What Do You Do About Barotrauma to the Ear?

Discussion Most ear barotrauma discussions are directed toward diving barotrauma where patients may have sudden nausea, headache, ear pain, tinnitus, deafness and vertigo. The tympanic membrane itself is evaluated on the Teed scale: 0 – Normal ear 1 – Congestion around the umbo, (happens with pressure differential of 2 pounds per square inch) 2 – Congestion of entire tympanic membrane (happens with a pressure differential of 2-3 pounds per square inch) 3 – Middle ear hemorrhage 4 – Extensive middle ear hemorrhage with visible blood bubbles behind the tympanic membrane, and tympanic membrane may rupture. 5 – Entire middle ear filled with deoxygenated (dark) blood The patient above would be a Teed 1 who had congestion around the umbo and not the entire ear or middle ear hemorrhage. Another type of barotrauma is blast injury which the above patient’s injury was more consistent with. Primary blast injury is due to the high-pressure blast wave acting on the body. This has the most effect on air containing organs such as the ear, lung and bowel. Secondary blast injury is due to flying debris from the blast itself. Tertiary blast injury is due to impact with another object such as being thrown by the blast wind. Obviously all 3 types of injuries can occur in a patient and severity depends on many factors especially distance from the blast. With blast injuries the most common symptoms are hearing loss, tinnitus (most improve but may be perm...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news

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This study used an operant conditioning animal model to examine the interaction between tinnitus and auditory vigilant attention as well as auditory selective attention. Tinnitus was induced in 90-day-old rats by a unilateral exposure to band-limited noise (120 dB, SPL). Tinnitus testing began 90 days following exposure; afterward animals were divided into 3 groups: Unexposed controls without tinnitus, Exposed without tinnitus, and Exposed with tinnitus. Tinnitus was evident in the vicinity of 20 kHz. Vigilant attention was quantified by the behavioral (operant) response to unpredictable sound transitions signaling changes...
Source: Neuroscience - Category: Neuroscience Source Type: research
Publication date: Available online 17 October 2018Source: NeuroscienceAuthor(s): Dionéia Araldi, Luiz F. Ferrari, Jon D. LevineAbstractStimulation of the mu-opioid receptor (MOR) on nociceptors with fentanyl can produce hyperalgesia (opioid-induced hyperalgesia, OIH) and hyperalgesic priming, a model of transition to chronic pain. We investigated if local and systemic administration of biased MOR agonists (PZM21 and TRV130), which preferentially activate G-protein over β-arrestin translocation, and have been reported to minimize some opioid side effects, also produces OIH and priming. Injected intradermally (10...
Source: Neuroscience - Category: Neuroscience Source Type: research
CONCLUSIONS: There are significant knowledge gaps on effective self-management interventions for pain and depression post-SCI. There is a need to develop interventions that are multi-faceted, which include both pharmacological and non-pharmacological therapies to address multimorbidity. PMID: 30335601 [PubMed - as supplied by publisher]
Source: Journal of Spinal Cord Medicine - Category: Orthopaedics Tags: J Spinal Cord Med Source Type: research
Authors: Keener JD, Patterson BM, Orvets N, Chamberlain AM Abstract Degenerative rotator cuff tears are the most common cause of shoulder pain and have a strong association with advanced aging. Considerable variation exists in surgeons' perceptions on the recommended treatment of patients with painful rotator cuff tears. Natural history studies have better outlined the risks of tear enlargement, progression of muscle degeneration, and decline in the function over time. This information combined with the known factors potentially influencing the rate of successful tendon healing such as age, tear size, and severity ...
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research
DISCUSSION: The routine PE of FH specimens after arthroplasty for femoral neck fractures is not warranted and uneconomic. Sending the FH for PE, only when clinically indicated, rather than routine, will result in notable savings for the healthcare system. LEVEL OF EVIDENCE: Level IV. PMID: 30334845 [PubMed - as supplied by publisher]
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research
ConclusionsAlternative approaches for capturing the effects of weight status in the preschool years on preference-based HRQoL outcomes should be tested. The application of the QALY framework to economic evaluations of obesity-related interventions in young children should also consider longitudinal effects over the life-course.Clinical Trial Registration The Healthy Beginnings Trial was registered with the Australian Clinical Trial Registry (ACTRNO12607000168459).
Source: Quality of Life Research - Category: Health Management Source Type: research
This study examined the long-term effects of opioid use on HRQoL and its subdomains in patients with back pain or arthritis by comparing opioid users to non-opioid users for three metrics: (1) any opioid use, (2) duration of opioid use, and (3) average daily morphine equivalent dose.MethodsA nationally representative sample of cancer-free adults with chronic back pain or arthritis was selected. Using the 12-Item Short Form Survey, HRQoL measures of Mental Component Score (MCS), Physical Component Score (PCS), and individual subdomains were assessed at baseline and 1  year later. Opioid users were matched to non-opioid...
Source: Quality of Life Research - Category: Health Management Source Type: research
Objective: To determine the association between fracture collapse with altered gait after intertrochanteric (IT) fracture using the trochanteric fixation nail (TFN) and helical blade. Design: Prospective cohort study. Setting: Academic Level I trauma center. Patients: Seventy-two patients with IT hip fractures (OTA/AO 31) treated between 2012 and 2016. The average age was 79.7 years (range, 51–94 years); there were 59 women and 13 men. Intervention: All patients were treated with cephalomedullary nailing using the TFN (DePuy-Synthes, West Chester, PA) with a helical blade. Main Outcome Measures: At f...
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
Conclusion: A suboptimal outcome after open reduction and internal fixation of a tibial plateau fracture is common. If the underlying cause of the fracture is malreduction, malunion, or a nonunion, salvage of the joint without a knee replacement is worthwhile. When using a strategy incorporating revision plate fixation, osteotomy (intra- and/or extraarticular), debridement, and bone grafting when needed, patients should experience favorable long-term outcomes, including less residual pain and functional limitations. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
Placenta accreta spectrum is becoming more common and is the most frequent indication for peripartum hysterectomy. Management of cesarean delivery in the setting of a morbidly adherent placenta has potential for massive hemorrhage, coagulopathies, and other morbidities. Anesthetic management of placenta accreta spectrum presents many challenges including optimizing surgical conditions, providing a safe and satisfying maternal delivery experience, preparing for massive hemorrhage and transfusion, preventing coagulopathies, and optimizing postoperative pain control. Balancing these challenging goals requires meticulous prepa...
Source: Clinical Obstetrics and Gynecology - Category: OBGYN Tags: Management of Abnormal Placentation Source Type: research
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