Barotrauma, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

This book describes Barotrauma, Diagnosis and Treatment and Related Diseases

I first wrote a book in 2014 on work related Compressed Air Illness and Barotrauma that can occur in workers exposed to compressed air environment.
Barotrauma indicates injuries produced by raised air or water pressure, such as during airplane flights or scuba diving.
Barotrauma can affect air filled spaces in the body such as the sinuses, ears and lungs.
The most common cause is diving, air travel and tunneling works.

Barotrauma is divided into :
1.Sinus barotrauma with acute pain over the sinus area or nasal or postnasal bleeding
2.Middle ear Barotrauma with pain in the ear, bleeding from the ear, burst eardrum,together with hypoacusis, tinnitus, vertigo and hearing loss
3.Inner ear Barotrauma with severe vertigo and hearing loss of affected side
4.Pulmonary Barotrauma with chest pain, breathlessness, unconsciousness, subcutaneous emphysema.

Risk factors for barotrauma:
1.medical unfitness - workers with pre-existing medical conditions,chronic illness of the ears, poor air passages of the lungs are at higher risk
2.sudden changes of pressures -pressures of more tha 1 bar cause higher risk
3.long working hours in compressed air >4 hours
4.failure to follow proper decompression procedure
5.smoking
6.coughing
7.breath holding
8.infections affecting the ear or upper respiratory tract

Any part of the body that contains air can be responsive to these pressures:
1. Ear (most common)—affecting structures in the middle ear
2. Sinus—air-filled facial sinuses surround the bones in the skull
3. Pulmonary (most critical)—lungs
Generalized barotraumas (also termed decompression sickness) involves the whole body.

Activities that can expose someone to significant pressure changes are:
1. Airplane travel
2. Scuba diving, particularly:
a. Ascending without exhaling freely
b. Swimming quickly to the surface when diving
c. Holding the breath when ascending
d. Underwater diving for an increased period of time
e. Repeated dives within 24 hours
f. Flying in an airplane after diving
g. Having air pockets in equipment (such as masks and dry suits)
3. Mechanical ventilation - use of a machine to move air into and out of the lungs (associated with pulmonary trauma)
4. Exposure to shock waves from an explosion

Blockages and congestion in these tubes increase the risk of ear barotrauma because the inside pressure is not allowed to change to match the outside pressure.

These tubes may be blocked or limited by:
1. Congestion from allergies or colds
2. Middle ear infections—more common in younger children
3. Defects of eustachian tube (small tube that runs from the middle ear to the back of the nose and upper throat and helps stabilize internal and external pressures)
4. Damaged or blockage of eustachian tube—resulting from scarring or a tumor
5. Cleft palate or lip

Computed tomography (CT) scans and magnetic resonance imaging (MRI) may be indicated when there is severe headache or severe back pain after diving or air travel.

Pulmonary barotrauma is serious and requires immediate medical attention.

The treatment will be dependent on the specific lung disorder that is present.

The primary medicines for lung barotrauma are oxygen, nitrogen oxide, isotonic fluids, anti-inflammatory medicines, decongestants, and analgesics.

To relieve the pressure in the eustachian tube, the patient can:
a. Suck candy
b. Chew gum
c. Yawn

Medicines to relieve ear and sinus pressure are:
a. Decongestant nasal sprays
b. Oral decongestants
c. Oral antihistamines

Surgery (incision eardrum) may be essential to relieve the pressure if the eustachian tube does not open with treatment..

TABLE OF CONTENT
Introduction
Chapter 1 Barotrauma
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Barosinusitis
Chapter 8 Eustachian Tube Blockage
Epilogue