Carbon Monoxide Poisoning
High-Frequency Jet Ventilation
Otitis Media with Effusion
Diving and the risk of barotrauma. (1/57)STUDY OBJECTIVES: Pulmonary barotrauma (PBT) of ascent is a feared complication in compressed air diving. Although certain respiratory conditions are thought to increase the risk of suffering PBT and thus should preclude diving, in most cases of PBT, risk factors are described as not being present. The purpose of our study was to evaluate factors that possibly cause PBT. DESIGN: We analyzed 15 consecutive cases of PBT with respect to dive factors, clinical and radiologic features, and lung function. They were compared with 15 cases of decompression sickness without PBT, which appeared in the same period. RESULTS: Clinical features of PBT were arterial gas embolism (n = 13), mediastinal emphysema (n = 1), and pneumothorax (n = 1). CT of the chest (performed in 12 cases) revealed subpleural emphysematous blebs in 5 cases that were not detected in preinjury and postinjury chest radiographs. A comparison of predive lung function between groups showed significantly lower midexpiratory flow rates at 50% and 25% of vital capacity in PBT patients (p < 0.05 and p < 0.02, respectively). CONCLUSIONS: These results indicate that divers with preexisting small lung cysts and/or end-expiratory flow limitation may be at risk of PBT. (+info)
Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. (2/57)BACKGROUND: Traditional approaches to mechanical ventilation use tidal volumes of 10 to 15 ml per kilogram of body weight and may cause stretch-induced lung injury in patients with acute lung injury and the acute respiratory distress syndrome. We therefore conducted a trial to determine whether ventilation with lower tidal volumes would improve the clinical outcomes in these patients. METHODS: Patients with acute lung injury and the acute respiratory distress syndrome were enrolled in a multicenter, randomized trial. The trial compared traditional ventilation treatment, which involved an initial tidal volume of 12 ml per kilogram of predicted body weight and an airway pressure measured after a 0.5-second pause at the end of inspiration (plateau pressure) of 50 cm of water or less, with ventilation with a lower tidal volume, which involved an initial tidal volume of 6 ml per kilogram of predicted body weight and a plateau pressure of 30 cm of water or less. The primary outcomes were death before a patient was discharged home and was breathing without assistance and the number of days without ventilator use from day 1 to day 28. RESULTS: The trial was stopped after the enrollment of 861 patients because mortality was lower in the group treated with lower tidal volumes than in the group treated with traditional tidal volumes (31.0 percent vs. 39.8 percent, P=0.007), and the number of days without ventilator use during the first 28 days after randomization was greater in this group (mean [+/-SD], 12+/-11 vs. 10+/-11; P=0.007). The mean tidal volumes on days 1 to 3 were 6.2+/-0.8 and 11.8+/-0.8 ml per kilogram of predicted body weight (P<0.001), respectively, and the mean plateau pressures were 25+/-6 and 33+/-8 cm of water (P<0.001), respectively. CONCLUSIONS: In patients with acute lung injury and the acute respiratory distress syndrome, mechanical ventilation with a lower tidal volume than is traditionally used results in decreased mortality and increases the number of days without ventilator use. (+info)
An approach to ventilation in acute respiratory distress syndrome. (3/57)Appropriate management of patients with acute respiratory distress syndrome (ARDS) represents a challenge for physicians working in the critical care environment. Significant advances have been made in understanding the pathophysiology of ARDS. There is also an increasing appreciation of the role of ventilator-induced lung injury (VILI). VILI is most likely related to several different aspects of ventilator management: barotrauma due to high peak airway pressures, lung overdistension or volutrauma due to high transpulmonary pressures, alveolar membrane damage due to insufficient positive end expiratory pressure levels and oxygen-related cell toxicity. Various lung protective strategies have been suggested to minimize the damage caused by conventional modes of ventilation. These include the use of pressure- and volume-limited ventilation, the use of the prone position in the management of ARDS, and extracorporeal methods of oxygen delivery and carbon dioxide removal. Although the death rate resulting from ARDS has been declining over the past 10 years, there is no evidence that any specific treatment or change in approach to ventilation is the cause of this improved survival. (+info)
Acute confusion secondary to pneumocephalus in an elderly patient. (4/57)PRESENTATION: an 83-year-old man was admitted to hospital with acute confusion 3 days after a direct flight from Australia. OUTCOME: computed tomography (CT) brain scan and magnetic resonance imaging head scan revealed the cause to be pneumocephalus, apparently the result of barotrauma caused by Valsalva manoeuvres when he attempted to unblock his nose during the flight. After 5 days of nursing in the vertical position the patient's Abbreviated Mental Score returned to normal. A CT brain scan 6 weeks later showed complete resolution of the pneumocephalus. (+info)
Neurologic complications of scuba diving. (5/57)Recreational scuba diving has become a popular sport in the United States, with almost 9 million certified divers. When severe diving injury occurs, the nervous system is frequently involved. In dive-related barotrauma, compressed or expanding gas within the ears, sinuses and lungs causes various forms of neurologic injury. Otic barotrauma often induces pain, vertigo and hearing loss. In pulmonary barotrauma of ascent, lung damage can precipitate arterial gas embolism, causing blockage of cerebral blood vessels and alterations of consciousness, seizures and focal neurologic deficits. In patients with decompression sickness, the vestibular system, spinal cord and brain are affected by the formation of nitrogen bubbles. Common signs and symptoms include vertigo, thoracic myelopathy with leg weakness, confusion, headache and hemiparesis. Other diving-related neurologic complications include headache and oxygen toxicity. (+info)
Cancer mortality after nasopharyngeal radium irradiation in the Netherlands: a cohort study. (6/57)BACKGROUND: Nasopharyngeal radium irradiation (NRI) was used widely from 1940 through 1970 to treat otitis serosa in children and barotrauma in airmen and submariners. We assessed whether NRI-exposed individuals were at higher risk for cancer-related deaths than were nonexposed individuals. METHODS: We conducted a retrospective cohort study of all-cause and cancer-related mortality in 5358 NRI-exposed subjects and in 5265 frequency-matched nonexposed subjects, who as children were treated at nine ear, nose, and throat clinics in The Netherlands from 1945 through 1981. We recorded personal and medical data from original patient medical records and assessed vital status through follow-up at municipal population registries. Risk of mortality was evaluated by standardized mortality ratios (SMRs). All statistical tests were two-sided. RESULTS: The average radiation doses were 275, 10.9, 1.8, and 1.5 cGy for the nasopharynx, pituitary, brain, and thyroid, respectively. The median follow-up was 31.6 years. Three hundred two NRI-exposed subjects had died, with 269.2 deaths expected (SMR = 1.1; 95% confidence interval [CI] = 1.0 to 1.3); among nonexposed subjects, 315 died, with 283.5 deaths expected (SMR = 1.1; 95% CI = 0.99 to 1.2). Cancer-related deaths of 96 exposed subjects (SMR = 1.2; 95% CI = 0.95 to 1.4) and 87 nonexposed subjects (SMR = 1.0; 95% CI = 0.8 to 1.3) were documented. There were no excess deaths from cancers of the head and neck area among exposed subjects. However, there were excess deaths from cancers of lymphoproliferative and hematopoietic origin (SMR = 1.9; 95% CI = 1.1 to 3.0), mainly from non-Hodgkin's lymphoma (SMR = 2.6; 95% CI = 1.0 to 5.3). We found no evidence that breast cancer deaths were less than expected (SMR = 1.7; 95% CI = 0.9 to 2.8) in contrast to an earlier study. CONCLUSIONS: Our findings do not indicate an increased cancer mortality risk in a population exposed to NRI in childhood. More prolonged follow-up of this and other NRI cohorts is recommended. (+info)
Proportional assist ventilation (PAV): a significant advance or a futile struggle between logic and practice? (7/57)Proportional assist ventilation is a promising addition to other more conventional modes of mechanical ventilation with the theoretical advantage of improving patient-ventilator interaction. It may also be of use as a diagnostic tool in the control of breathing in mechanically ventilated patients. (+info)
Continuous left hemidiaphragm sign revisited: a case of spontaneous pneumopericardium and literature review. (8/57)In pneumopericardium, a rare but potentially life threatening differential diagnosis of chest pain with a broad variety of causes, rapid diagnosis and adequate treatment are crucial. In upright posteroanterior chest radiography, the apical limit of a radiolucent rim, outlining both the left ventricle and the right atrium, lies at the level of the pulmonary artery and ascending aorta, reflecting the anatomical limits of the pericardium. The band of gas surrounding the heart may outline the normally invisible parts of the diaphragm, producing the continuous left hemidiaphragm sign in an upright lateral chest radiograph. If haemodynamic conditions are stable, the underlying condition should be treated and the patient should be monitored closely. Acute haemodynamic deterioration should prompt rapid further investigation and cardiac tamponade must be actively ruled out. Spontaneous pneumopericardium in a 20 year old man is presented, and its pathophysiology described. (+info)
There are several types of barotrauma that can occur in the human body, including:
1. Pulmonary barotrauma: This occurs when the air spaces in the lungs are subjected to sudden changes in pressure, leading to damage to the lung tissue and potentially causing pneumothorax (collapsed lung) or pneumomediastinum (air in the mediastinum).
2. Sinus barotrauma: This occurs when the sinuses are subjected to sudden changes in pressure, leading to damage to the sinus membranes and potentially causing bleeding or infection.
3. Middle ear barotrauma: This occurs when the eustachian tube, which connects the middle ear to the back of the throat, fails to equalize the pressure on both sides of the eardrum, leading to damage to the eardrum or middle ear bones.
4. Cerebral barotrauma: This occurs when the brain is subjected to sudden changes in pressure, potentially leading to damage to the brain tissue and other complications such as stroke or seizures.
Symptoms of barotrauma can vary depending on the location and severity of the injury, but may include:
* Chest pain or tightness
* Difficulty breathing
* Coughing up blood or froth
* Dizziness or loss of consciousness
* Hearing loss or ringing in the ears
Treatment of barotrauma depends on the underlying cause and severity of the injury. In some cases, medical intervention may be necessary to manage symptoms and prevent further complications.
The severity of decompression sickness can vary widely, ranging from mild discomfort to life-threatening complications. In severe cases, the condition can cause respiratory failure, cardiac arrest, and even death.
The risk of developing decompression sickness increases with the depth and duration of the dive, as well as the speed at which the diver surfaces. To minimize the risk of this condition, divers are advised to follow established diving procedures and protocols, including gradual ascent from depth and regular stops at specific depths to allow for decompression.
Treatment for decompression sickness typically involves hyperbaric oxygen therapy, which involves breathing pure oxygen in a pressurized chamber to help dissolved gases in the body to be absorbed and excreted more quickly. In severe cases, hospitalization may be necessary to monitor and treat complications such as respiratory or cardiac failure.
Prevention is key when it comes to decompression sickness, and divers are advised to take a number of precautions to minimize their risk, including:
1. Planning dives carefully to avoid excessive depth and duration.
2. Following established diving procedures and protocols.
3. Using proper equipment and maintaining it in good condition.
4. Making gradual ascents from depth and regular stops at specific depths to allow for decompression.
5. Avoiding alcohol and sedatives before and after diving.
6. Getting plenty of rest before and after diving.
7. Seeking medical attention if any symptoms of decompression sickness are experienced.
1. Acute respiratory distress syndrome (ARDS): This is a severe and life-threatening condition that occurs when the lungs become inflamed and fill with fluid, making it difficult to breathe.
2. Pneumonia: This is an infection of the lungs that can cause inflammation and damage to the air sacs and lung tissue.
3. Aspiration pneumonitis: This occurs when food, liquid, or other foreign substances are inhaled into the lungs, causing inflammation and damage.
4. Chemical pneumonitis: This is caused by exposure to harmful chemicals or toxins that can damage the lungs and cause inflammation.
5. Radiation pneumonitis: This occurs when the lungs are exposed to high levels of radiation, causing damage and inflammation.
6. Lung fibrosis: This is a chronic condition in which the lungs become scarred and stiff, making it difficult to breathe.
7. Pulmonary embolism: This occurs when a blood clot forms in the lungs, blocking the flow of blood and oxygen to the heart and other organs.
Symptoms of lung injury can include:
* Shortness of breath
* Chest pain or tightness
* Coughing up blood or pus
* Confusion or disorientation
Treatment for lung injury depends on the underlying cause and severity of the condition, and may include oxygen therapy, medications to reduce inflammation, antibiotics for infections, and mechanical ventilation in severe cases. In some cases, lung injury can be a life-threatening condition and may require hospitalization and intensive care.
Carbon Monoxide Poisoning Symptoms
The symptoms of carbon monoxide poisoning can vary depending on the level and duration of exposure, but they typically include:
* Dizziness or nausea
* Slurred speech
* Loss of consciousness
In severe cases, carbon monoxide poisoning can cause brain damage, coma, and even death.
Carbon Monoxide Poisoning Causes
Carbon monoxide is a byproduct of incomplete combustion of fuels such as gasoline, natural gas, or wood. Sources of carbon monoxide poisoning include:
* Faulty heating systems or water heaters
* Poorly vented appliances like stoves and fireplaces
* Clogged chimneys or vents
* Running cars in enclosed spaces like garages
* Overcrowding with too many people in a small, poorly ventilated space
Diagnosis of Carbon Monoxide Poisoning
Doctors may suspect carbon monoxide poisoning based on symptoms and medical history. Blood tests can measure the level of carboxyhemoglobin (COHb) in red blood cells, which indicates CO exposure. Chest X-rays or CT scans may also be used to check for signs of lung damage.
Treatment of Carbon Monoxide Poisoning
The treatment of carbon monoxide poisoning involves moving the patient to a location with fresh air and administering oxygen therapy to help remove CO from the bloodstream. In severe cases, medication may be given to help stimulate breathing and improve oxygenation of tissues. Hyperbaric oxygen therapy may also be used in some cases.
Prevention of Carbon Monoxide Poisoning
Prevention is key when it comes to carbon monoxide poisoning. Some steps you can take to prevent CO poisoning include:
* Installing a carbon monoxide detector in your home
* Regularly inspecting and maintaining appliances like furnaces, water heaters, and chimneys
* Properly venting appliances and ensuring they are installed in well-ventilated areas
* Not running cars or generators in enclosed spaces
* Avoiding overcrowding and ensuring there is adequate ventilation in living spaces
Carbon monoxide poisoning is a serious condition that can be fatal if not treated promptly. It's important to be aware of the sources of CO exposure and take steps to prevent it, such as installing carbon monoxide detectors and regularly maintaining appliances. If you suspect CO poisoning, seek medical attention immediately.
Ear Anatomy: The middle ear consists of three small bones called ossicles (the malleus, incus, and stapes) that transmit sound waves to the inner ear. The eardrum, a thin membrane, separates the outer ear canal from the middle ear. In OME, fluid accumulates in the middle ear, causing the eardrum to become congested and reducing its ability to vibrate properly.
Causes: There are several factors that can contribute to the development of OME, including:
1. Viral upper respiratory infections (such as the common cold)
3. Enlarged adenoids or tonsils
4. Cystic fibrosis
5. Sinus infections
6. Meniere's disease
7. Head injury
Symptoms: The symptoms of OME can vary depending on the severity of the condition, but may include:
1. Hearing loss or muffled hearing
2. Discharge or fluid leaking from the ear
3. Pain or discomfort in the ear
4. Difficulty responding to sounds or understanding speech
7. Vertigo or dizziness
8. Loss of balance or coordination
Diagnosis: OME is typically diagnosed through a combination of physical examination, medical history, and ear examinations using an otoscope or tympanometry. A tympanogram may also be performed to measure the movement of the eardrum.
Treatment: The treatment of OME depends on the severity of the condition and may include:
1. Watchful waiting: In mild cases, OME may resolve on its own within a few weeks without any treatment.
2. Antibiotics: If there is a concurrent infection, antibiotics may be prescribed to treat the underlying infection.
3. Pain relief medication: Over-the-counter pain relief medication such as acetaminophen or ibuprofen may be recommended to relieve any discomfort or pain.
4. Eardrops: Eardrops containing antibiotics or steroids may be prescribed to treat the infection and reduce inflammation.
5. Tubes in the ear: In more severe cases, tubes may be placed in the ear drum to help drain fluid and relieve pressure.
6. Surgery: In rare cases, surgery may be necessary to remove the membrane or repair any damage to the middle ear bones.
Prognosis: The prognosis for OME is generally good, with most cases resolving within a few weeks without any long-term complications. However, in some cases, the condition can persist for longer periods of time and may lead to more serious complications such as hearing loss or mastoiditis.
Prevention: There is no specific way to prevent OME, but good ear hygiene and avoiding exposure to loud noises can help reduce the risk of developing the condition. Regular check-ups with an audiologist or otolaryngologist can also help identify any early signs of OME and prevent complications.
Conclusion: Otitis media with effusion (OME) is a common condition that affects children and adults, causing fluid buildup in the middle ear. While it is generally not a serious condition, it can cause discomfort and affect hearing. Treatment options range from watchful waiting to antibiotics and surgery, depending on the severity of the case. Good ear hygiene and regular check-ups with an audiologist or otolaryngologist can help prevent complications and ensure proper management of the condition.
Hyperopia, also known as farsightedness, is a common vision condition in which close objects appear blurry while distant objects appear clear. This occurs when the eyeball is shorter than normal or the cornea is not curved enough, causing light rays to focus behind the retina rather than directly on it. Hyperopia can be treated with glasses, contact lenses, or refractive surgery.
Word origin: Greek "hyper" (beyond) + "ops" (eye) + -ia (suffix denoting a condition or state)
First recorded use: 1690s
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- Severe injuries such as collapsed lung, pulmonary barotrauma, or air embolism might need treatment tables or a recompression chamber. (aquafaq.com)
- Holding one's breath or performing a Valsalva maneuver during ascent may result in pulmonary barotrauma. (cancertherapyadvisor.com)
- Decreasing surrounding atmospheric pressure during ascent inversely expands lung volumes resulting in barotrauma and subsequent alveolar damage facilitating entry of air bubbles into the pulmonary venous circulation. (cancertherapyadvisor.com)
- If you must change altitude often or you are prone to barotrauma, you may need to have surgery to place tubes in the ear drum. (medlineplus.gov)
- This article is overview of the various types of barotrauma, such as decompression sickness, altitude sickness, medically induced barotrauma, primary blast injury, and self-inflicted barotrauma. (medscape.com)
- Barotrauma can occur when the pressure inside an air-filled, enclosed body space (e.g., abdomen, middle ear, sinuses) is not the same as the air pressure inside the aircraft cabin. (cdc.gov)
- This can lead to problems in the ear ( Otitic Barotrauma ), sinuses ( Sinus Barotrauma ), in the intestine or a bad tooth ( Aero-odantalgia ). (avmed.in)
- Barotrauma to the ears, sinuses, and lungs presents with local pain or shortness of breath during the dive itself. (cancertherapyadvisor.com)
- This is a true incidence of barotrauma of ears in a combat pilot. (avmed.in)
Tympanic membrane rupture2
- Barotrauma is an injury caused by a difference in pressure between a gas inside, in contact with, or outside the body and the pressure of the surrounding gas or fluid. (medscape.com)
- By practicing safe scuba diving and spearfishing, and getting medical attention on time, divers can reduce the chance of serious injury or death from barotrauma. (aquafaq.com)
- Barotrauma is a common ear injury for scuba divers and spearfishers. (aquafaq.com)
- Barotrauma is the second most frequent dive-related injury. (cancertherapyadvisor.com)
- The 3 major manifestations of barotrauma include (1) sinus or middle ear effects, (2) decompression sickness (DCS), and (3) arterial gas emboli. (medscape.com)
- Note that there are recorded cases of barotrauma with arterial gas embolism (AGE) occurring in very shallow dives (eg, less than 1.2 m). (medscape.com)
- Despite this treatment, she remained in status asthmaticus with high airway pressure and barotrauma causing pneumomediastinum and subcutaneous emphysema. (nih.gov)
- One of the possible injuries that may affect the patient during general anesthesia is known as barotrauma, which originates from a hypertension pneumothorax. (bvsalud.org)
- Trois chiens ont reçu un diagnostic de pneumothorax spontané et ont été référés au Ontario Veterinary College Health Sciences Centre pour prise en charge. (bvsalud.org)
- Barotrauma is a common challenge that spearfishers face, caused by the rapid changes in pressure that occur as they dive deeper into the water. (aquafaq.com)
- Though this piece has been written with focus on aircrew, especially pilots, barotrauma is known to occur in non-pilot aircrew, passengers, especially at the extremes of ages, as well as, those who choose to fly despite of a cold or flu. (avmed.in)
- Barotrauma can be prevented by equalizing ear and sinus pressure while descending, avoiding rapid ascents, and maintaining proper buoyancy control. (aquafaq.com)
- Barotrauma expands gasses in a fish causing the air bladder and other organs to expand as well, making it difficult for fish to swim after release. (noaa.gov)
- Expert spearfishers recommend undergoing proper training and certification before attempting to dive deeper depths, utilizing proper equipment such as masks and fins, and constantly monitoring and assessing their physical condition while diving to prevent barotrauma and other injuries. (aquafaq.com)
- Barotrauma is a game taking place in the deep oceans of Europa, one of Jupiter's moons, in which players act as members of a submarine crew navigating the frozen depths. (strangelyawesomegames.com)
- Diving barotrauma can present with various manifestations, from ear, face or mouth pain and headaches to major joint pain, paralysis, coma, and death. (medscape.com)
- If you have a congested nose from allergies, colds, or an upper respiratory infection, you are more likely to develop barotrauma. (medlineplus.gov)
- If barotrauma occurs while spearfishing, it should be treated immediately by ascending slowly and seeking medical attention if necessary. (aquafaq.com)
- Spearfishers and scuba divers should know the importance of preventing and treating barotrauma. (aquafaq.com)
- In this section of our article, we will focus on the topic of barotrauma in spearfishing. (aquafaq.com)
- By understanding the risks associated with barotrauma and how to mitigate them, divers can continue to enjoy this exciting sport without putting their health at unnecessary risk. (aquafaq.com)
- We'll explore how the body reacts to these changes, and how spearfishers can anticipate and prevent barotrauma by understanding the science behind it. (aquafaq.com)
- Barotrauma, oxygen toxicity and lung immaturity are presumed to play an important role in the development of ALE in children with BPD and most cases present overinflation [1,2]. (who.int)
- From there, we will explore why preventing and treating barotrauma is so important in the context of spearfishing. (aquafaq.com)
- En route to the shore (via boat), the victim received medical assistance which continued on consider upgrading manual underwater the shore. (cdc.gov)
- Barotrauma is usually a benign , self-limited condition that responds to self-care. (medlineplus.gov)
- Barotrauma to yield much difference between the trough and alternate treatment. (reso-nation.org)
- Barotrauma is a serious concern in the world of spearfishing that all divers should be aware of. (aquafaq.com)