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Barotrauma is physical damage to body tissues caused by a difference in pressure between a gas space inside, or in contact with, the body, and the surrounding gas or fluid. Barotrauma is a 2D co-op survival horror submarine simulator, inspired by games like FTL: Faster Than Light, Rimworld, Dwarf Fortress and Space Station 13. It’s a Sci-Fi game that combines ragdoll physics and alien sea monsters with teamwork and existential fear. Barotrauma Injury resulting from changes in atmospheric (barometric) pressure as in aircraft flight. Barotrauma mostly affects the ear drums when there is obstruction to the EUSTACHIAN TUBES. The most serious forms of barotrauma result from explosive noise which can literally shake the delicate hair-cell transducers in the middle ear to pieces. Barotrauma/Decompression Sickness Overview. Barotrauma often refers to medical problems that arise from the effects of water pressure when a scuba diver is beneath the surface.

Medically reviewed by Drugs.com. Last updated on Nov 16, 2020.

  • Care Notes
  • Overview


What is barotrauma?


Barotrauma is an injury to your body caused by a pressure change. You may have an injury to your ears, sinuses, or teeth. It can also affect your lungs, stomach, or intestines. It is also called ear, sinus, lung, or gut squeeze.

What increases my risk of barotrauma?

  • History of barotrauma
  • Activities such as scuba diving or flying
  • Blast injuries
  • Use of a ventilator
  • Hyperbaric oxygen treatment

What are the signs and symptoms of barotrauma?

  • Pain or a full feeling in your teeth, ears, face, chest, or abdomen
  • Popping in your ears when you swallow, yawn, or chew
  • Ringing in your ear or loss of hearing
  • Not being able to smile or frown
  • Fluid draining from your nose or ear
  • Dizziness or trouble breathing
  • Nausea, gas, or not being able to have a bowel movement
  • Blood in your bowel movement
  • Bruising, red or purple spots on your skin, or a rash that itches

How is barotrauma diagnosed?

Your healthcare provider will ask how and when your symptoms started. He will also ask if you take medicine or have other health conditions. He may ask you to chew, swallow, or yawn to release air from your ears. You may also need any of the following tests:

  • Ear tests may be done to check your hearing or check for damage to your ear.
  • An x-ray may be used to check for broken bones, or fluid or air in your sinuses, abdomen, or other areas of your body.
  • A CT or MRI scan may be used to look at your bones, lungs, stomach, intestines, or blood vessels. A CT uses x-rays and an MRI uses powerful magnets to take pictures of an area of your body. You may be given dye to help the pictures show up better. Tell your healthcare provider if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

How is barotrauma treated?

Do not fly or scuba dive until your symptoms are gone. You may not need medical treatment or you may need any of the following:

Barotrauma Game Download

  • Medicines can help decrease pain or swelling. They can also help dry fluid in your sinuses. You may also need medicine to make it easier to have a bowel movement.
  • Ear canal cleaning removes earwax and releases pressure in your ears.
  • Treatment for tinnitus helps relieve the ringing in your ears. Your healthcare provider may give you a device to put in your ears which decreases the ringing. Biofeedback therapy uses patches of electric current to relax your face and neck muscles. Your healthcare provider may also use transcutaneous electrical nerve stimulation (TENS) therapy. This uses an electrical current placed on the skin near your ears. You may get therapy to help you learn not to hear any ringing sounds.
  • Oxygen helps increase the oxygen level in your body and help with healing. Hyperbaric oxygen therapy may also help to reduce symptoms of barotrauma.
  • Surgery may be needed to repair damage from barotrauma. Ask your healthcare provider for more information about possible surgeries you may need.

How can I help prevent barotrauma?

  • Do not fly or scuba dive following a cold or ear infection. Ask your healthcare provider if and when it is safe for you to do these activities.
  • Follow the guidelines about the recommended time between flights, scuba dives, or skydives. Do not exercise or take a hot bath right after you scuba dive.
  • Keep your ears clear when you fly or scuba dive. Avoid earplugs and tight-fitting hoods when you dive. Swallowing, yawning, or moving your jaw sideways may help your ears adjust during pressure changes. Do not sleep during take-off or landings. You may also pinch your nose, close your mouth, and gently push air out as if you are blowing your nose. You may also pinch your nose and say the letter K over and over again.

When should I contact my healthcare provider?

  • You are dizzy, feel nauseated, or vomit.
  • You have a headache, face pain, or feel like one or both of your ears are blocked or painful.
  • You have swelling or pain in your abdomen or rectum.
  • You have severe pain in a joint or muscle.
  • You have swelling in your face, legs, or feet.
  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You have blood or fluid coming from your ear or nose.
  • You have skin changes, such as a rash or red or purple patches.
  • You cough up blood, have trouble breathing, or have chest pain.
  • You feel drowsy, there are changes in the way that you act, or you have trouble thinking clearly.
  • You have odd eye movements, or you have trouble keeping your balance.
  • You have changes in your hearing.
  • You cannot feel your arm or leg.
  • Your neck, shoulders, or chest swell, and your voice changes.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.Barotrauma

© Copyright IBM Corporation 2020 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Developer(s)Undertow Games, FakeFish Games
Publisher(s)Daedalic Entertainment
Director(s)Joonas 'Regalis' Rikkonen
Platform(s)Microsoft Windows, Mac OS X, Linux
ReleaseJune 5, 2019 (Early Access)

Barotrauma is a side-scrollingrole-playing video game developed by Finnish studio Undertow Games and published by Daedalic Entertainment.

Barotrauma takes place in the distant future, on a submarine traversing the inhospitable oceans of Europa, one of Jupiter's moons. The player is assigned a job on the submarine, and must coexist with other crewmen aboard the vessel.

Barotrauma Shop


Barotrauma largely takes place inside submarines submerged beneath Europa's ocean. At the start of each game, players are assigned a 'job', which may provide them access to specialized traits and equipment. The submarine's crew are given a mission, which may involve hauling cargo from one outpost to another, hunting hostile undersea wildlife, or recovering alien artifacts. The players are then free to act at their own discretion for the duration of the round, with few, if any, additional objectives provided by the game itself.

Various hazards will frequently jeopardize the submarine's voyage, such as hostile fauna, parasite outbreaks, and player-controlled traitors. Player incompetence can also be a source of disaster, as improperly-maintained ship equipment (such as nuclear reactors or oxygen generators) can quickly render the submarine inoperable. Crisis management is a recurrent theme in moment-to-moment gameplay, as players are implicitly encouraged to use their job skills to both avoid and mitigate disaster.

In the event that the submarine's hull is damaged, water will begin to flood the vessel, which damages submarine structures and significantly impedes player movement; without appropriate equipment, a player trapped in a flooded segment of the sub is liable to suffocate, or in areas with high water pressure, be crushed via barotrauma. As the submarine effectively functions as a lifeline for its crew, an irreparably-damaged vessel often signals the end of a round.


Lead developer Joonas Rikkonen cited the online role-playing game Space Station 13 as the biggest single source of inspiration for Barotrauma, praising its emergent gameplay and emphasis on human interaction. However, he also critiqued Space Station 13's unintuitive user interface and various technical issues; with Barotrauma, Rikkonen sought to create a game that 'built on the foundation of SS13' while 'smoothing some of the rougher edges'. Rikkonen also drew heavy inspiration from 'Pressure', a game concept anonymously posted to 4chan's video games board.[1]

Development on Barotrauma began in 2014, under the working title Subsurface.[1] From 2015 to 2018, pre-alpha builds of Barotrauma were freely released to the public for testing and feedback. Following the 2019 commercial release, future versions of Barotrauma were made exclusive to Steam, and the unsupported free version was retitled Barotrauma Legacy.[2]

In 2017, the source code for Barotrauma was publicly released under a limited license to facilitate the creation of community mods.[3] The source repository continues to be updated in tandem with the commercial release.[4]

In 2018, Undertow Games partnered with FakeFish Games to jointly develop Barotrauma, turning the solo project into one developed by nearly a dozen individuals.[1] In early 2019, Undertow Games signed Daedalic Entertainment, a German games publisher, to handle Barotrauma's publishing and marketing.[5] Mirror: songs of the maidens.

Barotrauma was released onto early access on June 5, 2019.[6] While originally planned for a full release in Fall 2019, as of November 2020, the game is still in early access.[6]


Barotrauma was voted 'Best hardcore game' at Game Connection Europe 2018, where it was also nominated in three other categories.[7]


  1. ^ abcRegalis (March 15, 2019). 'WELCOME TO EUROPA: THE HISTORY OF BAROTRAUMA'. barotraumagame.com. Retrieved June 3, 2019.
  2. ^'Barotrauma Legacy'. undertowgames.com. Retrieved June 6, 2019.
  3. ^Regalis (June 4, 2017). 'BAROTRAUMA SOURCE CODE'. barotraumagame.com. Retrieved June 3, 2019.
  4. ^Regalis11. 'Regalis11/Barotrauma'. github.com. Retrieved June 6, 2019.
  5. ^Regalis (February 28, 2019). 'COLLABORATION WITH DAEDALIC ENTERTAINMENT'. barotraumagame.com. Retrieved June 6, 2019.
  6. ^ abFraser Brown (June 5, 2019). 'Barotrauma, the 16-player submarine sim, hits Early Access'. pcgamer.com. PC Gamer. Retrieved June 5, 2019.
  7. ^'GAME CONNECTION EUROPE 2018 DEVELOPMENT AWARDS'. game-connection.com. Retrieved June 3, 2019.
Barotrauma wiki

External links[edit]

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