Diagnosis and Treatment of Gas Embolism

As with most aspects of underwater medicine the terminology related to pulmonary barotrauma and associated arterial gas emboli is often confused. For the purpose of this chapter, pulmonary barotrauma is synonomous with burst lung and pulmonary overinflation syndrome and refers to decompression-induced trauma to lung tissue. This decompression- induced lung damage must be distinguished from compression-induced pulmonary barotrauma, which is often known as lung squeeze.Compression-related pulmonary barotrauma is relatively rare and occurs when lung volumes contract as a result of compression to less than residual volume. Such an occurrence is only found in breath-hold diving and other forms of diving where the breathing mixture is not adjusted to compensate for an increase in the depth of the diver. Theoretically, very rapid initial compression rates during the initial phases of compression from atmospheric pressure are capable of causing compression pulmonary barotrauma. In practice, such compression rates cannot be achieved by the diver descending in water.