Monitoring unconsciousness

The Glasgow Coma Scale is a common method of monitoring the progress of coma, producing a score between 15 (normal) and 3 (deep coma) and taking into account eye opening, motor responses, and verbal responses. Frequent assessment of the Glasgow Coma Scale gives an objective measure of progress. Otherwise the prognosis deteriorates with the duration of coma; patients with postanoxic coma for 3 days rarely survive without severe disability.

Poor prognostic features are listed in Table 1... Outcome from coma is primarily dependent on the cause, assuming that appropriate steps are taken to avoid secondary injury from hypoxia, hypotension, etc. In cases of severe head injury, recent data give an overall mortality of 37 per cent, and good or moderate outcome at

43 per cent (Chesnut.et.al 1993). Coma from anoxia is associated with a poor prognosis, with 90 per cent mortality at 1 year if coma lasts for more than 6 h ( Levy.et.

al 1985). Septic encephalopathy carries a mortality of 35 to 53 per cent depending on severity (Young. et.al 1990). Hepatic coma is associated with good recovery in only 27 per cent of patients (Leyy.ef..a/ 1981). Outcome from drug ingestion, if the patient survives until admission to hospital, is quite good.

Sleep Apnea

Sleep Apnea

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