A list of tips is given for divers suffering from a ruptured eardrum. Immediate advice from a specialist is required to prevent the problem from becoming a major injury. Giving ample time for healing is also important to deter further damage.
How To Prevent A Simple Accident From Becoming A Devastating Injury
Medical experts estimate 65 percent of all divers have some type of ear problem during their diving careers. The most common problem is swimmer’s ear (otitis externa), an infection of the outer ear canal – most often caused by bacteria and, occasionally by a fungus.
Yet, every once in a while a diver suffers a ruptured eardrum. One would think this is a rather remote possibility for a well-informed, experienced diver. Oddly enough, ruptured eardrums happen to experienced divers just as often (or more often) than to new divers. Experienced divers who dive frequently become accustomed to easy equalization and rapid descents. When one of their eustachian tubes jams up, it often occurs so suddenly the diver cannot slow or stop in time to prevent a rupture.
No one knows for sure how many ruptured eardrums occur each year, as there is no program for monitoring this type of injury on a nationwide basis. Some doctors believe ruptured eardrums far exceed the number of bends cases. As divers travel farther from home on long range trips, this type of injury becomes more of a concern.
What do you do when your eardrum breaks? How do you prevent further damage? Will you ever be able to dive again? These questions become much more critical when you are on an overseas dive trip, far from home and far from your physician.
The following is a list of 15 important tips for dealing with a ruptured eardrum. These are written from a layman’s point of view and are based on discussions with medical experts in the field of otolaryngology – and witnessing actual ruptured eardrum events, as well as interviewing other divers who have suffered similar accidents. In essence, this is a practical approach to eardrum first aid when you are far from home.
1 Carry your doctor’s number with you: First aid for a ruptured eardrum begins with pre-trip preparation. When you start packing for your vacation, be sure to write down the full name and telephone number of your personal physician (family doctor). Better yet, jot down the number of your ENT (ear, nose and throat) doctor, if you have or know one.
2 Recognize the symptoms: It is not always easy to recognize a ruptured eardrum as the symptoms can vary greatly. Some people experience a sharp, knife-like pain in the ear followed by no pain at all. Some experience a slight dizziness upon surfacing and exiting from the water. Some experience a great deal of dizziness while others have none.
One of the telltale signs of a ruptured eardrum is a feeling of fullness in the damaged ear, as if the ear canal was filled with water. If, upon inflating your ears, you hear a squeaking noise, you may have a perforated eardrum. If this occurs, do not inflate your ears further. This could cause bacteria to enter the ear from the nasal cavity.
A loss or reduction of hearing is another symptom. If you experience one or more of the symptoms described and also discover a trickle of blood coming out of your ear, there is a good chance you have ruptured your eardrum.
3 Cease diving immediately: If you think (or even suspect) you have ruptured your eardrum, stop diving immediately. Any further diving could cause an infection or additional damage that might lead to a permanent loss of hearing. The eardrum is designed to protect your sensitive and vulnerable middle ear from external bacteria, fungus or virus infections. Once the eardrum is perforated, the door is open to invasive diseases.
4 Avoid putting anything in your ear: Even though your ear may be bleeding or may feel as if it is filled with water, do not put a cotton swab in your ear. Your outer ear contains a natural collection of various bacteria and dirt. Probing the ear canal with a cotton swab may push the bacteria, residual saltwater and dirt beyond the eardrum and into the middle ear. This could result in an unwanted and unnecessary middle ear infection.
5 Avoid plugging your ear with cotton: A bleeding wound motivates most people to cover it with an adhesive bandage or cotton, in an effort to stop the bleeding. This is the wrong thing to do with a ruptured eardrum. Plugging the ear with cotton traps water and moisture in the ear canal and encourages infection. Instead, leave the ear open so the water inside can eventually dry out. The blood will clot and the bleeding will stop on its own.
6 Avoid putting eardrops in your ear: The first aid treatment for a ruptured eardrum is just the opposite of the remedy for an ear infection. Most experienced divers are familiar with some form of antibiotic eardrops such as VoSol HC. These prescription antibiotics are specifically designed to treat infection in the outer ear canal as long as the eardrum is intact. Avoid putting any sort of antibiotic eardrops or solutions into your ear canal, if you suspect a ruptured eardrum. The drops or solution can carry bacteria and water from the side walls of the ear canal directly into the middle ear and cause an infection.
7 Keep the ear dry when showering: Most divers emerging from a dive (especially in seawater) are eager to take a shower – particularly in preparation for the return trip home. If you suspect you have a ruptured eardrum, you must take steps to prevent shower water and shampoo from entering your ear canal. The best way to keep your ear dry is to place a small cotton ball or gauze temporarily over the ear.
Cover the cotton and your ear canal opening with your index finger while soaping and showering with your other hand. Take care to apply very light pressure with your finger. The finger will keep most of the water and shampoo from flowing into your ear canal. What little trickles past your fingertip is absorbed by the cotton. Remove the cotton from your ear after you have dried your hair with a towel and wipe any water droplets away from the outer ear.
8 Contact your doctor: Although you may be in a foreign country or on a remote island thousands of miles from home, the advent of satellite telecommunications puts your doctor just a phone call away. In these modern times, you can call home from just about anywhere in the world.
If you are unsure as to what to do or you wish to obtain a medical opinion, call your doctor back home. Describe the accident and your symptoms in detail. While it is difficult to make a diagnosis over the phone, your doctor will probably recommend you come in for an examination as soon as possible. Make the appointment in advance so your doctor can see you upon your arrival home. Most physicians will prescribe an oral antibiotic for this condition.
9 Rest quietly: If you cannot immediately depart for home because you are out at sea on a live-aboard boat or on an island where the planes fly in/out only twice a week, the best thing to do is rest quietly. Although you may not exhibit any signs of injury, your body has suffered a trauma and requires rest in order to fight off infection and repair itself. Rest quietly in your bunk or bed, either sleeping or reading. Try to lie on your side, with your injured ear facing down. This will aid the water and trickle of blood (if any) to run out of your ear instead of into your middle ear.
10 Return home as soon as possible: If you know you have a ruptured eardrum, you should return home as soon as possible and obtain medical treatment. Such an injury can be serious business and you do not want to risk getting an inner ear infection, mastoiditis or meningitis. The symptoms of a ruptured eardrum can sometimes be nebulous or misleading – and you may actually be suffering from a more serious type of injury known as round window rupture. This type of injury requires immediate medical attention and possible surgery. You need to get yourself back home to familiar surroundings and see either your personal physician or an ENT specialist.
11 You can fly with a ruptured eardrum: If you are sure your injury is a ruptured eardrum, you should not have any problem flying home. Since the eardrum is perforated, air can move in and out of the middle ear without much restriction. Just to be safe, you should take an over the counter (nonprescription) nasal decongestant such as Drixoral or Sudafed. This will help open up your eustachian tubes and prevent any possible equalization difficulty.
12 Have a medical examination: Not all eardrum ruptures are alike. Some people suffer a simple eardrum rupture that heals quickly (three to four weeks) and requires very little medical treatment. Other divers may suffer a bad tear that may require a much longer healing period (several months) or even surgery.
A medical examination is absolutely essential to determine the nature of the eardrum injury and the degree of resulting tissue damage. It is also important to confirm that the injury is a ruptured eardrum and not a round window rupture. Upon arriving home, arrange for a medical examination as soon as possible.
13 Take a hearing test: Don’t be surprised or worried if your doctor or ENT orders a hearing test for you. An audiological examination is one of the best diagnostic tools for determining the extent and type of ear injury. It is one way of determining the difference between a ruptured eardrum and a round window rupture – two entirely different injuries requiring different types of treatment. Most ENT physicians have an audiological testing facility within their offices or nearby.
14 Take all of your medicine: People have a tendency to stop taking their medication once they start to feel better. This is the worst thing you can do when you have ruptured your eardrum. Stopping your medication too soon can result in a secondary infection. Continue taking your oral antibiotic until your supply of pills is gone. You will have a better chance of avoiding infection, healing faster and getting back into the water sooner.
15 Allow your ear time to heal: People experience different rates of healing. The same is true with divers recovering from a ruptured eardrum. Don’t go diving just because you heard that some other diver’s eardrum healed in just two weeks. Follow the advice of your physician and give your eardrum adequate time to heal. Not only does the eardrum tissue have to mend but the external ear canal must recoat the walls with wax for protection from infection.
Take Immediate Action
A ruptured eardrum need not be a major medical problem if you take immediate action and seek proper medical treatment. Follow your physician’s advice and take sufficient time to heal completely and your eardrum can be as good as new. In most cases, your hearing will probably be completely restored to normal. Many professional divers and dive guides have suffered several eardrum ruptures and are still able to continue diving.