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Barotrauma, Sports Medicine

Dusty Marie Narducci, MD, Board Certified Family Medicine, CAQSM Reviewed 04/2019
 


BASICS

  • Barotrauma is defined as physical damage to the body from the mechanical effects of pressure.

  • Can occur due to overpressurization (during ascent) or more commonly underpressurization (during des...

DIAGNOSIS

Essential workup: 
  • Head, eyes, ears, nose, and throat (HEENT) exam with particular attention paid to the TM to determine if rupture has occurred

  • Pulmonary exam looking for signs of subcutaneou...

TREATMENT

  • Hospital admission criterion: PBT, arterial gas embolism, unstable patients

  • Emergency department (ED) treatment:

    • Establish intravenous (IV) access for unstable patients.

    • Intubation in patients ...

ONGOING CARE

  • Good prognosis, with most cases being self-limited

  • No diving until TM has healed and other symptoms have resolved.

  • Predive medical clearance is recommended for anyone with prior PBT or deco...

REFERENCES

1
Glazer TA, Telian SA. Otologic hazards related to scuba diving. Sports Health.  2016;8(2):140–144.
2
Vaezeafshar R, Psaltis AJ, Rao VK, et al. Barosinusitis: comprehensive review and pr...

ADDITIONAL READING

  • Bove A. Diving medicine. Am J Respir Crit Care Med.  2014;189(12):1479–1486.

  • Divers Alert Network: http://www.diversalertnetwork.org

  • Lee YI, Ye BJ. Underwater and hyperbaric medi...

CLINICAL PEARLS

  • Barotrauma is the most common form of diving-related injury; most common is middle ear barotrauma.

  • Most serious complication of barotrauma is arterial gas embolism.

  • Divers with lung dise...

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