JORDI DESOLA, MD, PhD
Hyperbaric Medical Centres often are located far from diving areas. Some very famous recreational diving centres are placed at more than five hundred or even one thousand kilometres. In case of Decompression Illness a quick transport is necessary and air evacuation is then the most advisable form.
Air transport can be done with 1) conventional regular line airplane, 2) special freighted airplanes, 3) helicopter, and 4) air ambulance at atmospheric pressure.
The special conditions of aircrafts and helicopters, the cockpit, the environment, air-surface, and flying altitude, can remarkably influence on the evolution of the disease, specially if time and distance are long.
The ideal air transport should have the following characteristics. 1) Near atmospheric pressure environment, 2) Possibility of critical care assistance during long distance transfer, 3) Low noise, 4) Mild kinetic conditions of trepidation and acceleration.
Regular aircrafts could be used but international air-line regulations add some uncomfortable restrictions, for instance, for breathing oxygen. Special single freighted airplanes may have difficulties for pressurizing cockpits and not always are available. No helicopter permits atmospheric isopressure simulation, but for them flying at mild altitude is easier. Atmospheric-pressure air ambulances would provide the best conditions for transport but they are available only in few cases and their services used to be very expensive.
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