Coma position Health Dictionary

The state of complete loss of consciousness... coma

If an individual is unconscious – whether as a result of accident or illness or when in the postoperative recovery unit – but is breathing and has a pulse, he or she should be placed in the recovery position. The individual is turned on his or her side to allow the tongue to fall forwards and so reduce the likelihood of pharyngeal obstruction (see PHARYNX). Fluid in the mouth can also drain outwards instead of into the TRACHEA and LUNGS. The person can lie on either side with upper or lower leg ?exed. Sometimes the semi-prone position is used; this gives better drainage from the mouth and greater stability during transport, but makes it more di?cult to observe the face, colour or breathing. (See APPENDIX 1: BASIC FIRST AID.)... recovery position

A method developed by two doctors in Glasgow that is used to assess the depth of COMA or unconsciousness suffered by an individual. The scale is split into three groups – eye opening, motor response, and verbal response – with the level of activity within each group given a score. A person’s total score is the sum of the numbers scored in each group, and this provides a reasonably objective assessment of the patient’s coma state – particularly useful when monitoring people who have suffered a head injury. (See also PERSISTENT VEGETATIVE STATE (PVS).)... glasgow coma scale

Position in which a patient lies on his or her back with the hips and knees bent and the legs wide apart.

Once used for lithotomy, the position is still used for pelvic examinations and some types of pelvic surgery.... lithotomy position

See GLASGOW COMA SCALE.... coma scale

Hypoglycaemia or low blood sugar occurs when a patient with DIABETES MELLITUS suffers an imbalance between carbohydrate/glucose intake and INSULIN dosage. If there is more insulin than is needed to help metabolise the available carbohydrate, it causes a range of symptoms such as sweating, trembling, pounding heartbeat, anxiety, hunger, nausea, tiredness and headache. If the situation is not quickly remedied by taking oral sugar – or, if severe, giving glucose by injection – the patient may become confused, drowsy and uncoordinated, ?nally lapsing into a COMA. Hypoglycaemia is infrequent in people whose diabetes is controlled with diet and oral HYPOGLYCAEMIC AGENTS.

Treatment of acute hypoglycaemia depends upon the severity of the condition. Oral carbohydrate, such as a sugary drink or chocolate, may be e?ective if the patient is conscious enough to swallow; if not, glucose or GLUCAGON by injection will be required. Comatose patients who recover after an injection should then be given oral carbohydrates. An occasional but dangerous complication of coma is cerebral oedema (see BRAIN, DISEASES OF – Cerebral oedema), and this should be considered if coma persists. Emergency treatment in hospital is then needed. When the patient has recovered, management of his or her diabetes should be assessed in order to prevent further hypoglycaemic attacks.... hypoglycaemic coma

This is a steep head-down tilt so that the patient’s pelvis and legs lie above the heart. It is used to improve access, and to limit blood loss, during surgery to the pelvis. It has been used to treat shocked patients (see SHOCK), but, as the position increases pressure on the DIAPHRAGM and embarrasses breathing, raising the legs by themselves is better.... trendelenberg position

the internationally accepted body position for anatomical descriptions, such that any part of the body can be related to any other part of it. A person in the anatomical position stands erect, the arms hanging by the sides with the palms facing frontwards and the legs and feet together with the toes pointing forwards (see illustration overleaf).... anatomical position

(BPPV) a common cause of vertigo in which the patient complains of brief episodes of rotatory vertigo precipitated by sudden head movements. It is thought to be due to microscopic debris derived from the *otoliths of the utricle and displaced into one of the semicircular canals, most commonly the posterior semicircular canal. The debris is most commonly thought to be free in the canal (canalithiasis; see canalith) but can be attached to the *cupula (cupulolithiasis; see cupulolith). Diagnosis is by performing a *Dix–Hallpike test. Treatment is with a predetermined set of head movements to move the debris from the semicircular canal (see Epley particle repositioning manoeuvre; Semont liberatory manoeuvre; Brandt-Daroff exercises). Surgery is occasionally used to occlude the relevant semicircular canal, cut the *singular nerve or vestibular nerves, or perform a *labyrinthectomy. Drugs are generally ineffective in the treatment of this condition.... benign paroxysmal positional vertigo

the buttocks-up position assumed by patients undergoing anorectal examinations, now commonly performed in the left lateral position. It is useful for helping patients dispel excess flatus following colonoscopy.... knee-elbow position

the left-sided knees-up position commonly assumed by patients undergoing examinations of the anus and rectum or vagina. [J. M. Sims (1813–83), US gynaecologist]... sims’s position

a special operating-table posture for patients undergoing surgery of the pelvis or for patients suffering from shock to reduce blood loss in operations on the legs. The patient is laid on his or her back with the pelvis higher than the head, inclined at an angle of about 45°. [F. Trendelenburg (1844–1924), German surgeon]... trendelenburg position

a life-threatening condition due to severe *hypothyroidism, which is often precipitated by an acute event, such as surgery, prolonged exposure to cold, infection, trauma, other severe illness, or sedative drugs. It manifests as hypothermia, slowing of the heart rate with a reduction in blood pressure and sometimes heart failure, pleural and peritoneal effusions, urinary retention, and a gradually reduced conscious state resulting in coma. Blood tests show hypothyroidism, *hyponatraemia, hypercholesterolaemia, retention of carbon dioxide, and anaemia. Treatment is with intravenous *thyroxine at a high dosage until the patient wakes up, when tablets can be administered. Support on a ventilator and intravenous fluids may be needed. Active slow rewarming should be undertaken.... myxoedema coma