What is Barotrauma?

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Barotrauma can occur in workers exposed to compressed air environment.

Barotrauma can affect air filled spaces in the body for example the sinuses, ears and lungs.

What is the cause of Barotrauma?

The most common cause is diving and tunneling works.

What are the Signs and symptoms of Barotrauma?

Barotrauma presents with symptoms of:
1.Joint pains
2.rashes
3.breathing symptoms
4.neurological symptoms
5.intravascular coagulation in severe cases

What are the types of Barotrauma?

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.

What are the risk factors for Barotrauma?

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

Diagnostic Criteria of Work relatedness:
A good occupational history to determine the worker’s exposure to hyperbaric or high pressure environment.

The worker may be exposed to:
1.tunneling or shaft sinking in water bearing strata
2.caisson works on river beds
3.pressure checks on aircraft
4.work in medical locks or recompression chambers
5.diving

Investigation to establish work relationship to barotrauma:
Correlate exposure history and work periods to symptoms of compression and investigation results such as sinus, chest, long bones x-rays, audiograms.
Check correlation with workers’ record of work in compressed air or diving.

What is the management of Barotrauma?

Management:

1.Treatment for barotrauma may involve the use of antihistamines, decongestants, analgesics and antibiotics depending on how severe the case is.

2.Sinus x-rays, audiograms and tympanograms are useful to further investigate the condition.

How is Barotrauma prevented?

Prevention:
1.Avoid further exposure to compressed air during recovering from barotrauma.

2.Avoid entering compressed air environment if there is a cold, sore throat, earache or chest infection.

3.treat cases of contact dermatitis with creams and corticosteroids.

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Answer to medical question about Sinusitis:
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I have a sinus infection and not I’m coughing up GREEN?
I’ve had a sinus infection for a week, been on meds for 2 days, now I’m coughing up green stuff. My chest hurts, and my throat is swollen. What can I do to feel better?

Best Answer – Chosen by Voters

If you have a confirmed sinus infection, the green stuff that you are coughing up is probably from the sinuses.

Any infection of the nose or sinuses can cause your throat to feel swollen and your chest to feel congested and painful.

You can try steam inhalation to loosen the green mucous stuck in your sinuses or see your doctor for a sinus washout.

Sometimes antibiotics are needed for a bacterial infection of the sinuses. With treatment you should feel within a few days.

Source(s):

A Simple Guide to Medical Conditions

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DOC I HAVE SINUSITIS

Sinusitis is not sensitive nose as many patients seems to think. The sinuses are air sacs in the skull which lighten the skull and produce mucus to clean the bacteria and other particles out of the air you breathe out through your nose. Sinusitis occur when the infection or inflammation occurs in the sinuses.

Sinusitis is a condition in which the lining of your sinuses becomes inflamed.

The paranasal sinuses are in direct communication with the nose. 

The sinuses are normally sterile. 

If the sinus openings may become blocked, the mucus becomes congested in the sinuses, resulting in stagnation of secretion and finally bacterial growth.


Anything that causes swelling in your sinuses or keeps the cilia from moving mucus can cause sinusitis. 

This can occur because of:
Changes in temperature or air pressure.
Using decongestant nasal sprays too much,
Smoking,
Swimming or diving.
Nasal polyps that block their sinus passages.

When sinusitis is caused by a bacterial or viral infection, you get a sinus infection.
Sinus infections sometimes occur after you had a common cold.
The common cold virus attacks the lining of your sinuses, causing them to swell and become narrow.
Your body responds to the virus by producing more mucus which get blocked in your swollen sinuses because the outlet is higher than the mucus collection.
This built-up mucus makes a good place for bacteria to grow.
The bacteria can cause a sinus infection.


Acute sinusitis is usually bacterial in origin.
Haemophilus influenzae and Streptococcus pneumoniae are the organisms most commonly found in adults.

In children, similar organisms are seen, with the addition of Moraxella catarrhalis. 

In older children and young adults, Staphylococcus aureus is an occasional finding.

In people with low immunity, Fungal infection such as Candida, Aspergillus, and Phycomycetes may be the cause.


Risk factors include the following: 
diabetes mellitus, cancer, hepatic disease, renal failure, burns, extreme malnutrition, and immunosuppressive diseases.


Presentation of sinusitis is often nonspecific.
Patients may present with a persistent common cold.
A common cold that starts to get better and then gets worse may be a sign of acute sinusitis. 

Pain or pressure in some areas of the face (forehead, cheeks or between the eyes) is often a sign of blocked sinus drainage and can be a sign of acute sinusitis.

Pain in your forehead that starts when you lean forward can also be a sign.

Other symptoms may include a stuffy nose.

Some patients complain of dental pain or alteration in smell.

Fever is seen in fewer than 2% of individuals with sinusitis.

Facial tenderness to palpation is present.

Complete opacification of sinus on transillumination is present.

An X-ray of the paranasal sinuses usually confirms the presence of sinusitis as opacity in the sinuses.


Your doctor may prescribe an antibiotic.
You may take an antibiotic for 10 to 14 days, but you will usually start feeling better a couple of days after you start taking it.It is important to take this medicine exactly as your doctor tells you and to continue taking it until it is gone, even after you’re feeling better. 

If you have sinus pain or pressure, your doctor may prescribe or recommend a decongestant to help your sinuses drain.

Painkillers may be prescribed if there is severe pain.


Besides medicines you should help yourself by:
1.Get plenty of rest. 

2.Lying down can make your sinuses feel more congested, so try lying on the side that lets you breathe the best. 

3.Drink plenty of fluids. 

4.Apply moist heat by holding a warm, wet towel against your face or breathing in steam through a cloth or towel. 

5.Rinse your sinus passages with a saline solution. 
You can buy an over-the-counter saline solution or ask your doctor how to make one at home.


In cases where the acute sinus infection does not cleared or become chronic, a sinus washout may be necessary to remove the mucus stuck in the sinuses. 

Most doctors who had done an ENT posting like myself have done many of this washouts and should be able to do it for you. 

This involves syringing of antiseptic solution through a hole in the septum separating the maxillary sinuses from the nose. 

Sometimes syringing of frontal sinuses can be done through a tube inserted into the sinuses.

In severe case of chronic sinusitis, endoscopy surgery may be done to strip the lining of the maxillary sinuses and clean the cavity of the sinuses.

 A new therapy is the use of phage therapy where viruses are used to cause bacteria lysis in the sinuses.

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DOC I HAVE A COMMON COLD

Who has never have the common cold? The code words are “Ah Choo” or sneezing, dripping of nose, pain in the throat and occasional fever. Cold weather, rain, snow, freezer, air conditioner are the precursor of a common cold. Once one person gets the common cold, every one in a closed environment gets it. That is why they called it the common cold.

The Common Cold (A Simple Guide to Coryza(Common Cold))is one of the most common infections seen by the family doctor.


Unlike Influenza, the patient suffer more from inflammation of the mucous membranes of the nose and throat, with sneezing, sore throat, and usually mild coughing. 

There are over 200 different viruses which can cause a common cold: rhinovirus, respiratory syncytial virus (RSV), corona virus, rotavirus.


Generally the common cold viruses produces mild but uncomfortable symptoms which seldom last more than 1 week:

1.Runny nose
2.Sneezing
3.Nasal congestion
4.Tiredness
5.Headache especially around the eyes and forehead
6.Fever – low grade rare


Usually a common cold runs its course without complications in one week. Because there is no cure for a viral infection, I usually aim at relieving the symptoms:


1.Rest is the most important part of treatment. 
A rested patient will recover faster.


2.Adequate warm fluids keep the mucus membranes moist to allow infected mucus to flow better and also to replace wet mucus lost during the runny nose.


3.If there is any fever, headaches and pains, paracetamol can be given to relieve symptoms.


4.Oral (tablet or syrup) decongestants may also relieve nasal symptoms. 
Antihistamines may help to reduce mucus production.


5.Decongestant sprays can relieve block nose temporarily, but should not be used for more than three days. 
Longer use can lead to rebound congestion with more symptoms of congestion.


6.Antibiotics and vitamin C are not helpful in relieving symptoms of the common cold.


Very rarely young children may develop complications such as bronchitis, viral pneumonia, and croup.  
I would check the lungs of young children carefully to make sure there is no breathing problem.

Acute otitis media ( A Simple Guide to Otitis Media) , an infection of the middle ear occurs in 2% of patients with a cold. 
I would ask all patients with cold whether there is pain in the ear or blockage in the ear.

Bacterial Sinusitis (A Simple Guide to Sinusitis) occurs in 0.5% of people with a cold. I would ask them for pain in the cheek and forehead area. If necessary an X-ray of the Sinuses should be done.

People with chronic obstructive pulmonary disease ( A Simple Guide to Chronic Obstructive Lung Disease) who have a rhinovirus infection are more likely to have a more serious or longer duration of illness.

Prevention of the common cold is by :
1.Proper hygienic care of the hands and body
2.Well balanced diet with enough fluids
3.Adequate exercise

It is important to distinguish a Common Cold from Influenza which is usually more serious.

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