Coma

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Treatment

Patients who are unresponsive require immediate treatment in order to avoid serious consequences.

The "Coma Cocktail"
Although the treatment of coma depends on the cause, there are some general treatment rules. If the cause is unknown, what is often called a "coma cocktail" is given to the patient. It's a mixture of thiamin (a vitamin that can help in alcoholic or nutritionally starved patients), glucose (a sugar that can help diabetics who have developed a coma due to low sugar level), and naloxene (a substance that reverses the action of many narcotics and is used to treat overdoses).

Correcting for Electrolyte Imbalance or Toxic Substances
Electrolytes are chemicals like salts, such as sodium and chlorine salts, that are found in the blood and tissues throughout the body and play an essential role in most physiological processes. Depending on what has caused the coma, it may be necessary to correct any electrolyte abnormalities. A renal dialysis, for example, is a process that removes toxins and maintains normal electrolyte balance in the kidneys.

Decreasing Intracranial Pressure
If the coma is related to increased pressure in the brain, there are various things that can be done to reduce it, including hyperventilation, diuretics and surgery. Hyperventilation involves increasing the rate and depth of breathing so that the blood vessels in the brain constrict and the blood flow slows down, which can decrease the brain pressure. Diuretics, also known as fluid pills, can decrease brain pressure by removing excess fluid in the brain. If there is an accumulation of fluid in the ventricles, known as hydrocephalus, surgery can remove excess fluid, which can also decrease the intracranial pressure.

Other Treatments
It may be necessary to prescribe medications to treat seizures. If the coma is caused by an infection, antibiotics will be prescribed.

Most comatose patients are not able to breathe on their own and need to be put on a respirator. Some patients also need cardiovascular support, hydration, and some form of nutrition.

Sometimes physical therapy is used to prevent skeletal or muscular deformities that may develop in people who come out of a coma.

Treatment of Long-term Coma and Persistent Vegetative State
Some people do not immediately come out of coma despite having been treated for the suspected underlying cause. In such cases, treatment focuses on preventing infections such as pneumonia, maintaining the patient's physical state (preventing bed sores, for example), and providing adequate nutrition. This is true for people in persistent vegetative state as well, for whom pneumonia is the most common cause of death.

Prognosis
The prognosis, whether or not a person will come out of coma, depends on what causes the coma. If it's caused by reversible metabolic processes and is treated rapidly, patients tend to recover very well. If it's caused by massive bleeding in the brain or large brain tumors, however, most patients do not recover.

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