape from the coma. In the end, they will remain in a vegetative state for a long time. Some patients die from serious complications caused by deep coma.

2. Treatment measures for comatose patients

Once coma occurs, regardless of the cause, it indicates that the condition is critical and the patient must receive effective on-site first aid as soon as possible.

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.

(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.