Scuba Diving

Certified divers in United States: 9 million
Distribution
1. Coastal areas
2. Inland water areas: lakes, streams, quarries
3. Distant travel (e.g. island resorts)
Annual injuries in United States
1. Deaths: 90 per year
2. Injuries requiring Recompression Therapy: 1,000/year

Middle Ear Barotrauma (Barotitis Media)
1. Otalgia
2. Vertigo
3. Tympanic Membrane Rupture or Hemorrhage
4. Facial baroparesis resulting in Bell's Palsy
Inner Ear Barotrauma (Round and oval window rupture)
1. Causes Tinnitus, Vertigo, Hearing Loss
2. Avoid strenuous activity
Alternobaric Vertigo
Sinus Barotrauma (Sinus Squeeze)
1. Causes sinus pain and Epistaxis
2. Responds to topical and Systemic Decongestants
Gastrointestinal Barotrauma (aerogastralgia)
1. Causes Colicky Abdominal Pain and Belching
2. Prevent by clearing in head up position
Tooth squeeze (Barodontalgia)
1. Causes Tooth Pain while diving
2. Prevent by no diving 24 hours after dental work
Mask Squeeze
1. Causes Corneal injection and Conjunctival Hemorrhage
2. Prevent by ventilating mask while diving
Pulmonary Barotrauma
1. Arterial Gas Embolism
2. Mediastinal Emphysema
3. Subcutaneous Emphysema
4. Pneumothorax

Prepare for Scuba Diving
1. Avoid Alcohol before diving
2. Do not dive alone
3. Plan dive in advance and follow plan
4. Stay within no-decompression limits
Avoid airplane flight immediately after Scuba Diving
1. No decompression dive: no flight for 12 hours
2. Decompression dive: no flight for 24 hours