Sea Level Flights – Need or Dogma?

David Quayle, Chief Flight Nurse&

Dr Jonathan Warwick, Medical Director AirMedical Ltd, Oxford, UK

Indications for sea-level cabin?

• Pneumocephalus

• Pneumothorax

• Intraocular gas

• Abdominal distension

• Decompression sickness

• Gas gangrene

• Hypoxic respiratory failure

Indications for sea-level cabin?

• Pneumocephalus

• Pneumothorax

• Intraocular gas

• Abdominal distension

• Decompression sickness

• Gas gangrene

• Hypoxic respiratory failure

Pneumocephalus

Monro – Kellie doctrine

ICP change is magnified by:

• A large initial volume of air

• An already elevated ICP

• A fast rate of change

Air transport of patients with intracranial air: computer model of pressure effects. Andersson N, Grip H, Lindvall P et al. Aviat Space Environ Med 2003;74:138-44

Aeromedical evacuation of patients with pneumocephalus: outcomes in 21 cases

Donovan DJ, Iskander JI, Dunn CJ et al. Aviat Space Environ Med 2008, 79(1): 30-35

Aeromedical evacuation of patients with pneumocephalus: outcomes in 21 casesDonovan DJ, Iskander JI, Dunn CJ et al. Aviat Space Environ Med 2008, 79(1): 30-35

Pneumothorax

The “staged ascent”

Please Feel Free To Wake Up Now And Ask Questions – Thank you!

david.quayle@airmed.co.ukwww.airmed.co.uk

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