Coma

  • Alcoholic apoplectically hypoglycemic gipohloremichesky coma
  • Diabetic malaria adrenal coma
  • Hepatic thyrotoxic traumatic coma
  • Uraemic atleticheskaja coma
  • Epileptic coma
  • Coma - unconsciousness with deep braking functions of the cortex and subcortical structures of the brain, manifested disorder reflex activity, blood circulation and breathing.
    Depending on the causes of whom, they are divided into the following groups:
    1) coma due to exogenous (carbon monoxide, etc.) and endogenous (liver, uraemic) toxic hazards;
    2) coma associated with endocrine disorders (diabetes, adrenal, thyroid, etc.)
    3) coma toxico-infectious origin (malaria); 4) coma with lesions of the Central nervous system (trauma, stroke and other).
    The development of symptoms in a coma any etiology is connected with the violation of the brain caused by a number of factors. Among them of great importance impaired circulation and circulation of cerebrospinal fluid in the brain, increased intracranial pressure, and swelling of the brain and meninges, oxygen starvation of the brain, the impact on the fabric of his toxic substances, metabolic and hormonal disorders, changes in mineral and acid-base balance.
    Coma with complete loss of consciousness, in violation of all reflexes, oppression of the cardiovascular and respiratory systems, involuntary urination and defecation may come on suddenly or develop gradually, passing through various stages of human consciousness. This period preceding the full development of the coma, call or pre-comatose state.
    Assistance to the patient in a coma, must begin with some treatment and diagnostic procedures, shown in any form coma. You first need to see if there are violations of the vital functions: circulation and respiration. Start with probing heart to peripheral (radial artery) or large (carotid artery) vessels, listening to the heart and blood pressure measurement. If systolic blood pressure below 80 mm RT. Art. should be administered by intravenous caffeine-benzoate sodium 2 ml of 10% solution, 20 ml of glucose 40% solution, kordiamin 2 ml.
    In the absence of independent breathing, you start artificial respiration way "the mouth in a mouth", "the mouth in a nose" (see CPR), and in the presence of conditions and appropriate skills to intubirovti patient and start breathing with the help of Ambu bag and enter 1 ml of 1% solution lobelina intravenously. Then proceed to a more detailed examination of the patient, based on clinical symptoms qualify the nature of the coma, and depending on him to carry out further treatment; urgent premises of the patient to the hospital, where can be applied to all modern methods of treatment.