Barotrauma

Introduction to barotrauma Cases of barotrauma include temporary blockage of the Eustachian tube and swelling of the eardrum due to sudden changes in air pressure. This disease usually occurs on the way to travel by air. Negative pressure in the tympanic cavity can cause vasodilatation of the submucosal tissue, causing leakage of serum, or even bleeding, forming middle ear effusion or blood accumulation. The tympanic membrane itself may increase with the negative pressure of the middle ear, and may cause invagination, congestion, mucosal layer and The fibrous layer is peeled off, and even the perforation causes a barotrauma. basic knowledge The proportion of illness: 20% Susceptible people: no specific people Mode of infection: non-infectious Complications: deafness, dizziness, nausea and vomiting

Cause of barotrauma

The higher the normal air force takes off, the lower the atmospheric pressure, and the higher the pressure inside the drum. When the pressure difference between the inside and outside of the drum reaches 2 kPa (equivalent to 152 meters), the gas in the drum chamber will escape from the eustachian tube, thereby maintaining the pressure balance inside and outside the drum. If the volley continues to fly high, whenever the pressure difference reaches 1.5 kPa, the Eustachian tube can be automatically opened once for adjustment. Therefore, it is lifted up and climbed, and tympanic trauma is not easy to occur. On the contrary, from the high altitude, the external air pressure increases and the pressure inside the air bubble gradually becomes smaller, and it is difficult for the outside air to open the eustachian tube and enter the tympanic chamber. According to Armstrong (1937), when the pressure difference between the inside and outside of the drum is 12 kPa, the eustachian tube cannot be automatically opened. In the 1947 McGibbon study, the tympanic pressure difference caused by the sudden drop from high altitude and the sudden drop from low altitude was completely different, such as the fall of 9144 meters at high altitude to 6096 meters, the decrease of 3048 meters, the pressure difference was 16.4 kPa, and the drop was 3657.6 meters at low altitude. To 609.6 meters, the same drop is 3048 meters, and the tympanic pressure difference is 29.7kPa, which is almost doubled. It can be seen that the low-altitude subduction flight has a larger difference than the high-altitude subduction pressure, so the incidence of tympanic trauma is also relatively high, often occurring at an altitude of 1000 to 4000 meters. The diver enters the water and increases the atmospheric pressure every 10 meters. If the compressed air is not inhaled, it will also cause tympanic trauma. Once the tympanic cavity forms a negative pressure, the tympanic membrane is invaginated, the mucosal blood vessels are also dilated and edematous, and even bleeding can occur.

Air pressure injury prevention

The aim is to eliminate the cause of sinus occlusion as soon as possible and restore its ventilation function. It is advisable to use vasoconstrictor, local hot compress and physiotherapy for mucosal congestion and swelling. Apply antibiotics or anti-allergic drugs to the body. It is feasible to inject gas into the air-damaged maxillary sinusitis to relieve symptoms. If the lesion is serious and it is difficult to eliminate the cause of the blockage immediately, the patient can be placed in the low pressure chamber, and the air pressure can be slowly adjusted to maintain the rebalancing of the air pressure inside and outside the nose. When the symptoms appear in the airplane's rapid decline, the original speed can rise again and then slowly drop. There is a hematoma in the submucosal sinus cavity, especially near the sinus ostium. If the short-term observation is not observed, the sinus surgery should be removed.

Strictly select flight and diving personnel, regular physical examination, and find that patients with nasal diseases should suspend work and give treatment. In addition, efforts should be made to improve the cabin conditions and keep the air pressure stable.

The church occupants do how to swallow and pinch the nose. The flight crew mainly performs open training on the eustachian tube muscles, including swallowing, lifting throat, soft palate movement and jaw movement. In the case of a cold, it is advisable to use 1% ephedrine solution in the nose before taking the machine to make the nasal cavity unobstructed and the eustachian tube not to be occluded.

Com of air injury Complications, deafness, nausea, nausea and vomiting

The tympanic membrane is ruptured, the ear pain is severe, the tinnitus and deafness are aggravated, and there are dizziness, nausea, vomiting, etc., generally lasting for half a day to two days, and the symptoms gradually disappear. Deafness: Different in weight, because it is more common in single ear, it is easy to be ignored. Such deafness is more proportional to the progress of the disease, that is, the lesion is heavier and the deafness is also aggravated. Generally, it is conductive sputum, the tympanic membrane is congested and invaginated, the blood around the hammer stem is congested, there is scattered bleeding point, and sometimes the blood plane and air bubbles are visible through the tympanic membrane, and the tympanic membrane is linearly perforated.

Symptoms of barotrauma common symptoms tinnitus internal bleeding soft tissue swelling congestive ear tympanic membrane perforation coma

Symptoms occur during or after the aircraft descends. Mainly for the forehead pain or numbness of the cheeks and molars, occasionally with a snot, occasionally a shock occurred. Nasal secretions are mucous, often with bloodshot. Nasal examination is often covered by the original lesion, or no abnormalities are found, and bloody secretions are seen in the middle nasal passage. X-ray photographs thickened sinus mucosa, sinus opacity, often with a liquid level, and a semicircular shadow when submucosal hematoma. Lighter hours or days can be gradually restored, and severe cases often last for several weeks to heal. Patients with combined purulent infections have worsened symptoms for a longer period of time with fever.

Mainly for the forehead or cheeks, varying degrees of pain, accompanied by pain in the roots of the teeth, occasional nosebleeds, eye pain, tearing and blurred vision. Nasal examination showed mucosal congestion and serous blood secretions, mucosal swelling or polyps near the sinus ostium. X-ray sinus film shows thickening of the sinus mucosa or a liquid level, and a hematoma can be seen with a semi-circular shadow.

Pneumatic injury check

Negative pressure in the tympanic cavity can cause vasodilatation of the submucosal tissue, causing leakage of serum, or even bleeding, forming middle ear effusion or blood accumulation. The tympanic membrane itself may increase with the negative pressure of the middle ear, and may cause invagination, congestion, mucosal layer and The fibrous layer is peeled off and even perforated. Therefore, the performance of sudden feelings of ear nausea, tinnitus, headache, dizziness and other symptoms. The lighter ones only feel the ear suffocation and healed after a few hours. In severe cases, earache, tinnitus and suction loss are obvious, and it can be restored in the future. If the tympanic effusion and blood accumulation are not easy to absorb, it will last for several days. In some cases, the tympanic membrane can be congested, and the tympanic membrane can be perforated. After repeated injuries, the tympanic membrane is often invaginated, the turbidity is thickened, the activity is poor, and the vocal tract is transmitted.

Gas pressure injury diagnosis

X-ray sinus film shows thickening of the sinus mucosa or a liquid level, and a hematoma can be seen with a semi-circular shadow.

Negative pressure in the tympanic cavity can cause vasodilatation of the submucosal tissue, causing leakage of serum, or even bleeding, forming middle ear effusion or blood accumulation. The tympanic membrane itself may increase with the negative pressure of the middle ear, and may cause invagination, congestion, mucosal layer and The fibrous layer is peeled off and even perforated. Therefore, the performance of sudden feelings of ear nausea, tinnitus, headache, dizziness and other symptoms. The lighter ones only feel the ear suffocation and healed after a few hours. In severe cases, earache, tinnitus and suction loss are obvious, and it can be restored in the future. If the tympanic effusion and blood accumulation are not easy to absorb, it will last for several days. In some cases, the tympanic membrane can be congested, and the tympanic membrane can be perforated. After repeated injuries, the tympanic membrane is often invaginated, the turbidity is thickened, the activity is poor, and the vocal tract is transmitted.

Differential diagnosis of barotrauma:

Sinus pressure injury: When the sinus air pressure is flying or diving, the external air pressure changes drastically, and the air pressure in the sinus and the outside air pressure cannot be balanced, so that the sinus mucosa is hyperemia and swelling, and even a series of diseases such as mucosal or submucosal hemorrhage and edema are called Sinus pressure injury. Occur in the frontal sinus and maxillary sinus.

Middle ear barotrauma should be prevented. Every occupant in the church how to do swallowing and pinching the nose, and the flight crew mainly performs open training on the eustachian tube muscle, including swallowing, lifting throat, soft palate movement and jaw movement. When taking a cold, it is advisable to use 1 ephedrine solution in the nose before taking the machine, so that the nasal cavity is unobstructed, the eustachian tube is not blocked, and if necessary, it is temporarily stopped. If the driver has earache in the fall, he can fly back to the original height, and then descend at a low speed and continue to open the eustachian tube to avoid causing damage to the middle ear.

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