Page 200 - PJ MED OPS Handbook 8th Ed

Barotrauma
Ear Squeeze, Middle Ear Squeeze, Sinus Barotrauma, Reverse Squeeze,
Dental Barotrauma
Ear Squeeze Signs and Symptoms:
1. Pain not relieved by Valsalva
2. Hemorrhage and/or edema in ear canal
3. In severe cases, the tympanic membrane (TM) may rupture
4. Vertigo

Treatment:
Conduct visual exam of TM. Keep ear canal dry. No diving until ear is healed. No ear drops if TM
ruptured. Consider antibiotics if damage to TM is moderate to severe.

Sinus Barotrauma Signs and Symptoms:
1. Pain over affected sinus on descent (pain will subside with equalization)
2. Blood or mucus from the nose on ascent
Treatment:
1. Symptomatic pain relief
2. Decongestants
3. Antibiotics if infected

Dental Barotrauma Signs and Symptoms:
1. Gum Abscess: Dull pain on ascent
2. Root Abscess: Dull pain on descent

Treatment:
1. Analgesics PRN
2. Dental repair

Reverse Squeeze:
May be external ear, sinus, or dental
Signs and Symptoms:
1. Sharp pain on ascent (pain is relieved by descending a few feet [bouncing])
2. Bloody discharge in mask

Treatment:
Decongestants. No ear drops if TM ruptured
Consider antibiotics if damage to TM is moderate to severe

198 n Pararescue Medical Operations Handbook / 8th Edition