BAROTRAUMA & DYSBARISMS #7

PNEUMOMEDIASTINUM & INTERSTITIAL EMPHYSEMA:
Ruptured airways allow air to escape into the soft tissues.
Air dissects into the mediastinal – into the pericardium – cephalad into the neck.

SYMPTOMS: 
subcutaneous air & crepitus on compression of the skin – neck
change in voice
dyspnea
pericardial air on x-ray

TREATMENT: 
Interstitial (subcutaneous) emphysema is not dangerous.
100% O2 will hasten recovery.
Must be monitored for other sequela = pericardial tamponade.

PNEUMOTHORX:   (TENSION PNEUMOTHORAX)
Ruptured airways allow air to escape into the pleural space.
Air trapped in the pleural space.

SYMPTOMS: 
Vary from mild to severe dyspnea with cyanosis.

TREATMENT: 
Monitor if mild.
100% O2 in severe cases, may require artificial ventilation.
Chest tube thoracotomy for severe = tension pneumothorax.
Needle thoracotomy in emergency.

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