What do people feel in a coma? Classification and consequences of coma
What do people feel in a coma? Let's look at this in more detail.
Coma is a state of a person when it is completely unconscious, abruptly weakened, or there are no reactions to stimuli, the reflexes fade away until they disappear completely, the respiratory rate is broken, the pulse slows down or the pulse becomes more frequent, etc.
When a person is ina state of coma, he is between life and death. And it is dangerous that in addition to loss of consciousness, at a coma in a person vital vital functions are violated. Classification com will be presented below.
Typically, this condition is a complication of a particular disease or appears due to some pathological case, for example, trauma, etc. However, the clinical symptoms of coma can be very diverse, depending on the causes of its onset.
To remove a person from a coma, it is necessary to carry out resuscitation measures, which are aimed at maintaining the basic functions of the body in order to prevent brain death.
What people feel in a coma is of interest to many.
Mechanism of action of coma
At the heart of this state of man lies two main mechanisms:
- bilateral defeat of the cerebral cortex;
- primary or secondary lesion of its trunk, where the reticular formation is located, which supports the cerebral cortex in tonus and activity.
This is a brain coma.
Brainstem disease occurs when a person has a stroke or a traumatic brain injury. Secondary disorders, as a rule, occur when metabolic processes in the body change, for example, in poisoning, diseases of the endocrine system, etc.
In addition, there are cases of a combination of both mechanisms of coma, which is very common. It is believed that this is the line between life and death.
As a result, the normal transmission of nerve impulses in the human brain becomes impossible, the activity of all structures that are switched to the autonomous mode is lost. Thus, the brain temporarily ceases to function and monitor the processes occurring in the body.
Classification of com
Coma states are divided into several varieties depending on various factors and attributes. The main classifications are those that differ in the causal factor and in the depth of the coma.
Because of coma, there is:
- with primary neurological disorder( when it was caused by a process in the nervous system);
- with a secondary neurological disorder( when the cause of coma with the nervous system is not connected in any way).
Establishing the cause of this condition is necessary in order to correctly determine the tactics of treatment of the patient.
What is an artificial coma?
From a medical point of view, this is a temporary immersion of the patient in an unconscious state. The activity of the cerebral cortex and subcortex is inhibited and all reflex functions are completely turned off.
Artificial to whom apply only in the most extreme cases. That is, when there is no other way to protect the patient's body from irreversible brain changes that threaten his life. This is the case with swelling of brain tissue and compression effects on them, as well as with hemorrhage or bleeding, accompanied by severe craniocerebral trauma or pathology of the cerebral vessels.
An artificial coma may be replaced by general anesthesia in cases of emergency large-volume surgery or direct on the brain.
Coma of neurological( primary) genesis
This kind of coma happens:
- In case of craniocerebral trauma( traumatic).
- In case of violations of the cardiovascular system, as well as disorders of cerebral circulation( cerebrovascular coma).This is the case with stroke. A person in a coma may turn out to be for other reasons.
- As a result of epileptic seizures.
- Coma, which originated in the process of inflammatory disease of the brain or its membranes( meningoencephalitic).
- As a consequence of the tumor process in the brain( hypertensive).
Coma of secondary genesis
Species of this condition are:
- endocrine coma( for example, diabetes mellitus), thyrotoxic, hypothyroid( with pathologies of the thyroid gland), hypocorticoid( acute adrenal insufficiency), hypolitic( acute deficiency of hormones produced by the pituitary gland);
- toxic coma( during hepatic or renal failure, poisoning, alcohol or drug overdose, as well as cholera;
- hypotoxic form( with severe forms of heart failure, as well as with anemia, lung obstruction);
- coma caused by anyor physical factors( hypothermia, overheating, electric shock, etc.),
- coma, the cause of which is dehydration, or in case of deficiency of electrolytes.
What is the danger of coma?
According to statistics, the most common cause of comatosis is stroke, followed by an overdose of narcotic substances, and the third is the consequences of diabetes mellitus
Classification com in depth of oppression of consciousness: 1 degree( the so-called "subcortical" coma, mild degree), 2 degrees( anterolateral, middle degree of severity), 2 degrees( posterolateral, deep), 4 degree( extreme, extremely difficult condition).
The transition from one degree of coma to another is sometimes very sharp, so it is sometimes difficult to determine the coma stage in a patient.
Coma 1 degree
This condition is called the subcortical coma and is characterized by inhibition of the activity of the cerebral cortex, as well as the subcortical formations of this organ. This type of coma differs from the others in the following features:
- sensation, as if the patient is in a dream;
- disorientation of a person in time and location;
- lack of awareness of reality, inarticulate speech;
- disappearance of reactions to pain stimuli;
- increased muscle tone;
- enhanced deep reflexes;
- suppression of surface reflexes;
- by maintaining pupillary response to light stimuli, strabismus, spontaneity of eye movements;
- saved breathing;
- tachycardia( increased heart rate).
Coma of the 2nd degree
At this stage of the cerebral coma, the activity of the subcortical zones begins to decelerate, which characterizes this stage with the following states:
- the onset of tonic convulsions or flinches of some parts of the patient's body;
- complete absence of speech, impossibility of verbal contact with the patient;
- strong attenuation of pain reactions;
- sharp oppression of both deep and superficial reflexes;
- weak pupillary response to light stimuli, their narrowing;
- fever and excessive sweating;
- sharp changes in blood pressure indicators;
- violation of respiratory activity( respiratory arrest, various depth of inspiration).
Coma 3 degrees
Pathological processes occur in the medulla oblongata. In this case, the risk to the life of the patient is quite large, and the prognosis of recovery after a coma is significantly reduced. What do the comatose feel? The third degree is characterized by the following states:
- no pain reaction is complete;
- lack of reflexes;
- sharp suppression of muscle tone;
- complete absence of pupillary reactions;
- surface respiration, expressed by its arrhythmia;
- sharp decrease in blood pressure;
What else is a coma? Exit from a coma does not always happen.
Coma 4 degrees
In this condition, a person absolutely lacks any signs of brain activity. And this is manifested as follows:
- lack of reflexes;
- full dilated pupils;
- muscle atony;
- sharp decrease in body temperature and blood pressure( to zero marks);
- Absolute lack of independent breathing.
Coma 4 degrees - this is almost 100% probability of a lethal outcome.
Consequences of comatose conditions
Coma lasts, usually, from one to several weeks. However, there are a lot of cases when this condition lasted much longer - up to several months and even years.
The patient regains consciousness slowly. At first he can recover only a few minutes or hours, and in due course this time increases. The return of a person to a normal state largely depends on the depth of his coma, and also on a number of reasons why this condition arose.
The consequences of a coma are sometimes very severe. During this condition, the brain is damaged, so a person may not recover some of the body's functions. Very often after a coma, people can not walk, make movements with their hands, there is a slowing down of speech activity or its complete absence.
After a coma of the first degree, a person, as a rule, quickly wakes up, and his body in most cases does not lose his abilities. After a coma of the third degree, the brain is destroyed almost completely. Accordingly, the field of this in a person no longer remains the opportunity to live a full life.
Consequences of coma can also be memory impairment, changes in human behavior( aggressiveness or inhibition), decreased attention and reactions. After suffering a coma, people restore their abilities for a long time, even in the domestic sphere - independent food, bathing, changing clothes, etc.
What does a person feel in a coma?
The experiences and sensations of a person who is in a coma, have been studied for many years in various countries around the world. However, there are still no reliable facts on this matter.
Nevertheless, some scientists have made some conclusions, for example, it is scientifically proven that even people who are in a state of deep coma experience certain states, and the brain has some activity. Thus, it turned out that a patient in a coma has an internal ability to respond to external stimuli. This fact is due to the fact that special research equipment recorded special waves of the brain, emitted at the moments when the person is spoken by his relatives and relatives. What else do people feel in a coma?
The patient internally responds to tactile sensations, which can also be confirmed by rapid heart rate, changes in breathing intensity, or changes in blood pressure values. This can be confirmed by the fact that a person experiencing a coma is in a certain way reacting to events occurring in the external world and responding to them. What people feel in a coma, can tell those who have successfully emerged from it.
Many people who have experienced this state share their feelings and experiences. Some of them say that they were in a kind of altered state of consciousness, when they seemed to travel between worlds, they could see their deceased relatives and even talk with them. Other patients claim that they were conscious, heard the speech of doctors, relatives who were with them, but could neither move nor confirm in any way their ability to understand everything. A third group of people in a coma could have various dreams, or they were in a state of unconsciousness, when, after leaving the coma, they absolutely could not remember anything.