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A CT scan the following day revealed abundant mediastinal air around the heart and lungs and in the neck. The treating physician noted no complications besides the subcutaneous emphysema in the neck, which did not affect the airway, so he administered high-flow oxygen and allowed Rick to return to his resort. The Diagnosis of Pulmonary BarotraumaĪ doctor at the local hospital on Bonaire performed a complete neurological assessment on Rick and diagnosed pulmonary barotrauma (pressure injury to the lungs) and subcutaneous emphysema (air under the skin). All symptoms had resolved by the following morning, and he completed the last two dives of the certification without any problems. That evening he took an over-the-counter pain reliever and Benadryl and went to bed early. Others in his group discounted his symptoms as bad gas, or water in the ears.
PULMONARY BAROTRAUMA SKIN
After he removed his gear he noticed a change in his voice and what he describes as water under the skin around his neck. When Rick was completing the second dive of his Wreck Diver certification a year before, he surfaced completely exhausted with a burning sensation in his throat. After he surfaced from the next dive, Rick boarded the boat and immediately noticed a change in his voice, a sore throat and crackles under the skin around his neck. He took lots of photos during the dive and occasionally inverted himself to see inside the reef. The chest discomfort resolved during the boat ride to the dive site, so he proceeded with the dive, descending to a maximum depth of 13m. He discounted it as a result of eating leftover pizza for lunch and even mentioned that he needed to take an antacid. Prior to beginning his third dive of the day, Rick felt tightness in his chest. Certified approximately two years prior, Rick was 38 years old and in good health, with no significant medical history except what he describes as ‘athlete’s asthma’ as a child.
PULMONARY BAROTRAUMA SERIES
On a recent trip to Bonaire with his dive club, Rick (a pseudonym) was completing his fourth dive of the day, which was his 14th dive in a three-day series and his 145th lifetime dive. 2018 48(3):186-193.4 Pulmonary Barotrauma Discussion About the Bonaire Diver Inner ear barotrauma in divers: an evidence-based tool for evaluation and treatment. Available at:Įvaluation and management of middle ear trauma. American Academy of Otolaryngology-Head and Neck Surgery website. Accessed March 1, 2021.Įars and altitude.
PULMONARY BAROTRAUMA MANUAL
Merck Manual Professional Version website. Accessed March 1, 2021.ĭiving precautions and prevention of diving injuries.
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