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Suggestions
for Medical Staff and Family
A coma can be defined as a state in which arousal and awareness are not present. There is no evidence of a sleep/wake cycle or eye openings. Coma is only one of the stages in the recovery process resulting from a severe brain injury. A coma usually does not persist longer than a few weeks (American Congress of Rehabilitation Medicine, 1995).
Vegetative state and Slow to Recover are diagnoses given to patients who are wakeful and lack cognitive or affective mental functioning. The primary differences between coma and vegetative state are eye opening responses and sleep/wake cycles (Berrol,1986).
The term minimally responsive is not a diagnosis. It applies to patients with severe cognitive and motoric limitations resulting from brain injury (American Congress of Rehabilitation Medicine, 1995). Minimally responsive patients function at a higher level than those in coma or vegetative state. Patients demonstrate voluntary movements and behaviors.
While in coma, healthcare professionals will perform Multisensory Coma Stimulation on the patient. It involves repetitive tactile, auditory, visual, taste, proprioceptual, and olfactory stimulation. It is also knows as coma arousal therapy, sensory stimulation, and coma care.
Anterograde amnesia is the inability to remember anything from the point of injury and after. The patient cannot lay down new memories.
Retrograde amnesia is the inability to remember anything from the point of injury and before the injury.
Agitation
refers
to the restless, undirected aggression associated with brain injury.
Causes of Coma:
Common causes of coma may
include, but are not limited to, the following: head injury, extreme
fatigue, seizure activity, stroke, heart failure, drug abuse, or hypoglycemia.
However, the most common cause of coma results from a head injury in an
automobile accident.
Purpose of Coma Stimulation:
Coma recovery programs aim
to provide multiple sensory stimulation to patients in coma or vegetative
state. It is hoped that with intense and repetitive stimulation,
the patient will awaken and return to a higher level of functioning.
Coma arousal therapy is believed to provide the sensory stimulation
needed to activate the reticular system, which is responsible for maintaining
consciousness. These procedures are appropriate for any individual
who is in coma or vegetative state and is medically stable.
