Barotrauma is the pain or discomfort that you feel when there is a difference in air pressure between the outside environment and the inside of your body. You may have this discomfort when you fly in an airplane or go scuba diving.
The air inside your body squeezes together or swells as the outside pressure increases or decreases. The outside pressure can increase or decrease from water or air pressure. The squeezing and the swelling can cause pain and damage. Barotrauma can affect the ear, face (sinuses), and lungs. It can affect any part of the body with air inside.
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Pulmonary barotrauma is the injury that is caused when outside pressure is different than the pressure of the air in your lungs.
Barotrauma can even be due to equipment such as a mask or dry suit used for scuba diving. The equipment can block and trap air against the skin. You may become injured if an air pocket happens when you dive. Dry suits can painfully pinch your skin. Masks can cause blood vessels in the eyes to burst.
Contact your doctor if you think you may have some type of barotrauma.
Barotrauma is caused when the air pressure inside and outside the body are different. This results in discomfort. Causes include:
Risk factors that increase your chance of developing barotrauma include:
You need to seek treatment immediately if you have symptoms of an air embolism due to pulmonary barotrauma. Symptoms of an air embolism to the brain are usually identified very quickly after you surface from the water.
Symptoms of decompression sickness usually occur within an hour of surfacing from the water. They can also occur up to six hours later. It is very important to seek treatment immediately if you have decompression sickness.
If you have any of these other symptoms do not assume it is due to barotrauma. These symptoms may be caused by other, less serious health conditions.
Symptoms may include:
Decompression symptoms may include:
Your doctor will ask about your symptoms and medical history. A physical exam will be done. If you have been flying or have been diving recently it is important to tell your physician.
Get medical help right away if you think that you have pulmonary barotrauma or decompression sickness.
Your doctor will look into your ear with a special flashlight called an otoscope. The otoscope allows your doctor to see your eardrum. Your doctor may see a bulge of the eardrum if you have barotrauma. This bulge occurs from the difference in pressure between the inside and outside of your eardrum. There may even be blood behind the eardrum.
There are no tests to diagnose sinus barotrauma. Diagnosis depends on your doctor getting an accurate history and then conducting a physical exam.
Your doctor may order tests to check for air embolisms and possible lung collapse.
Your doctor may choose to treat you immediately if you have been diving recently and show symptoms of decompression sickness.
Talk with your doctor about the best treatment plan for you. The following measures can also prevent barotrauma. Treatment options include the following:
To relieve the pressure in your eustachian tube, you can:
It is important to relieve nasal congestion and open your eustachian tube. Your doctor may recommend that you take some medications, including:
Your doctor may prescribe antibiotics to prevent an ear infection if the barotrauma is severe.
Surgery may be necessary to relieve the pressure if your eustachian tube does not open with other treatments. Your doctor will make a small cut in your eardrum to equalize the air pressure. Any fluid blocking the tube may also be removed.
Oxygen should be given immediately if you have pulmonary barotrauma. The oxygen can be given through a mask over the face or by a tube near your nose.
If you have decompression sickness, you need to be in a high-pressure environment. This allows the air bubbles that have formed to shrink and break up in your blood. Some medical centers have hyperbaric chambers (also known as high-pressure or recompression chambers). These chambers provide a high-pressure environment.
The Divers Alert Network offers information on these chambers.
Take the following steps to help reduce your chances of getting barotrauma:
American Academy of Audiology
American Academy of Otolaryngology—Head and Neck Surgery
Divers Alert Network
Canadian Society of Otolaryngology—Head and Neck Surgery
Barotrauma. American Hearing Research Foundation website. Available at: http://american-hearing.org/disorders/barotrauma. Updated October 2012. Accessed November 12, 2012.
Brandt MT. Oral and maxillofacial aspects of diving medicine. Military Medicine. 2004;169:137-141.
Ears and altitude. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/earsAltitude.cfm. Updated February 2, 2012. Accessed November 12, 2012.
Ears and sinuses. Alert Diver. Jan 2001. Available at: http://www.diversalertnetwork.org/medical/articles/Ears_and_Sinuses.
Newton HB. Neurologic complications of scuba diving. Am Fam Physician. 2001;63:2211-2118, 2225-2226.
Last reviewed November 2012 by Peter Lucas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2012 EBSCO Publishing All rights reserved.
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