Coma and brain death: Difference between revisions
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'''Infective causes of new coma''': | '''Infective causes of new coma''': | ||
*'''[[Septicaemia]]''' | *'''[[Septicaemia]]''' | ||
*'''[[Meningitis]]''' and [[ | *'''[[Meningitis]]''' and [[encephalitis]]. | ||
'''Neurological causes of new coma''': | '''Neurological causes of new coma''': | ||
*'''Trauma''' - [[Head injury]] is a good one for putting you in a coma. | *'''Trauma''' - [[Head injury]] is a good one for putting you in a coma. |
Revision as of 12:02, 10 December 2009
The difference between coma and brain death is that patients can recover from coma. They can't recover from brain death. Kind of like the difference between having a cold, and being Welsh.
New Onset Coma
Medical Emergency - New onset coma is an immediate reason to worry, start crying, and perhaps call a real doctor!
Causes
There are three main categories that cause new onset coma: metabolic, infective and neurological: Metabolic causes of new coma:
- Drug - Alcohol abuse, drug abuse and carbon monoxide poisoning are all good.
- Sugar - Low sugar (hypoglycaemia), or high sugar (ketoacidosis) both cause coma in diabetics.
Infective causes of new coma:
Neurological causes of new coma:
- Trauma - Head injury is a good one for putting you in a coma.
- Tumour - A brain tumour in the wrong place can cause a coma.
- Vascular - A stroke or a haemorrhagic bleed.
Management
Diagnosis
A coma is a deep state of unconciousness. Unlike sleep, they cannot wake up, respond to pain or perform voluntary actions. The most widely recognised way of diagnosing a coma is through the Glasgow Coma Scale:
Motor
- Makes no movements.
- Extension on pain
- Abnormal flexion on pain.
- Withdrawal/flexion on pain.
- Localises painful stimuli.
- Moves on command.
Verbal
- Makes no sounds.
- Makes noises.
- Makes words, but no sense.
- Confused conversation.
- Normal conversation.
Eyes
- Does not open eyes.
- Opens eyes to pain.
- Opens eyes to voice.
- Opens eyes spontaneously.
Score Your score is out of 15.
- <9. Well done! You have a severe coma.
- 9-12. You have a moderate coma. With a little work, you may still make it!
- >13. Sorry, you only have a mild problem. Maybe try another bottle of whisky?