# Coma Info



## lebrbria (May 4, 2012)

Anyone have a good understanding of what could cause someone to end up in a coma?  More specifically with a head trauma?  Also, any information someone has on how a coma patient is treated while in the hospital (not how to recover from a coma- I have that covered), I would appreciate it.


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## shadowwalker (May 4, 2012)

What research have you done already? I know when I was researching head injuries there was a ton of information and support sites on the 'net.


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## I survived (May 15, 2012)

Swelling on the brain and medically induced coma are two of the most common but like shadow walker said there is a ton out there if you look.


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## lebrbria (May 15, 2012)

I'm going with swelling on the brain (fits with the head trauma).  Now I'm looking into how coma patients are treated in the hospital- feeding tubes, IVs, etc.


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## TheBelindaAngel (May 15, 2012)

lebrbria said:


> Also, any information someone has on how a coma patient is treated while in the hospital



Usually they are said to be 'in a permanent vegetative state' rather than a coma. What kind of information are you looking for? The day to day care is focused on hygiene, infection control, preventing pressure sores (bed sores) and nutrition. They are fed through a tube that leads to the stomach. This tube can be a temporary one through the nose or more directly via a port in the abdomen known as a PEG tube. They are cared for much like babies actually. Not all are quiet and peaceful as portrayed in films, some groan and twitch occasionally. Being in this state for a prolonged period caused muscle atrophy and limbs would be contracted making walking again a long process. Also were someone to awaken it would be by degrees over a few days. Some confusion would persist until the brain and body adjusted.
Hope some of this was helpful


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## lebrbria (May 15, 2012)

TheBelindaAngel said:


> Usually they are said to be 'in a permanent vegetative state' rather than a coma. What kind of information are you looking for? The day to day care is focused on hygiene, infection control, preventing pressure sores (bed sores) and nutrition. They are fed through a tube that leads to the stomach. This tube can be a temporary one through the nose or more directly via a port in the abdomen known as a PEG tube. They are cared for much like babies actually. Not all are quiet and peaceful as portrayed in films, some groan and twitch occasionally. Being in this state for a prolonged period caused muscle atrophy and limbs would be contracted making walking again a long process. Also were someone to awaken it would be by degrees over a few days. Some confusion would persist until the brain and body adjusted.
> Hope some of this was helpful



Thanks.  So here's the scenario- an older woman is in her shop working when a fire breaks out.  She somehow gets hit in the head, leaving a sizable gash.  She's knocked out and ends up in a coma.  Now I need to figure out all the specifics.  For example, how a head trauma and comas are related.  I don't need to worry about her coming out of a coma because that factors into the extra elements in the work.  I just need to know how she'll be taken care of in the hospital.


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## Potty (May 15, 2012)

lebrbria said:


> I just need to know how she'll be taken care of in the hospital.



TheBelindaAngel was pretty acruate. To prevent pressure sores, the patient will be moved to a different position regularly, usually a "recovery position" type of affair and every few hours rolled onto the oposite side with occasional rest on their backs. (being on their backs mainly for feeds. they wouldn't spend a vast ammount of time like this due to the risk of choking.)

Mostly feeds are done as TheBelindaAngel describes, through a tube that's going into their stomachs through the belly. A liquid feed containing the various nutrients and calories the body needs is slowly fed through the tube via a little machine pump that regulates the speed. 

They will have adult nappies on... but more likley a catheter (spelling).

hygene will be given in the form of a pretty pathetic attempt at a bed bath (A wet flannel) and is few and far between as hospital staff are usually to busy to dedicate much time to each patient like that. 

Interaction will be minimal. Basically not cared for at all in this respect. Only family members will spend time talking to the patient. the staff will gossip over the top of her as though she isn't there.


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## Cefor (May 15, 2012)

Potty said:


> hygene will be given in the form of a pretty pathetic attempt at a bed bath (A wet flannel) and is few and far between as hospital staff are usually to busy to dedicate much time to each patient like that.
> 
> Interaction will be minimal. Basically not cared for at all in this respect. Only family members will spend time talking to the patient. the staff will gossip over the top of her as though she isn't there.




Hehe, Potty, this sounds more like a bad stereotype than what every nurse or carer would do 

I'm sure there are some folks out there who would give the utmost attention to their patients, persistent vegetative state or not. The newer the nurse, the easier it would be for them to work as best they can -- without any kind of resentment of the job or their responsibilities.

For a bit of variation, I'd have only the one nurse who talks to your character, lebrbria; perhaps have that nurse confront a colleague about their behaviour towards the patients?

Anyways, my two pennies worth ^_^


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## Potty (May 16, 2012)

Cefor said:


> Hehe, Potty, this sounds more like a bad stereotype than what every nurse or carer would do
> 
> I'm sure there are some folks out there who would give the utmost attention to their patients,



I work in the industry, I wish it was an exaggertion. best intentions not withstanding, you just don't have the time.


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## SeverinR (Jun 12, 2012)

TheBelindaAngel said:


> Usually they are said to be 'in a permanent vegetative state' rather than a coma. What kind of information are you looking for? The day to day care is focused on hygiene, infection control, preventing pressure sores (bed sores) and nutrition. They are fed through a tube that leads to the stomach. This tube can be a temporary one through the nose or more directly via a port in the abdomen known as a PEG tube. They are cared for much like babies actually. Not all are quiet and peaceful as portrayed in films, some groan and twitch occasionally. Being in this state for a prolonged period caused muscle atrophy and limbs would be contracted making walking again a long process. Also were someone to awaken it would be by degrees over a few days. Some confusion would persist until the brain and body adjusted.
> Hope some of this was helpful


Coma is more common to short term(hours-weeks), prolonged vegitative state-unsure of how long it will be, but not ready to say permanent(weeks to months), and permanent veg state (longer then months), in reality, even permanent isn't permanent.

The longer the coma, the more time to rehab from it.  Exercise leaders are right, if you don't use it, you lose it.  Working someones joints does nothing to keep their muscles, so unlike the movies, the man in a permanent vegitative state(years) could not jump out of bed and fight/kill within minutes/hours or waking.


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## MPC (Jun 19, 2012)

I am also writing a story that involves a comatose patient and would like to thank Potty and TheBelindaAngel for their very helpful exposition on the subject.

I am wondering about talking to coma patients. I know the cases may vary, but how much information that they hear during the coma do they retain if they later wake up and make a full recovery? For example, if I read the entirety of "The Great Gatsby" to a comatose patient, would they wake up and be able to take a test on it or talk to another person about the book, be able to recall characters and events? Would they remember conversations that people had in the room, even if just parts of it? Or would it be more buried in the subconscious, similar to having a dream about something and only vaguely remembering it much later if triggered? And thus it's more just a matter of mental health that you should be positive and encouraging when talking to them while in a coma because they are sensitive to attitude and the like? Or does that all depend on the extent of the injuries, time spent in the coma, etc? 

Similarly, would they feel as though all that time has passed? If they are in a coma for a year, do they feel as though a year has passed? Or do they not remember that time passing? If someone went into a coma because of a car crash, for example, would they wake up in a panic thinking they're still in the crash? 

Also, what wing of a hospital would a coma patient be kept in? Intensive care? Something else? How many medical professionals tend to the coma patient and how often during the day? Are there limited visiting hours or are family members encouraged and allowed to spend the night at a patient's bedside? Any help on the matter would be greatly appreciated.


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## egpenny (Jul 21, 2012)

My late husband was in a coma for a month.  When he came out of the coma, it took him several weeks to be barely ambulatory (sp).  He was very weak.
He couldn't believe he'd been out of it for a month and had a hard time understanding or accepting what had happened to him, to the point of being argumentative.
 He died two months later with all the symptoms of going into another coma, except . . . Well, that's another story.  
The nurses were in as often as required and would talk to him as they were doing what they needed to do.  Often they would try to get a response out of him as they went about their duties.


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