Symptoms and Signs of Scuba Diving: Barotrauma and Decompression Sickness

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 3/11/2019

Doctor's Notes on Scuba Diving: Barotrauma and Decompression Sickness

Barotrauma refers to injuries that arise from the pressure differences between areas of the body and the environment. Scuba divers may suffer from a particular type of barotrauma called decompression sickness, or “the bends.” While diving, water pressure causes body tissues to absorb nitrogen gas faster when a diver descends than when ascending to the surface. If a diver comes up to the surface too quickly, nitrogen gas bubbles form in body tissues rather than being exhaled. These nitrogen bubbles cause severe pain.

Symptoms of barotrauma include pain in the ear canal and blood from your ear, ear fullness, eardrum rupture, disorientation, nausea, vomiting, ringing in the ear, dizziness, hearing loss, sinus pressure or pain, nasal bleeding, "bloodshot" eyes and redness or bruising of the face under the mask, chest pain, cough, bloody cough, shortness of breath, abdominal fullness, colicky pain (severe pain with fluctuating severity), belching, flatulence, hoarseness, neck fullness, painful swallowing, loss of consciousness, paralysis, numbness, blindness, deafness, seizures, confusion, or difficulty speaking. Specific symptoms of decompression sickness include rashes, itching, bubbles under the skin, localized swelling, joint pain that worsens with movement and commonly involves the elbows and shoulders, paralysis, sensory disturbances, bladder problems, chest pain, cough, and shortness of breath.

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.