Identify the 4 stages of coma – How long does coma last?

4 stages of coma - Sriramakrishnahospital

Coma is a word for which everyone has different definitions, and only some understand it. A coma can be challenging to comprehend, mainly because the term is sometimes used in jest to refer to persons who are sleeping deeply or not paying attention. However, a coma is a dangerous condition unrelated to sleep. This article gives you the correct information about coma, its different stages, and how long it lasts.

Coma: Here’s what you need to know

A coma is a state of extended unconsciousness that can have many different origins, including but not limited to severe brain injury, stroke, brain tumour, drug or alcohol intoxication, or a chronic disease like diabetes or an infection.

To put it simply, a coma requires immediate medical attention. Urgent intervention is required to prevent permanent brain damage and save lives. Critical care doctors will typically recommend a battery of diagnostic tests, including a brain scan and blood work, to establish the underlying cause when treating a patient who has fallen into a coma.

The average duration of a coma is a few weeks. Those who remain unconscious for extended periods may enter a chronic vegetative condition or die.

Semi coma stage is also a stage where it is not more profound than a coma; the patient can respond to stimuli, can groan, and mumble. The semi-coma symptoms can be similar to a coma with slight differences. 

The significant signs of coma which can help identify:

Coma signs are pretty evident and have few precise identifications

  • Closed eyes
  • Irregular breathing
  • Reflexes in the brainstem, such as the pupil’s reaction to light, become less active.
  • No limb activity except reflexes.
  • Except for reflex actions, no reaction is shown to painful stimuli.

What is referred to as the staging of a coma?

An intense coma, in which the patient shows no response or consciousness at all, contrasts with a shallow coma, in which the patient responds to stimulus by, for example, moving or opening their eyes. The patient may respond in some way to speak at even more superficial levels.

Here are the major stages of coma that you need to know:

Stage 1: Unresponsiveness:

Patients in the unresponsive stage rarely respond in the same way throughout time. Those who are entirely unresponsive are said to be in a coma. Patients in the unresponsive period may respond reflexively or make confusing gestures.

Stage 2: Early Responsiveness:

The patient will show signs of responsiveness throughout this time. Inconsistent and delayed responses are to be expected, but at least they will be less unpredictable. Movement in response to sound or touch, eye-opening and closure, and grasping and releasing objects are all possible early responses.

Stage 3: Agitation and confusion:

Now, the patient might start responding more regularly. They may need help remembering recent events and may be disoriented about their current location. The patient could display various behavioural difficulties, including outbursts, swearing, biting, or physical aggressiveness.

Stage 4: A higher level of responsiveness:

A patient may have no trouble performing daily activities at this point. Problem-solving, judgment, and decision-making may still be difficult for them. A patient’s awareness of their limitations may still be limited during this time. During this time, friends and family members may also observe behavioural changes.

Patients may spend more or less time in each stage of the healing process, depending on their unique circumstances and the stages of the coma.

The primary causes that can lead to coma condition:

Traumatic brain injuries:

Most of the time, these result from car accidents or violent activities.


A stroke is caused by a lack of blood flow to the brain or an interruption in that flow due to clogged arteries or a ruptured blood vessel.

Lack of oxygen:

It is possible that victims of cardiac arrest or drowning who have been resurrected will not regain consciousness.


Swelling of the brain, spinal cord, or tissues around the brain can result from infections such as encephalitis and meningitis. The infection can cause brain damage or coma in extreme circumstances.


Seizures almost seldom cause coma on their own. However, status epilepticus, which involves persistent seizures, can. Failure to allow the brain to rest and recuperate in between seizures is a consequence of frequent seizures. Prolonged coma and unconsciousness will result from this.

Among all these, traumatic brain injuries are the most common reasons that can lead to coma. 

Traumatic brain injury – an overview:

A hit or jolt to the head or body is typically the cause of traumatic brain injury. In addition to blunt force trauma, traumatic brain injury can be caused by any object penetrating the skull and striking the brain. If you’ve suffered a mild traumatic brain injury, your brain cells may be temporarily damaged.

In cases of severe injury, receiving brain damage treatment without delay is essential to avoid severe repercussions. 

Can coma be cured?

The priority for medical staff will be to ensure the patient’s immediate survival by restoring normal breathing and blood flow. If the patient is in diabetic shock or has a brain infection, the doctors may give them glucose or antibiotics before the results of the blood tests are complete. Whether a coma treatment is for kidney failure, liver illness, diabetes, poisoning, etc., depends on the underlying reason. 

Surgery to relieve pressure on the brain is required if brain swelling develops. The medical community must act quickly when confronted with a patient in a coma. Doctors will first ensure the patient can breathe and do what they can to keep their blood pumping. Medical professionals may provide life-sustaining interventions such as mechanical ventilation, blood transfusions, and oxygen therapy.

Most people dealing with coma are generally admitted to the ICU hospital as they require close monitoring.

How long does the coma last?

Comas typically don’t last more than four weeks. After years in a chronic vegetative state, some individuals may gradually regain consciousness.

The prognosis of coma:

The outlook for someone in a coma might be unpredictable. The likelihood of a full recovery is affected by several factors, including the nature of the underlying condition, the type of coma, the severity of the problem, and how long the coma has lasted. It’s not uncommon for someone to regain full functionality once the underlying issue is fixed. However, if the brain injury is very significant, the victim may never regain consciousness again or remain permanently incapacitated.

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