Comas explained by Dr Townsend

The term ‘coma’ covers many conditions and in severe cases can be a result of a brain injury, drugs, infection or cardiac arrest. They can be medically induced or naturally occurring due to illness.

It has always been speculated whether a patient in a coma can dream or even hear what is going on around them.

So, we asked Director of Royal Brisbane and Women’s Hospital Intensive Care Services Dr Shane Townsend his thoughts on the matter.

“The short answer is, possibly,” Dr Townsend said.

“The comas that are very severe, the patient doesn’t appear to respond or be aware, but there aren’t any tests to prove otherwise.

“The comas where a patient is in a more twilight state, patients often wake and can recall conversations and noises that they have heard.

“I have had a patient wake up from a twilight coma before and he recalled hearing the smart bed beeping orders and the nurses talking around him.”
As the Intensive Care Director, Dr Townsend knows that the things patients hear and recall could also be a symptom of delirium.

“There is a misconception that you are either in a deep sleep or wide awake when in reality they sit somewhere in the middle, and we use a scale called the Glasgow coma scale to grade the severity of the coma,” he said.

The scale assesses patients according to three aspects of responsiveness: eye-opening, motor, and verbal responses. The coma is graded between 3 and 15, with 3 as the most severe.

Dr Townsend said that comas essentially give time for the body to heal.

“We say to family no matter how unconscious they are, to treat them like they are awake, and also encourage them to keep diaries with words and pictures and give to their loved one when they way up,” he said.

“It helps to fill the gap and give them closure of what they went through, and what their family went through while they were in a coma.”