Barotrauma is a tissue injury caused the volume of gas in the body cavity to the factors that increase the risk for pulmonary barotrauma by a pressure-induced change in specific behaviors include (z. B. rapid ascent, breath holding, inhalation of compressed air), and pulmonary diseases (e.g., B . COPD). Pneumothorax and pneumomediastinum are common phenomena. Patients require neurological examination, and breast imaging. Pneumothorax is treated. Prevention includes reducing risky behaviors and advising divers at high risk.
Overstretching and alveolar rupture can occur when during a very rapid emergence of the breath is held (usually when compressed air is inhaled). The result can be a pneumothorax, which is accompanied by dyspnea, chest pain and a unilateral reduction in breath sounds, or a pneumomediastinum that a feeling of fullness in the chest, neck pain, pleuritic pain that may radiate to the shoulders, dyspnea, cough, hoarseness, and dysphagia caused. A pneumomediastinum may cause crepitus in the neck area due to subcutaneous Hautemphysemen, and it can also a crackling noise during systole to be heard above the heart (Hamman’s sign). A tension pneumothorax which, although rare in barotrauma may have a drop in blood pressure, jugular venous distension, a state-sonorous percussion and, as a later finding cause Trachealverschiebung. As part of alveolar ruptures gas can enter the pulmonary venous flow path, resulting in an arterial gas embolism follows.
Barotrauma is a tissue injury caused the volume of gas in the body cavity to the factors that increase the risk for pulmonary barotrauma by a pressure-induced change in specific behaviors include (z. B. rapid ascent, breath holding, inhalation of compressed air), and pulmonary diseases (e.g., B . COPD). Pneumothorax and pneumomediastinum are common phenomena. Patients require neurological examination, and breast imaging. Pneumothorax is treated. Prevention includes reducing risky behaviors and advising divers at high risk. Overstretching and alveolar rupture can occur when during a very rapid emergence of the breath is held (usually when compressed air is inhaled). The result can be a pneumothorax, which is accompanied by dyspnea, chest pain and a unilateral reduction in breath sounds, or a pneumomediastinum that a feeling of fullness in the chest, neck pain, pleuritic pain that may radiate to the shoulders, dyspnea, cough, hoarseness, and dysphagia caused. A pneumomediastinum may cause crepitus in the neck area due to subcutaneous Hautemphysemen, and it can also a crackling noise during systole to be heard above the heart (Hamman’s sign). A tension pneumothorax which, although rare in barotrauma may have a drop in blood pressure, jugular venous distension, a state-sonorous percussion and, as a later finding cause Trachealverschiebung. As part of alveolar ruptures gas can enter the pulmonary venous flow path, resulting in an arterial gas embolism follows. With very deep dive with bated breath the compression of the lungs during the submarining in rare cases can lead to a reduction in volume under the residual volume and cause a Mucosaödem, vascular congestion and hemorrhages that manifest themselves in the ascent clinically as dyspnea and hemoptysis. Diagnosis Clinical examination Imaging Techniques patients need a neurological examination for signs of brain dysfunction due to arterial gas embolism. If no neurological deficits found a chest x-ray picture is taken while standing, is sought in the for signs of pneumothorax or pneumomediastinum (radiolucent band along the cardiac border). If the chest X-ray scan is negative but a strong clinical suspicion, a CT, which is more sensitive than a simple x-ray, be diagnostically effective. Ultrasound can also be useful for rapid diagnosis of pneumothorax at the bedside. Therapy 100% O2 Sometimes pleural drainage A suspected tension pneumothorax is treated with a needle decompression and subsequent thoracotomy. When a small (eg., 10-20% strength) pneumothorax is present and there are no signs of hemodynamic or respiratory instability, the pneumothorax is able to reproduce, when 100% pure O2 with a high flow over 24-48 h woks , If this treatment is ineffective, or when a larger pneumothorax is present, a pleural drainage can be carried out using a Pigtailkatheters or a small chest tube. In a Pneumomediastinum no specific treatment is required; the symptoms usually disappear within hours or days. After a few hours of observation, most patients can be treated on an outpatient basis. In order to accelerate the absorption of extraalveolärer air in these patients, a ventilator with 100% O2 is recommended with high flow. Rarely has a mediastinotomy is necessary to relieve a Spannungspneumomediastinum. Prevention The prevention of pulmonary barotraumas top priority. Proper techniques of ascent and timing are essential. Patients with pulmonary bullae, Marfan syndrome or chronic obstructive pulmonary disease (COLD) are under high risk of pneumothorax and should not dive or work in areas with compressed air. Patients with asthma are at risk of a pulmonary barotrauma, but many people with asthma can dive safely after they have been examined and treated accordingly. Key points Pulmonary barotraumas can lead to tension pneumothorax, which must be decompressed immediately in rare cases. All patients who have pulmonary barotraumas should be examined for signs of brain dysfunction due to arterial gas embolism. All patients with suspected pulmonary barotraumas are ventilated with 100% O2 and diagnostically tested. For more information Divers Alert Network: 24-hour emergency hotline, 919-684-9111