Irreversible processes in the brain, if I'm not mistaken, begin in 1-3 hours. That is, the longer a person stays in a coma, the stronger the brain dies. It is the brain that is responsible for consciousness, and the spinal cord for the unconscious. In other words, after a long time in a coma, the body loses the organ responsible for consciousness. As a result, only the shell remains - physically the arms, legs ... will live, but it will no longer be a person.

A person can be in a coma for a long time, it all depends on the severity of the disease or injury, from several hours, days, months and up to ten years, until he comes to his senses or dies. One American after a car accident was in a coma for 19 years, and a resident of China for 30 years.

Usually they fall into a coma due to a serious illness or from injuries received, especially the brain. I know that you can be in a coma from several days to several years. People who are in a coma rarely survive or become disabled for life, but it all depends on doctors and proper care.

Until he dies, and this, with proper use, can last up to ten years or longer. But usually during this time a person gets cold, bedsores start, sepsis and all ...

It is very scary when a loved one is in a coma.

A person can lie in a coma from several days to several months, and even years.

The duration of being in a coma depends on several different factors.

A person can be in a coma for a completely different amount of time from 3 days to several years.

It is simply impossible to determine how long a person can lie in a coma. A person can be in this state for several days, or several months and years. Even after being in a coma for several years, people can recover and return to normal life.

A person can be in a coma for a very long time. There have been cases for ten or more years. In general, a coma is scary. A person dies only when the brain dies. I had 2 friends in a coma, none of them came out of this state.

Until they are declared brain dead. The more severe the damage to the brain, the more severe and deeper the coma and, accordingly, the less chance of getting out of it.

If during the day the pupil does not react to a beam of light, then the chances are minimal.

And if the pressure dropped below 80 and there was no reaction of the muscles, then the brain died ..

There have been cases where people have been in a coma for years. The record term is 42 years. Eduard Obar was in a coma for so many years, who fell into a coma at the age of 16, and all this time she was looked after first by her mother, and then by her sister. She did not regain consciousness and died.

And there is a case when a person, after 19 years of being in a coma, came to himself. I wrote about it, I won't repeat it. This is also a record.

A person, if he cannot breathe on his own, will be in a coma as long as he is connected to life support devices and until his brain is dead. If he can breathe on his own, can swallow, and is in a more or less stable condition, he will be in a coma until someone cares for him or until he dies from some concomitant disease of an immobile lifestyle, such as pneumonia. . Or until you regain consciousness.

The duration of a person's stay in a coma depends on many different factors. From the reasons that caused the coma, the intensity of treatment, care and others. As a rule, this period can be from several weeks, months and even years.

What do people feel in a coma? Let's take a closer look at this issue.

Coma is such a state of a person when he is completely unconscious, reactions to stimuli are sharply weakened or completely absent, reflexes fade until they disappear completely, breathing is disturbed, the pulse slows down or quickens, etc.

When a person is in a coma, he is between life and death. And this is dangerous because, in addition to loss of consciousness, in a coma, a person’s vital functions of the body are violated. The classification of com will be presented below.

As a rule, this condition is a complication of a certain disease or appears as a result of some pathological event, such as trauma, etc. Nevertheless, the clinical symptoms of coma can be very diverse, depending on the causes of its onset.

To bring a person out of a coma, it is necessary to carry out resuscitation measures for him, which are aimed at maintaining the basic functions of the body in order to prevent brain death.

What people feel in a coma is of interest to many.

This human condition is based on two main mechanisms:

• bilateral damage to the cerebral cortex;
• primary or secondary damage to its trunk, where the reticular formation is located, which maintains the cerebral cortex in good shape and activity.

This is the brain coma.

Brain damage occurs when a person has a stroke or traumatic brain injury. Secondary disorders, as a rule, occur when metabolic processes in the body change, for example, in case of poisoning, diseases of the endocrine system, etc.

In addition, there are cases of a combination of both mechanisms for the occurrence of a coma state, which is observed very often. It is believed that this is the line between life and death.

As a result, the normal transmission of nerve impulses in the human brain becomes impossible, the activity of all structures that switch to an autonomous mode is lost. Thus, the brain temporarily ceases to function and control the processes occurring in the body.

Coma conditions are divided into several varieties depending on various factors and symptoms. The main classifications are those that differ in the causative factor and in the depth of the coma.

Due to the occurrence of coma, it happens:

• with a primary neurological disorder (when it was caused by a certain process in the nervous system);
• with a secondary neurological disorder (when the cause of the onset of coma with the nervous system is in no way connected).

Establishing the cause of this condition is necessary in order to correctly determine the tactics of treating the patient.

From a medical point of view, this is a temporary immersion of the patient in an unconscious state. The activity of the cortex and subcortex of the brain is inhibited and all reflex functions are completely turned off.

Artificial coma is used only in the most extreme cases. That is, when there is no other way to protect the patient's body from irreversible brain changes that threaten his life. This happens with swelling of brain tissues and compression effect on them, as well as with hemorrhage or bleeding, accompanied by severe traumatic brain injury or pathologies of cerebral vessels.

An artificial coma can be replaced by general anesthesia in cases of emergency surgical interventions of a large volume or directly on the brain.

Coma of neurological (primary) genesis

This type of coma happens:

• With traumatic brain injury (traumatic).
• With violations of the cardiovascular system, as well as disorders of cerebral circulation (cerebrovascular coma). This is what happens with a stroke. A person may be in a coma for other reasons.
• As a result of epileptic seizures.
• Coma that arose in the process of an inflammatory disease of the brain or its membrane (meningoencephalitic).
• As a consequence of the tumor process in the brain (hypertensive).

Varieties of this condition are:

• endocrine coma (for example, in diabetes mellitus), thyrotoxic, hypothyroid (with thyroid pathologies), hypocorticoid (acute adrenal insufficiency), hypolituitar (acute deficiency of hormones produced by the pituitary gland);
• toxic coma (during liver or kidney failure, in case of poisoning, an overdose of alcohol or drugs, as well as cholera;
• hypotoxic form (in severe forms of heart failure, as well as anemia, pulmonary obstruction);
• coma that has arisen under the influence of any physical factors (hypothermia, overheating, electric shock, etc.);
• coma, the cause of which is dehydration, or with a deficiency of electrolytes.

Why is coma dangerous? Is it possible to come out of a coma?

According to statistics, the most common cause of a coma is a stroke. In second place on this list is an overdose of narcotic substances, and in third place are the consequences of diabetes.

Classifications of coma according to the depth of depression of consciousness: 1st degree (the so-called "subcortical" coma, mild degree), 2nd degree (anterior-stem, moderate severity), 2nd degree (posterior-stem, deep), 4th degree (outrageous, extremely serious condition).

The transition from one degree of coma to another is sometimes very abrupt, so it is sometimes quite difficult to determine the patient's stage of coma.

This condition is called subcortical coma and is characterized by inhibition of the activity of the cerebral cortex, as well as the subcortical formations of this organ. This type of coma differs from the rest in the following ways:

• feeling as if the patient were in a dream;
• disorientation of a person in time and location;
• lack of awareness of reality, inarticulate speech;
• the disappearance of reactions to painful stimuli;
• increased muscle tone;
• increased deep reflexes;
• inhibition of surface reflexes;
• preservation of the reaction of pupils to light stimuli, strabismus, spontaneity of eye movements;
• saved breath;
• tachycardia (increased heart rate).

At this stage of the cerebral coma, the activity of the subcortical zones begins to slow down, which characterizes this stage with the following conditions:

• the occurrence of tonic convulsions or shudders of some parts of the patient's body;
• complete lack of speech, impossibility of verbal contact with the patient;
• a strong weakening of pain reactions;
• sharp inhibition of both deep and superficial reflexes;
• weak reaction of pupils to light stimuli, their constriction;
• increased body temperature and excessive sweating;
• sudden changes in blood pressure;
• tachycardia;
• violation of respiratory activity (stops in breathing, different depth of breaths).

Pathological processes occur in the medulla oblongata. In this case, the risk to the patient's life is quite large, and the prognosis of recovery from a coma is significantly reduced. What do people in a coma feel? 3 degree is characterized by the following conditions:

What else is a coma? Coming out of a coma does not always happen.

In this state, a person has absolutely no signs of brain activity. And it shows up like this:

• lack of reflexes;
• full expansion of the pupils;
• muscle atony;
• a sharp decrease in body temperature and blood pressure (to zero levels);
• absolute absence of spontaneous breathing.

Grade 4 coma is almost a 100% chance of death.

The coma usually lasts from one to several weeks. However, a huge number of cases are known when this condition lasted much longer - up to several months and even years.

The return of the patient to consciousness is slow. At first, he may recover for only a few minutes or hours, and over time, this time increases. The return of a person to a normal state largely depends on how deep the coma has occurred, as well as on a number of reasons why this condition has arisen.

The consequences of a coma are sometimes very severe. During this condition, brain damage occurs, so some body functions may not be restored in a person. Very often, after a coma, people cannot walk, make movements with their hands, there is a slowdown in speech activity or its complete absence.

After a coma of the first degree, a person, as a rule, quickly comes to his senses, and his body in most cases does not lose its abilities. After a coma of the third degree, the brain is destroyed almost completely. Accordingly, the field of this person no longer has the opportunity to live a full life.

The consequences of coma can also be memory impairment, changes in human behavior (aggressiveness or lethargy), decreased attention and reactions. After suffering a coma, people recover their abilities for a very long time, even in the domestic sphere - self-catering, bathing, changing clothes, etc.

The experiences and sensations of a person who is in a coma have been studied for many years in various countries of the world. However, there are still no reliable facts about this.

Nevertheless, scientists nevertheless made some conclusions, for example, it has been scientifically proven that even those people who are in a state of deep coma experience certain states, and the brain has some activity. Thus, it turned out that the patient in a coma has an internal ability to respond to external stimuli. This fact is due to the fact that special research equipment has recorded special brain waves emitted at the moments when relatives and friends speak to a person. What else do people feel in a coma?

The patient internally reacts to tactile sensations, which can also be confirmed by a rapid heartbeat, a change in the intensity of breathing, or changes in blood pressure. This may confirm that a person experiencing a coma is reacting in a certain way to events occurring in the outside world and responding to them. What people feel in a coma can tell those who successfully came out of it.

Many people who have experienced such a state share their feelings and experiences. Some of them claim that they were in a kind of altered state of consciousness, when they seemed to travel between worlds, could see their dead relatives and even talk to them. Other patients claim that they were conscious, heard the speech of doctors, relatives who were next to them, but could neither move nor in any way confirm their ability to understand everything. A third group of people in a coma could have had a variety of dreams, or they were in a state of unconsciousness, when, after coming out of a coma, they could remember absolutely nothing.

From the ancient Greek "coma" is translated as "deep sleep". While a person is in a state of coma, the nervous system is depressed. This is very dangerous, because this process progresses and failure of vital organs is possible, for example, respiratory activity may stop. Being in a coma, a person stops responding to external stimuli and the world around him, he may have no reflexes.

• Prekom. Being in this state, a person remains conscious, while there is a slight confusion in actions, impaired coordination. The body functions according to the concomitant disease.
• Coma 1 degree. The reaction of the body is very much inhibited even to strong stimuli. It is difficult to find contact with the patient, while he can make simple movements, for example, turn in bed. Reflexes are preserved, but very weakly expressed.
• Coma 2 degrees. The patient is in a deep stage of sleep. Movements are possible, but they are performed spontaneously and in a chaotic manner. The patient does not feel touch, the pupils do not react to light in any way, there is a violation of the respiratory function.
  

  Classifying coma according to the degree of its depth, the following types of such a state can be distinguished:

  In this article, we will take a closer look at the condition of a person who is in a penultimate coma.

  This is a very dangerous condition for human life, in which the body cannot practically function independently. Therefore, how long the unconscious state will last is impossible to predict. It all depends on the body itself, on the degree of brain damage, on the age of the person. Getting out of a coma is quite difficult, usually only about 4% of people are able to overcome this barrier. At the same time, even if the person came to his senses, most likely, he will remain disabled.

  In the case of being in a third-degree coma and regaining consciousness, the recovery process will be very long, especially after such serious complications. As a rule, people learn to speak, sit, read, walk again. The rehabilitation period can take quite a long time: from several months to several years.

  
  

  

  According to studies, if in the first 24 hours after the onset of a coma a person does not feel external stimuli and pain, and the pupils do not react to light in any way, then such a patient will die. However, if at least one reaction is present, then the prognosis is more favorable for recovery. It is worth noting that the health of all organs and the age of the patient, who has a coma of 3 degrees, play a huge role.

  About thirty thousand people a year die as a result of road accidents and three hundred thousand become their victims. Many of them become disabled as a result. One of the most common consequences of an accident is a traumatic brain injury, which often causes a coma.

  If, after an accident, a person’s life requires hardware support, and the patient himself does not have any reflexes and does not respond to pain and other stimuli, a coma of the 3rd degree is diagnosed. The chances of survival after the accident that led to this condition are negligible. The prognosis for such patients is disappointing, but there is still a chance for a return to life. It all depends on the degree of brain injury as a result of an accident.

  If grade 3 coma is diagnosed, the chances of survival depend on the following factors:

  • degree of brain injury.
  • Long-term consequences of TBI.
  • Fracture of the base of the skull.
  • Fracture of the cranial vault.
  • Fracture of the temporal bones.
  • Concussion.
  • Injury to blood vessels.
  • Cerebral edema.

  A stroke is a disruption in the blood supply to the brain. It happens for two reasons. The first is a blockage of blood vessels in the brain, the second is a hemorrhage in the brain.

  One of the consequences of cerebrovascular accident is coma (apoplektiform coma). In case of hemorrhage, a coma of the 3rd degree may occur. The chances of survival after a stroke are directly related to age and the extent of damage. Signs of this condition:

  • Lack of consciousness.
  • Change in complexion (becomes purplish).
  • Loud breathing.
  • Vomit.
  • Problems in swallowing.
  • Slow heart rate.
  • Increase in blood pressure.

  The duration of a coma depends on a number of factors:

  • Coma stage. In the first or second stage, the chances of recovery are very high. With the third or fourth outcome, as a rule, unfavorable.
  • Body condition.
  • The age of the patient.
  • Equipping with the necessary equipment.
  • Patient care.

  This condition has its own distinctive features:

  • Lack of response to pain.
  • Pupils do not react to light stimuli.
  • Lack of swallowing reflex.
  • Lack of muscle tone.
  • Decreased body temperature.
  • Inability to spontaneously breathe.
  • The bowel movements happen uncontrollably.
  • Presence of seizures.

  As a rule, the prognosis for exiting a third-degree coma is unfavorable due to the absence of vital signs.

  A child may fall into a coma in case of a deep disorder of the central nervous system, which is accompanied by loss of consciousness. The following pathological conditions serve as the reason for the development of a coma in a child: renal and hepatic insufficiency, meningoencephalitis, tumor and brain injury, diabetes mellitus, impaired water and electrolyte balance, cerebral hemorrhage, hypoxia during childbirth and hypovolemia.

  Newborns fall into a coma much easier. It is very scary when a coma of the 3rd degree is diagnosed. A child has a higher chance of survival than older people. This is due to the characteristics of the child's body.

  In the case when a coma of the 3rd degree occurs, the chances of survival for the newborn are, but, unfortunately, very small. If the baby manages to get out of a serious condition, severe complications or disability are possible. At the same time, we should not forget about the percentage of children, albeit a small one, who managed to cope with this without any consequences.

  The longer the unconscious state lasts, the more difficult it will be to get out of it and recover. Everyone can have a coma of 3 degrees in different ways. The consequences, as a rule, depend on the degree of damage to the brain, the duration of being unconscious, the causes that led to the coma, the state of health of the organs and age. The younger the body, the higher the chances of a favorable outcome. However, doctors rarely make a prognosis for recovery, since such patients are very difficult.

  Despite the fact that newborns come out of a coma more easily, the consequences can be the most deplorable. Doctors immediately warn relatives how dangerous grade 3 coma is. Of course, there are chances of survival, but at the same time, a person can remain a “plant” and never learn to swallow, blink, sit and walk.

  For an adult, a long stay in a coma is fraught with the development of amnesia, the inability to move and speak, eat and defecate on their own. Rehabilitation after a deep coma can take from a week to several years. At the same time, recovery may not occur, and a person will remain in a vegetative state until the end of his life, when he can only sleep and breathe on his own, while not reacting to what is happening.

  Statistics show that the chance of a full recovery is extremely small, but such events do happen. Most often, a fatal outcome is possible, or in the case of a coma, a severe form of disability is possible.

  The main complication after an experienced coma is a violation of the regulatory functions of the central nervous system. Subsequently, vomiting often occurs, which can enter the respiratory tract, and stagnation of urine, which is fraught with rupture of the bladder. Complications also affect the brain. Coma often leads to respiratory failure, pulmonary edema, and cardiac arrest. Often these complications lead to biological death.

  Modern medicine makes it possible to artificially maintain the vital activity of the body for a long time, but often the question arises of the appropriateness of these measures. Such a dilemma arises for relatives when they are told that the brain cells have died, that is, in fact, the person himself. Often the decision is made to disconnect from artificial life support.

  In 2009, a 17-year-old Daniela Kovacevic from Serbia during childbirth, blood poisoning occurred. She fell into a coma, and her recovery from a coma after 7 years, doctors do not call it anything other than a miracle. After active therapy, the girl can move around (so far with the help of outsiders), hold a pen in her hands. And those who are on duty near the bedside of the sick, who are in a coma, have a hope that the same miracle can happen to their loved ones.

  More than 3 years ago, she was in a coma Maria Konchalovsky, daughter of director Andron Konchalovsky. In October 2013, the Konchalovsky family had a serious accident in France. The director and his wife, Yulia Vysotskaya, escaped with minor bruises thanks to deployed airbags. And the girl, who was not wearing a seat belt, received a severe head injury. Doctors saved the child's life, but warned that the recovery would be long. Alas, their prediction came true. The girl's rehabilitation continues.

  21 years of rehabilitation Colonel General Anatoly Romanov, commander of the combined grouping of federal troops in Chechnya. On October 6, 1995, his car was blown up in a tunnel in Grozny. Romanov was collected literally piece by piece. Thanks to the efforts of doctors, after 18 days, the general opened his eyes and began to respond to light, movement and touch. But the patient is still not aware of what is happening around him. What methods were not used by doctors to “break through” into his mind. For 14 years, the general was treated at the Burdenko hospital. Then he was transferred to the Moscow region hospital of internal troops. But while this strong and courageous man, as the doctors say, is in a state of minimal consciousness.

  Sharon Stone suffered an intracerebral hemorrhage, due to which she was in a coma for 9 days. Stevie Wonder, American blind soul singer, got into a serious car accident and was in a coma for 4 days, after the exit he partially lost his sense of smell. In 2013, he received a severe head injury seven-time Formula 1 champion Michael Schumacher. He remained unconscious for more than six months. Then there was progress in his condition, but rehabilitation continues to this day.

  Until now, only one case is known when the patient managed to return to a full life after a long coma. June 12, 1984 Terry Wallace from Arkansas, pretty drunk, went with a friend to ride. The car went off the cliff. A friend died, Wallace fell into a coma. A month later, he went into a vegetative state, in which he remained for almost 20 years. In 2003, he suddenly uttered two words: "Pepsi-Cola" and "mom." After conducting an MRI study, scientists discovered that the incredible happened: the brain repaired itself, growing new structures to replace the affected ones. For 20 years of immobility, all the muscles atrophied in Wallace and he lost the simplest self-care skills. He also did not remember anything about the accident or the events of the past years. In fact, he had to start life from scratch. However, the example of this man still inspires hope in those who continue the struggle for the return of their loved ones to normal life.

  Mikhail Piradov, Academician of the Russian Academy of Sciences, Director of the Scientific Center for Neurology:

  - From the point of view of pathophysiology, any coma ends no later than 4 weeks after its onset (if the patient has not died). There are options for getting out of a coma: a transition to consciousness, a vegetative state (the patient opens his eyes, breathes on his own, the sleep-wake cycle is restored, consciousness is absent), a state of minimal consciousness. The vegetative state is considered permanent if it lasts (according to various criteria) from 3-6 months to a year. In my long practice, I have not seen a single patient who would come out of a vegetative state without loss. The prognosis for each individual patient depends on many factors, the main of which are the nature and nature of the injuries received. The most favorable prognosis is usually for patients with metabolic (eg, diabetic) coma. If resuscitation care was provided competently and in a timely manner, such patients come out of a coma fairly quickly and often without any loss. However, there have always been, are and will be patients with severe brain damage, which is very difficult to help even with the highest level of resuscitation and rehabilitation. The worst prognosis is in coma due to vascular origin (after a stroke).

  Every day, new patients enter hospitals in different cities. Sometimes the patient has to make a choice in favor of this or that treatment, or refuse it altogether, but what about the one who is in a coma?

  People who are in deep sleep cannot make decisions, and therefore this heavy responsibility falls on the shoulders of their next of kin. To understand what to do in such a situation, you need to know what a coma is, how you can get a person out of it and what are its consequences. We'll talk about this.

  Coma is a severe coma in which man is in a deep sleep. Depending on what degree of coma the patient has, various functions of the body can be slowed down, brain activity is turned off, metabolism is completely stopped or significantly slowed down, the functioning of the nervous system.

  The cause of whom can be: stroke, brain injury, meningitis, epilepsy, encephalitis, hypothermia or overheating of the body.

  Coma is conditionally divided into 5 degrees of severity, namely:

  • 1 degree - precoma. Those affected by this gradually begin to experience general lethargy, a drop in reaction, a feeling of drowsiness, lack of sleep, confusion in the mind. Rarely, but still it happens that everything happens the other way around, in excessive excitement. Reflexes at this stage are preserved, while the work of all internal organs is already inhibited. Sometimes precoma is called nothing more than a state before a coma, and is not referred to as a coma at all.
  • Grade 2 - initial level of severity. They begin to slow down reactions to external stimuli. A person still retains the ability to swallow liquid food and water, he can move his limbs, but only slightly.
  • Grade 3 - medium severity. The patient is already entering a state of deep sleep, contact with him becomes impossible. Only sometimes movements of the limbs can be observed, but rarely they are realized. The skin already has low sensitivity, a person walks under himself.
  • Grade 4 - high severity level. There is a lack of pain, consciousness, tendon reflexes, no reaction to light. Reduced not only body temperature but also the pressure with breathing.
  • 5degree - severe coma. Violation of consciousness becomes deep, reflexes are absent. There is a cessation of breathing and the patient is transferred to the artificial respiration apparatus.

  Only specialists can recognize who. For these purposes, they conduct the following studies:

  • The level of alcohol in the blood is determined to exclude alcohol intoxication, in which consciousness can be turned off for a while.
  • Determine the presence of drugs in the blood to exclude drug syncope.
  • Conduct an electrocardiogram.

  These are only general studies, special ones can be prescribed by doctors if necessary.

  Doctors still cannot answer the question of how long people can be in a coma. The thing is that history knows cases when, after 12 years, people managed to get out of a coma. This is purely individual and one can get out of this state in three days, and someone will spend years of his life in it.

  It is worth saying that doctors often, after several years, advise relatives to make a decision to disconnect a person from devices that support his life. Forecasts are becoming unfavorable, and life support is not cheap, so many agree to this step. But do not forget that a person is still alive, he just cannot live without special help. The longest recorded time a person spent in a coma 37 years.

  The reactions have already been mentioned earlier, depending on the severity, a person may feel touch, or may not feel it. All people who survived who claim that they heard everything that happened around them, but could not understand whether it was a dream or reality.

  Doctors also say that when relatives often communicate with patients in a coma, they begin active activity in the area of ​​\u200b\u200bthe brain responsible for face recognition. Also, active impulses appear in the centers responsible for emotions.

  Someone claims to have met with deceased relatives, all this happens in patients in a state of sleep, in which, as you know, anything can happen.

  Unfortunately, there is no answer to the question of interest to everyone “how to get a loved one out of a coma”, today. All that doctors advise is to talk to a person, hold his hand, let him listen to music, read books. Sometimes some sound or phrase contributes to the fact that a person, grabbing it like a string, comes out of a coma.

  The exit from the coma is gradual. At first, a person can wake up for a couple of minutes, look around and fall back into a dream. An hour or two will pass, and he will wake up again, and this happens several times.

  Coming out of a coma, a person will need a lot of time to adapt. Everything around him seems strange, if he has spent more than a year in this state, he needs time to realize that so much time has passed. You should not expect that a person will immediately get on his feet and begin to live as before. Speech will not be restored immediately.

  At this moment, a person will need the help of loved ones more than ever, everything around him will be alien to him, and he, as if a child, will begin to learn to walk and talk again.

  Due to the fact that a coma is characterized by brain damage, it must be understood that it will take time to restore some functions. For rehabilitation, special developing simulators will be required.

  Memory problems, up to amnesia, can be attributed directly to the consequences. There may be lethargy, absent-mindedness, aggressiveness. Do not be afraid, all this is recoverable, you just need time and patience. A person may have lost everyday skills, so he will need to be taught everything again. It is easy to understand what consequences await those who have spent more than five years in a coma, during this time much has changed around and then a person needs to be introduced to everything around.

  A coma is certainly scary, but if your loved ones got into it, you don’t need to give up, because people get out of it, and after that they begin to live their old life again, albeit not immediately.

  Coma is a phenomenon that is not fully understood by doctors and scientists. A person can be unconscious for several hours or years, apparently not reacting to external stimuli. However, recent studies show that patients still do not completely lose contact with the world.

  By definition, coma is a state characterized by a complete loss of consciousness. A person in a coma has no active movements, the process of breathing and cardiac activity is disturbed. Often, doctors and relatives of the patient are faced with the question of whether to expect a miracle, or the patient should be disconnected from the life support machine and allowed to die. However, a person in a coma can be much more alive than it seems.

  A person lying in a coma, as a rule, relatives and relatives come to visit. They read to him, tell him the latest news and events from their lives. Outwardly, the patient does not react in any way to their presence, but if you connect special equipment, a different picture emerges. For example, German scientists discovered an interesting phenomenon in a young man who fell into a coma after a serious accident and received head injuries as a result. Whenever a girlfriend came to visit an unfortunate motorcyclist, the patient's heart began to beat faster, which was recorded by the equipment. Subsequently, when the young man began to recover, it was the presence of the girl that had a beneficial effect on him and contributed to his recovery.

  Paying attention to the brain lying in a coma, you can also find that he is not at rest. Based on the waveforms, patients respond to the presence of loved ones, as well as what they say to them, according to research conducted at the University of Tübingen in Germany. Every fourth person has this ability. Hugs or touch also affect heart activity and brain activity. The more pronounced such reactions are, the more chances the patient has to get out of the coma.

  Responding to the words of others and external stimuli, as well as experiencing emotions depending on their content, is capable of not only people lying in a coma, but also patients under anesthesia. A curious incident occurred in a German clinic during an operation on a particularly obese patient. While he was unconscious on the operating table, the doctors took the liberty of making a couple of jokes about his extra weight. Waking up from anesthesia, the patient was indignant and upset by the ridicule he heard. For this reason, relatives and medical staff are not recommended to make negative predictions while at the bedside of a person who is unconscious or in a coma.

  How do people feel in a coma?

Coma is a condition that threatens a person's life and is characterized by loss of consciousness, an absent or weakened response to external stimuli, a violation of the frequency and depth of breathing, the extinction of reflexes, a change in pulse, vascular tone, and a violation of temperature regulation.

The development of coma is due to deep inhibition in the cerebral cortex, which extends to the subcortical and lower parts of the central nervous system due to head injuries, acute circulatory disorders in the brain, poisoning, inflammation, hepatitis, diabetes mellitus, uremia.

The goal of treating coma is to eliminate the causes that caused this condition, and to carry out measures aimed at eliminating collapse, oxygen starvation, restoring breathing, and acid-base balance.

Types and causes of coma

By origin, the following types of coma are distinguished:

• neurological coma. Its cause is the depression of the central nervous system in primary brain damage (apoplectic coma in stroke, epileptic coma, traumatic coma, coma caused by brain tumors, coma in meningitis, encephalitis);
• To whom with endocrine diseases. This kind of coma is associated with metabolic disorders with an insufficient level of hormone synthesis (hypothyroid coma, diabetic, hypocorticoid), their excessive production or overdose of drugs based on hormonal agents (thyrotoxic, hypoglycemic);
• Toxic coma. This type of coma is associated with exogenous (coma with poisoning), endogenous (coma with liver or kidney failure) intoxication, toxic infections, pancreatitis, infectious diseases;
• To whom, associated with a violation of gas exchange:
• To whom, due to the loss of electrolytes, energy substances, water by the body.

Certain types of coma cannot be attributed to any group (for example, coma caused by overheating of the body), and some can be attributed simultaneously to several groups (electrolyte coma in liver failure).

Coma symptoms

The rate of development of coma symptoms can be different. Coma may occur:

Suddenly. The patient abruptly loses consciousness, and in the next minutes all the signs of a coma appear: a disorder in the depth and rhythm of breathing, noisy breathing, a drop in blood pressure, disturbances in the pace and rhythm of heart contractions, the work of the pelvic organs;

Fast. The increase in symptoms occurs over several minutes to several hours;

Gradually (slowly). In this case, precoma first develops with an increase in the symptoms of the underlying disease, against which there is a gradual increase in neurological and mental disorders. A change in consciousness can be manifested by lethargy, drowsiness, lethargy, or, conversely, psychomotor agitation, hallucinations, delirium, delirium, twilight, which are gradually replaced by stupor and coma.

There are 4 degrees of coma:

• 1 degree coma. Symptoms of a coma of this severity are characterized by: stupor, sleep, inhibition of reactions; the patient can perform simple movements; its muscle tone is increased, the reaction of the pupils to light is preserved; pendulum-like movements of the eyeballs are sometimes noted; skin reflexes in the patient are sharply weakened;
• 2 degree coma. Characterized by deep sleep, stupor; a sharp weakening of reactions to pain; pathological types of breathing are observed; spontaneous rare movements are chaotic; involuntary defecation and urination may occur; pupils are narrowed, their reaction to light is weakened; corneal and pharyngeal reflexes are preserved, skin reflexes are absent, muscular dystonia, pyramidal reflexes, spastic contractions are observed;
• 3 degree coma. It is characterized by the absence of consciousness, corneal reflexes, reaction to pain; inhibition of pharyngeal reflexes; pupils do not react to light; muscle tone and tendon reflexes are absent; blood pressure is reduced; there are involuntary urination and defecation, arrhythmic breathing, a decrease in body temperature;
• 4 degree of coma (outrageous). It is characterized by complete areflexia, hypothermia, muscle atony, bilateral mydriasis, profound disruption of the medulla oblongata with a sharp decrease in blood pressure and cessation of spontaneous breathing.

The prognosis of coma depends on what causes it was caused and the severity of damage to the brain stem.

Rapid (within 20-30 minutes) recovery of stem and spinal reflexes, spontaneous breathing and patient consciousness determines a favorable coma prognosis. With grade 3 coma, the prognosis for the patient is usually unfavorable; the prognosis for transcendental coma is absolutely unfavorable, since this is a borderline condition, followed by brain death.

Coma treatment

The initial measures in the treatment of coma are: ensuring the patency of the airways and the correction of cardiovascular activity and respiration. Next, the nature of the disease that caused the development of coma is clarified, and appropriate treatment is carried out. If the coma is caused by an overdose of narcotic drugs, then the patient is shown the introduction of naloxone. With purulent meningitis, antibacterial drugs are prescribed, with epilepsy - anticonvulsants. With an unclear diagnosis, it is advisable to administer a dextrose solution.

In addition, symptomatic and pathogenetic treatment of coma is also used. For this use:

• Hyperventilation and osmotic diuretics (with intracranial hypertension);
• Anticoagulants and antiaggregants (in acute cerebral ischemia).

Treatment of common diseases complicated by coma is carried out: diseases of the kidneys and liver, diabetes mellitus. If necessary, prescribe plasmapheresis, detoxification therapy, hemosorption.

When leaving the state of coma, a gradual restoration of the work of the central nervous system occurs, as a rule, in the reverse order: first, the pharyngeal and corneal reflexes are restored, then the pupillary ones, and the severity of vegetative disorders decreases. Consciousness is restored, passing through the stages: confusion and stupor, delirium and hallucinations, motor restlessness.

When the patient's condition stabilizes, the underlying disease is treated, which caused the development of coma, and measures are taken to prevent possible complications.

Thus, coma is a dangerous condition, indicating the presence of certain diseases, injuries, circulatory disorders in the brain, lack of oxygen in the blood; about poisoning, the impact of psychogenic factors, which, if a certain degree is reached, can lead to death.

The prognosis for the development of this condition depends on the cause that caused it, the timeliness and adequacy of the therapeutic measures taken, and the characteristics of the patient's body.

Extensive stroke lesions sometimes provoke a state when the brain does not respond to external stimuli - this is a coma in a stroke. The complication is not very common, and the resulting condition exacerbates the course of the disease, requiring a special rehabilitation program for the patient. How much a person recovers after a stroke attack is affected by the nature of the brain lesion and the characteristics of comatose disorders.

What is stupor and coma

Sopor is a severe coma during a stroke, when, due to severe inhibition of nervous activity, the patient experiences deviations in the work of vital systems:

• breathing becomes uneven;
• pupils are constricted, there is no reaction to light;
• swallowing is disturbed (the patient chokes on water or food).

Sopor is one stage of coma. If doctors say that a stroke patient is in a soporous state, it means that important body functions are impaired and the prognosis may turn out to be unfavorable.

Why does a person fall into a coma

With stroke, edema and necrosis of cerebral structures develop. Coma after a stroke is a protective mechanism that reduces the load on damaged brain structures.

Coma is caused by:

• hemorrhage in the brain;
• stem stroke.

In the ischemic form, a coma develops if an extensive stroke occurs and the departments responsible for the regulation of important centers are affected.

The pathogenesis of the development of the condition can be briefly described as a violation of the neural connection of brain cells responsible for the receipt and analysis of impulses coming from the external environment. People lose consciousness, reflex reactions slow down or completely disappear. The risk of developing a coma increases after a second stroke.

Signs of a coma in a stroke

Symptoms increase gradually, and the signs of coma in stroke will depend on the stage of the pathological process. To diagnose the disorders that have arisen, neurologists and resuscitators recommend conducting a simple test, during which the degree of stroke complications is assessed by checking the patient:

• the presence of paralysis;
• speech disorders;
• lack of ability to assess what is happening;
• memory impairment (complete or partial);
• confusion.

If in ischemic stroke the symptoms progress gradually, then hemorrhagic coma occurs within a few minutes. With a hemorrhagic lesion, the victim almost immediately loses consciousness and suppresses protective reflexes.

Coma stages

The prognosis of treatment depends on the degree of coma in stroke. A person with precoma or stage 1 comatose disorders has a better prognosis than when a deep cerebral coma is detected.

It's important to know!

With the timely provision of medical care, the coma process can be stopped and the severity of possible consequences reduced.

Precoma

The main characteristic of the resulting state: deep stun. In doing so, the person:

• excited or depressed;
• unable to answer questions;
• cannot understand what is said to him.

Often, the state of stunning provokes the appearance of hallucinations and psychopathic delusions.

Reflexes and motor functions are preserved, but the victim feels severe weakness. If help is not provided to the patient, then a coma occurs.

1 degree

The patient falls into a state of stupor and on examination it is noted:

• slow reaction to external stimuli;
• moderate muscle hypertonicity;
• "floating" look;
• decreased pain sensitivity.

A patient with a grade 1 coma retains water or liquid food, can move independently, but is unable to communicate and does not understand speech.

The prognosis for the first degree depends on the duration of the comatose process. If the patient was unconscious for a short time and the therapy was carried out in a timely manner, then there is a chance to avoid serious consequences.

2 degree

Sopor or coma of the 2nd degree causes more severe consequences:

• lack of consciousness;
• uncontrolled chaotic movements;
• constriction of the pupils and a weak reaction to light;
• respiratory failure (becomes deep and noisy);
• the appearance of convulsive twitches (muscles tense and relax uncontrollably);
• weakening of the sphincters, accompanied by involuntary defecation and urination.

The prognosis of the second degree depends on the nature of the brain lesion. Ischemic stroke has fewer consequences and, with timely assistance, recovery is possible, but the chances of a full recovery are reduced.

Hemorrhagic stroke is more dangerous and the symptoms progress rapidly. Some people who fall into a coma after a hemorrhagic stroke die in the first hours, and the survivors almost always remain disabled.

3 degree

The third stage or deep coma is characterized by the development of severe disorders:

• no consciousness;
• all reflexes are absent;
• pupils are constricted;
• atony (possible convulsions with loss of breath for a short time);
• decrease in blood pressure;
• frequent shallow breathing;
• loss of control over natural excretions (patients urinate and walk on a large "under themselves").

Grade 3 coma often occurs with hemorrhagic stroke with extensive hemorrhage.

At the third degree, the prognosis is unfavorable and the consequences of brain disorders are almost irreversible.

4 degree

There is no prognosis for survival - a coma of the 4th degree causes the death of the cerebral cortex. The patient does not have:

• independent breathing;
• pupil reaction;
• protective reflexes;
• muscle tone.

There is no pulse on large vessels, pressure is not determined. It is possible to save a patient's life only when connected to a life support apparatus.

Introduction to artificial coma

The message that a medical coma has been carried out often frightens the patient's relatives. But an artificial coma during a stroke is necessary to reduce the load on the brain tissue and provide:

• connecting processes of surviving brain cells to each other to create new neural chains;
• redistribution of brain functions (surviving structures begin the work of dead cells).

Relatives of a stroke patient are explained in detail: why they are introduced into an artificial coma and tell what consequences an artificially induced coma process can prevent:

• after a stroke with hemorrhage, the pressure of hematomas decreases and the risk of re-hemorrhage decreases;
• during an ischemic attack, it is possible to achieve a redistribution of cerebral blood flow and reduce the focus of necrosis.

While the patient is unconscious and does not respond to stimuli, the brain recovers faster after an attack.

How many days the artificially induced condition lasts, doctors decide individually, assessing the recovery processes using CT and monitoring the patient's vital functions. Sometimes the treatment takes several weeks, which the person spends in intensive care, under the supervision of staff.

The duration of recovery from drug-induced coma sleep depends on the action of drugs. After the drugs have ceased to be administered, the reaction to external stimuli gradually returns, consciousness appears and the ability to consciously move.

What does a person in a coma feel like?

Under the influence of television, where survivors told someone about their visions and that they heard all the conversations in the room, relatives of a stroke patient are interested in whether a person hears and what he sees while in an unconscious state. But these are only myths, in fact, a person is in a coma after a stroke:

• unable to focus, and therefore see;
• cannot hear noises and cannot hear.

In short, what a person feels in a coma is the natural urge to urinate and defecate, irritation from cold or excessive heat, and a weak reaction to pain (if reflexes are preserved). Patients do not experience other sensations.

Coma care

Unconscious people need to be fed and hygienic. If a person breathes on his own, then hygiene procedures are limited to washing and preventing bedsores.

In the absence of spontaneous breathing, artificial ventilation of the lungs is indicated. If mechanical ventilation is performed for a stroke, then it is necessary to sanitize the breathing tube to remove accumulated mucus. This will help reduce the risk of developing congestive pneumonia.

Nutrition

If a person falls into a coma, then he cannot eat on his own. How people in a coma are fed depends on the duration of the coma process:

• the first few days a person is given intravenous infusions of nutrient solutions;
• if there is no improvement and the patient cannot swallow food on his own, then the patient is fed through a gastric tube.

If feeding is carried out using a probe, then baby food, liquid fruit and vegetable purees, broths are used.

Hygiene

To prevent the formation of bedsores and other complications, daily the patient needs:

• wash the body with water and hypoallergenic soap;
• clear the oral cavity of mucus;
• comb your hair.

Shampooing is done at least once a week.

To prevent bedsores, it is often necessary to change the position of the patient in bed and place rollers or pillows under places subject to pressure.

Treatment

Therapy is selected taking into account the nature of brain lesions. To stabilize the condition, patients are prescribed:

• blood-thinning drugs;
• means for improving cerebral blood flow;
• drugs that strengthen blood vessels.

Additionally, drugs to lower cholesterol or antihypertensive drugs may be prescribed.

If an extensive cerebral hemorrhage occurs, then the hematoma is surgically removed, and then the medications necessary for treatment are selected.

How long can a coma last

How many people can be in a coma? The duration is influenced by the severity of cerebral disorders and the ability of the body of a stroke patient to recover.

With a hemorrhagic stroke, if a person breathes on the apparatus, a coma continues for years. A vegetative state develops when people live in a coma due to life support and force-feeding.

In ischemic stroke, the duration of coma usually ranges from several hours to several days. How long the coma lasts depends on:

• Age. In the elderly, the recovery of brain functions is slower, so the coma lasts longer in an old person.
• The nature of the lesion. Hemorrhage in the brain gives more severe consequences and patients with hemorrhage lie in a coma for a longer time than those who have suffered an ischemic attack.
• General health. If a person previously had diabetes, beriberi, endocrine diseases and other serious pathologies, then with a stroke, the patient's condition is more severe.

How long a patient can lie in a coma, doctors cannot predict due to the fact that the ability to recover in each patient is individual. But the longer the coma lasts, the greater the chance of serious complications and the higher the risk of death.

Consequences of a coma

If a coma occurs after a stroke, the chances of survival depend, first of all, on the stage of the coma process:

• Coma 1 degree. If it does not last long (up to 5 days), then a person has the opportunity not only to survive, but also to almost completely get rid of the violations that have arisen. A longer comatose process increases the likelihood of disability.
• Coma 2 degrees. Sopor causes more severe consequences, but, with timely medical attention, the chances of survival are high, although full recovery is almost never found. These people are going to be disabled.
• Coma 3 degrees. The prognosis is severe: patients rarely come to their senses. Most lead a vegetative existence.
• Coma 4 degrees. The brain is dead. Artificial ventilation is required to sustain life. This condition provokes a massive stroke with cerebral hemorrhage and, without the support of medical equipment, the person dies shortly after the attack.

Other factors also influence the nature of the consequences:

• The nature of the attack. With an ischemic stroke, the survival prognosis is higher than when a hemorrhagic stroke occurs.
• The frequency of strokes. After the second stroke, pathological changes in the brain are more severe.

Young people, even with a deep stroke, are more likely to survive than those in the elderly and senile age.

Consequences for the elderly

In coma after a stroke in the elderly, the prognosis is more difficult:

• hemorrhagic stroke of the brain often ends in death;
• after an ischemic stroke, even if the coma was short-lived, the consequences for the elderly will be severe (I or II disability group and dependence on the care of third parties).

If the patient has experienced a massive stroke and was able to get out of a coma, then the following complications are often noted:

• tactile disorders;
• vision problems;
• the appearance of abnormal reflexes;
• restriction of mobility;
• psychical deviations;
• speech disorders;
• memory loss;
• impossibility of self-service.

A deep coma at 80 almost always ends in death or a vegetative existence, and the chances of survival in the elderly at 90 are minimal.

But these are just general statistics. Some ninety-year-olds who had suffered hemorrhage, were in a coma for 10 days or longer, were able not only to recover, but also partially restore their lost skills. Cases of recovery are single, more often the prognosis is severe.

Risk of death

The likelihood of developing a severe coma ending in death is increased by:

• repeated stroke;
• hemorrhagic apoplexy;
• extensive ischemic stroke in the brain stem;
• elderly age;
• severe degree of hemorrhagic or ischemic coma;
• coma lasting 7 days or longer.

Often a person dies not from stroke disorders, but from comatose complications, when bedsores become infected, kidney function is disrupted, or congestion develops in the respiratory tract.

How to get out of a coma

In intensive care, they do everything possible to pull a person out of a developed state. But the exit from a coma after a stroke occurs in stages and is sometimes accompanied by temporary mental disorders.

Exit stages:

1. Hearing and sight. The patient's eyes open, the pupils react to light. The ears begin to perceive sounds. These are the initial signs of an exit. If the patient opened his eyes, then the chances of getting a person out of a developed state increase. At this stage, involuntary reflex movements are possible.
2. Swallowing recovery. The appearance of a swallowing reflex increases the chances of a successful withdrawal from a coma. Additionally, people begin to focus their eyes, watching the medical staff moving around the ward.
3. The return of consciousness. The process is reversed from stupor to stupor and then to stun. During this period, short-term symptoms of a mental disorder (fear, agitation, hysteria, hallucinations) may appear. At this stage, the withdrawal from the coma should be carried out carefully.
4. Tactile sensitivity and conscious motor activity are restored.

People, when the severity of the stun decreases, try to communicate with the medical staff. If everything goes well and the stroke patient can be brought out of a coma, then an appropriate rehabilitation program is selected. But the probability of exit after a hemorrhagic stroke is low.

Recovery after a coma

A coma is a trauma for the psyche, so relatives of a stroke patient need to show maximum attention when a person is at home. Doctors recommend:

• Create a comfortable environment that allows the patient to feel that after a stroke he is not a burden. This is an important stage of rehabilitation.
• Learn basic massage skills. To restore muscle function, massage procedures are necessary.
• Follow the rules of nutrition. Food should be easy to digest and provide the human body with the necessary nutrients.

An important factor is attention and praise. Stroke survivors experience their limitations more acutely and rejoice in success. It is important to notice even small progress and encourage a person.

A stroke coma is not a sentence. A person can get out of a coma, and how much he then adapts to life depends not only on medical forecasts, but also on psychological comfort. The attention and care of relatives often helps to rehabilitate even "hopeless" patients.

Coma is a severe pathology that threatens life. The central nervous system is depressed, the person loses consciousness. The operation of critical systems is also disrupted.

The main reason lies in damage to the structure of the brain. It can be due to injury, a fall, hemorrhage (with a stroke) or be the result of a disease, including cancer. So the main reasons are:

1. mechanical damage to the brain (hemorrhage in hemorrhagic or ischemic stroke, trauma, accident, tumor in oncology);
2. infectious diseases;
3. poisoning, drowning, disruption of the glands, etc.

In the treatment of coma, it is important to eliminate the cause that provoked it. Then procedures are carried out that eliminate the collapse. Everything must be done in the shortest possible time. The patient needs to restore the oxygen supply, normalize the acid-base balance. Often the brain in a newborn suffers if the umbilical cord is entangled. A comatose patient is always considered severe. It often takes a long time to deal with the consequences. Many factors influence the prognosis - the severity of the condition, the cause, timely qualified assistance, age, the presence of chronic diseases, etc. Worst of all is the case with stroke, cancer.

If a coma has overtaken a child, it is important not to waste a minute and start treatment. If symptoms of precoma appear, call an ambulance immediately. In children, the condition can deteriorate rapidly. The liver, lungs, heart, kidneys, and, of course, the brain suffer immediately. That's why it's important to watch for warning signs.

The rate of development of coma can be:

• Unexpected. Consciousness is abruptly lost, signs of coma develop (violation of the heart rhythm, breathing, pressure drops).
• Slow. Precoma develops first. Reactions are slow, the person is drowsy or overexcited. At this stage, hallucinations, delusions can be observed. Signs of the underlying disease gradually increase. Over time, all the functions of the central nervous system are upset.
• Fast. Symptoms develop over a period of minutes to hours.

Stages

Coma proceeds in several stages.

Precoma

This stage precedes the immediate onset of coma. Its length varies from 5 minutes to 1-2 hours. At this time, the patient's consciousness is confused. Lethargy and stupor are periodically replaced by unhealthy excitement. Reflexes are still preserved, but coordination of movements is disturbed. Severe condition. Its severity depends on the cause. A relatively mild condition can quickly turn into a serious one.

1 degree

Its main causes are a hormonal crisis, intoxication, shock, inflammation of the brain, problems with metabolism. In a coma of the first degree, the reaction is clearly inhibited. While a person is aware of his actions, he feels pain. It is difficult to establish contact with the patient. Muscles are in good shape. The patient has difficulty swallowing. Mostly he drinks. Can eat something liquid. Pupils continue to respond to light. If a coma of 1 degree has begun, the chances of survival are high.

If the liver fails, the body can be poisoned by its own waste products. From the intestines, poisons enter the circulatory system. The body is quickly poisoned, the central nervous system suffers. Hepatic encephalopathy begins.

Before a coma, vomiting is often observed. This is a signal that the body is trying to get rid of the poisons that began to poison it.

2 degree

In the second degree, stupor is observed, contact is lost. Impaired response to stimuli. Sometimes the patient may make chaotic movements. The muscles then relax, then tense up again. There is a serious violation of breathing. Intestines, bladder can be involuntarily emptied. The chances of survival are quite high. It is often possible to achieve a complete recovery. The exit from the stupor will be gradual. Its duration depends on the general condition of the patient and the timeliness of the assistance provided by doctors.

This type of coma often occurs with severe alcohol poisoning.

When a grade 2 coma develops, the chances of survival depend on timely medical attention and quality care. You can't give up. The scenario may develop positively for the patient. It is important to quickly restore spinal and stem reactions, restore breathing, and regain consciousness.

3 degree

If a person is in a grade 3 coma, the chances of survival depend on comprehensive medical treatment and the general condition of the body. The patient is unconscious. Reactions are completely absent. Pupils constrict. Seizures may develop. Decreased body temperature and blood pressure. Breathing loses rhythm. We need to stabilize the situation. If a coma of the 3rd degree has begun, the chances that a person will come out of it are not so high. There is a possibility of mortality. Young and middle-aged adults are more likely to survive.

The development scenario of the third stage is often unfavorable. The medulla oblongata is severely affected. This is extremely life-threatening.

The following symptoms signal the danger of death:

• the patient does not move the limbs, does not respond to the injection;
• muscles are inactive;
• the pressure is reduced;
• shallow breathing;
• pupils are dilated, do not react to light in any way;
• convulsions are observed.

Doctors consider the third degree the most mysterious. It is her symptoms that are very similar to the signs of death. However, some patients have come out of it. At the same time, they describe their state as a dream in which there are no dreams. The body at the same time throws all its resources into recovery, the survival program is turned on.

It is those patients who have come out of the third degree who tell conflicting stories about the journey to God in empty space. At the same time, they heard voices, but did not perceive them.

In order for the victim to survive, resuscitation should begin immediately. It is important to restore circulation as soon as possible. This is how the maximum number of brain cells will survive.

4 degree

At the fourth stage there are no reflexes. The temperature and pressure drop sharply. This has a general effect on the state. It is supported with the help of IVL.

Coma 4 degrees - a terminal state.

How to get out of a coma

To bring the patient out of a coma, urgent treatment, resuscitation is necessary. Its goal is to restore the functioning of the brain, central nervous system, and stimulate reflexes. It is important that the doctor prescribes therapy as soon as possible. It depends on whether a person survives. With proper treatment and favorable development, consciousness gradually returns to the patient. At first, delirium, hallucinations, anxiety, chaotic movements, and impaired coordination may be observed. Consciousness can be periodically disturbed. Convulsions worry.

Kinds

Who can not be considered a disease. This is the result of serious pathological changes. Brain tissues suffer from them, the work of the central nervous system is disrupted. The type of coma directly depends on the disease or mechanical damage that caused it. The less damage, the higher the chance to survive.

Coma diabetic

The reason for its development is the advanced stage of diabetes mellitus. Coma can be hypoglycemic or hyperglycemic. At first, the glucose level goes off scale. The first sign of impending danger is the sharp smell of acetone from the patient's mouth. It is important to quickly establish a diagnosis and bring the patient out of a coma.

Coma hypoglycemic

It also develops in diabetes. Its cause, on the contrary, lies in a sharp decrease in blood glucose (less than 2 mmol / l). In the precoma stage, there is a strong hunger. Characteristic is that the patient experiences irresistible hunger, regardless of when he last ate.

Coma traumatic

The reason is a head injury, a bruise during an accident, a fall, a fight, etc. In this case, the skull and brain are damaged. A characteristic manifestation is nausea, vomiting. The goal of treatment is to restore the blood supply to the brain, to resume its usual functions.

Coma meningeal

The reason is brain intoxication due to the penetration of meningococcal infection into the body. A lumbar puncture is required. It will help to accurately identify the presence of an infection. In the precoma, this species is characterized by severe headaches. The patient has problems with the simplest physical functions. He cannot raise his leg in a lying position, straighten it. You can test for Kernig's sign. The patient will not be able to bend the leg only in the hip joint. She will involuntarily bend also at the knee.

Another test is for Brudzinsky's symptom. It is necessary to passively tilt the patient's head forward. At the same time, he bends his knees. This movement is involuntary.

Another sign of this coma is that a rash appears on the skin, areas of necrosis are formed, including non-mucous ones. These are the smallest hemorrhages. They can also be observed on the internal organs. This causes them to fail.

Despite the listed groups of tests and symptoms, the final diagnosis is made after a lumbar puncture. If the cerebrospinal fluid is cloudy, with a high protein content, a high number of blood cells, then the test is positive.

Coma cerebral

Occurs when brain tumors form. The underlying disease develops slowly. Clinical symptoms are varied. It all starts with regular headaches. They are often accompanied by vomiting. Over time, it is already difficult for the patient to swallow liquid food. He often chokes. He also drinks with difficulty. These are symptoms of bulbar syndrome. It can take quite a long time. The life and health of the patient is already under threat.

The sooner the doctor prescribes treatment, the higher the chances that the patient will live. Comatosis in tumors can be very deep. Often, intervention by a neurosurgeon is required. Even with a favorable outcome, disability is possible. All sorts of complications from the central nervous system, partial and even complete paralysis are not uncommon.

During this period, it is important to provide the patient with a complete qualified therapy. Otherwise, a coma may develop. The tumor itself can be easily detected using MRI, CT. CSF analysis will show an abnormally high level of protein, leukocytes. It is important to remember that in the presence of a tumor in the region of the posterior cranial fossa, it is strictly forbidden to take a puncture of the cerebrospinal fluid. This can lead to death.

Similar symptoms are observed with a brain abscess. But this species has its own differences. Coma is preceded by inflammatory processes (otitis media, sinusitis, tonsillitis, etc.), fever, and the level of leukocytes increases. It is important that the patient is examined by an infectious disease specialist.

Coma epilepticus

This is a consequence of a severe epileptic seizure. In this case, the patient's pupils will be dilated, the skin becomes pale, most of the reflexes are reduced. A characteristic sign that the coma was the result of epileptic seizures is bites on the tongue. There is also involuntary emptying of the intestines, bladder. The pulse is frequent, the pressure is low. As the condition worsens, the pulse will become thready. Shallow breathing can be replaced by deep breathing and vice versa. Cheyne-Stokes respiration may be observed. It consists in the fact that between periods of deep and shallow breathing there are small pauses when a person stops breathing at all. Then the breath reappears.

When the condition worsens, blood pressure drops as much as possible, reflexes completely disappear. It is extremely important that the patient receives the help of doctors as soon as possible. Otherwise, death occurs.

Coma hungry

The reason for its development is the third degree of dystrophy. It leads to starvation. Often, people who are on a protein diet bring themselves to such a pathological condition. In this case, the body is deficient in protein. Don't underestimate his role! Protein performs essential functions in the body. Its deficiency causes serious disturbances in the work of almost all systems and organs. Including begins a serious inhibition of brain functions.

This pathological condition develops gradually. The first alarm signal to which the patient must respond is a hungry faint. Over time, they become more frequent, as the body experiences an increasing lack of a vital protein. Fainting is accompanied by an increased heartbeat, general weakness, and rapid breathing. When a hungry coma sets in, a person's temperature drops greatly, pressure drops, and convulsions appear. In this case, the intestines and bladder can spontaneously empty.

A blood test will reveal a reduced level of white blood cells, cholesterol, protein, and platelets. The amount of glucose in the blood is greatly reduced.

artificial coma

In severe traumatic injuries and other conditions, the patient may be put into a coma on purpose. This is a medicinal form, artificial.

State Danger

Coma is dangerous because the brain suffers from hypoxia. At the same time, his cells die. The primary task is to restore its blood circulation, restore functions. The patient undergoes detoxification measures. In the uremic form, hemodialysis may be prescribed. With hypoglycemia - glucose.

If intoxication has begun, shock has developed, the brain tissue experiences an energy deficit. The consequences may be as follows:

1. The condition is deteriorating.
2. Mortality sets in.
3. Energy deficiency is growing, oxygen starvation of the central nervous system is increasing, neurons are dying. Even if such a patient survives, the risk of disability is high.

Every day, new patients enter hospitals in different cities. Sometimes the patient has to make a choice in favor of this or that treatment, or refuse it altogether, but what about the one who is in a coma?

People who are in deep sleep cannot make decisions, and therefore this heavy responsibility falls on the shoulders of their next of kin. To understand what to do in such a situation, you need to know what a coma is, how you can get a person out of it and what are its consequences. We'll talk about this.

What is a coma and why can people enter this state?

Coma is a severe coma in which man is in a deep sleep. Depending on what degree of coma the patient has, various functions of the body can be slowed down, brain activity is turned off, metabolism is completely stopped or significantly slowed down, the functioning of the nervous system.

The cause of whom can be: stroke, brain injury, meningitis, epilepsy, encephalitis, hypothermia or overheating of the body.

Are there coma qualifications?

Coma is conditionally divided into 5 degrees of severity, namely:

• 1 degree - precoma. Those affected by this gradually begin to experience general lethargy, a drop in reaction, a feeling of drowsiness, lack of sleep, confusion in the mind. Rarely, but still it happens that everything happens the other way around, in excessive excitement. Reflexes at this stage are preserved, while the work of all internal organs is already inhibited. Sometimes precoma is called nothing more than a state before a coma, and is not referred to as a coma at all.
• Grade 2 - initial level of severity. They begin to slow down reactions to external stimuli. A person still retains the ability to swallow liquid food and water, he can move his limbs, but only slightly.
• Grade 3 - medium severity. The patient is already entering a state of deep sleep, contact with him becomes impossible. Only sometimes movements of the limbs can be observed, but rarely they are realized. The skin already has low sensitivity, a person walks under himself.
• 4 degree - high level of severity. There is a lack of pain, consciousness, tendon reflexes, no reaction to light. Reduced not only body temperature but also the pressure with breathing.
• 5degree - severe coma. Violation of consciousness becomes deep, reflexes are absent. There is a cessation of breathing and the patient is transferred to the artificial respiration apparatus.

By what signs to recognize whom?

Only specialists can recognize who. For these purposes, they conduct the following studies:

• The level of alcohol in the blood is determined to exclude alcohol intoxication, in which consciousness can be turned off for a while.
• Determine the presence of drugs in the blood to exclude drug syncope.
• Conduct an electrocardiogram.

These are only general studies, special ones can be prescribed by doctors if necessary.

How long can a person stay in a coma?

Doctors still cannot answer the question of how long people can be in a coma. The thing is that history knows cases when, after 12 years, people managed to get out of a coma. This is purely individual and one can get out of this state in three days, and someone will spend years of his life in it.

It is worth saying that doctors often, after several years, advise relatives to make a decision to disconnect a person from devices that support his life. Forecasts are becoming unfavorable, and life support is not cheap, so many agree to this step. But do not forget that a person is still alive, he just cannot live without special help. The longest recorded time a person spent in a coma 37 years.

How does a person feel when in a coma?

The reactions have already been mentioned earlier, depending on the severity, a person may feel touch, or may not feel it. All people who survived who claim that they heard everything that happened around them, but could not understand whether it was a dream or reality.

Doctors also say that when relatives often communicate with patients in a coma, they begin active activity in the area of ​​\u200b\u200bthe brain responsible for face recognition. Also, active impulses appear in the centers responsible for emotions.

Someone claims to have met with deceased relatives, all this happens in patients in a state of sleep, in which, as you know, anything can happen.

How can a person be brought out of a coma?

Unfortunately, there is no answer to the question of interest to everyone “how to get a loved one out of a coma”, today. All that doctors advise is to talk to a person, hold his hand, let him listen to music, read books. Sometimes some sound or phrase contributes to the fact that a person, grabbing it like a string, comes out of a coma.

How do they get out of it?

The exit from the coma is gradual. At first, a person can wake up for a couple of minutes, look around and fall back into a dream. An hour or two will pass, and he will wake up again, and this happens several times.

Coming out of a coma, a person will need a lot of time to adapt. Everything around him seems strange, if he has spent more than a year in this state, he needs time to realize that so much time has passed. You should not expect that a person will immediately get on his feet and begin to live as before. Speech will not be restored immediately.

At this moment, a person will need the help of loved ones more than ever, everything around him will be alien to him, and he, as if a child, will begin to learn to walk and talk again.

Are there any consequences?

Due to the fact that a coma is characterized by brain damage, it must be understood that it will take time to restore some functions. For rehabilitation, special developing simulators will be required.

Directly to the consequences can be attributed, up to amnesia. There may be lethargy, absent-mindedness, aggressiveness. Do not be afraid, all this is recoverable, you just need time and patience. A person may have lost everyday skills, so he will need to be taught everything again. It is easy to understand what consequences await those who have spent more than five years in a coma, during this time much has changed around and then a person needs to be introduced to everything around.

A coma is certainly scary, but if your loved ones got into it, you don’t need to give up, because people get out of it, and after that they begin to live their old life again, albeit not immediately.