Ques. 1 What is Coma?
Ans. It is a state of profound unconsciousness from which the patient cannot be aroused, even by powerful stimuli.
Ques. 2 What are the causes of Coma?
Ans. Causes :
- Renal failure,
- Heat hyperpyrexia,
- Hypopituitary and hypothyroid coma,
- Pulmonary embolism and carbon-oxide narcosis,
- Alcohol or opium or barbiturates poisoning.
- Coronary thrombosis and stokes Adams syndrome,
- Head injury (concussion), C.V.A., Meningitis, encephalitis, cerebral tumour, epilepsy etc.
- Diabetic coma,
- Hypoglycaemic coma,
- Hepatic coma
Ques. 3 What are the clinical features of Coma?
Ans. Clinical Features :
- Absolute flaccidity of the hand and feets.
- Asymmetry of the mouth and lower face which puffs in and out with respiration.
- Unable to swallow fluids.
- Pupils are insensitive to light.
Ques. 4 What are the investigations of Coma?
- General examinations for all the systems, viz. Nervous system, C.V. systems, Respiratory system, Alimentary system, ophthalmoscopic examination etc.
- Laboratory test – (i) blood-T.C., D.C., blood culture, sugar, urea, serum bilirubin S.G.O.T. & S.G.P.T., W.R. for syphilis. (ii) Urine – albumin, sugar, acetone, casts. (iii) C.S.F. – cytological, bacteriological, serological etc.
- Full history of the case (from relatives).
- Oxygen inhalation if dyspnoca is present.
- In case of hyperpyrexia ice sponging should be applied.
- Treatment of underlying cause.
- In case of low B.P. foot end of the bed should be raised.
- Maintain nutrition if there is no contra-indication by glucose, horlicks, fruits juice etc.
- The patient should be kept in a calm and quiet room, in a railed cot.
- Change the posture from time to time.
- Homoeopathic remedies.
(1) CAMPHOR – After injuries or shock the whole surface of body cold and clammy; face pale and bluish, unconsciousness.
(2) OPIUM – Breathing rapid, stertorous ; tubular at long intervals ; eyes fixed unequally; face pale or livid ; injuries of brain, shock and concussion, unconsciousness.