Blood in Mucus after Dives

[Scuba446]

Hi,
Don't mean to be gross, but after our last 2 dives, my dive partner conplained of bloody mucus from his sinuses after the dive. It cleared up about 10 mins after the dive was over.

Any idea why this is happening to him? He denies any sinus problems or allergy problems or recent colds or infections.

I thought perhaps it was due to ear equalization? Perhaps he is equalizing too hard?

????

 

[The Iceni]

Scuba446 once bubbled...
I thought perhaps it was due to ear equalization? Perhaps he is equalizing too hard?

????

Hi Scuba446,

This is almost certainly sinus barotrauma, which is a very common problem and has nothing whatsoever to do with ear clearing.

These problems were discussed on the following threads.

http://www.scubaboard.com/showthread.php?s=&threadid=9463

http://www.scubaboard.com/showthread.php?s=&threadid=5318

http://www.scubaboard.com/showthread.php?s=&threadid=14126

http://www.scubaboard.com/showthread.php?s=&threadid=14302

You may also find a lot more information if you do a search on sinus barotrauma.

 

[Scuba446]

OK,
Read the threads on this topic from before...now I'm REALLY confused! One of the threads was two divers needling each other to death - didn't enlighten me much, I am afraid...

First of all, whats REALLY happening when someone gets a sinus barotrauma?

Second, are you implying that EVERY time this happens to a diver, they should:

1) Go to an ENT doctor for an exam?

2) Not dive again that day?

3) Quit diving all together?


This may sound ignorant, but just HOW serious can it really be? If it stops bleeding after the dive, just how serious can it be anyways?

Now, my origional question dealt with my friend NOT having had a cold, NOT have had ANY problems equalizing his ears, etc. So WHAT caused this to happen? WHY does this happen? Whats gone wrong in the sinuses? Can this be prevented? Would Sudafed prior to diving assist in PREVENTING it from happening?And does this happening cause any REAL damage?

I don't think he's going to want to give up diving because this happens - he loves diving, although it does seem to happen to him 3 out of 4 times he goes diving.

Why him perhaps and not I?

 

[The Iceni]

Scuba446 once bubbled...
. . First of all, whats REALLY happening when someone gets a sinus barotrauma?

Because the sinus is isolated from ambient pressure (by a blockage of the connection with the nose) the pressure WITHIN will become less than ambient pressure on descent, therefore the membrane linings become engorged by the increased blood to them supplied at AMBIENT pressure, are damaged and bleed. See my original post (quoted below) and the diagram.

Second, are you implying that EVERY time this happens to a diver, they should:

1) Go to an ENT doctor for an exam?

No. Only if it persists as it is very common in novices and usually resolves spontaneously.

2) Not dive again that day?

Yes. If he is sensible.

3) Quit diving all together?

If the ENT man suggests it.

This may sound ignorant, but just HOW serious can it really be? If it stops bleeding after the dive, just how serious can it be anyways?

It is not SERIOUS but if it becomes an established problem it will prevent diving due to pain and he could develop chronic sinus problems that cannot be treated and which may become very problematic in later life.

Now, my origional question dealt with my friend NOT having had a cold, NOT have had ANY problems equalizing his ears, etc. So WHAT caused this to happen? WHY does this happen? Whats gone wrong in the sinuses? Can this be prevented? Would Sudafed prior to diving assist in PREVENTING it from happening?

Sinus problems and ear equalisation are not related, but yes decongestants can help.

And does this happening cause any REAL damage?

It can cause permanant damage to the membranous lining. (See my earlier reply).

I don't think he's going to want to give up diving because this happens - he loves diving, although it does seem to happen to him 3 out of 4 times he goes diving.

Why him perhaps and not I?

Anatomical differences.

I hope my one-word replies are sufficient.

By Dr Paul Thomas
. . . With a little bit of imagination you can see how a deviated septum, or a damaged turbinate, could block the opening into the frontal sinus sealing it off from ambient pressure. When this opening is blocked air cannot enter the affected sinus which remains at a lower than ambient pressure during further descent. The result is damage to the mucosal lining from the blood supplied to it, from the heart through the arterioles, the pressure of which is increased by the higher ambient pressure over and above that within the sinus itself.

The result? The blood vessels rupture damaging the mucosal lining and they bleed into the sinus. On ascent some of this blood is forced out in to the nose by the relative increase in pressure caused by the ascent but some must remain behind as debris, making sinus equalisation even more unlikely on subsequent dives.

 

[Scuba446]

Yes there are - thanks!