Decompression Yare Bere a Wɔatu Wimhyɛn Akyi, Aso Barotrauma, ne Akwantu Aduruyɛ mu Apɔwmuden¶

Sɛ wode wimhyɛn a wɔde di gua anaasɛ wode kar twa bepɔw atenten bi a ɛtwam bere a woakɔ nsu ase ntɛm ara a, ɛma wo nipadua no ma wim nhyɛso a atwa wo ho ahyia no so tew ntɛmntɛm. Ɛwom mpo sɛ aguadi wimhyɛn ahorow no de nhyɛso ahyɛ wimhyɛn dan mu de, nanso aban ne amanaman ntam wimhyɛn gyinapɛn ahorow ma kwan ma wimhyɛn no mu nhyɛso a ɛwɔ beae a ɛkɔ soro a wɔde tu kwan no so tew kodu mita 1,830 kosi 2,440 (anammɔn 6,000 kosi 8,000) fi po so pɛ. Saa nhyɛso a ɛkɔ fam yi bɛyɛ pɛ bɛyɛ wim tebea 0.75 koraa, na ɛba fam fi wim tebea 1.0 wɔ po so. Sɛ woda so ara kura nitrogen a apete a aka wɔ wo mogya ne ntini ahorow a efi nsu ase a wode wo ho hyɛ mu mu, anaasɛ wowɔ mframa kotoku a akyea wɔ mfinimfini aso, sinus cavity, beae a wɔyɛɛ no ​​oprehyɛn nnansa yi, anaa ahurututu mu ahurututu a mframa nnim mu a, saa mpofirim a ɛma wo ho yɛ den yi betumi ama woanya ɛyaw a edi dɛm, aso mu ntini a ɛyɛ den daa, anaasɛ mframa a edi awu a ɛba mframa mfinimfini mu.

Sɛ́ ebia worehyia nkwaa mu yaw ne nea ɛyɛ mmerɛw bere a worekɔ wimhyɛn mu wɔ akwamma akyi, worepere aso mu nhyɛso a emu yɛ den a ɛrenyɛ pɛ bere a wosi fam no, anaasɛ woresusuw ho sɛ ebia abusua no muni bi fata wɔ aduruyɛ mu sɛ ɔbɛforo amanaman ntam wimhyɛn bere a wɔde no akɔ ayaresabea wɔ amannɔne akyi no, gye a wohu no ntɛmntɛm ne nipadua mu nhyehyɛe a emu yɛ den siw opira a ɛtra hɔ daa ano. Saa akwankyerɛ yi ka nneyɛe a egye ntɛmpɛ wɔ wimhyɛn mu ma wosusuw sɛ obi anya yare a ɛma obi ho dwiriw no, Divers Alert Network (DAN) ne Undersea and Hyperbaric Medical Society (UHMS) ansa na wimhyɛn no akɔ soro, akwan a ahobammɔ wom a wɔfa so yɛ otic ne sinus barotrauma a emu yɛ den, ne Aerospace Medical Association (AsMA) MEDIF fitness-to-fly mmara ho asɛm.

Yɛ eyi mprempren¶

1. **Sɛ wo anaa wo hokafo bi nya nkwaa mu yaw a emu dɔ, wo honam ani yɛ mmerɛw, wo ho yɛ wo yaw, wo ho yɛ wo yaw, wo ti yɛ wo yaw, wosakra w’ani so, anaasɛ wo home tiaa bere a woretu wimhyɛn anaa woreka kar wɔ bepɔw bi so bere a woakɔ nsu ase awie no a, mia wimhyɛn sohwɛfo no frɛ bɔtn ntɛm ara anaasɛ twe kɔ na frɛ wo mpɔtam hɔ nɔma a ɛfa ntɛmpɛ ho (911 wɔ United States ne Canada no, . 112 wɔ Europa Aman Nkabom no nyinaa mu, . 999 wɔ United Kingdom) de yɛn nɔma ahorow a egye ntɛmpɛ directory a wɔde kyerɛw nsɛm.
2. Besrɛ aduruyɛ mu oxygen a ɛsen ɔha biara mu nkyem 100 ntɛm ara. Ka kyerɛ wimhyɛn no mu adwumayɛfo anaa nnuruyɛfo a wɔboa nkurɔfo no sɛ: "Meyɛ obi a ɔde nsu gu nsu mu a ɔde me ho kɔhyɛɛ nsu mu wɔ nnɔnhwerew 48 a atwam no mu, na merehyia yare a wosusuw sɛ ɛyɛ decompression yare. Mehia oxygen a ɛsen kɔ so ɔha biara mu nkyem 100 mprempren." Bisa adwumayɛfo no sɛ wɔmfa akataso a ɛnyɛ rebreather anaasɛ demand valve nni dwuma sɛ ɛwɔ wimhyɛn no mu a wɔahyɛ no den a aduruyɛ a wɔde di dwuma ntɛm ara, sen sɛ wɔde bɛhyɛ hwene mu afiri a ɛsen kakraa bi.
3. Divers Alert Network (DAN) Nnɔnhwerew 24 Emergency Hotline no nni nkitaho na woanya oduruyɛfo akwankyerɛ a ɛyɛ hyperbaric. Sɛ wonya satellite Wi-Fi, telefon a efi mframa kɔ fam, anaa asase so cellular sɛnkyerɛnne ara pɛ a, frɛ DAN Emergency Hotline wɔ +1-919-684-9111 (wiase nyinaa, gye frɛ a wogye tom) anaa DAN Europe telefon a wɔde frɛ nkurɔfo wɔ +39-06-4211-8685 enti asuguare mu aduruyɛ ho ɔbenfo betumi ne wimhyɛn adwumakuw no asase so aduruyɛ sohwɛfo (te sɛ MedAire anaa Stat-MD) ayɛ biako na wahu hyperbaric dan a ɛbɛn a ɛyɛ adwuma wɔ mmeae pii.
4. Fa ɔyarefo no to fam (supine) na fa nsu a ɛnyɛ den ma nsu sɛ n’adwene mu da hɔ koraa a. Ma onipa a ɔyare no aka no no nna hɔ tẽẽ. Mma wo nan so anaasɛ mfa ɔyarefo no ti nkɔ fam (Trendelenburg gyinabea), efisɛ sɛ wode ne ti to fam a, ɛma amemene no ntini mu nhyɛso yɛ kɛse na ɛma amemene no mu ntini a ɛyɛ mmerɛw no yɛ kɛse. Fa nsu a ɛnyɛ nsa a caffeine nnim a wɔnom ma no sɛ onipa no tumi mene dwoodwoo a.
5. Gyae hwene a wobɛbɔ denneennen ntɛm ara sɛ wote nka sɛ wo ho ayɛ wo yaw mpofirim, wo tinnitus, anaasɛ wote asɛm a ɛyɛ den bere a w’aso reyɛ pɛ no a. Sɛ mmɔden a wobɔ sɛ wobɛbɔ w’aso no ma wote nka mpofirim sɛ wobɛkyinkyin, wobɛbɔ denneennen, anaasɛ wobɛte asɛm a ɛyɛ mmerɛw a, ebia woapaapae w’aso mu mfɛnsere kurukuruwa anaa kurukuruwa no mu (inner ear barotrauma). Gyae Valsalva maneuver no yɛ, tra ase gyina hɔ, kwati sɛ wobɛtwetwe nkotoku a emu yɛ duru anaasɛ wobɛma so, na hwehwɛ aso, hwene, ne menewa (ENT) nhwehwɛmu a egye ntɛmpɛ bere a woasi fam no.
6. Nforo wimhyɛn anaasɛ nka kar a ɛboro mita 610 (anammɔn 2,000) da ansa na woawie wo ahyɛde sɛ wobɛfa wimhyɛn no akyi. Sɛ wo dive kɔmputa no da so ara da "No-Fly" ahyɛnsode adi anaasɛ woantumi anwie nnɔnhwerew 12 kosi nnɔnhwerew 24 a ɛba fam ho akwankyerɛ a DAN ne UHMS de asi hɔ no so a, twa wo wimhyɛn no mu anaa san kyerɛw wo wimhyɛn no. Wimhyɛn nsakrae ho ka a wotua no yɛ ketewaa bi sɛ wɔde toto akyi berɛmo a ɛyɛ obubuafo a worehu amane wɔ mita 11,000 (anammɔn 36,000) wɔ po so no ho a.

flowchart TD
    A["Akwantufo a Ɔrenya Nsɛnkyerɛnne a Ɛyɛ Den wɔ Wimhyɛn anaa Bepɔw so Twam"] --> B{"So Akwantufo Scuba Dive Anaasɛ Freedive Wɔ Nnɔnhwerew 72 a Atwam Mu?"}
    B -->|"Yiw"| C{"Nsɛnkyerɛnne: Nkwaa mu Ɛyaw, Ntini a Ɛyɛ Hu, Adwene a Ɛyɛ Hu, Akisikuru, Anaa Ɔhome a Ɛyɛ Tiaa?"}
    B -->|"Dabi"| D{"Nsɛnkyerɛnne: Aso/Sinus mu Ɛyaw a Ɛyɛ Den, Popping, Anaasɛ Asotiw Mpofirim?"}
    C -->|"Yiw - Wosusuw sɛ DCS anaa AGE"| E["Bɔ Cabin Crew kɔkɔ Ntɛm ara na Bisa 100% High-Flow Oxygen"]
    E --> F["Fa Ɔyarefo no To Flat (Supine) + Fa Nsu a Wɔde Ano Ma Sɛ Wote Ase a"]
    F --> G["Bisa Pilot Contact Ground Medical Control + Bisa Lower Cabin Altitude / Diversion"]
    G --> H["Frɛ DAN Emergency Hotline (+1-919-684-9111) Bere a Woasi fam no ma Hyperbaric Chamber Transfer"]
    D -->|"Aso/Sinus Ɛyaw Nkutoo"| I["Fa Nsuo a Wɔnom, Mene, Toynbee, anaa Gentle Lowry Maneuver + Oxymetazoline Spray di dwuma"]
    D -->|"Vertigo, Akisikuru, anaa Sensorineural Deafness a Ɛba Mpofirim"| J["Wosusuw sɛ Aso Mu Barotrauma / Perilymph Fistula: Gyae Valsalva Koraa"]
    J --> K["Ma Ti no Kɔ soro, Kwati sɛ Wobɛtwetwe anaasɛ Wobɛbɔ Hwene, Hwehwɛ ENT Nhwehwɛmu a Egye Ntɛmntɛm bere a Woadu hɔ no"]

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Nea enti a wimhyɛn a wɔde tu kwan anaa mmepɔw atenten a wɔfa so twa bere a wɔde wɔn ho ahyɛ nsu mu akyi no kanyan decompression yare¶

Sɛ wohome mframa a wɔahyɛ no den anaa mframa mu nitrox a wɔahyɛ no ma wɔ nsu ase a, nsu a atwa wo ho ahyia no nhyɛso a ɛkɔ soro no ma nitrogen mframa a ɛnyɛ adwuma fa w’ahurututu mu ntini mu kɔ wo mogya ne wo nipadua mu ntini ahorow mu. Po mu nsu a ɛyɛ mita 10 (anammɔn 33) biara de wim tebea 1.0 (kilopascal 101.3 anaa nkaribo 14.7 wɔ nsateakwaa ahinanan biara mu) ka ho. Bere a woforo kɔ nsu no ani wɔ nsu ase a wobɛkɔ no awiei no, nhyɛso a ɛwɔ wo ho no so tew, na ɛma nhyɛso a ɛkɔ soro ba a ɛma nitrogen a apete no trɛw fi wo ntini mu na ɛsan kɔ w’ahurututu mu ma wɔtwe mframa.

Bere a wufi nsu no mu a wunni sɛnkyerɛnne biara mpo akyi no, wo ntini a ɛho tew nkakrankakra (te sɛ nnompe mu ntini, ntini, ntini, akyi berɛmo mu myelin, ne srade a ɛwɔ srade) no kɔ so yɛ nea nitrogen a wɔapete ahyɛ mu ma dodo nnɔnhwerew 12 kosi 48. Decompression algorithms bu sɛnea woforo kɔ soro a ahobammɔ wom ho akontaa a wofa no sɛ wobɛkɔ so atra wim nhyɛso a ɛte sɛ po so (1.0 ATA, anaa 760 mmHg) bere a worebɔ mframa no.

Abɔde mu nneɛma a ɛfa aguadi wimhyɛn mu nhyɛso ho¶

Akwantufo pii di mfomso gye di sɛ wɔde nhyɛso ma aguadi wimhyɛn adan mu ma ɛkɔ soro kodu po so. Sɛ wɔhyɛ wimhyɛn bi akyi ma ɛyɛ po so nhyɛso a edi mũ bere a ɛretu mmirika mita 10,600 kosi 12,500 (anammɔn 35,000 kosi 41,000) a, ɛbɛma wimhyɛn no afã abrɛ dodo. Wɔ United States Federal Aviation Administration (FAA) mmara (14 CFR § 25.841) ne European Union Aviation Safety Agency (EASA) gyinapɛn ahorow ase no, wɔayɛ aguadi wimhyɛn ahorow sɛnea ɛbɛyɛ a ɛbɛkɔ so akura wimhyɛn no mu nhyɛso a ɛsen biara mu mita 2,438 (anammɔn 8,000) bere a wɔde po so hyɛn tu kwan daa no:

• Wimhyɛn a ɛwɔ nipadua teateaa ne nea ɛtrɛw a ɛyɛ gyinapɛn (te sɛ Boeing 737, 767, 777, ne Airbus A320/A330): Kɔ so kura wimhyɛn no mu sorokɔ a ɛwɔ mita 1,830 ne 2,438 (anammɔn 6,000 kosi 8,000), a ɛne mframa a atwa yɛn ho ahyia nhyɛso a ɛyɛ 0.75 kosi 0.80 wim tebea (565 kosi 609 mmHg).
• Wimhyɛn a ɛwɔ ahoɔden a wɔabom ayɛ (te sɛ Boeing 787 ne Airbus A350): Ma wimhyɛn no mu sorokɔ a ɛba fam yɛ mita 1,524 kosi 1,830 (anammɔn 5,000 kosi 6,000), anaasɛ bɛyɛ 0.80 kosi 0.83 wim.
• Nsupɔw so wimhyɛn ne helikopta a wɔmfa nhyɛso nni dwuma: Turboprop anaa piston wimhyɛn nketewa a wɔde di dwuma wɔ nsupɔw a wɔde wɔn ho hyɛ nsu mu ntam no taa yɛ nea nhyɛso nni mu na ɛma akwantufo no hu nhyɛso a atwa wɔn ho ahyia a ɛwɔ wɔn wimhyɛn no sorokɔ ankasa no mu tẽẽ.

Sɛ wofi po so (1.0 ATA) kɔ wimhyɛn dan a ɛwɔ mita 2,438 (anammɔn 8,000, anaa 0.75 ATA) mu a, ɛne sɛ wobɛforo afi po mu nsu a ɛyɛ mita 3.3 (anammɔn 11) akɔ soro no yɛ pɛ wɔ nipadua mu. Saa nhyɛso a ɛwɔ wo nipadua mu a ɛso tew ɔha biara mu nkyem 25 no ma nitrogen microbubbles a aka wɔ wo ntini mu no trɛw kɔ gas bubbles a ɛkyerɛ sɛ ɛyɛ sɛnkyerɛnne a esiw ntini nketenkete, ɛtrɛw ntini ahorow mu, na ɛkanyan Decompression Sickness (DCS).

Bepɔw so kwan a ahintaw afiri a ɛwɔ nsupɔw a wɔde wɔn ho hyɛ nsu mu no so¶

Ɛho nhia sɛ woforo wimhyɛn ansa na woanya decompression yare a efi beae a ɛkorɔn ba no. Wɔ mmeae pii a ogya bepɔw mu asuguare kɔ no, mpoano asuguare sotɔɔ ahorow te po so bere a ɔkwan kɛse a ɛsan kɔ w’ahomegyebea anaa wimhyɛn gyinabea no foro kɔ bepɔw a ɛkorɔn so no:

• Hawaii (Big Island ne Maui): Sɛ woka Saddle Road a ɛda Kona ne Hilo ntam a, ɛforo kɔ mita 2,021 (anammɔn 6,632), na sɛ wode kar foro Haleakala a, ɛkɔ ** mita 3,055 (anammɔn 10,023)**.
• Canary Islands, Reunion Island, Bali, Taiwan, ne Costa Rica: Akwan akɛse a efi mpoano kɔ asase mu taa twa mmepɔw so akwan a ɛwɔ mita 1,000 kosi 2,500 (anammɔn 3,300 kosi 8,200) wɔ simma 45 mu fi mpoano.

Sɛ obi de kar anaa kar a wɔde fa nhama so foro kɔ soro boro mita mita 300 kosi 610 (anammɔn 1,000 kosi 2,000) bere a wɔakɔ nsu ase awie pɛɛ no ​​de asiane a ɛne sɛ wobɛtrɛw ahurututu mu no pɛpɛɛpɛ te sɛ wimhyɛn a wɔde nhyɛso ahyɛ mu a wɔde tu no.

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Aban akwankyerɛ a ɛfa bere a wɔde tu kwan ansa na wɔatu (DAN ne UHMS) .¶

Sɛnea ɛbɛyɛ na wɔasiw decompression yare a efi sorosoro ba ano no, Divers Alert Network (DAN) ne Undersea and Hyperbaric Medical Society (UHMS) de akwankyerɛ a wɔpene so sii hɔ a ɛkyerɛ bere a ɛsɛ sɛ wotwɛn wɔ po so bere a woafi wo nsu ase a etwa to no mu ansa na woaforo akɔ soro anaasɛ woatu wimhyɛn wɔ aguadi wimhyɛn mu.

Pre-flight surface interval gyinaesi pon¶

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Wimhyɛn mu decompression sickness (DCS) a wobehu na wɔadi ho dwuma .¶

Mpɛn pii no, wimhyɛn no decompression yare a ɛma obi nya ahoɔden a ɛkɔ soro no ho sɛnkyerɛnne fi ase bere a wimhyɛn no foro kɔ baabi a ɛkɔ soro mfiase no (wɔ simma 20 kosi 60 bere a ɛretu) anaasɛ nnɔnhwerew abien kosi anan a edi kan wɔ wimhyɛn no mu. Ayaresafo kyekyɛ decompression yare mu Type I (Musculoskeletal, Cutaneous, and Lymphatic) ne Type II (Neurological, Inner Ear, and Cardiopulmonary), ɛwom sɛ abien no nyinaa hwehwɛ ntɛm ara ɔha biara mu 100 oxygen ne hyperbaric aduruyɛ mu nhwehwɛmu efisɛ Type I taa kɔ so kɔ Type II bere a wimhyɛn no da so ara wɔ soro no.

Nsɛnkyerɛnne ne sɛnkyerɛnne ahorow a ɛkyerɛ sɛ obi anya yare a ɛma obi gyae nsu mu nsu ase¶

• Type I DCS (Ɛyaw-Nkutoo ne Wora):
  • Deep periarticular joint pain ("The Bends"): Ɛyaw a ɛyɛ kusuu, a emu dɔ wɔ nkwaa kɛse bi mu, a ɛtaa ba mmati, nsateaa, kotodwe, anaa asen. Nea ɛnte sɛ akisikuru no, DCS nkwaa mu yaw no ntaa nyɛ kɛse bere a wɔde kankyee brɛoo no, na sɛ wɔde mogya mmoroso afiri a wɔde twa nkwaa no ho hyia a, ebetumi atew ɛyaw no so bere tiaa bi.
  • Cutaneous DCS (Cutis Marmorata / Skin Bends): Ɛyaw a emu yɛ den a ɛno akyi no, akisikuru a ɛyɛ nsensanee, marbled, kɔkɔɔ-akutu anaa bruu-fitaa ba wɔ nipadua no akyi, mmati, moma so, anaa yafunu no so. Aduruyɛ mu nhwehwɛmu kyerɛ sɛ cutis marmorata ne koma a ɛkɔ nifa kɔ benkum (Patent Foramen Ovale, anaa PFO) wɔ abusuabɔ kɛse na ɛtaa di ntini mu akyi berɛmo anaa amemene mu DCS anim.
  • Lymphatic swelling: Localized pitting edema anaasɛ lymph nodes a ɛyɛ mmerɛw wɔ koko fasu, abasa, anaa akyi berɛmo mu.
• Type II DCS (Ntini ne Koma ne Ahurututu a Ɛde Nkwa To asiane Mu):
  • Akyi berɛmo DCS: Anan, nan, anaa nsa a ɛyɛ mmerɛw anaasɛ pin-ne-needles a ɛyɛ mmerɛw (paresthesia); nan a ɛyɛ mmerɛw nkakrankakra; ɛyɛ den sɛ wobɛnantew wimhyɛn kwan no so; akisikuru a ɛte sɛ band a atwa yafunu anaa akyi berɛmo ho ahyia; anaasɛ wontumi ntow nsu mpofirim (neurogenic bladder retention) anaasɛ dwensɔtwaa a wontumi nni so.
  • Amemene mu DCS: Tiyɛ a emu yɛ den, aniwa a ɛyɛ basaa (anifuraefo, tunnel vision, aniwa abien), kasa a ɛnyɛ den, adwene mu naayɛ, ɔbrɛ a ɛtra so, anaa mmerɛwyɛ a ɛwɔ ɔfã biako a wosuasua a ɔyare a ɛma obi hwe ase.
  • Inner ear DCS (Vestibular Bends / "The Staggers"): Mpofirim a ɛkyinkyini vertigo, akisikuru ne ɔfe, aniwa a ɛwosow a ɛnyɛ ne pɛ (nystagmus), ne kari pɛ a ɛyera.
  • Koma ne ahurututu mu DCS ("The Chokes"): Koko mu yaw a ɛhyew wɔ akyi, ɔfe a ɛyɛ kusuu a ɛnam ahome a emu dɔ, ahome a emu nnɔ ntɛmntɛm, ne cyanosis a ɛnam venous gas emboli a ɛyiri fa ahurututu mu filter no so na ɛba. Eyi betumi akɔ so akɔ mogya a ɛkɔ nipadua no mu no asɛe wɔ simma kakraa bi mu.

Anamɔn biara a wɔde yɛ ntɛmpɛ ho nhyehyɛe wɔ wimhyɛn dan mu¶

Sɛ wo anaa wo yɔnko bi a wode wo ho hyɛ nsu mu no nya saa sɛnkyerɛnne yi bi bere a wowɔ mframa mu a:

1. Bɔ Lead Flight Attendant (Purser) amanneɛ ntɛm ara na mfa wo sɛnkyerɛnne no nsie. Ɛtɔ da bi a wɔn a wɔde wɔn ho hyɛ wimhyɛn mu no yɛ komm wɔ wimhyɛn mu efisɛ wosuro sɛ wɔbɛbɔ wɔn sobo sɛ wɔabu wimhyɛn a wɔde tu akyi ho mmara so anaasɛ wɔama wimhyɛn no adane. Oxygen a wobɛtwentwɛn so bere a nitrogen ahurututu mia w’akyi berɛmo mu wɔ po so no betumi ama woabubu daa.
2. Ka aduruyɛ kasasin pɔtee a ɛbɛkanyan wimhyɛn adwumayɛkuw asase so aduruyɛ so tumi: > "Meyɛ scuba diver a merehyia acute Decompression Sickness a efi cabin altitude na ɛkanyan no. Yɛsrɛ wo, kɔ Captain ne wo fam wimhyɛn aduruyɛ oduruyɛfo (MedAire anaa Stat-MD) nkyɛn ntɛm ara. Mihia aduruyɛ mu oxygen ɔha biara mu nkyem 100 a ɛkɔ so wɔ flow rate a ɛkorɔn sen biara a ɛwɔ hɔ."
3. Ma wimhyɛn mu oxygen a wɔde ma no nyɛ papa:
   • Wɔtaa hyehyɛ akwantufo oxygen nkotoku a wɔtaa fa so a ɛwɔ aguadi wimhyɛn mu no denam constant-flow regulator a wɔde asi hɔ sɛ 2 lita simma biara (LPM) anaa 4 LPM denam hwene mu kankyee a ɛnyɛ den anaa mfitiase akataso so.
   • Kyerɛkyerɛ mu wɔ animtew mu kyerɛ wimhyɛn no mu adwumayɛfo sɛ **wɔma oxygen a ɛwɔ decompression yare mu no ma ɛnyɛ zero-nitrogen washout gradient enti nitrogen trɛw ntɛmntɛm fi ahurututu no mu. Bisa adwumayɛfoɔ no sɛ wɔnhwɛ wimhyɛn no Enhanced Emergency Medical Kit (EEMK) mu sɛ Non-Rebreather Mask a ɛwɔ reservoir bag na wɔmfa oxygen cylinder regulator no nsi ne flow a ɛkorɔn sen biara (10 kɔsi 15 LPM), nhwɛ cylinder a wɔde ma wɔ wimhyɛn bere a aka no mu.
4. Bisa Captain no sɛ ɔmma cabin pressure altitude no nkɔ fam sɛ adwumayɛ mu yie a:
   • Ɛdenam wimhyɛn no su, wim akwantu, ne pɛtro a wɔde asie so no, wimhyɛn mu adwumayɛfo no betumi de wɔn nsa ahyɛ wimhyɛn no mu nhyɛso sohwɛfo no sɛnea ɛbɛyɛ a ɛbɛkɔ so akura nhyɛso a ɛsen biara mu wɔ wimhyɛn no gyinabea a ɛba fam mu, na ɛtew wimhyɛn no mu sorokɔ a ɛkɔ po so (anaasɛ mita 600 kosi 1,200 / anammɔn 2,000 kosi 4,000) so. Wim tebea no fã biara a ɛwɔ dan mu nhyɛso a ɛkɔ soro no mia nitrogen ahurututu no honam fam sɛnea Boyle Mmara (\(P_1 V_1 = P_2 V_2\)) kyerɛ no.
   • Sɛ obi a ɔde ne ho hyɛ nsu mu no wɔ Type II ntini anaa koma ne ahurututu mu sɛnkyerɛnne (nan a ɛyɛ mmerɛw, obubuafo, akisikuru a ɛtwetwe, adwene mu naayɛ, anaa "the chokes") wɔ wimhyɛn tenten mu a, mpɛn pii no, asase so aduruyɛ sohwɛfo bɛtu Captain no fo sɛ ɔnyɛ aduruyɛ mu kwan a ɛdannan ntɛm ara nkɔ wimhyɛn gyinabea a ɛbɛn no a ɔwɔ aduruyɛ a ɛboro so.
5. Kɔ so gyina gyinabea a ɛkɔ soro ne nsu a ɛwɔ ano:
   • Fa nkongua no to fam koraa anaasɛ fa nea ɔde ne ho hyɛ nsu mu no to nkongua a ɛda mpan a ɛwɔ toatoa so a wɔde seatbelt ntrɛwmu abɔ ho ban bere a basabasayɛ rekɔ so no so.
   • Ma nea ɔde ne ho hyɛ nsu mu no nnom nsu mililita 500 kosi 1,000 (nsu ounces 17 kosi 34) anaasɛ aduru a wɔde ma nsu a wɔde ma anom wɔ dɔnhwerew a edi kan no mu sɛ n’ani da hɔ koraa na ɔfe a. Nsu a ɛtɔ fi mframa a ɛyɛ nwunu a ɛwɔ dan no mu ne nsu a wɔde gu nsu mu mu no ma mogya no dɔɔso, na ɛma ntini mu ischemia a atwa nitrogen ahurututu ho ahyia no yɛ kɛse.
   • Mma aspirin anaa ibuprofen gye sɛ oduruyɛfo a ɔde ne ho hyɛ nsu ase kyerɛ wo, na sɛ wosa no akyiri yi wɔ ayaresabea a, mma nitrous oxide anesthesia da, efisɛ nitrous oxide trɛw kɔ nitrogen ahurututu mu na ɛtrɛw ntɛmntɛm.
6. Fa dive kɔmputa no sie ɔyarefo no ho anaasɛ fa gu wɔn bag a wɔde fa mu no mu:
   • Hyperbaric oduruyɛfo a ɔwɔ ayaresabea a ogye no bɛhwɛ dive kɔmputa no depth-time log no mu de apaw US Navy Treatment Table 6 ( nnɔnhwerew 4 simma 45 hyperbaric oxygen recompression protocol a wɔahyɛ da ayɛ wɔ 2.8 ATA / mita 18 a ɛne ne bun yɛ pɛ) anaa pon a wɔatrɛw mu.

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Aso ne sinus barotrauma a emu yɛ den bere a wɔretu wimhyɛn na wɔreforo mmepɔw no¶

Akwantufo a wɔnnkɔ nsu ase da mpo taa nya aerotitis media (otic barotrauma) ne aerosinusitis (sinus barotrauma) bere a wɔretu wimhyɛn a wɔde di gua, wɔte gondola so, anaasɛ wɔretu kwan wɔ mmepɔw so a ɛso yɛ toro no. Boyle Mmara ne Eustachian tube no nipadua akwaa a wobɛte ase no ma wuhu nsonsonoe a ɛda aso mfinimfini a ɛyɛ yaw a ɛyɛ yaw ne aso mu a ɛyɛ oprehyɛn a egye ntɛmpɛ ntam.

Nea enti a sian yɛ asiane kɛse ma w’aso sen sɛ wubetu¶

Sɛnea Boyle Mmara kyerɛ no, mframa dodow a wɔahyɛ da ayɛ no kɛse ne ne nhyɛso koraa wɔ ɔhyew a ɛkɔ so daa mu no hyia wɔ ɔkwan a ɛne no bɔ abira so. Nsakrae kɛse a ɛba wɔ mframa dodow mu a ɛne ne ho hyia no ba wɔ baabi a ɛbɛn po no (ɛwɔ mita 0 kosi 2,440 / anammɔn 8,000 ntam):

• Bere a ɛretu na woaforo (Ascent): Bere a cabin pressure so tew fi 1.0 ATA kosi 0.75 ATA no, mframa a ɛda w’aso mfinimfini no mu no trɛw bɛyɛ ɔha biara mu nkyem 33. Sɛ nhyɛso a ɛwɔ w’aso mfinimfini boro hyɛn no mu nhyɛso so bɛyɛ mmHg 15 kosi 20 pɛ a, mframa a ɛretrɛw no pia Eustachian tube a ɛyɛ mmerɛw no bue a ɛnyɛ hwee te sɛ flapper valve a ɛkɔ ɔkwan biako so, na ɛma ahurututu kɔ wo hwene akyi. Ɛyaw a ɛba bere a wɔforo kɔ soro no taa ba wɔ sinus cavity a asiw mu nkutoo anaasɛ bere a alternobaric vertigo, baabi a aso biako pue mpofirim bere a ɔfoforo no tra nhyɛso mu nkutoo.
• Bere a ɛrebɛn (Descent): Bere a wimhyɛn no san sian kɔ po so wɔ simma 20 kosi 30 mu no, wimhyɛn no mu nhyɛso kɔ soro fi 0.75 ATA san kɔ 1.0 ATA. Mframa kotoku a ɛwɔ w’aso mfinimfini no tew ne nne so ɔha biara mu nkyem 25, na ɛma baabi a ɛhɔ yɛ hyew kakra wɔ mfinimfini aso no mu. Esiane sɛ Eustachian afiri no mu nkyem abiɛsa mu abien a ɛwɔ fam no yɛ afiri a ɛyɛ mmerɛw a ɛtumi bubu nti, ɛsɛ sɛ wode nsiyɛ twetwe wo hwene ne wo hwene mu ntini a ɛyɛ mmerɛw no (denam mene, a wobɛbɔ, anaasɛ wobɛma ayɛ pɛ so) na ama woatwe afiri no abue na ama mframa akɔ mfinimfini aso no mu.
• The Locking Phenomenon (At roughly 90 to 120 mmHg differential): Sɛ woda kɔsi wimhyɛn no sian mfiase anaasɛ wowɔ mucosal swelling esiane atiridii anaasɛ allergies nti a, cabin pressure a ɛkɔ soro wɔ w’aso akyi no piapia wo Eustachian tube flat shut no afasu a ɛyɛ mmerɛw no. Sɛ nhyɛso nsonsonoe a ɛwɔ afiri no mu boro 90 kosi 120 mmHg (ɛkame ayɛ sɛ ɛne sian a ɛyɛ mita 900 kosi 1,200 / anammɔn 3,000 kosi 4,000 a ɛnyɛ pɛ no yɛ pɛ a, vacuum a enye no de ahoɔden a ɛboro w’anom ntini a ɛyɛ mmerɛw no ntini mu ahoɔden so to Eustachian afiri no mu. Sɛ obi mene na ɔbɔ yaw a, entumi mmue afiri no mu bio, aso no trɛw kɔ mu, mogya ntini a ɛwɔ mfinimfini aso no mu no mu paapae (hemotympanum), na aso mu ntini no tumi totow.

Ahobammɔ vs. asiane aso equalization akwan¶

Nsonsonoe a ɛda Mfinimfini Aso Barotrauma ne Mfinimfini Aso Barotrauma (Perilymph Fistula) ntam .¶

Sɛ wote ɛyaw a ano yɛ den mpofirim anaasɛ wobɔ w’aso mu bere a worekɔ wimhyɛn mu anaasɛ bere a woakɔ nsu ase awie a, kyerɛ nsonsonoe a ɛda apirakuru ahorow abien ntam:

• Mfinimfini Aso Barotrauma (Tympanic Membrane a Ɛpaapae / Hemotympanum):
  • Nsɛnkyerɛnne: Ɛyaw a ɛyɛ nnam a ɛkɔ soro bere a woresiane a ebetumi atew wɔ pop a ano yɛ nnam akyi, na ɛno akyi no, aso a ɛyɛ mmerɛw a ɛyɛ muffled, atenka a ɛyɛ ma anaa nsu a ɛwɔ aso no akyi, ne ɛtɔ mmere bi a mogya ketewaa bi a ɛtɔ anaa nsu a emu da hɔ wɔ aso no mu.
  • Mmoa a edi kan: Ma aso no nwo koraa. Mfa aso mu nsu, nsu, ngo, hydrogen peroxide, anaa cotton swabs nhyɛ aso a wosusuw sɛ aso mu tokuru mu da. Aso mu ntokuru a ɛyɛ hu dodow no ara sa ara kwa wɔ adapɛn 2 kosi 6 mu, ɛwom sɛ ɛsɛ sɛ oduruyɛfo hwɛ aso no mu de.
• Aso a ɛwɔ mu Barotrauma (Mfɛnsere a ɛyɛ kurukuruwa anaa nea ɛyɛ kurukuruwa a ɛpaapae / Perilymph Fistula):
  • Symptoms: Ɛba ntɛm ara wɔ forceful Valsalva maneuver akyi bere a worebɔ mmɔden sɛ wobɛhyɛ aso a asiw no ma pop. Wo nya rotational vertigo (cabin no twitwiw), akisikuru ne ɔfe a ɛba ntɛm ara, tinnitus a ɛyɛ dede anaasɛ ɛyɛ dede, ne sensorineural hearing loss a emu dɔ (ntini mu asotiw wɔ saa aso no mu).
  • Adeyɛ a egye ntɛmpɛ: Eyi kyerɛ sɛ ntini a ɛyɛ mmerɛw a ɛtetew w’aso mfinimfini ne w’aso mu ntini a nsu ahyɛ mu ma no mu atetew, na nsu a ɛwɔ aso mu perilymph no mu retu. Gyae hwene-bɔ ne pɛpɛɛpɛyɛ nyinaa ntɛm ara. Tena ase a wo ti so ma digrii 30 kosi 45, kwati sɛ wobɛtwetwe anaa wobɛma bag a emu yɛ duru so, na fi wimhyɛn gyinabea kɔ baabi a wɔhwɛ ntɛmpɛ so tẽẽ a Otolaryngologist (ENT surgeon) a ɔfrɛ wo. Ɛho hia sɛ wɔde corticosteroids di dwuma ntɛm, wɔde wɔn ho to mpa so, anaasɛ wɔyɛ oprehyɛn a wɔde hyɛ fistula no mu na ama wɔagye aso a ɛtra hɔ daa.

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Wimhyɛn a ɛne ayaresa tebea afoforo: Aerospace Medical Association (AsMA) apɔwmuden ho mmara¶

Ɛnyɛ nsu ase a wɔde wɔn ho hyɛ mu nkutoo ne tebea a ɛma nhyɛso a ɛba hyɛn no mu no ma aduruyɛ mu tebea a egye ntɛmpɛ ba. Wɔ Boyle Mmara ase no, mframa kotoku biara a ɛda onipa nipadua mu no trɛw ɔha biara mu nkyem 30 kosi 35 wɔ ɔdan no mu sorokɔ a ɛyɛ mita 2,438 (anammɔn 8,000). Wɔ akwantufo a wɔwɔ apɔwmuden mpo mu no, mogya mu oxygen fã bi nhyɛso (\(PaO_2\)) so tew fi bɛyɛ 95 kosi 100 mmHg wɔ po so kodu 55 kosi 60 mmHg wɔ ɔdan no mu sorokɔ a ɛyɛ anammɔn 8,000 (pulse oximeter \(SpO_2\) bɛyɛ ɔha biara mu nkyem 88 kosi 91).

Sɛ wopira, wɔyɛ wo oprehyɛn, anaa yareɛ bi wɔ amannɔne a, wimhyɛn adwumayɛkuo hyɛ Ahunmu Aduruyɛ Fekuo (AsMA) ne Amanaman Ntam Wimhyɛn akwantuo Fekuo (IATA) Medical Manual clearance intervals no mu den ansa na wɔama wo kwan ma woaforo aguadi wimhyɛn akɔ fie.

Mmere a ɛyɛ ahyɛde sɛ wɔde twɛn aduruyɛ ansa na wɔatu wimhyɛn a wɔde di gua (IATA / AsMA akwankyerɛ) .¶

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Sɛnea wobɛnya Airline Medical Clearance (IATA MEDIF Form) ne akwantuo ho insurance ho dwumadie¶

Sɛ worenya ahoɔden afi dive decompression therapy, dompe a abubu, ahurututu mu yare, anaa oprehyɛn a wɔayɛ wɔ amannɔne mu na ɛsɛ sɛ wode wimhyɛn kɔ fie wɔ aguadi wimhyɛn adwumakuw bi mu a:

1. Brɛ wimhyɛn adwuma no Mmoa Titiriw / Aduruyɛ Dwumadibea (MEDIF) kratasin no anyɛ yiye koraa no nnɔnhwerew 48 kosi 72 ansa na woafi hɔ:
   • Ɛkame ayɛ sɛ amanaman ntam wimhyɛn adwumayɛkuw nyinaa de IATA Medical Information Form (MEDIF) a ɛwɔ afã abien a wɔahyɛ da ayɛ no di dwuma.
   • Ɔfa 1 no, ɔkwantufo anaa akwantufoɔ no na ɔwie (ɔkyerɛw wimhyɛn nɔma, mmubuafoɔ akongua ahiadeɛ, stretcher abisadeɛ, anaa oxygen a ɛsen wɔ wimhyɛn mu).
   • Ɔfã 2 no awie na oduruyɛfo a ɔhwɛ wo so wɔ mpɔtam hɔ ayaresabea no de ne nsa ahyɛ ase (akyerɛw nea wɔahu no pɛpɛɛpɛ, hemoglobin dodow, dan mu mframa oxygen a ɛdɔɔso \(SpO_2\), da a etwa to a wɔde wo ho kɔhyɛɛ nsu mu anaa oprehyɛn, sɛ ebia oprehyɛn koko mu ntini anaa casts biara mu apaapae, ne sɛ ebia aduruyɛfo a ɔka ho).
2. Wo ne wo Akwantuo Insurance / Mmoa Aduruyɛ sohwɛfoɔ nyɛ adwuma ansa na woakyerɛw wo tekiti a wode bɛkɔ fie:
   • Sɛ wo nyaa decompression yare anaa aduruyɛ mu ntɛmpɛ foforo a emu yɛ den wɔ amannɔne a, kenkan yɛn akwankyerɛ a ɛfa ho no aduruyɛ mu ntɛmpɛ ne nnipa a wotu kɔ amannɔne na frɛ w’akwantu ho insurance beae a wɔboa ntɛm ara nnɔnhwerew 24 ntɛm ara.
   • Wɔ Type II decompression yare a emu yɛ den akyi no, aguadi wimhyɛn a ɛkɔ soro anammɔn 8,000, wɔ nnɔnhwerew 72 mpo wɔ hyperbaric ayaresa akyi no, betumi ama ntini mu sɛnkyerɛnne ahorow asan aba bio. Wɔ nsɛm a emu yɛ den mu no, wo dive insurance anaa akwantuo aduruyɛ ho nhyehyɛeɛ no bɛyɛ nhyehyɛeɛ ama po-level pressurized air ambulance evacuation (baabi a aduruyɛ wimhyɛn a wɔatu ho ama tu a ne dan mu nhyɛsoɔ akɔ 1.0 ATA po so nhyɛsoɔ) enti wobɛnya zero decompression stress wɔ akwantuo a wode bɛkɔ fie no mu.

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Nsɛm a wɔtaa bisa¶

So metumi atu wimhyɛn dwoodwoo bere a makɔ snorkel anaa maguare wɔ nsu no ani awie no ara pɛ?¶

Sɛ wuguare wɔ nsu no ani nkutoo na worehome denam snorkel so a woankɔ nsu ase a, ɛnde na woaboaboa nitrogen a ɛboro so biara ano na wubetumi atu ntɛm ara. Nanso, sɛ woyɛɛ freediving a ɛma wohome a emu dɔ mpɛn pii (wɔde wo ho kɔhyɛɛ nsu mu mpɛn pii koduu mita 10 kosi 30 / anammɔn 33 kosi 100 nnɔnhwerew pii), titiriw sɛ wosan nso de scuba dived ntɛm wɔ dapɛn no mfiase a, nitrogen betumi aboaboa ano araa ma ɛde freediving decompression yare aba. Bere a woayɛ freediving a emu dɔ mpɛn pii akyi no, anyɛ yiye koraa no, twɛn nnɔnhwerew 12 kosi 24 ansa na woatu wimhyɛn.

Sɛ mete me nkwaa mu yaw kakra anaasɛ me honam ani yɛ mmerɛw bere a mafi wimhyɛn a mede kɔ fie no asi fam dedaw a, dɛn na ɛba?¶

Mfa no da sɛ wimhyɛn akyi sɛnkyerɛnne ahorow no ankasa befi hɔ mprempren a woasan aba fam no. Nitrogen ahurututu a ɛkanyan bere a wimhyɛn no retu no ma endothelial sɛe, mogya nkwammoaa a ɛboaboa ano, na ɛma ɔfe hohoro wɔ wo ntini mu a ɛkɔ so bere a asan akɔ po so nhyɛso mu mpo akyi. Frɛ Divers Alert Network Emergency Hotline (+1-919-684-9111) ntɛm ara na kɔ dwumadibea bi a wɔhwɛ ntɛmpɛ a ɛne hyperbaric nnuruyɛbea bi wɔ abusuabɔ. Hyperbaric oxygen therapy da so ara yɛ adwuma bere mpo a wofi ase nnɔnhwerew 24 kosi 72 wɔ sɛnkyerɛnne ahorow no mfiase akyi no.

So aso a wɔde hyɛ aso mu a wɔde nhyɛso ahyɛ mu no siw aso barotrauma ano ankasa wɔ wimhyɛn mu?¶

Aso a wɔde hyɛ aso a wɔde dɔte ayɛ a ɛma nhyɛso no yɛ nea ɛwɔ aso a ɛwɔ abon a ɛma mframa a ɛwɔ dan no mu a ɛresakra no bɔ w’aso bere a woreforo na woresiane no brɛoo. Bere a wɔn ankasa ntumi mmue Eustachian afiri a asiw ano no, nhyɛso nsakrae no a wɔma ɛyɛ brɛoo no ma afiri a ɛyɛ brɛoo no nya bere foforo de yɛ pɛ ansa na wɔato mu. Fa hyɛ mu ansa na woatu, yi fi baabi a ɛkorɔn a worekɔ no, na san fa hyɛ mu simma 45 ansa na woasi fam bere a woremene na worenom nsu no.

Dɛn nti na oduruyɛfo bi a ɔhwɛ me ntɛm ka kyerɛɛ me sɛ m’aso a merepira wɔ nsu mu no yɛ aso mu yare bere a efii ase bere a na merekɔ nsu ase anaasɛ meretu wimhyɛn no?¶

Ɛtɔ mmere bi a nnuruyɛfo a wɔnyɛ adwuma titiriw wɔ asuguare anaa ahunmu aduruyɛ mu hwɛ aso mu ntini kɔkɔɔ a mogya tu a nsu wɔ n’akyi bere a wɔatu wimhyɛn anaasɛ wɔakɔ nsu ase awie no na wohu mfinimfini aso mu yare a ɛnteɛ sɛ ɛyɛ aso mu yare a emu yɛ den a efi ɔyare mmoawa mu ba. Ka barometric abakɔsɛm pɔtee kyerɛ oduruyɛfo a ɔreyɛ nhwehwɛmu no bere nyinaa: sɛ ebia ɛyaw no fii ase bere a woresiane, sɛ ebia woyɛɛ Valsalva a ɛyɛ den, ne sɛ ebia wowɔ vertigo anaasɛ aso a ɛyɛ den bi.

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Sources a wɔhwɛɛ mu¶

• Divers Alert Network (DAN) & Undersea and Hyperbaric Medical Society (UHMS): Wimhyɛn a Wɔtu wɔ Ahomegyeɛ akyi Diving Adwumayɛbea Nhyiamu Nhyiamu ne Akwankyerɛ a Wɔpene so (Amanaman Ntam / United States).
• United States Po so Asraafo: U.S. Navy Diving Manual, Revision 7, Volume 2, Ti 9 (Ascent Procedures and Flying After Diving) & Po 5, Ti 20 (Decompression Yare ne Arterial Gas Embolism a Wɔhwehwɛ na Wɔsa) (United States).
• Ahunmu Aduruyɛ Fekuw (AsMA): Aduruyɛ ho Akwankyerɛ a ɛfa Wimhyɛn Akwantu ho, 2^nd Edition / Wimhyɛn akwantuo Aduruyɛ Boayikuo Fitness-to-Fly Advisories (Amanaman Ntam).
• Amanaman Ntam Wimhyɛn akwantuo Fekuo (IATA): IATA Aduruyɛ Nhoma, 12^th Edition: Akwantufoɔ Hwɛ, MEDIF Clearance Bere Nhyehyɛeɛ, ne Cabin Altitude Physiology (Amanaman Ntam).
• British Thoracic Society (BTS): Ayaresabea Asɛm a Ɛfa Wimhyɛn Akwantuo Ho Nkamfo a Wɔde Ma Akwantufoɔ a Wɔwɔ Ɔhome Yareɛ ne Bere a Wɔtwɛn wɔ Pneumothorax Akyi (United Kingdom).

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Akwankyerɛ ahorow a ɛfa ho¶

• Aduruyɛ mu nsɛm a egye ntɛmpɛ ne nnipa a wotu wɔn kɔ amannɔne
• Embassy ne consular mmoa
• Stranded wɔ amannɔne anaasɛ wimhyɛn a wɔatwa mu
• Po so hyɛn a wɔde tu kwan a egye ntɛmpɛ, po so hyɛn a wogyaw, ne onipa kɔ po so
• Emergency nɔma ahorow ho kyerɛwtohɔ