Barotrauma of ascent

Barotrauma of ascent is a condition experienced by divers during a rapid or uncontrolled ascent from depth. This condition is a type of barotrauma, which refers to physical damage caused to body tissues by a difference in pressure between an air space inside or beside the body and the surrounding fluid. In the context of diving, barotrauma of ascent specifically relates to the expansion of gases within the body as a diver ascends and the ambient pressure decreases, according to Boyle's Law. This can affect various parts of the body, leading to potentially serious injuries.

Causes

The primary cause of barotrauma of ascent is the failure to equalize pressure in body air spaces with the decreasing ambient pressure as a diver ascends. The most common sites of barotrauma are the middle ear, sinuses, lungs, and teeth (dental barotrauma). The risk is significantly increased in situations where the ascent is rapid or uncontrolled, often due to panic, equipment failure, or a lack of awareness of ascent speed.

Symptoms and Effects

Symptoms of barotrauma of ascent can vary depending on the affected area but generally include pain, discomfort, and in severe cases, physical damage to the tissues. For example, in the case of the middle ear, symptoms might include pain, hearing loss, and vertigo. If the lungs are affected, symptoms could range from mild chest pain and shortness of breath to serious conditions such as a pulmonary barotrauma, pneumothorax, or arterial gas embolism, which can be life-threatening.

Prevention

Prevention of barotrauma of ascent involves proper dive planning, adherence to safe diving practices, and adequate diver training. Key preventive measures include:

• Ascending slowly and controlling the ascent rate to allow gases to safely expand and escape from body air spaces.
• Performing regular equalization techniques during descent and ascent to balance pressure in the ears and sinuses.
• Using a dive computer or depth gauge to monitor ascent rate.
• Avoiding diving with a cold or nasal congestion, which can block air passages and prevent equalization.
• Ensuring proper training and familiarity with diving equipment and emergency procedures.

Treatment

Treatment for barotrauma of ascent depends on the severity and the area of the body affected. Mild cases may resolve with rest and over-the-counter pain medication, while more severe cases require professional medical treatment. For example, a severe ear barotrauma might necessitate the use of decongestants, steroids, or in some cases, surgical intervention. Pulmonary barotrauma requires immediate medical attention and may involve treatments such as oxygen therapy or in severe cases, surgical procedures to repair lung damage.

Conclusion

Barotrauma of ascent is a preventable condition that can have serious consequences for divers. Awareness, education, and adherence to safe diving practices are crucial in minimizing the risk of this condition. Divers should always plan their dives carefully, ascend slowly, and be vigilant about equalizing pressure in their body air spaces to ensure a safe and enjoyable diving experience.