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What You Need to Know about Comas
When your loved one is in a coma, it can be hard to accept all the health implications and risks that come with such a prognosis. You may ask: Why did this happen? How long will the coma last? What can I do?
This feeling of desperation is not one that any person wants to go through. No one wants to see their family member or loved one suffer. You need support. You want answers. We at the Brain Injury Law Center understand this and want to help as much as we can.
Alternatively, if you’ve experienced a coma and have seen your quality of life decline, you know firsthand how difficult it is to recover from a brain injury. It’s not only the setback to your health that has caused prolonged suffering, but emotional and financial hardships as well.
A coma is the result of a severe brain injury, but can be categorized into subgroups as listed below. Click on each topic to read more:
- Vegetative State
- Minimally Responsive State
- Akinetic Mutism
- Locked-in Syndrome
- Brain Death
- Treatment in ICU
- Possible Tests and Assessments
- Frequently Asked Questions
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While in a coma, a person can continue to heal and progress through different states of consciousness. However, persons who sustain a severe brain injury and experience coma can make significant improvements, but are often left with permanent physical, cognitive or behavioral impairments. People in a coma:
- May appear to be “asleep” because they cannot be awakened or alerted;
- May not move at all, even to painful stimuli. The person may be unable to produce any voluntary actions or meaningful responses;
- Can show various levels of non-purposeful movements. The person may respond minimally or not at all to stimuli;
- Will not be able to talk to you.
Unfortunately, there is no treatment a physician can use to bring a person out of a coma. Likewise, there is no test to predict when a person will come out of a coma or what a person’s recovery will be like.
“A coma can last days, weeks, months or indefinitely. The length of a coma cannot be accurately predicted or known.”
What should you do? Talk to the person in your regular tone a voice with the assumption that the person can understand what you are saying. Some people who have emerged from a coma report remembering the conversations of others.
The Brain Injury Law Center is your source of information and support when it comes to anything related to brain injuries and the terrible effects they can cause. A brain injury can change someone’s life and the lives of those around them.
If you or a loved has suffered a brain injury that resulted in a coma, discuss your case with a personal injury attorney who can help you understand your legal rights and options. Contact our law firm today for a free case evaluation by calling us toll-free at (877) 537-4340.
A vegetative state (VS) describes a severe brain injury in which arousal in the person is present, but the ability to interact with the environment is not. A person in this state may open their eyes spontaneously or in response to stimulation. General responses to pain exist, such as increased heart rate, increased respiration, or sweating. There is no test to specifically diagnose vegetative state; the diagnosis is made only by repetitive neurobehavioral assessments.
A minimally responsive state (MR) is when a person with a severe traumatic brain injury is no longer in a coma or a vegetative state. A person in this state may demonstrate primitive reflexes and an awareness of environmental stimulation, but an inconsistent ability to follow simple commands.
Akinetic mutism is a neurobehavioral condition that results when pathways in the brain are damaged, which results in minimal amount of body movement, little or no spontaneous speech and infrequent and incomplete ability to follow command. Akinetic mutism is different from a minimally responsive state because the lack of movement and speech with akinetic mutism is not because of neuromuscular disturbance.
Locked-in syndrome is a rare neurological condition in which a person is conscious and able to think, but cannot physically move any part of the body except the eyes. Vertical eye movements and eye blinking can be used to communicate with others and operate environmental controls.
Brain death can result from a very severe injury to the brain. When brain death occurs, the brain shows no sign of functioning. The physician performs a specific formal brain death examination.
Treatment in the Intensive Care Unit (ICU)
After receiving emergency medical treatment, a person suffering from a severe brain injury and coma may be admitted to a hospital’s Intensive Care Unit. The goals in the ICU include achieving medical stability, medical management, and prevention of medical crisis. An explanation of the type of medical equipment frequently used in an ICU is provided below.
Possible medical equipment in the ICU
- A ventilator (also called a respirator)is a machine that helps a person receive oxygen and breathe when unable to breathe on his or her own.
- A tracheotomy (trach)is a tube placed in a person’s windpipe to help them breathe. A trach may be used if a person has a lot of secretions in the lungs that need to be suctioned, or if they are on a ventilator for a long time.
- Intravenous lines (IVs)are tubes placed in a person’s veins to deliver medications and fluids to the person’s body.
- Arterial linesare tubes placed in a person’s arteries to measure blood pressure.
- A person who has sustained a brain injury may be unable to control bladder functions. A Foley catheteris used to collect and monitor a person’s urine output
- A nasogastric tube (NG tube) is used to deliver medication and nutrients directly to a person’s stomach, if a person is unable to swallow due to a brain injury.
- An EKG machine monitors a person’s heart.
- As the brain swells, the skull does not also swell; therefore, the brain has limited room to expand in. Swollen brain tissues can compress, causing further injury or death. An intracranial pressure (ICP) monitoris a device that indicates the amount of pressure in the brain. The device is placed in or on top of the brain through a small hole in the skull.
- A pulse oximeteris a small clamp-like device placed on a person’s finger, toe, or earlobe. The Pulse oximeter measures the amount of oxygen in the blood stream.
- Anti-embolism stockings (TED hose)are worn on the person’s legs to help prevent embolisms (blood clots) from forming and to assist in circulation of blood and fluids in the legs. The stockings are long (up to the thighs) and made of tight elastic material.
- Sequential compression stockings (Kendalls)are worn on the person’s legs to help prevent blood pooling. These are plastic leg wraps operated by a machine to inflate and deflate around the person’s legs.
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Possible Tests and Assessments
As each person is an individual, the tests and assessments selected by the healthcare professionals may differ from person to person. Possible tests and assessments that may be used are described below:
An EEG detects electrical brain abnormalities, such as seizures. Testing involves placing small metal discs, called electrodes, on a person’s scalp.
X-rays are a type of picture taken to check the structural integrity of bones and the lungs. X-rays are also used to evaluate the placement of tubes, such as feeding tubes, in the stomach. To take an x-ray, a camera is focused on the body area to be examined and a picture is taken.
CT or CAT Scan (Computed Tomography Scan)
CT scans are used to view harm to brain structures, the skull, and facial bones. CT scans are a good detector of bleeding, blood clots, swelling or compression in the brain. CT scans take pictures of the brain in layers, so it produces images in the form of slices that make up the brain, like the slices that make up a loaf of bread. Not all types of brain injuries show up on CT scans. To take a CT scan, a camera is focused on the body area to be examined and the pictures are taken.
MRI (Magnetic Resonance Imaging)
A MRI uses an imaging technique to provide a more detailed view of the brain structure than CT scans. A MRI is advantageous for examination of the brain stem and cerebellum structure (deep brain structures), since these views can be limited on a CT scan.
Other types of tests might include:
- Arterial Blood Gas (ABG)
- Electrolytes Angiogram
- Spect Scan
- Neurological Exam
- Glasgow Coma Scale (GCS)
- Rancho Los Amigos Scale
Frequently Asked Questions
What happens in the brain when someone is in a coma?
What can cause a coma?
How long can a coma last?
How long can a person be in a coma and still recover?
Can a person recover from brain damage?
Can a comatose person hear me when I speak to them?
Can a person in a coma respond to commands?
Can a coma cause death?
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The Brain Injury Law Center is a supporter of the Brain Injury Association of America and encourages everyone to become a member of this outstanding organization.
Please contact the Brain Injury Law Center for a FREE case evaluation with a caring and knowledgeable personal injury lawyer who can help you understand your legal rights and options. You should be compensated for your suffering and know someone is standing beside you.