If vertigo persists and you cannot distinguish AGE from inner ear barotrauma, what do you do?

• A. Recompress the diver
• B. Administer decongestants and wait
• C. Ignore symptoms if mild
• D. Call for helicopter evacuation only

Answer: (A)

When vertigo persists after a dive and you can’t be sure whether it’s AGE or inner ear barotrauma, the priority is to treat as potential decompression illness and get the diver into a hyperbaric environment. Recompression with 100% oxygen is the best move because it directly targets both possibilities. Increasing ambient pressure shrinks nitrogen bubbles in the blood and tissues (Boyle’s law) and the high oxygen partial pressure speeds nitrogen washout and improves tissue oxygenation. This combination reduces ongoing injury and helps relieve the symptoms more effectively than passive waiting or symptomatic meds alone.

Other options don’t address the underlying issue. Waiting while giving decongestants doesn’t resolve gas bubbles, ignoring symptoms risks progression to more severe effects, and evacuation alone without definitive hyperbaric treatment could delay crucial care. So, arrange and initiate recompression as soon as feasible, with 100% oxygen during treatment and transport to a hyperbaric facility.