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.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Barotrauma can cause air bubbles to form and go to areas of your body. Air bubbles may go into your skin and cause a rash, skin dimpling, or purple skin patches. They may also cause your skin to swell up. Swelling may occur in your neck and spread to your shoulders, face, or chest. It can cause voice changes and other problems. Air bubbles may go into your joints and cause pain and swelling. Joints are the places in your body where two bones meet, such as your knees and elbows. Air bubbles may damage your nerves and you may have trouble seeing. You may also be unable to move the muscles of your face, such as when you smile.
  
  
• Air bubbles may damage your spinal nerves, causing pain or trouble moving your arms and legs. Air bubbles may enter your blood, and block your blood vessels. If this happens, blood and oxygen will not be able to get to body areas where it is needed. If air bubbles travel to your heart, you may have an irregular heartbeat or a heart attack. If a body part or organ is damaged, it may not get better. If the bones around your sinuses break, air bubbles may enter your brain. This causes changes in how you act and think. You may feel very tired, faint (pass out), or have seizures (convulsions). Air bubbles in your brain can cause a coma (when you cannot be woken up), or you may die.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

An IV (intravenous)

is a small tube placed in your vein that is used to give you medicine or liquids.

Vital signs:

Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

Medicines:

You may be given the following medicines:

• Analgesics: These medicines help decrease pain.
  
  
• Antibiotics: These medicines kill germs and treat infection. Your caregiver may give this to you if you have a torn eardrum or sinus infection.
  
  
• Decongestants: These medicines help dry up fluid in your nose. They also decrease swelling of the lining of your nose and sinuses. These medicines may be given to you if you have ear or sinus squeeze.
  
  
• 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.

Tests:

Caregivers may collect samples of your blood or urine to be tested. You may also need any of the following tests:

• Hearing tests: These are tests to measure what sound levels you can hear. Pure tone audiometry and speech audiometry will show if you have hearing loss. Tympanometry is a test to check if your middle ear can send sound to your inner ear. For this test, your caregiver will insert a probe (small tube) that makes a sound in your ear. Tests may be done to learn if your cochlea is damaged. The cochlea is part of your inner ear, and is the main organ for hearing.
  
  
• Vestibular function tests: The vestibula is a part of the inner ear that helps you keep your balance. These tests check for damage to the vestibula. For this test, you are asked to look in certain directions, and change your body position.
  
  
• X-ray: Your caregiver may take pictures of your sinuses to check for fluid. This test also shows if the bones around your sinuses are broken. This test also checks for air that should not be in your abdomen (stomach) or other body areas.
  
  
• Computed tomography scan: This is also called a CAT scan. A special x-ray machine uses a computer to take pictures of your bones, lungs, stomach, intestines, and blood vessels. You may be given dye before the pictures are taken. The dye is usually given through a vein (blood vessel) to help your caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if you are allergic to shellfish.
  
  
• Magnetic resonance imaging: This test is also called an MRI. During the MRI, pictures of your abdomen, ear, lungs, and sinuses may be taken. You will need to lie still during this test. The MRI machine contains a very powerful magnet. Never enter the MRI room with any metal objects. This can cause serious injury. Tell your caregiver if you have any metal implants in your body.

Treatment options:

• Ear canal cleaning: Your caregiver may need to remove earwax to release air pressure in your ears.
  
  
• Treatment for tinnitus: Your caregiver may give you a device to put in your ears, which will decrease the ringing that you hear. Biofeedback therapy uses patches of electric current to relax your face and neck muscles. Your caregiver may also use transcutaneous electrical nerve stimulation (TENS) therapy. This uses an electrical current placed on the skin near your ears. Tinnitus retraining therapy may also be done to help you learn not to hear any ringing sounds.
  
  
• Oxygen: If you have lung squeeze, you may need extra oxygen. You may need to breathe into a face mask to get more oxygen as your lungs heal.
  
  
• Hyperbaric oxygen treatment: You may need to go inside a chamber, and breathe in high-pressure oxygen if you have lung barotrauma. You may need to have more than one HBOT treatment.
  
  
• Surgery: If an organ or body part has been hurt by barotrauma, you may need surgery to repair it. If you need to have any of the following surgeries, ask your caregiver for more information about it:
  
  
  • Myringotomy: During this surgery, a small cut is made into your eardrum to release pressure. Your caregiver may do this if your ears are plugged up and painful.
    
    
  • Needle decompression: A needle is put into your chest to make an opening so that trapped air can come out.
    
    
  • Sinus surgery: You may need sinus surgery to widen the sinus openings.
    
    
  • Thoracostomy: During this surgery, a cut is made into your chest to remove air caused by lung squeeze. A tube may be placed in your chest, and left in for a period of time.
    
    
  • Tympanoplasty: If you have a torn eardrum, this surgery may be done to attach it back into place.

Learn more about Barotrauma (Inpatient Care)