COMA

Preparation Supervisor

Solin Bilal Dr. Ezaddin Kamal

Nahla Sadradin
Derin Kawa
CONTENTS

States of consciousness

Introduction

Etiology

Assessment and Diagnosis

Medical management

Complications

Nursing intervention

Reference
“States of consciousness
Consciousness

Wakefulness

Arousal

Drowsiness

Confusion

Inattentiveness

Delirium

Stupor

Vegetative state

Coma
“Introduction to Coma
Coma is a state of prolonged unconsciousness in which the
patient is unresponsive to external stimuli and unable to
initiate voluntary actions.
clesed eyes , unconsciousness Altered breathing pattern Absence or altered pupil response

Unresponsiveness
 Cerebral cortex

Thalamus

Hypothalamus

Pons

Medulla
Cerebellum Reticular activating system
 Wakefulness Vs. Awareness

3.Minimally
1.Coma
conscious state
Wakefulness Wakefulness
Awareness Awareness

2.Vegetative 4.Locked in
state syndrome
Wakefulness Wakefulness
Awareness Awareness
+ Quadriplegia
“ Etiology
 Structural Metabolic

Brain trauma Infection

Brain tumor Meningitis
Brain hemorrhage Encephalitis
Brain hematoma Hypoglycemia
Hydrocephalus Hyperglycemia
Ischemic stroke Intoxication
Opioid overdose
Electrolyte imbalance
Poisoning
“Assessment and diagnosis
Initial assessments Physical examination Neurological examination

Imaging test Lab tests Detailed history

EEG Lumbar puncture

“ Medical management
1.Medical stabilization 2.Treating underlying cause

3.Supportive care

4.Medications 5.Rehabilitation
“ Complications
Infections

Pressure ulcers

Muscle contractures

Deep vein thrombosis

Respiratory complications

Nutritional issues

Cognitive and neurological deficit

Persistent vegetative state

“ Nursing intervention
Frequent monitoring

Positioning and prevention of complications

Airway management

Assess and manage pain

Maintaining nutrition and hydration

Medication administration

Prevent infection

Communication and emotional support

Collaborate with the healthcare team

“ Reference
Urden LD , Stacy KM , Louch ME (2022) . Critical Care Nursing : Diagnosis and Management . 9th ed . Canada .
Elsevier . P. 606-608 .

Alejandro RA (2018) . Coma and Brain Death . American Academy of Neurology . 24(6) : 1708-29 .

Daroff RB, et al. Stupor and coma. Bradley's Neurology in Clinical Practice. 7th ed. Elsevier; 2016.
Thank you
For your listening