Pulmonary barotrauma: Difference between revisions
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==Background== | ==Background== | ||
*Occurs when diver breathing compressed air ascends too rapidly | *Occurs when diver breathing compressed air ascends too rapidly | ||
==Clinical Features== | |||
*Symptoms occur minutes to hours after surfacing | *Symptoms occur minutes to hours after surfacing | ||
**Can occur without rapid ascent in patients with obstructive lung disease | **Can occur without rapid ascent in patients with obstructive lung disease | ||
*Lung rupture can lead to | *Lung rupture can lead to: | ||
**Pneumomediastinum | **[[Pneumomediastinum]] | ||
**[[Pneumothorax]] | |||
**[[Air embolism]] | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Evaluation== | ==Evaluation== | ||
*Clinical diagnosis; do not delay intervention for studies | |||
*[[CXR]] | |||
*Assess for alternate etiologies | |||
==Management== | ==Management== | ||
*[[Pneumomediastinum]] and [[pneumothorax]] do ''not'' require recompression; see management section on those pages | |||
*[[Air embolism]] | |||
**IVF (increases tissue perfusion) | |||
**Rapid recompression | |||
==Disposition== | ==Disposition== | ||
Revision as of 23:22, 2 September 2019
Background
- Occurs when diver breathing compressed air ascends too rapidly
Clinical Features
- Symptoms occur minutes to hours after surfacing
- Can occur without rapid ascent in patients with obstructive lung disease
- Lung rupture can lead to:
Differential Diagnosis
Diving Emergencies
- Barotrauma of descent
- Otic barotrauma
- Pulmonary barotrauma
- Sinus barotrauma
- Mask squeeze
- Barodentalgia (trapped dental air causing squeeze)
- Barotrauma of ascent
- Pulmonary barotrauma (pulmonary overpressurization syndrome)
- Decompression sickness (DCS)
- Arterial gas embolism
- Alternobaric vertigo
- Facial baroparesis (Bells Palsy)
- At depth injuries
- Oxygen toxicity
- Nitrogen narcosis
- Hypothermia
- Contaminated gas mixture (e.g. CO toxicity)
- Caustic cocktail from rebreathing circuit
Barotrauma Types
- Otic barotrauma
- Pulmonary barotrauma
- Sinus barotrauma
- Mask squeeze
- Barodentalgia (trapped dental air causing squeeze)
Evaluation
- Clinical diagnosis; do not delay intervention for studies
- CXR
- Assess for alternate etiologies
Management
- Pneumomediastinum and pneumothorax do not require recompression; see management section on those pages
- Air embolism
- IVF (increases tissue perfusion)
- Rapid recompression