DIVING RELATED INJURIES

NON-LIFE THREATING

At constant temperature the volume of a flexible container depends upon the

surrounding pressure and the volume is indirectly proportional to the absolute

pressure.P1 V1 = P2 V2

Boyle explains Barotrauma

Mask

Tooth

Stomach

Dry Suit

Ear

Sinus

Squeeze Barotrauma

• Space Characteristics: – Gas Filled – Rigid walls– Enclosed – Vascular Penetration

• Environment– Ambient Pressure Change

Mask SqueezeAKA: Facial Barotrauma

• Failure to equalize Mask Air Space during Descent

• Occurrence: – as shallow as 15 ft.– Typically unexperienced divers– Not with Full Face Masks

• S/Sx: – Injected Sclera– Periorbital Edema – Usually Painless– Usually No Effect on Vision

• Tx: – Time (approx 2 weeks)– ANY pain or VISION problems Optho Eval STAT

OTS Full Fask Mask

Mask TypesVBPD Divers

VBPD Dive Drill – Dredge Ops 18 MAR 2015

Half Mask

Tooth SqueezeAKA: Barodontalgia

• Occurrence– Descent or Ascent – Decay, filling, abscess

• S/Sx:– Pain, throbbing

• What to do:– During Descent

• Tooth ache = Abort Dive

– During Ascent• Fracture or Rupture of tooth• Don’t swallow !

• Tx: – Pain Medication– Dentist

What could change this to a life threat?

• Cause:– Air Flow from Regulators– Swallowed air

• Occurrence:- ASCENT

- S/sx:- Severe Abdominal Cramps and

bloating

- Tx:- Prevention- Extended DECO stop

Stomach Squeeze

Dry Suit Squeeze

Dry Suit Squeeze

VBPD Dive Drill, Dredge Ops, 18 MAR 2015

VBPD Dive Drill, Dredge Ops, 18 MAR 2015

VBPD Dive Drill, Dredge Ops, 18 MAR 2015

Ear Squeeze“Otic Barotrauma”

• Most Common Diving Related Injury• Types

• Middle Ear Squeeze – Descent • Inner Ear Squeeze (Reverse Ear Squeeze) – Ascent

• Occurrence: • Any Depth• Any Time• Any Diver

• S/Sx: • Acute

• Ear Pain• Vertigo• Tinnitis

• Long Term• Can lead to permanent hearing loss

Ear Squeeze“Otic Barotrauma”

• Tx:• Middle Ear Squeeze – Symptomatic• Inner Ear Squeeze

• In addition to Middle Ear Tx • Bed Rest with Elevated Head of Bed• Avoidance of any Valsalva maneuvers

• Stool Softeners• ENT

Anatomy of the Ear

Middle Ear Squeeze

Reverse Ear Squeeze

Ear Squeeze

Injected Tympanic Membrane TEED Scale

What conditions could increase the risk of Ear Squeeze and possibly Ear Drum (Middle Ear) or

Tympanic Membrane (Inner Ear) Rupture?

Diving Distracted

Sinus Squeeze

Other Dive related injures

• Vertigo– Alternobaric Vertigo (ABV) – Caloric Vertigo

• Nitrogen narcosis

VERTIGO

• Function of Inner Ear Balance

Vertigo: Other Types

• Alternobaric Vertigo– Transient– d/t unequal middle ear pressures on ascent

• Caloric Vertigo– Stimulated by cold water in the ear

Nitrogen narcosis

• Deep Dives– 100 ft or more

• Breathing Compressed Air• Resolve during descent

• s/sx• wooziness;• giddiness; • euphoria; • disorientation; • loss of balance;

• loss of manual dexterity; • slowing of reaction time; • fixation of ideas; • and impairment of complex

reasoning.

Carnival Cruise Lines Return to Norfolk Spring 2015