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Medical Author:

Daniel F. Noltkamper, MD, FACEP, CDR

Daniel F. Noltkamper, MD, FACEP, CDR

Dr. Daniel Noltkamper, Medical Corps, United States Navy, received his undergraduate degree from the United States Naval Academy. He attended medical school at the University of Texas Medical Branch at Galveston, graduating in 1990. He completed his internship in Family Medicine at Naval Hospital Charleston. CDR Noltkamper served as a General Medical Officer and Radiation Health Officer on board the USS Bainbridge and Squadron Medical Officer at Regional Support Group Norfolk.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Most problems that arise from barotrauma will require medical diagnosis or treatment. The most important thing the patient can do if they experience barotrauma is to seek medical attention and avoid future dives until cleared by a doctor.

Some injuries from barotrauma require immediate medical attention, while others can wait for treatment. In all cases, stop further diving until the patient has been seen by a doctor.

Air embolism is life threatening and requires immediate attention. Planning ahead is important.

• Know the location of the nearest emergency facility and recompression (hyperbaric) chamber before you dive.
• Bring emergency phone numbers with you on the dive. A phone can be the best immediate life saving tool.
• The Divers Alert Network (DAN) at Duke University maintains a list of recompression facilities and can be reached around the clock at (call local EMS first, then DAN):
  • (919) 684-8111 (collect)
  • 800-446-2671 (toll free)
  • 1-919-684-9111 (Latin America Hotline)
• If a diver collapses within 10 minutes of diving, suspect air embolism and seek help immediately. Most U.S. communities have an emergency access number (911). Find out in advance if such a number is available and how to activate emergency medical services when diving in a foreign country. A diver who has collapsed requires oxygen and emergency life support. Lay the person flat and keep the diver warm until help arrives.

Decompression sickness also requires immediate attention, but its symptoms may not appear as quickly as those of air embolism.

• Information on recompression chambers is important and generally can be obtained through the emergency medical system (911 in the U.S.).
• Divers with complaints consistent with decompression sickness should seek attention through their doctor or a hospital's emergency department.

Pulmonary barotrauma and lung squeeze will require attention in an emergency department in most instances because the studies required to evaluate the symptoms and determine the possible treatment must be performed in the hospital environment.

A doctor can evaluate and treat ear squeezes and sinus squeezes initially and refer the patient to a specialist if required.

• Evaluation may require a dive history.
• Ear squeezes require an examination to ensure the eardrum has not ruptured.

The diver needs immediate medical attention if they lose consciousness, show paralysis, or exhibit stroke symptoms within 10 minutes of surfacing.

You or your diving buddy should contact an ambulance through 911 or the local emergency phone numbers.

Symptoms of chest pain and shortness of breath may occur minutes to hours after a dive. These require emergency department evaluation.

• If the symptoms are severe enough, contact an ambulance. Otherwise, have someone drive the patient to the hospital, but do not drive yourself.
• These symptoms can be dive-related or could be caused by another condition, such as a heart attack. This will be sorted out in the hospital.

Decompression sickness, or "the bends,” may require an emergency department to control pain and arrange for recompression services using specialized equipment that is available only at regional centers that specialize in barotrauma.

Dizziness or pain from a squeeze may require emergency attention as well. When in doubt, contact a doctor or a local emergency department for advice.

Must Read Articles Related to Barotrauma/Decompression Sickness

Decompression Syndromes: The Bends The bends, or decompression sickness occur when nitrogen bubbles expand in the bloodstream and tissues when a scuba diver surfaces too fast. Treatment for the b...learn more >>

Ear Pain, Scuba Diving Ear pain is the most common complaint from scuba divers and is experienced by almost every diver at some point. Some divers call it ear squeeze. The pain occurs...learn more >>

Starfish and Crown of Thorns Puncture Wounds Starfish (sea star) and crown of thorns puncture wounds are bottom dwellers, so contact with scuba divers or snorkelers is usually by accident. Symptoms of a st...learn more >>

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