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Exposure to reduced barometric pressure shortly after diving can increase a diver's risk of decompression sickness (DCS). Before flying, a diver should remain at sea level long enough to allow the elimination of excess inert gas, mainly nitrogen, from tissues. If a diver flies too soon, the inert gas can come out of the solution, form bubbles in tissues, and result in DCS. Preflight surface intervals vary and depend on the type of diving done before the flight. This activity describes the pathophysiology of DCS and highlights the interprofessional team's role in treating patients who want to fly after diving. Objectives: Identify the issues of concern for divers who want to fly after diving. Identify the pathology of decompression sickness and how it may affect a flyer. Apply appropriate strategies for pre-flight assessment, including patient education on potential risks and preventive measures. Coordinate with the interprofessional team to communicate effectively with divers, providing clear instructions on safe post-dive flight recommendations and potential risks. Access free multiple choice questions on this topic.

Exposure to reduced barometric pressure shortly after diving can increase a diver’s risk of decompression sickness (DCS). Before flying, a diver should remain at sea level long enough to allow the elimination of excess inert gas, mainly nitrogen, from peripheral tissues. If a diver flies too soon, the reduction of environmental pressure leads to dissolved nitrogen coming out of the solution, forming bubbles in tissues and the blood, and resulting in decompression illness. These bubbles interfere with the perfusion of the blood and cause ischemia and inflammation.[1]  Preflight surface intervals to prevent this vary and depend on the type of diving done before the flight.[2][3][4]

Scuba divers who decide to fly right after the water activity are at risk for decompression illness and gas emboli. Thus, an interprofessional team, including the nurse, should advise all divers to take an 18- to 24-hour break before flying. If the diver sustained decompression sickness, this rest period should be prolonged. In general, such advice is followed by recreational divers.[17] If bubbles were to occur on an airplane, the treatment might be delayed. Symptoms of decompression sickness can appear late, and hyperbaric oxygen has proven efficacious even in presentations as late as days after diving and flying.[18] Of note, decompression sickness may present with vague neurologic symptoms. Divers and healthcare personnel must maintain a high sensitivity to the possibility of decompression illness after diving, especially after flying after diving.[19]