Induced Coma - Bolton NHS FT

The term induced coma is commonly used to describe the state of sedation that some patients on critical care are temporarily placed into, most commonly in order to facilitate therapies like going onto a ventilator. You may have heard phrases like ‘going off to sleep’, ‘intubated’ or ‘placed on a ventilator’ to describe these overlapping areas, and we hope this video can help clarify these sometimes confusing terms.

When a patient is critically unwell and needs to go onto a ventilator for any reason, there are a series of steps that are followed in order to do this safely. Ventilation is often started in response to an emergency, or sudden deterioration, and therefore it is not always possible to update family/next of kin until after the procedure has been performed and the patient is safe, which may be up to a few hours later.

As soon as the need for ventilation arises, a team of critical care staff comprising specialist doctors and nurses is assembled and use well practiced drills and checklists to ensure all the correct staff, equipment and medications are present. The patient is given high concentrations of oxygen to breathe, and when everything is ready, anaesthetic drugs are given through a drip to make the patient fall asleep. A special tube is then inserted into the mouth and down towards the lungs. This is then connected to a ventilator which essentially takes over the work of breathing – please see the associated video for a more detailed explanation regarding this.

Patients are only kept in an induced coma for as long as is required, which can range from a matter of hours to several weeks. Anaesthetic medicines are infused through drips and the experienced nursing team monitor and adjust the rates of these infusions according to several factors.

An induced coma is not a specific treatment for any illness – it is merely a requirement for being able to offer a patient ventilation, which is itself only a form of breathing support to give the body time to recover from whatever insult it has sustained.

Like with any therapy, there are risks associated with being placed into an induced coma, but these are outweighed by the intended benefits. The anaesthetic medicines used to keep a patient sedated tend to cause the blood pressure to drop. For this reason, special medications must be given to support the blood pressure, and these often requires special drips called central lines to be placed. If it has not already been inserted, another monitoring device called an arterial line will usually be inserted at this point – please see the associated video for a more detailed explanation regarding this.