tailieunhanh - Musculoskeletal problems and injuries - part 9

cấm bơi lội hoặc bay cho đến khi màng tympanic chữa lành một cách tự nhiên. Thuốc thông mũi và thuốc kháng histamin thường được khuyến khích. Thuốc kháng sinh đã được đề xuất nhưng có giá trị không chắc chắn. Bệnh nhân không nên nhảy hoặc bay cho đến khi họ có sự chuyển động của màng tympanic | 266 Allan V. Abbott prohibiting swimming or flying until the tympanic membrane heals spontaneously. Decongestants and antihistamines are usually recommended. Antibiotics have been suggested but are of uncertain value. Patients should not dive or fly until they have movement of the tympanic membrane on autoinflation during otoscope examination by the physician. Patients with inner ear barotrauma should be referred to an otolaryngologist. Sinus barotrauma can be treated with decongestant nasal sprays such as phenylephrine Neo-Synephrine and oral decongestants such as pseudoephedrine Sudafed which shrink the nasal mucosa to help open and drain the affected Patients with recurrent sinus barotrauma or sinus barotraumas that is resistant to medical treatment should be referred to an Decompression Sickness Pulmonary Barotrauma Decompression sickness the bends most often occurs after divers descend and remain deeper than 10 m 33 feet . As divers increase underwater depth time nitrogen gradually dissolves in the blood and tissues. If ascent is rapid this nitrogen can become insoluble forming bubbles in the bloodstream and the tissues. Decompression sickness usually manifests immediately or shortly after the dive but may occur as long as 12 hours later. Most commonly the victim experiences steady or throbbing pain in the shoulders or elbows with some relief on bending the affected joint. The skin may become pruritic with rashes and purplish mottling. Cerebral effects include headache fatigue inappropriate behavior seizures hemiplegia and visual disturbances. Pulmonary effects include substernal pain cough and 12 Pulmonary barotrauma is a risk during SCUBA diving and mechanical ventilation especially when peak airway pressures are more than 70 cm H2O. a scuba diver breathing compressed air who ascends from depth without exhaling runs a risk of pulmonary trauma as a result of overdistention of the lungs. Overinflated alveoli can .