Awakening From a Coma

A coma can result from trauma or is sometimes medically induced. What happens during a coma and what is the outlook for recovery?

Recognizing a Coma

Finding someone in a coma at home or in the hospital is traumatizing. This is a medical emergency that needs prompt treatment to restore and protect the individual from brain damage. Coma symptoms include closed eyes, irregular breathing, no response to pain stimuli, and pupils unresponsive to light.

A coma is a prolonged unconscious state in which a person is unresponsive to any stimuli. Clinicians use the Glasgow coma scale to assess the level of consciousness. They consider a score of less than 8 to be a coma.^[1] Temporary or permanent brain trauma can cause a coma. There may also be an interruption of the brain’s circulatory system. Such factors include toxins, metabolic problems, seizures, alcohol poisoning, infections, or loss of oxygen.

Medically Induced Coma

Physicians sometimes induce coma by using a controlled dose of anesthetic agents such as barbiturate drugs. They may refer to it as a medically induced coma, barbiturate-induced coma, or barb coma. A medically induced coma reduces the electrical activity of the brain. This decreases brain inflammation, swelling, and brain damage.^[2]

Doctors induce this coma during neurosurgery. As protection from brain swelling after head injury, hospital intensive care units induce coma. Induced coma can result in severe systemic effects including loss of respiratory drive, reduced gut motility, and hypertension.

What Happens During Coma?

Activity During Coma

During a coma, the person is alive but the body goes into a state of minimal consciousness. There is very low brain activity. A comatose person is unable to respond to physical pain, sounds, ambient temperature, or communication.

Someone in a coma can breathe on his own with a reduction in basic reflexes such as coughing and swallowing. Doctors rate patients with a Glasgow Coma Scale between 3 (dead) and 15 (fully awake).^[3]

Without response, a comatose person can process the events from his surroundings such as approaching footsteps or sounds. Even with the reduction in brain activity, autonomic bodily functions continue. This includes blood circulation, hair growth, and breathing. The body also digests food. Neuroscientists have observed brain activity in a man who was in a coma for 12 years by using fMRI brain scanning technology.^[4]

The body heals and responds to medical care in comatose patients. Treatment aims to reverse the brain damage and swelling. Diabetic patients can receive medication to restore normal blood sugar levels.

Prognosis For Coma Patients

The prognosis of a reversible coma patient depends upon the extent of brain damage. Based on this and patient age, a coma may last from weeks to several years. Treatable brain damage, regaining consciousness, and normal brain function is possible. Otherwise, permanent disability and inability to regain consciousness is likely.

Most people recover from a coma without any serious neuronal damage. Others may progress into a vegetative state. People recovering from a coma feel disorientation or agitation. They require rehabilitative therapy for the revival of normal brain functioning.

Comatose people can recover with speech impediments, incoordination, and intellectual disability.^[5] Recovery from a coma is a gradual process that needs psychological and emotional support from loved ones.

February 3, 2021 – British teenager Joseph Flavill went into a coma following an automobile accident prior to the pandemic. Ten months later, he awakened to a new world. Able to communicate without yet speaking, he is making rapid recovery. —CNN

A prolonged vegetative state can result in serious health complications. This includes infections, contracture, blood clots in the legs, and pressure sores. Muscle atrophy is the main issue that arises due to inactivity.

If you discover a comatose individual in a public place, contact emergency services immediately. The operator will provide direction until first responders arrive. For your own care, a medical directive can speak for you when you’re unconscious. This legal document should include instructions about the extent of extraordinary medical care. It can state how long to keep you on artificial life-support systems in the event of a coma.