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

By Kenneth Kee

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

• Language: English
• Publisher: Kenneth Kee
• Release date: Dec 7, 2019
• ISBN: 9780463795378

Kenneth Kee

Medical doctor since 1972. Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009. Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993. Dr Kenneth Kee is still working as a family doctor at the age of 70. However he has reduced his consultation hours to 3 hours in the morning and 2 hours in the afternoon. He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com. His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com This autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com. From which many free articles from the blog was taken and put together into 1000 eBooks. He apologized for typos and spelling mistakes in his earlier books. He will endeavor to improve the writing in futures. Some people have complained that the simple guides are too simple. For their information they are made simple in order to educate the patients. The later books go into more details of medical disorders. He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter. The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks. He does not do any night duty since 2000 ever since Dr Tan had his second stroke. His clinic is now relocated to the Buona Vista Community Centre. The 2 units of his original clinic are being demolished to make way for a new Shopping Mall. He is now doing some blogging and internet surfing (bulletin boards since the 1980's) starting with the Apple computer and going to PC. The entire PC is upgraded by himself from XT to the present Pentium duo core. The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive. He is also into DIY changing his own toilet cistern and other electric appliance. His hunger for knowledge has not abated and he is a lifelong learner. The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned. This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale. Dr Kee is the author of: "A Family Doctor's Tale" "Life Lessons Learned From The Study And Practice Of Medicine" "Case Notes From A Family Doctor"

Book preview

Barotrauma,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2019 Smashwords Edition,

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Barotrauma, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Barotrauma)

This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 e-Books.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Barotrauma

What is Barotrauma?

Barotrauma indicates injuries produced by raised air or water pressure, such as during airplane flights or scuba diving.

Barotrauma can cause pain or discomfort that is felt when a difference in air or water pressure between the outside environment and the inside of the body happens.

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

Barotrauma of the ear is frequent.

Generalized barotraumas (also termed decompression sickness) involves the whole body.

The middle ear involves the eardrum and the space behind it.

The only bond between the middle ear and the exterior is a thin canal termed the Eustachian tube.

This joins the ear with the back of the mouth.

When the patient swallows anything, the patient may hear a small click in the ears.

This click is a bubble of air being transported through the Eustachian tube.

These bubbles constantly move into the middle ear where they equalize or balance the ear's inner pressure.

Ear barotrauma can happen when these tubes are totally or partly blocked.

On an airplane, barotrauma to the ear (also termed aero-otitis or barotitis) can happen as the plane goes down to land (make a descent).

Barotrauma of the ear also can happen when scuba divers goes into the water depth (descend).

The pressure change can produce a vacuum in the middle ear that draws the eardrum inward.

This can produce pain and can dampen sounds.

The ear will feel blocked and the patient may feel as if he or she needs to pop it.

In more serious cases of barotrauma, the middle ear can fill up with clear fluid as the body attempts to balance or equalize the pressure on both sides of the eardrum.

This fluid is pulled out of blood vessels in the lining of the inner ear, and can only pass out (drain) if the Eustachian tube is open (not blocked).

Fluid stuck behind the eardrum is called serous otitis media.

It can produce pain and hearing difficulty that is similar to a middle ear infection.

The eardrum can rupture (break) in severe cases of ear barotrauma, producing bleeding or leaking of fluid from the ear.

A ruptured eardrum can