A coma is defined as a state of complete lack of arousal and awareness that lasts for at least one hour. It is caused by an injury or functional disruption of the ascending reticular activating system in the brainstem or bilateral cortical regions. Comatose patients lack the ability to open their eyes, speak, or move spontaneously. Semi Coma is defined as a partial or moderate comatose state.
A comatose patient is treated in the same way as a critically ill patient that presents to the emergency room. Before attempting to diagnose or treat specific causes of coma, it is necessary to address airway, breathing, and circulation impairment.
In comatose patients, neurologic examination is critical, and a structured evaluation is performed once immediate hazards to life have been addressed. A level of awareness test, a cranial nerve exam, and a motor assessment are all done.
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