| 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 |
