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| | ==Types== |
| {{Scuba diving DDX}} | | {{Scuba diving DDX}} |
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| ==Barotrauma of Descent== | | ==Differential Diagnosis== |
| ===[[Otic barotrauma]] ("ear squeeze")===
| | {{Water related injuries DDX}} |
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| ===[[Sinus barotrauma]] ("sinus squeeze")=== | | ==See Also== |
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| ===[[Face squeeze]]===
| | [[Category:Environmental]] |
| *Occurs when air is not added to facemask during descent resulting in:
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| **Facial bruising
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| **Conjunctival Injection/hemorrhage
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| **Retrobulbar hemorrhage if severe
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| ==Barotrauma of Ascent==
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| ===[[Pulmonary barotrauma]]===
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| *Occurs when diver breathing compressed air ascends too rapidly
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| *Symptoms occur minutes to hours after surfacing
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| **Can occur without rapid ascent in pts w/ obstructive lung disease
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| *Lung rupture can lead to pneumomediastinum, pneumothorax, or air embolism
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| **Pneumomediastinum and pneumothorax do not require recompression
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| ===[[Decompression sickness]] (DCS)===
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| *Dissolved inert gases come out of solution and form bubbles in blood and tissue
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| ====Types====
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| =====Type I (Pain only DCS)=====
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| *Involves the joints, extremities, and skin ("cutis marmorata")
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| *Usually only single joint is involved
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| =====Type II (Serious DCS)=====
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| *Spinal cord involvement
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| **Ascending paralysis
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| **Signs often cannot be traced to single location in the cord (may have skip lesions)
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| *Vestibular ("staggers") involvment
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| **Vertigo, hearing loss, tinnitus
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| ***Differentiated from inner ear barotrauma which usually occurs on descent
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| *Pulmonary "chokes"
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| **Cough, hemoptysis, dyspnea, substernal chest pain
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| =====Type III (Type II + gas embolism)=====
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| *Variety of stroke symptoms/signs
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| **May spontaneously resolve
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| ===[[Arterial gas embolism===
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| *Results from pulmonary barotrauma (most common) and decompression sickness
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| *Symptoms develop during ascent or immediately upon surfacing
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| *Causes variety of stroke syndromes depending on part of brain affected
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| **Immediate death, loss of consciousness, seizure, blindness, hemiplegia
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| :;Treatment
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| #Place in supine position
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| #100% O2
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| #IVF (increases tissue perfusion)
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| #Rapid recompression
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| ==At Depth injuries==
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| *[[Oxygen toxicity]]
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| *[[Nitrogen narcosis]]
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| *[[Hypothermia]]
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| *Contaminated gas mixture (e.g. [[CO toxicity]])
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| ==Source==
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| Tintinalli
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| [[Category:Environ]] | |