Coma - approach in the emergency Department of the Institute of Emergency Medicine

Abstract

Background. The global incidence of non-traumatic coma (NTC) remains poorly defined, with limited comprehensive data available. In the USA, acute disorders of consciousness account for approximately 5%, while in Europe the incidence ranges from 5%-9%, only up to 2% of cases progress to a comatose state. Objective(s). The aim of research was to evaluate the incidence, etiological structure and approach to non-traumatic coma in the ED of the Institute of Emergency Medicine (IEM) during the year 2024. Materials and methods. The research used information from the database of the information system of IMSP IMU from the period of 2024 (01.01.24- 31.12.24). The study was a prospective descriptive one, which included 34 patients with the diagnosis of unspecified coma (R40.2) who were treated in the red zone of the ED. The data were statistically and analytically processed. Results. In 2024, in the UPU of the IMSP IMU, there were 2248 (2.64%) in the red zone, and the incidence of patients in a state of CNT was 0.04%, which was conditioned in 35.29% of cases by stroke, clinical death-20.59%, airway obstruction in 11.76%, neurological pathology-11.76%, hypoglycemia-2.94%, intoxication-8.83%, brain neoplasm-8.83%. The average age of the patients was 61.94 years. According to GCS, subjects with 3 points prevailed in 52.94% of cases. All patients were approached according to the ABCDE principle. In 17.65% of cases, death was found in the red zone, and in 82.35% of cases, patients were transferred to specialized departments. Conclusion(s). Stroke is the most common cause of NTC in ED, IEM. The complex multidisciplinary approach to patients with NTC according to the ABCDE principle increased the survival rate of patients to 83.35%, capitalizing on the importance of a systematized evaluation from a clinical and curative point of view.