Care for the comatose

October 29, 2011 11:50 AM

What's the current method of caring for patients in a long-term coma?

Have there been any recent advancements in how patients in long-term comas or persistent vegetative states are cared for? I know that the problems inherent in such states are pretty broad, but I was wondering if any new medical technologies have improved patient care, or survival rates? What's currently involved in caring for these patients?

posted by MrVisible to Health & Fitness (3 answers total)

Best answer: I'm not extremely familiar with it, but from what I understand and have seen, they typically get a tracheostomy and a G-tube for feeding, and they get sent to one of the rare skilled nursing facilities that takes ventilator dependent patients.

Then they just sort of hang out on the vent and getting their feeds, while whoever is taking care of them does their best to try to keep them from getting complications like pressure ulcers or blood clots or skin infections, or other such things that tend to befall people who are unconscious and cannot move around or take care of themselves.

It's nothing cutting edge (although there may be cutting edge technology available in some places that I am not aware of), it's mostly just paying attention to good daily nursing care.
posted by treehorn+bunny at 8:37 PM on October 29, 2011

Response by poster: I appreciate the answer, treehorn+bunny. It helps.
posted by MrVisible at 3:03 PM on October 31, 2011

Yeah, treehorn+bunny pretty much nailed it. Trach for airway management, vent if they're unable to breath on their own. Suctioning to manage secretions. G-tube for hydration, nutrition and med administration. Then it's about managing the problems inherent with immobility- turning and positioning to prevent pressure ulcers (usually every 2hrs, but there are some bed surfaces that are good for up to 4hrs), cleaning them up promptly if they've been incontinent to prevent skin breakdown (catheters are useful, but also a huge infection risk), anti-embolism stockings and blood thinners to prevent blood clots, range of motion exercises to prevent contractions.

I usually try to talk to them. Supposedly a significant number of people who wake up from comas can remember things that have been said to them or around them.

I don't know about survival rates.

Take care.
posted by brevator at 6:29 PM on November 15, 2011