Overview of barotrauma

[Hina Muqadas]

Barotrauma is tissue injury caused by a pressure-related change in body compartment gas volume; it affects air-containing areas, including lungs, ears, sinuses, gastrointestinal (GI) tract, air spaces in tooth fillings, and space contained by the diving face mask. Manifestations depend on the affected area. Diagnosis is clinical but sometimes requires imaging tests. Treatment generally is supportive but may include oxygen and chest tube placement for pneumothorax.
(See also Overview of Diving Injuries.)
Risk of barotrauma (often called squeeze by divers) is greatest from the surface to 10 m (33 ft). Risk is increased by any condition that can interfere with equilibration of pressure (eg, sinus congestion, eustachian tube blockage, structural anomaly, infection) in the air-containing spaces of the body.
Ear barotrauma constitutes about two thirds of all diving injuries.
In divers who inspire even a single breath of air or other gas at depth and do not let it escape freely during ascent, or when ascent is rapid, the expanding gas may overinflate the lungs, causing pulmonary barotrauma. Lung overinflation occurs mostly in divers breathing compressed air but can occur even in swimming pools when compressed air is inspired at the bottom of the pool (eg, when scuba gear is used there) and, rarely, from an inverted bucket.
Barotrauma can also affect the GI tract (gastrointestinal barotrauma), teeth (dental barotrauma), eyes (eye barotrauma), and face (mask barotrauma).