Blood from nose?

[Mark Derail]

Your advice is helpful, DD - and right on the money IMHO.

But ...


My training (which I admit, I disregard in this case) taught me not to use a decongestant due to the risk of it losing its effect underwater and suffering from a reverse block upon ascent ...

FYI - Reverse if far worse, and can lasts DAYS causing lack of sleep. Worse case scenario, you get a reverse block the day before you fly out...

Anyhow, like Currier & Don suggest, don't mess medication. I'd go instead with a strong coffee.

My best method for equalizing going down is "swallowing air" and taking at least 5 minutes getting to 50-60 feet. Doesn't equalize as fast, and I also blow air through my nose into the mask as I go down. All gently.

No more nosebleeds. Doing the Aaaaaaahhhh Aaaaaahhh going back up. Sounds like I have 7-Up in my ears...Also I go up very slowly.

 

[TracyN]

Thanks guys. I'm not too concerned about it now. Probably was just something with over equalizing.

 

[Duke Dive Medicine]

...however NITROX divers need to remember they are at a greater risk of CNS oxygen toxicity if using such meds.
TC

Hi TC,
There's no evidence to support a blanket statement like this. Pseudoephedrine has been theorized to predispose divers to O2 toxicity because of its sympathomimetic properties (it stimulates the sympathetic nervous system). The late Dr. Ed Thalmann's original article is published here on the DAN website. He based his opinion on a 1962 study by Dr. Peter Bennett that linked increased risk of oxygen toxicity in rats to sympathomimetic drugs.

If you take a closer look at this study, specifically the methods, you'll read that, in order to ensure that all of his rats experienced the effects of high partial pressures of O2, Dr. Bennett compressed them to 80 PSIG of oxygen in 1.5 minutes. 80 PSIG is equivalent to approximately 180 FSW, or 6.44 ATA, which makes the descent rate about 120 FPM. He then gave them one of a number of drugs. The ones that were found to enhance the sensitivity of the rats to O2 were megimide (bemegride), a strong CNS stimulant that has been used as an antidote to barbiturate poisoning; methedrine, i.e. methamphetamine; and leptasol (pentylenetetrazol), a drug that has been used to induce seizures in laboratory animals.

Dr. Claude Piantadosi, our director, is one of the world's leading experts on the biological mechanisms of oxygen toxicity. He does not believe that pseudoephedrine increases the risk of O2 toxicity, when taken as directed by an otherwise healthy individual who dives within established safe parameters. He states that it would be necessary to overdose on it to produce a high enough sympathomimetic effect to (theoretically) increase the risk, and at that dose, the blood vessels in the brain would be constricted, thus limiting the flow of blood and oxygen.

Best regards,
DDM

 

[EODiver]

I can't comment from a medical standpoint, but my partner at work has suffered from bloody nose during dives as long as I have known him(5~6 yrs). The first time I saw it was during a checkout dive with full face mask. He says it's just him, and now we expect it. Ask a Dr. sometime, but if you're not having any other trouble it may be "just you", and no big thing.

 

[Mark Derail]

My first deep dive, near 100 feet at Molokini crater. had big problems equalizing, one side versus the other. Topside had lots of blood clogged.

My mistake was trying to follow the group too quickly. I should have stayed at 20-30 feet for awhile and followed the group from above. I did that on the second dive.

 

[DandyDon]

My first deep dive, near 100 feet at Molokini crater. had big problems equalizing, one side versus the other. Topside had lots of blood clogged.

My mistake was trying to follow the group too quickly. I should have stayed at 20-30 feet for awhile and followed the group from above. I did that on the second dive.

My home bud is bad about leaving the water without me, like a practice site with stairs or maybe at sea, and I am bad about wanting to drop fast when he cannot. We have a deal which I remind him of: I will wait with him at 20 ft until he clears if he will wait for me on exit - we stay together, period.

 

[Ted S]

My step-father doesn't dive anymore much but every time he exits the water almost regardless of depth and duration, he's got a little blood in the mask. He tends to need a few minutes to clear going down and I assumed that while it wasn't an immediate cause and effect, that's what triggeed this.

After realizing this was a regular occurrence without any discomfort or even awareness, I wrote it off and stopped calling dives on him when I saw little amounts of red Nice to see that he wasn't alone.

 

[Duke Dive Medicine]

Blood in the mask is often related to sinus barotrauma. If a sinus is fully or partially blocked for some reason, e.g. a cold, allergies, chronic inflammation from smoking, or an anatomic abnormality, the pressure inside the sinus can't effectively be equalized with the ambient pressure. On descent, the air in this blocked sinus will be compressed. The sinus is a rigid space, so blood may be literally sucked out of the delicate capillaries in the mucous membrane that lines the sinus. It sounds painful, but in reality, the diver often does not feel it. On ascent, the reverse happens, and the blood is ejected from the sinus.
A one-time sinus squeeze with no complications is probably nothing to worry about. However, if a diver suffers from reoccurring sinus barotrauma, a visit to an ENT familiar with diving injuries is in order. Repeated trauma to the sinus tissues can escalate the problem.

 

[TracyN]

Blood in the mask is often related to sinus barotrauma. If a sinus is fully or partially blocked for some reason, e.g. a cold, allergies, chronic inflammation from smoking, or an anatomic abnormality, the pressure inside the sinus can't effectively be equalized with the ambient pressure. On descent, the air in this blocked sinus will be compressed. The sinus is a rigid space, so blood may be literally sucked out of the delicate capillaries in the mucous membrane that lines the sinus. It sounds painful, but in reality, the diver often does not feel it. On ascent, the reverse happens, and the blood is ejected from the sinus.
A one-time sinus squeeze with no complications is probably nothing to worry about. However, if a diver suffers from reoccurring sinus barotrauma, a visit to an ENT familiar with diving injuries is in order. Repeated trauma to the sinus tissues can escalate the problem.

Thanks for this info. I don't have any sinus issues that I know about but this seems like a resonable explanation. I cannot recall ever having any sinus pain either upon descent or ascent. I had it happen to me again this week on my nitrox cert dives. When we surfaced my instructor told me that I had a small amount of blood in my nose.

 

[Mark Derail]

My second day diving near Lanai for the Cathedrals, I got down easier, no blood.

I felt pressure going deep, faster that I normally would, because the entire group was down waiting for me, and the DM (Seth - Mike Severns) kept coming back up to help.

Probably didn't help that I had had a bad cold some 2 weeks before. There were lots of surges and probably currents at Molokini, Seth did his job in keeping the group together. On dive #2 Seth was ok with me following above, because we had changed location closer to shore of Wailea.