Barotrauma is described as injury to the tissues caused by pressure changes which compresses or expands gas present in various bodily structures. The elevated pressure outside of the body is conveyed correspondingly all over the blood and bodily tissues which do not squeeze since they are comprised mostly of liquid.
Barotrauma usually affect the ears. Nevertheless, it can also affect the lungs which is the most serious. The risk for barotrauma is heightened by conditions that prevent the air from freely flowing between the spaces.
Indications of barotrauma
The indications of barotrauma typically start close to the surface throughout descent or ascent. The symptoms typically depend on the organs involved.
Pulmonary
- Pneumothorax can trigger chest pain and shortness of breath.
- Some can cough up blood or produce bloody foam at the mouth if the lung tissue is damaged.
- Air in the neck tissues can crush the nerves to the vocal chords which causes hoarseness
Pneumothorax can trigger chest pain and shortness of breath. - Subcutaneous emphysema results to crackling when the area of affected skin is touched.
Ear
- Painful inward bulge of the eardrum if the pressure in the middle ear is lower than the water pressure during descent
- Eardrum ruptures if the pressure difference is too high which causes the rush of cold water into the middle ear, resulting to vertigo, nausea, disorientation and sometimes vomiting.
- The ruptured eardrum affects hearing and can result to a middle ear infection hours or days after, resulting to pain and drainage from the ear.
- The inner ear might be affected as well, resulting to abrupt loss of hearing, vertigo and tinnitus.
Eye
- Formation of small air bubbles that become trapped behind hard contact lenses
- The bubbles can impair the eyes and trigger vision loss, soreness and appearance of halo around lights.
Preventive measures
The pressure in the airways and lungs is instantly equalized with the outside pressure once a supply of pressurized air is available at depth such as an air tank or diving helmet.
Earplugs or a close-fitting wet suit hood provides a closed area between the earplug and the eardrum where pressure could not be equalized. The pressure within goggles could not be equalized either. With this in mind, earplugs or goggles should not be used while diving.
A decongestant can be taken before a dive by those who have nasal congestion that can obstruct the nasal passages. Relief from the congestion can promote equalization of the pressures between the sinuses and ears, thus preventing sinus and ear barotrauma.
Management
Some individuals with pneumothorax necessitate treatment such as the insertion of a plastic tube into the chest cavity to drain the air and allow the lung to re-expand.
As for ear and sinus barotrauma, nasal decongestants are used or the oral forms. In some cases, if the recovery is sluggish, corticosteroids might be given as a nasal spray or in pill form.
A broken eardrum typically heals on its own, though a middle ear infection requires treatment using antibiotics in oral form or as eardrops. Damage involving the middle and inner ear might necessitate immediate surgery to prevent lasting damage.