An ear barotrauma prevented further diving on dive trip


I was diving at a reef (I don't know the name). We got in the water and started to go under. I made sure to equalize all the way down to 65 fsw. I never felt any pain, nor did I feel like I had to equalize more than normal. However, during the dive, I felt like I had to continue equalizing frequently. This particular reef had lots of elevation changes, so we would go from 65 feet to 44 feet and back to 60 feet. I'm not used to a dive that includes a lot of up and down like that. I still never felt any issues other than having to equalize frequently. At one point, I felt I needed to equalize and I tried, but nothing happened. Seconds later, my left ear made a pop sound and I felt relieved. We finished the dive by ascending slow and stopping at 15 feet for 3 minutes. About 1-2 hours after the dive, I first felt my throat getting sore, like I was having lots of drainage causing some irritation. Shortly after, I started feeling pain around my ear and in my jaw. I decided to see the property nurse who called in a doctor. By the time the doctor arrived, I estimated the pain to be a 7 out of 10. Movements like yawning hurt. The doc examined me and said that I had ear barotrauma and prescribed a cocktail of drugs to treat it so that I could fly home 6 days later. The medicine cleared the pain quickly. I did not dive again on the trip.


This is indeed a real consideration when diving on a reef with a variable profile of depths. Frequently changing depths may be an issue with inert gas uptake as we are taught to avoid "saw-toothed" profiles. Taking the ears into consideration is not always a priority. Each change in depth represents the opportunity for a mishap. Repeated equalization can become distracting and we can have reduced situational awareness as we must focus on equalizing pressure changes. Any discomfort as the result of an injury can also be very distracting. Even with efficient equalization, the repeated stress of equalization can irritate the mucus membranes lining the sinuses and middle ears. This can contribute to problems during or after the dive.

You and your buddy need to discuss a dive plan prior to entering the water. If this is a familiar dive site the planning is easier. If unfamiliar ask someone who is familiar with the location or make sure you pay full and undivided attention to the pre-dive briefing from the boat crew. Keep in mind that just because the reef has a variable relief does not mean that you should follow its profile exactly. As a matter of safety, you may need to sacrifice some "close-up" views.

~ Martin McCafferty EMT-P, DMT-A