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dan avoiding ear & sinus injuries in scuba - Divers Alert Network

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THE UPS AND DOWNS OF DIVING.<br />

STUDENTS<br />

GUIDE<br />

DAN AVOIDING EAR & SINUS INJURIES IN SCUBA DIVING<br />

TO AVOID BAROTRAUMA, REMEMBER:<br />

• Test the <strong>ear</strong>s and <strong>s<strong>in</strong>us</strong>es by equaliz<strong>in</strong>g prior to enter<strong>in</strong>g the water or prior to<br />

your descent;<br />

• Descend at a slow, steady pace, and keep up with your cl<strong>ear</strong><strong>in</strong>g maneuvers;<br />

• Do not cont<strong>in</strong>ue to descend or forcefully cl<strong>ear</strong> if you’re hav<strong>in</strong>g difficulty<br />

— stop your descent before you experience <strong>ear</strong> or <strong>s<strong>in</strong>us</strong> pa<strong>in</strong> (wait<strong>in</strong>g until you<br />

feel discomfort to beg<strong>in</strong> cl<strong>ear</strong><strong>in</strong>g means that you’ve waited too long);<br />

• Descend and equalize <strong>in</strong> a feet-first position; it is easier than head-first;<br />

• If you do experience pa<strong>in</strong> or discomfort, ascend until it is relieved;<br />

• Equalize <strong>ear</strong>ly and often to stay “ahead” of barotrauma.<br />

DIFFICULTY EQUALIZING<br />

What if you can’t equalize? First, don’t dive until the problem is resolved. If a diver<br />

has trouble equaliz<strong>in</strong>g the <strong>s<strong>in</strong>us</strong>es and middle <strong>ear</strong>, there may be some pre-exist<strong>in</strong>g<br />

problem — the most common is div<strong>in</strong>g with a cold or flu. Frequently, the mucous<br />

membrane will reta<strong>in</strong> fluid and swell, partially occlud<strong>in</strong>g the air passages to your<br />

<strong>s<strong>in</strong>us</strong>es and the Eustachian tube go<strong>in</strong>g from the back of your throat to the middle<br />

<strong>ear</strong>. This not only makes cl<strong>ear</strong><strong>in</strong>g difficult, but it also may prevent it altogether. Other<br />

recognizable factors <strong>in</strong> equaliz<strong>in</strong>g problems are:<br />

• A history of childhood <strong>ear</strong> <strong>in</strong>fections or even one severe <strong>in</strong>fection that may<br />

leave the Eustachian tube scarred and partially occluded;<br />

• A history of a broken nose or a deviated septum that prevents one <strong>ear</strong> or set of<br />

<strong>s<strong>in</strong>us</strong>es from cl<strong>ear</strong><strong>in</strong>g as quickly as the opposite side;<br />

• Allergies, which may produce swell<strong>in</strong>g of the mucous membranes or cause<br />

nasal polyps that can partially or completely occlude a <strong>s<strong>in</strong>us</strong> cavity or airway.<br />

If you have a history that <strong>in</strong>cludes these conditions and want to dive successfully,<br />

it may require referral to an <strong>ear</strong>, nose and throat physician or allergy specialist who<br />

is familiar with these conditions. Nose sprays or oral medications can be used to<br />

shr<strong>in</strong>k swollen mucous membranes and facilitate <strong>s<strong>in</strong>us</strong> and middle <strong>ear</strong> equalization.<br />

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