Loss of consciousness. Coma. Health care

FUNDAMENTALS OF FIRST AID
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Loss of consciousness. Coma. Health care

Fundamentals of First Aid (OPMP)

coma called an unconscious state when there are no reactions to external stimuli. Consciousness is impaired due to insufficient oxygen supply, circulatory disorders and cerebral edema. Coma is a consequence of damage to the nervous system. There are comas primary cerebral origin (genesis) (coma apoplexy, traumatic or due to tumor growth) and secondary genesis (comatose state associated with diseases of internal organs or endocrine glands).

Comatose states can occur as a result of toxic effects (alcoholic coma or induced by sleeping pills); under the influence of physical factors (cold coma, heat coma, radiation coma, electric shock). Comas of infectious origin (with encephalitis, meningitis) develop relatively slowly. The sudden development of coma is characteristic of vascular disorders.

Signs. In the precomatose state and mild cases of coma, the patient resembles a sleeper: he lies with his eyes closed, but he can be awakened: he can open his eyes, respond, but then again plunges into a drowsy state. Involuntary urination often occurs. In more severe cases, the patient cannot be awakened, although pain sensitivity is still preserved. Muscle twitching and cramps may be observed, but there are no disturbances in swallowing, breathing or cardiac activity. In a deep coma, the patient does not respond to any irritation and is pale; Swallowing is impaired, convulsions, breathing disorders (uneven breathing) and cardiac activity appear, up to their complete stop.

First aid. To properly provide assistance, it is important to find out the cause of the coma, although this is not always possible. In any comatose state, the patient must be given complete rest, without trying to bring him to consciousness or wake him up. During convulsions, support the head; during vomiting and wheezing breathing, turn it on its side and tilt it back as much as possible, preventing the tongue from retracting. If mucus and vomit accumulate in the throat, it is necessary to clean the throat and oral cavity. Simultaneously with the above measures, you need to call an ambulance.

diabetic coma. Diabetes mellitus can cause two types of coma: hyper- и hypoglycemic.

When overeating carbohydrates, administering an insufficient dose or not injecting insulin on time, sometimes with excitement the amount of sugar in the blood increases, which leads to the development hyperglycemic coma (hyperglycemia - increased blood sugar). This is preceded by weakness, thirst, vomiting, headache, loss of appetite. It develops gradually, itching of the skin, pallor, drowsiness, weakening of the pulse, noisy breathing, and the smell of rotten apples (acetone) from the mouth appear.

If a patient receives insulin but does not eat, his blood sugar may drop sharply and develop hypoglycemic coma (hypoglycemia - low blood sugar). Such a coma occurs suddenly: weakness and drowsiness are noted; the skin turns pale, profuse sweat appears, the pulse is rapid, breathing is shallow; trembling of the limbs is observed, complete loss of consciousness and convulsions are possible.

First aid. If the patient takes insulin, you need to find out when the last time you took this medicine.

If a long break in insulin treatment is detected, it is necessary to call a medical professional to administer this drug.

In a comatose state that occurs shortly after the administration of insulin, the patient is given a few sips of water with three tablespoons of sugar diluted in it, and after a few minutes the sugar is given again. Due to the fact that more qualified measures of assistance can only be carried out by medical workers, it is necessary to call an ambulance or take the patient to a medical facility as quickly as possible.

Uremic coma develops in chronic kidney disease due to the accumulation in the blood of substances that are usually excreted in the urine. It is preceded by headaches, swelling and a number of other symptoms. First aid consists of quickly transporting the patient to the hospital.

Authors: Aizman R.I., Krivoshchekov S.G.

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