Barotrauma

WHAT YOU SHOULD KNOW:

• Barotrauma is an injury that is caused by pressure changes. The pressure changes happen between an area of your body, and the pressure of air or water around you. Body parts where this can occur include your ears, sinuses, and teeth. Body organs where barotrauma can occur include your lungs, stomach, and bowels (intestines). Barotrauma is also called ear, sinus, lung, or gut squeeze. Barotrauma may be caused by scuba diving, blast injuries, and traveling by aircraft. If you have had barotrauma once, you are more likely to get it again.
  
  
• You may have ear pain, trouble hearing, and blood or fluid may come out of your ears. You may have stomach pain, face pain, a headache, or a toothache. You may feel dizzy, or have chest pain and trouble breathing. Caregivers will ask you about recent activities. They may do ear tests and x-rays to learn if you have barotrauma. Treatment may include medicines, oxygen, or surgery. Barotrauma signs and symptoms may go away without treatment. In other cases, you will need treatment or surgery. Treatment may decrease problems such as pain and swelling, or it may make them go away. You may have lasting problems, such as hearing loss, after getting barotrauma.

INSTRUCTIONS:

Take your medicine as directed:

Call your primary healthcare provider if you think your medicine is not working as expected. Tell him if you are allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs you take. Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists.

• Analgesics: You may need to use this medicine to decrease pain.
  
  
• Antibiotics: This medicine helps prevent, or treats infections caused by bacteria.
  
  
• Decongestants: These medicines help dry up fluid in your nose. This medicine may be needed if you have barotrauma of the ears and sinuses.
  
  
• Laxatives: These medicines make your stool softer to prevent straining (pushing) while having a stool. Straining may increase the pressure inside your brain. Your caregiver may give you this if you have ear squeeze.
  
  
• Steroids: These are medicines that decrease swelling of the lining of your ear, nose and sinuses.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

• You may need to see your caregiver for years after having barotrauma. You may need to have hearing tests, blood tests, and other tests. Hearing and imaging tests may need to be done again. Tell your caregiver if you get any new signs and symptoms.
  
  

Decrease the risk of getting barotrauma while traveling by air:

Ask your caregiver if it safe for you to travel by air.

• Avoid air travel if you have an upper respiratory infection (cold), or an ear infection.
  
  
• Follow guidelines that tell you how long to wait to fly on an aircraft after scuba diving. Scuba divers should always follow the guidelines given on dive tables and dive computers.
  
  
• Wait to fly on a plane for 24 hours (one day) after skydiving.
  
  
• Avoid sleeping when the plane takes off or lands. Sit up while flying on an airplane, rather than lying down.
  
  
• Swallow, yawn, move your jaw sideways, chew gum, and sip fluids while flying on an airplane. Do these actions 3 to 4 times as the plane takes off, and repeat them as it lands.
  
  
• Try the Valsalva's maneuver to clear your ears as the airplane is landing if jaw movements have not worked. The Frenzel's maneuver may also be tried as a plane takes off, and as it lands.
  
  
• Ask caregivers about a device that may help you clear your ears while flying in an airplane. The device is put into one nostril, and the other nostril is closed by pressing on it. You blow air through the nostril with the device in it to fill a balloon.

Decreasing the risk of getting barotrauma while scuba diving:

Ask your caregiver if it safe for you to scuba dive. If you are able to dive, ask him how long to wait before you may scuba dive.

• See your caregiver before you scuba dive. He may see if you are able to clear your ears easily. If you are not able to clear your ears, caregivers may suggest that you do not scuba dive.
  
  
• Do not scuba dive for two weeks after the signs and symptoms of a cold or infection have gone away.
  
  
• Drink enough liquids before diving. Men 19 years and older should drink about three liters of liquid each day (about 13 eight-ounce cups). Women 19 years and older should drink about two liters of liquid each day (about nine, eight-ounce cups). Avoid eating large meals or drinks that may make you gassy, such as soda, before diving.
  
  
• Do not wear earplugs or tight-fitting dive hoods.
  
  
• Learn how to swallow, yawn, and move your jaw sideways while scuba diving.
  
  
• Do the Valsalva's maneuver three times at every meter for the first five meters as you descend. If you feel that your ears are plugged or painful, slowly ascend. Repeat the Valsalva's maneuver as you slowly descend. If this action does not clear your ears, stop doing it.
  
  
• When diving, follow the guidelines given on dive tables and dive computers. These guidelines tell you how long to wait before diving again, and before flying in an airplane.
  
  
• Wait for a period of time after scuba diving before you exercise or take a hot bath.

CONTACT A CAREGIVER IF:

• You get dizzy or throw up.
  
  
• You have a headache, face pain, or feel like one or both of your ears are blocked or painful.
  
  
• You have pain in your anus.
  
  
• You have very painful joints or muscles.
  
  
• Your face, or your legs and feet swell up.
  
  
• Your stomach hurts, is swollen, or you feel sick to your stomach.

SEEK CARE IMMEDIATELY IF:

• Fluid or blood is coming out of your ear or nose.
  
  
• Skin changes, such as a rash, or red or purple patches.
  
  
• You cough out blood, or have sudden shortness of breath or chest pain.
  
  
• You feel sleepy all the time, there are changes in the way that you act, or you are having trouble thinking clearly.
  
  
• You have odd eye movements, or you have trouble keeping your balance.
  
  
• You have trouble hearing or cannot hear anything.
  
  
• You lose feeling in your arms or legs.
  
  
• Your neck, shoulders, or chest swell, and your voice changes.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Barotrauma (Aftercare Instructions)