| Disorder |
 |
Clinical
features |
|
Dive profile |
|
Treatment |
| Middle
ear
barotrauma of descent |
|
Pain,
dizziness,
hearing loss, rupture or hemorrhage of
tympanic membrane |
|
During
descent
usually, possible during ascent |
|
Improved
equalization
techniques, oral and nasal
decongestants; antibiotics |
| Facial
nerve
baroparesis |
|
Facial
paralysis,
resolves within hours |
|
During
ascent |
|
No
treatment |
Inner
ear
barotrauma, round or oval window
rupture, (?Perilymph fistula)
|
|
Dizziness,
nausea,
vomiting, ringing in ear, hearing loss;
often
associated with middle ear barotrauma |
|
During
descent
usually, possible during ascent |
|
ENT
specialist
evaluation,
bed rest, head elevation, avoid
straining, surgery if
persistent. |
Arterial
gas
embolism (pulmonary barotrauma)
|
|
Stupor,
confusion,
coma, seizures, focal weakness, visual
loss |
|
Within
five
minutes of surfacing (> 80 percent)
or during ascent;
significant time-depth exposure not
required. Usually a rapid ascent.
|
|
100
percent
oxygen, immediate United States Navy
Table 6 algorithm
recompression (HBOT),
supportive care |
| Inner
ear
DCS |
|
Dizziness,
nausea,
emesis, rapid eye movement, ringing in
ear, hearing loss |
|
Within
30
to 60 minutes of surfacing (> 50
percent), 90 percent by six
hours; significant time-depth exposure
required |
|
Same
as
above |
| Cerebral
DCS |
|
Confusion,
focal
weakness, fatigue, visual loss, double
vision, slurred speech,
staggering walk, headache |
|
Same
as
above |
|
Same
as
above |
| Spinal
cord
DCS |
|
Tingling/sensory
loss
in trunk and/or extremities, leg
weakness, loss of bowel/bladder
function |
|
Same
as
above |
|
Same
as
above |
| Headache
(arterial
gas embolism or DCS) |
|
Severe
generalized
headache associated with alteration of
consciousness and
other signs |
|
Usually
develops
within minutes of ascent, may persist
without recompression
treatment |
|
Same
as
above; analgesics |
| Oxygen
toxicity |
|
Focal
seizures,
visual constriction, nausea, vomiting,
dizziness, tingling,
rare generalized seizures |
|
Occurs
at
depth, associated with use of
rebreathers and nitrox at depth.
|
|
Reduce
depth
and oxygen exposure, supportive care,
seizure management; see
arterial gas embolism treatment |
