Pressure in the middle ear normally equilibrates with ambient pressure via the eustachian tube. This is the most common disorder among divers and the physiology behind it is similar to pulmonary barotrauma. The video below provides a clear explanation for the physiology of these processes: In addition to trauma to the tissues, bubbles can also build up in the blood vessels during rapid ascent and cause arterial gas embolisms, which can be lethal. These injuries can manifest themselves as a pneumothorax or subcutaneous emphysema (air trapped underneath the skin). The lungs do not sense pain when over-expanded, giving the diver little warning to prevent the injury. The compressed gas in the lungs expands as the ambient pressure decreases causing the lungs to over-expand and rupture unless the diver allows the gas to escape by maintaining an open airway, as in normal breathing. It is most commonly caused during breath-holding on ascent from scuba diving. ![]() We’ll break them each down one by one:Īlso known as “ pulmonary over-inflation syndrome“, and it’s the second leading cause of death among scuba divers, behind drowning. The areas of the body that are most affected by pressure changes are hollow organs, such as the lungs, ears, and sinuses. ![]() This is likely to occur any time someone is exposed to a significant change in ambient pressure, such as in scuba diving, explosive blast waves, and even aggressive mechanical ventilation. The term “ barotrauma” simply refers to any physical damage to body tissues caused by a difference in pressure between a gas space inside, or contact with, the body, and the surrounding gas or fluid.
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