Coma Agreement

Results: Kappa`s values were 0.90 for our system and 0.75 for the Synek system. (The Kappa score represents the Inter Rater chord that goes beyond chance; 0.90 is an almost perfect match, while 0.75 is an essential chord.) In contrast, RAS is a more primitive structure in the brain stem, which includes retinal formation (RF). The RAS has two wings, the ascending and descending wing. The ascending pathway or ascending retrecular activation system (ARAS) consists of a system of neurons producing acetylcholine and works to wake up and wake up the brain. Excitation of the brain begins from RF to the cerebral cortex to the thalamus. [12] Any impairment of ARAS function, neuronal dysfunction, along the aforementioned excitation pathway, prevents the body from becoming aware of its surroundings. [11] Some drug use under certain conditions can damage or weaken the synaptic function of the ascending retracticular activation system (SARA) and prevent the system from functioning properly to excite the brain. [12] Side effects of medications, including abnormal heart rate and blood pressure, as well as abnormal breathing and sweating, can also indirectly affect the functioning of ARAS and cause coma. Since drug poisoning is the cause of a large proportion of patients in a coma, hospitals first test all comatose patients by observing the size of the pupils and eye movement through the vestibular eye reflex. (see diagnosis below).

As a result, those who present to a hospital in a coma are usually examined for this risk (“respiratory management”). If the risk of asphyxiation is considered high, doctors may use different devices (for example.B. Using an oropharyngeal airway, nasopharyngeal airway, or endotracheal tube) to protect the airways. Background: Assessment of thalamocortic function in comatose patients in intensive care (ICU) may be difficult to determine. As the electroencephalogram (EEG) allows such an assessment, we have developed an EEG classification for comatose patients in our general intensive care unit. People can come out of a coma with a combination of physical, intellectual and psychological difficulties that require special attention. It is common for patients in a coma to wake up in a deep state of confusion and suffer from dysarthria, the inability to articulate any language. Recovery is usually gradual. In the first few days, patients can only wake up for a few minutes, with increased waking time, when their recovery progresses and can eventually regain full consciousness. . .