Reverse squeeze, what to do?

[Texasguy]

I read about a possibility of getting a reverse squeeze because of having a cold, allergy, or sinus medication. Never had it happened to me but I am curious if there are known steps to take in this instance. Let us say it happens, you are 30' under the water, ascending from 80', starts to hurts like hell to ascent, you got 400psi, extremely hurts to go any higher. What does one do?

As far as I understand, one must not blow into the nose (like during normal equalization) as it will make it only worse.

It seems I have read about it but there was never any description of steps to take if it happens to you.

 

[DevonDiver]

Firstly, its important to reiterate that a reverse squeeze is very unlikely unless you are diving with a cold/allergy.

The suggest response to a reverse squeeze is taught as part of the Open Water course. You should:

1) Halt your ascent.
2) Allow some time for equalization to occur.
3) If unsuccessful, descend slightly and try again.

Obviously, that is no guarantee of resolution. The issue may not resolve itself over the timescales permitted by your remaining air and/or remaining NDL. In which case, you are forced to ascend/surface and injure yourself. That is why divers are taught not to dive with colds/allergies, even if medication provides a temporary ease in symptoms.

Increased longevity of congestion medication has possible decreased the incidence of reverse block, as there is less chance of decongestants 'wearing off' during the course of a dive. However, there are many factors which can still cause congestion to return during a dive, such as water temperature etc.

One 'non-approved' resolution that I've used successfully is an 'improvised saline rinse'. Basically, remove your mask and snort up a noseful of sea water. That might temporarily clear the sinus congestion, thus enabling ascent. It's a particularly unpleasant experience and is likely to be highly stressful/panic inducing for many divers. A last resort only. Also, it leads to the chance of subsequent sinus infection (seawater not being sterile by any stretch of the imagination).

 

[Texasguy]

So, descent, wait and pray. Not really an action item (other than to inhale water).

 

[Bombay High]

So, descent, wait and pray. Not really an action item (other than to inhale water).

Pretty much. I had a very bad reverse squeeze on a recreational dive. I had taken no medication and had no cold that I knew of. I had a very painful sinus reverse squeeze. I descended slightly, shot my SMB and hung out. My equalizing happened by the blood vessels rupturing and filling blood into my sinuses which gave me enough relief to surface. Of course this was a boat dive and my instabuddy was long gone and on the boat, and in the time that I was waiting for the squeeze to relieve itself, no one was looking for the SMB that I shot for that purpose. When I surfaced I has a mask half full of blood with no one in the boat even looking in my direction. It was a long surface swim.
My sinuses were bleeding intermittently for a month.

 

[DevonDiver]

So, descent, wait and pray. Not really an action item (other than to inhale water).

Yep, which is why you won't ever find extensive instructions on how to 'deal' with it.... such instructions don't exist. The solution is avoidance, ​not resolution. Not every issue has a quick-fix solution or 'get out of jail card'.

 

[Griffo]

One technique i've read about but never had to try, is to squeeze your nose and swallow.

 

[vladimir]

I have read that a reverse valsalva might help: hold your nose and inhale gently.

I had a reverse block in Truk, at about 140', diving solo. Not a good situation. I got it for the usual reasons: Sudafed, Afrin, aggressive clearing on the way down. As I attempted to ascend the pain was excruciating. I had reserved a reasonable amount of gas, so I waited, but at 140', gas goes pretty fast. So I came up with a plan to deal with disorientation/vertigo that might result from my ascent and subsequent eardrum perforation. I began a hand-over-hand ascent up the anchor line, screaming into my regulator in pain. The block resolved itself in a couple of meters, sending a reassuring squeal and crackling and resolution of pain. It caused me a lot of reflection on my diving practices.

 

[windapp]

A non-sterile sinus rinse can contain any number of micro-organisms, many of which can kill you very quickly if intentionally run through your sinus cavities. I would say that your last resort is to take the injury to your ears, and not the sinus rinse.

 

[electrix]

I f you are really having to struggle to equalize ( like your eyes bulging out ) on the way down you should think it over, I had one in my face once and it was very painful it was all I could think about, that and how was I going to get another tank when this one ran out, it went away in a minute or so but I have not forgot it

 

[DevonDiver]

I have read that a reverse valsalva might help: hold your nose and inhale gently.

I've played with it myself - including on descent (to clear passages of mucus, then regular valsava to equalize). I'm not sure of any physiological dangers though - which is why I don't recommend it.

Would be a good question for the medical forum though...