Page 194 - ATP-P 11th Ed

4. Pulmonary barotraumas (to include subcutaneous emphysema):
a. If no respiratory distress, monitor patient closely. Use pulse oximetry if available.
b. If respiratory distress occurs – Treat per Pneumothorax, Acute (Atraumtic) Protocol.
5. If POIS is suspected, administer 100% oxygen and 1L normal saline IV 150cc/hr. Ur-
gent evacuation to recompression chamber.
6. If an unpressurized airframe is used, avoid altitude exposure greater than 1000 ft.
7. Treat per Pain Management Protocol. (Avoid narcotics if recompression is anticipated.)

SECTION 2 Disposition
1. Urgent Evacuation for cerebral arterial gas embolus, POIS, or pneumothorax
with respiratory distress.
2. Mild to moderate middle ear, sinus, or pulmonary barotraumas without respira-
tory distress, observation, and Routine evacuation.
3. Routine evacuation for consultation for tympanic membrane rupture.

Normal Tympanic Membrane Perforated Tympanic Membrane

184 SECTION 2 TACTICAL MEDICAL EMERGENCY PROTOCOLS (TMEPs) ATP-P Handbook 11th Edition 185