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Barotrauma, Emergency Medicine

Catherine M. Visintainer, Nicole L. Lunceford and Peter J. Park Reviewed 06/2017
 


Basics

Description

Injury resulting from the expansion or contraction of gases in an enclosed space 

Etiology

  • Tissue damage results when a gas-filled space does not equalize its pressure with external pr...

Diagnosis

Signs and Symptoms

  • Facial:

    • Occlusive dive mask: Conjunctival hemorrhage, facial edema, and swelling

  • Extremities:

    • Tight-fitting dive suit: Edema and erythema of the skin at locations of air pocke...

Treatment

Pre-Hospital

  • For barotrauma of descent, unless air-filled cavity has ruptured, no progression of disease on return to normal atmospheric pressure is to be expected.

  • If patient requires air eva...

Follow-Up

Disposition

Admission Criteria

  • PBTs

  • Inner ear barotrauma with round window rupture or severe vertigo

Discharge Criteria

  • Most non-PBT

  • ENT follow-up for severe TM or sinus pathology

Followup Recommendations

Pearls and Pitfalls

  • Watch closely for development of decompression sickness in patients who present with barotraumas.

  • Perform careful lung exam for signs of pneumothorax.

  • Perform careful history in pati...

Additional Reading

  • Divers Alert Network [Homepage]. Available at www.diversalertnetwork.org.

  • Klingmann  C, Praetorius  M, Baumann  I, et al. Barotrauma and decompression illness of the inner ear: 46 ca...

Codes

ICD9

  • 993.2 Other and unspecified effects of high altitude

  • 993.3 Caisson disease

  • 993.9 Unspecified effect of air pressure

  • 993.1 Barotrauma, sinus

  • 993.0 Barotrauma, otitic

  • 993.8 Other specified effects ...

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