How soon is too soon when it comes to flying after hyperbaric treatment? The purpose of this prospective study is to estimate the occurrence of returning or worsening symptoms of decompression illness (DCI) in both divers that fly after treatment and treated divers that do not and to determine how long divers wait before flying after treatment for DCI. DAN will enroll up to 1,000 eligible divers in the survey.
Judgment concerning when it is safe for a diver to fly after hyperbaric treatment for DCI is made by treating physicians, often without evidence in the medical literature to guide their advice. Accordingly, recommendations for preflight delay after treatment for DCI vary substantially. As long ago as 1992 Butler wrote “With the increasing popularity of recreational diving and the greater mobility of diving populations, flying after diving will continue to occur with greater frequency. Consequently, detailed follow-up studies of treated divers are now essential.”
In 1998 DAN retrospectively surveyed 126 divers in the DAN database treated for DCI on either Grand Cayman or Cozumel. The results indicated that a return or worsening of symptoms was reported by 31 of 126 treated divers (25%) who flew after recompression therapy for DCI. By 2004, recommendations to refrain from air travel in Australia still ranged from 1 day to 6 weeks, and Australian Standard AS2299 mandated a delay of at least 7 weeks. A 2005 survey of 18 UK hyperbaric chambers found recommended delay before flying after treatment for DCI ranged from no delay to six weeks. To date there is still not sufficient evidence upon which to guide recommendations for delay to takeoff after treatment for DCI.
This prospective study aims to determine how long the delay should be before flying in an aircraft after a diver has been treated for decompression illness.