Underwater Diving Injuries Types
Pressure on the body increases as a diver descends deeper into the water. The body may be unable to equalize the pressure between the water and the pressure inside a cavity, such as the middle ear, sinuses or lungs. An injury related to the increasing pressure is called squeeze, or a descent scuba injury.
Types of squeeze injuries include:
- Barotitis externa
- Barotitis media
- Sinus squeeze
- Eye squeeze
- Tooth squeeze
Pressure on the body decreases as a diver ascends to the surface. As the pressure decreases, trapped air expands. The expanding air can cause serious injury to a body cavity. An injury related to the decreasing pressure is called reverse squeeze, or an ascent scuba injury.
Types of reverse squeeze injuries include:
Underwater Diving Injuries Ascent Injury
Air is present at atmospheric pressure in many areas of the body. Hollow areas such as the ears, sinuses, intestines and others are directly affected by outside air pressure.
The pressure applied to the body decreases greatly as a person ascends closer and closer to the surface. The body may be unable to equalize the pressure between the water and the pressure inside a cavity, such as the middle ear, sinuses or lungs. As the pressure decreases, trapped air expands in the air cavities.
Less serious injuries include:
- Reverse ear squeeze
- Reverse tooth squeeze
The expanding air can cause serious injury to a body cavity. The diving term for this is called a pop.
More serious injuries include:
Underwater Diving Injuries Pneumothorax
- Gas expands in the lungs as the surrounding pressure decreases during ascent.
- The lung becomes over-inflated.
- The small air sacs in the lung rupture.
When air escapes outside the lungs, the air collects in the space between the outside of the lung and the inside the chest cavity.
Underwater Diving Injuries Reverse Squeeze
Reverse squeeze occurs when gas expands in the ear, sinuses or intestines as the surrounding pressure decreases during ascent.
Reverse ear squeeze
In this case, air expands in the middle ear, causing pain. The eardrum can rupture if the pressure increases too much.
Tooth reverse squeeze
Fillings, decay, dental infections, or recent extractions can form tiny pockets of air around a tooth. Severe dental pain occurs when the pressure increases inside the air pocket.
Sinus reverse squeeze
In this case, air expands in the sinuses, causing pain. The wall of the sinus can rupture if the pressure increases too much.
Intestinal reverse squeeze
This is caused by the expansion of gas in the intestine when the surrounding pressure is decreased during ascent.
Underwater Diving Injuries Descent Injury
The pressure applied to the body increases greatly as a person descends deeper and deeper in the water. Squeeze occurs when pressure from the surrounding water compresses gas in the ear, sinuses, or intestines, as the pressure increases during descent.
In the case, pressure is exerted on the ear canal when a diver descends. A small pocket of air in the ear canal can form if the ear canal is plugged with wax or earplugs. This can result in eardrum rupture or damage to the ear canal.
In this case, pressure is exerted on the middle ear. This can also result in eardrum rupture.
- Arness MK. Scuba decompression illness and diving fatalities in an overseas military community. Aviat Space Environ Med. 1997 Apr;68(4):325-33. 
- Freiberger JJ, Lyman SJ, Denoble PJ, Pieper CF, Vann RD.Consensus factors used by experts in the diagnosis of decompression illness. Aviat Space Environ Med. 2004 Dec;75(12):1023-8. 
- Germonpre P. Patent foramen ovale and diving. Cardiol Clin. 2005 Feb;23(1):97-104. 
- Hunt JC. Diving the wreck: risk and injury in sport scuba diving. Psychoanal Q. 1996 Jul;65(3):591-622. 
- Moon RE, de Lisle Dear G, Stolp BW. Treatment of decompression illness and latrogenic gas embolism. Respir Care Clin N Am. 1999 Mar;5(1):93-135. 
- Smerz RW. Age associated risks of recreational scuba diving. Hawaii Med J. 2006 May;65(5):140-1, 153. 
- Tetzlaff K, Shank ES, Muth CM. Evaluation and management of decompression illness--an intensivist's perspective. Intensive Care Med. 2003 Dec;29(12):2128-36. 
- Tetzlaff K, Thorsen E.Breathing at depth: physiologic and clinical aspects of diving while breathing compressed gas. Clin Chest Med. 2005 Sep;26(3):355-80, v.