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Evidence summaries

Transport of Patients with Decompression Illness

Evidence is insufficient for conclusions about air transportation of people with suspected decompression illness. Experts recommend that the altitude of air transport should not exceed 500 feet (152 metres) above the departure level. Level of evidence: "D"

A systematic review 1 including 2 retrospective case series with a total of 9 subjects was abstracted in DARE. Additionally 7 citations, either letters in peer-reviewed journals or opinions of organisations, were identified. One case series (n=6) reported that decompression illness (DCI) symptoms worsened in 4 patients when the altitude of the helicopter rose above 700 to 1 000 feet (213 to 304 m) above ground level, but were resolved at 500 feet above ground level. No symptoms were noted in the other 2 patients when the helicopter stayed below 500 feet (152 m) above ground level. The other case series (3 patients who experienced symptoms on a commercial flight after hypobaric high-altitude military training) reported no complications in any of the 3 patients when the helicopter stayed below 1 000 feet (304 m) above ground level. None of the expert opinions cited clinical trials or prospective cohort studies. Expert opinions recommended a maximum altitude of 500 to 1 000 feet but did not specify whether this was above sea level or ground level.

Comment: The quality of evidence is downgraded by limitations in study quality (case series and expert opinions only).

    References

    • MacDonald RD, O'Donnell C, Allan GM, Breeck K, Chow Y, DeMajo W, Peerbaye Y, Sawadsky B, Wax R. Interfacility transport of patients with decompression illness: literature review and consensus statement. Prehosp Emerg Care 2006 Oct-Dec;10(4):482-7 [PubMed][DARE]

Primary/Secondary Keywords