Barotrauma — What It Is and Why It Matters
Barotrauma is physical tissue damage caused by pressure changes affecting gas-filled spaces in the body. As a diver descends, increasing pressure compresses air in the ears, sinuses, mask, and lungs. If the diver cannot equalize these spaces, the pressure differential causes pain, tissue damage, or injury. Ascending barotrauma occurs when expanding gas cannot escape, most dangerously in the lungs.
The most common form is middle ear barotrauma (ear squeeze), caused by failing to equalize during descent. The most dangerous form is pulmonary barotrauma (lung overexpansion), caused by holding the breath during ascent. This is why "never hold your breath" is the most fundamental rule in scuba diving.
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Frequently Asked Questions
What is the most common barotrauma in diving?
Middle ear barotrauma (ear squeeze) is by far the most common, usually caused by descending too fast or diving with congestion. It presents as ear pain and, in severe cases, eardrum perforation. It is preventable through gentle, frequent equalization during descent.
Can barotrauma be fatal?
Pulmonary barotrauma (lung overexpansion) can be fatal if it causes an arterial gas embolism — air bubbles entering the bloodstream and traveling to the brain or heart. This is rare and almost always caused by holding the breath during ascent or a rapid uncontrolled ascent. Normal breathing eliminates this risk.
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