Comatose conditions

Comatose conditions occur with significant changes in the system of homeostasis, which is often caused by severe lesions of internal organs.

The most commonly observed: uremic, hepatic, diabetic (ketoacidotic, hypoglycemic) coma, to whom with craniocerebral trauma (CCT) and alcoholic coma.

• Uremical coma occurs due to terminal failure of kidney function due to impaired excretion of nitrogenous slags from the body. The coma develops gradually against the background of other signs (anemia, hyperkalemia, acidosis) of far-gone renal damage in the terminal stage of chronic renal failure, less often it occurs in acute kidney failure. The timely use of hemodialysis in these patients prevents the development of a coma, associated with uremia.
• Hepatic coma occurs with severe liver damage and can develop in a fairly short time. It is usually preceded by changes in the psyche, which doctors often regard as random events that reflect the patient's characterological characteristics (nervousness, sleep inversion).
• A diabetic (ketoacidotic) coma can develop quite quickly against a background of satisfactory state of health, although it is often preceded by expressed thirst with the release of a large amount of urine in combination with dry skin, which the patients themselves usually keep silent.
• Hypoglycemic coma usually occurs in diabetes mellitus as a result of insulin treatment. Although diabetic patients are familiar with the feeling of hunger as a precursor of this condition, a coma can develop suddenly (on the street, in transport). For the duration of these cases, each patient must carry a "Diabetic Diabetic Book" or other medical documentation that indicates the dose of insulin administered. One of the bright signs of this coma, which distinguishes it from the diabetic, is the pronounced moisture of the skin.
• Coma in case of traumatic brain injury. With them, it is often possible to identify external signs of a trauma or information about it in an anamnesis (hematoma, bleeding from the ear, nose or srl, etc.); the pupils of the part are asymmetric, their responses to light are slowed down or absent; the nature of breathing is different (it is often rare or irregular); the pulse is variable (initially frequent, then rare).
• When a person is unconscious, it is necessary to keep in mind the alcoholic coma. It develops at a concentration of ethanol in the blood of 0.3-0.7 mg%; the smell of alcohol from the mouth is characteristic (nevertheless it is necessary to exclude craniocerebral trauma in a state of intoxication.

[1], [2], [3]