Time to fly after hyperbaric chamber treatment for decompression illness: current recommendations.

(St Leger Dowse M, Barnes R, Smerdon G, Bryson P. Time to fly after hyperbaric chamber treatment for decompression illness: current recommendations. SPUMS J. 2005; 35: 67-70.) Divers suffering decompression illness (DCI) increasingly undertake high altitude travel after hyperbaric treatment. Anecdotal evidence suggests hyperbaric medical professionals give widely differing advice regarding the safe time to fly after treatment (TFAT), resulting in possible health, socio-economic and insurance implications. Thirty-two chamber facilities were contacted to determine current trends in advice on TFAT and the rationale behind these trends. Twenty-three (72%) facilities responded of which five returned incomplete data, and 18 returned data fulfilling all the criteria. This study collates the current advice given by staff at these 18 chambers, and the basis on which it is given. Only one of the responding chambers had no relevant guidelines. Advised TFAT differed widely, varying from immediately to six weeks. Seven chambers gave advice based on Divers Alert Network (DAN) recommendations, two based on research, and the remaining chambers relied on local staff advice based on their own experience. Only six chambers followed up divers after treatment, leading to a paucity of data regarding complication and recurrence rates following ‘return home’. Repeated contact with chambers revealed many units kept inadequate records, or did not have the staffing available to collate information for this study, limiting the success of this type of research. Guidelines on TFAT for DCI vary radically between chambers, and are rarely evidence based.