Barotraumatism

Abstract

Although human tissues is able to withstand significant pressure, tissue injury can occur when a gas-filled space is unable to equilibrate to environmental pressure - whether increasing or decreasing - as described by Boyle's Law. This phenomenon is called barotrauma. Two main conditions must be present for barotrauma to occur: (1) a change in ambient pressure; and (2) transfer of pressure to a non- or partially collapsible gas-filled space. Gas expansion may tear tissue while gas volume reduction may cause vascular engorgement, mucosal swelling and haemorrhage. In particular this may affect the middle ear and sinuses; lung; intestines; teeth; eye, particularly when surrounded by an air space like a face mask; and other physiological or pathological gas spaces An understanding of these effects and the exclusion of pathology that may introduce risk of disequilibration are best achieved through education and training of divers and the physicians examining them