Scuba diving emergencies

Barotrauma of Descent

1. Otic Barotrauma ("ear squeeze")
   1. Results from inability to equalize middle ear pressure
   2. Pain, fullness, vertigo, conductive hearing loss
   3. Treatment = Decongestants, consider antibiotics
2. Sinus barotrauma ("sinus squeeze")
   1. Pain over affected sinus, possible bleeding from nare
   2. Treatment = Decongestants, consider antibiotics
3. Inner ear barotrauma
   1. Sudden onset of sensorineural hearing loss, tinnitus, severe vertigo after Valsalva
   2. Treatment = Head of bed up, no nose blowing, antivertigo medications
   3. Urgent ENT consult as some surgeons advocate early exploration

Source

Tintinalli