Most divers are familiar with the dangers of not equalizing their ears and sinuses during descents and ascents. But there are other less common 'squeezes' such as a dental barotrauma (Barodontalgia), facial barotrauma and gastrointestinal barotrauma.

Dental Barotrauma  
Ear Barotrauma (inner)  
Ear Barotrauma (middle)  
Ear Barotrauma (outer)  
Facial Barotrauma  
Gastrointestinal Barotrauma  
Pulmonary Barotrauma  
Sinus Barotrauma  

Cause of Dental Barotrauma:
• Air trapped in a tooth cavity beneath a filling or cavity

Signs & Symptoms of Dental Barotrauma:
• Tooth or facial pain
• Bleeding
• Broken tooth

First Aid Treatment for Dental Barotrauma:
• Analgesics as directed
• Dental repair

Cause of Ear Barotrauma (Inner):
• Forceful equalisation of ears
• Severe middle ear barotrauma

Signs & Symptoms of Inner Ear Barotrauma:
The symptoms usually persist longer than 20 minutes after the dive;
• Vertigo
• Nausea and/or vomiting
• Ringing in ear(s)
• Hearing loss

First Aid Treatment for Inner Ear Barotrauma:
• Sit down, keep still and quiet
• Avoid exertion, coughing, sneezing, bending and further equalisation attempts
• Consult an ENT specialist or diving doctor and don't dive until reviewed

Cause of Ear Barotrauma (Middle):
Inadequate equalisation during descent due to;
• Poor equalising technique
• Diving with a cold, hay fever, flu or blocked Eustachian tube(s)
• Rapid descent
Inadequate equalisation during ascent due to;
• Swelling of the middle ear lining due to inadequate equalisation on descent
• Decongestants wearing off underwater
• Rapid ascent

Signs & Symptoms of Middle Ear Barotrauma:
• Fullness in ear
• Discomfort
• Ear pain during the dive
• Hearing loss
• Ruptured eardum
• Vertigo during or shortly after the dive

First Aid Treatment for Middle Ear Barotrauma:
• Ascend slowly
• Take analgesics as directed
• Use decongestants as directed
• Do not equalise forcefully
• Consult a diving doctor and don't dive until reviewed
• Seek ENT medical advice if dizziness, hearing loss or ringing continue

Cause of Ear Barotrauma (Outer):
Inadequate equalisation during descent due to;
• Tight hood
• Blocked external ear canal due to wax or exostoses (bony outgrowths)
• Mask strap covering the ear

Signs & Symptoms of Outer Ear Barotrauma:
• Pain in ear not relieved by equalisation
• Discharge or bleeding from the ears
• Other symptoms similar to those of middle ear barotrauma if eardrum ruptures

First Aid Treatment for Outer Ear Barotrauma:
• Ascend slowly
• Take analgesics as directed
• Use decongestants as directed
• Do not equalise forcefully
• Consult a diving doctor and don't dive until reviewed
• Seek ENT medical advice if dizziness, hearing loss or ringing continue

Cause of Facial Barotrauma:
• Failure to equalise the pressure inside the mask with the ambient pressure (mask squeeze)

Signs & Symptoms of Facial Barotrauma:
• Tightness on face
• Red or bruised eyes or face
• Change in vision (rare)

First Aid Treatment for Facial Barotrauma:
• Cease diving until the injury has healed
• If a change in vision occurs, see a doctor to check for bleeding

Cause of Gastrointestinal Barotrauma:
Gas may enter the stomach and expand on ascent causing distension due to;
• Swallowing air
• Equalising ears when swimming head-down
• Gas produced from certain foods and drinks

Signs & Symptoms of Gastrointestinal Barotrauma:
• Stomach pain and cramps
• Burping and/or flatulence
• Sometimes difficulty breathing

First Aid Treatment for Gastrointestinal Barotrauma:
• Stop the ascent
• Loosen the weight belt and/or BCD straps, if required
• Release the gas and continue the ascent when comfortable

Cause of Pulmonary Barotrauma:
• Holding breath on ascent
• Rapid ascent with inadequate exhalation
• Trapping of air in the lungs
(due to asthma, lung disease, smoking, mucus, cough or cold)

Signs & Symptoms of Pulmonary Barotrauma:
• Shortness of breath
• Chest pain
• Coughing (sometimes bloody sputum)
• Cyanosis (blueness)
• Shock
• Heart irregularities
• Crackly skin
• Voice changes
• Fullness in the throat
• Difficulty swallowing
• Leaning to affected side
• Poor chest movement of the affected side
• Deviated windpipe

First Aid Treatment for Pulmonary Barotrauma:
• Monitor responsiveness, airway and breathing and begin CPR if necessary
• Lay the diver down and maintain the airway. A diver who is nauseated, vomiting or not fully conscious should be placed on their side (recovery position)
• Administer 100% oxygen as soon as possible
• Seek medical aid immediately. Arrange a consultation between attending medical personnel and a diving medical specialist
• Transfer to a recompression chamber may be required if signs of decompression illness are also present
• Non alcoholic fluids may be given, but only if the diver is fully conscious, appears to be stable and is not nauseated
• Record the details of the dive profile, first aid given and the diver's response to first aid

Cause of Sinus Barotrauma:
Equalisation problems due to nasal congestion or anatomical deformity

Signs & Symptoms of Sinus Barotrauma:
• Facial pain or headache which can occur in the forehead, behind the eyes, in the cheeks or upper teeth; The pain increases with depth and then ceases; Can also occur on ascent
• Blood or mucus from the nose or mouth
• Headache

First Aid Treatment for Sinus Barotrauma:
• Analgesics as directed
• Decongestants
(An effective decongestant is saline - 1.5ml of salt in 250ml of water at body temperature sniffed up the nose one nostril at a time and then spit out)
• Medical advice