COMA

coma

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 :

  1. Eclampsia,
  2. Renal failure,
  3. Heat hyperpyrexia,
  4. Hypopituitary and hypothyroid coma,
  5. Pulmonary embolism and carbon-oxide narcosis,
  6. Alcohol or opium or barbiturates poisoning.
  7. Coronary thrombosis and stokes Adams syndrome,
  8. Head injury (concussion), C.V.A., Meningitis, encephalitis, cerebral tumour, epilepsy etc.
  9. Diabetic coma,
  10. Hypoglycaemic coma,
  11. 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?

Ans.          Investigations:

  1. General examinations for all the systems, viz. Nervous system, C.V. systems, Respiratory system, Alimentary system, ophthalmoscopic examination etc.
  2. 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.
  3. Full history of the case (from relatives).

Treatment :

  1. Oxygen inhalation if dyspnoca is present.
  2. In case of hyperpyrexia ice sponging should be applied.
  • Treatment of underlying cause.
  1. In case of low B.P. foot end of the bed should be raised.
  2. Maintain nutrition if there is no contra-indication by glucose, horlicks, fruits juice etc.
  3. 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.

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