4
descent, you should still land and seek medical
evaluation while continuing to breathe oxygen.
• If one of your symptoms is joint pain, keep the
affected area still; do not try to work pain out by
moving the joint around.
• Upon landing seek medical assistance from an
FAA medical ofcer, aviation medical examiner
(AME) military ight surgeon, or a hyperbaric
medicine specialist. Be aware that a physician not
specialized in aviation or hypobaric medicine may
not be familiar with this type of medical problem.
Therefore, be your own advocate.
• Denitive medical treatment may involve the use
of a hyperbaric chamber operated by specially
trained personnel.
• Delayed signs and symptoms of altitude DCS can
occur after return to ground level whether or not
they were present during ight.
THINGS TO REMEMBER
• Altitude DCS is a risk every time you y in an
unpressurized aircraft above 18,000 feet (or at
lower altitude if you SCUBA dive prior to the ight).
• Be familiar with the signs and symptoms of
altitude DCS (see Table 1) and monitor all aircraft
occupants, including yourself, any time you y an
unpressurized aircraft above 18,000 ft.
• Avoid unnecessary strenuous physical activity
prior to ying an unpressurized aircraft above
18,000 ft. and for 24 hrs. after the ight.
• Even if you are ying a pressurized aircraft,
altitude DCS can occur as a result of sudden loss
of cabin pressure (inight rapid decompression).
• Following exposure to an inight rapid
decompressions do not y for at least 24 hrs. In
the meantime, remain vigilant for the possible
onset of delayed symptoms or signs of altitude
DCS. If you present delayed symptoms or signs of
altitude DCS, seek medical attention immediately.
• Keep in mind that breathing 100% oxygen during
ight (ascent, enroute, descent) without oxygen
prebreathing prior to take off does not prevent the
occurrence of altitude DCS.
• Do not ignore any symptoms or signs that go away
during the descent. In fact, this could conrm that
you are actually suffering altitude DCS. You should
be medically evaluated as soon as possible.
• If there is any indication that you may have
experienced altitude DCS, do not y again until
you are cleared to do so by an FAA medical ofcer,
an aviation medical examiner, a military ight
surgeon, or a hyperbaric medicine specialist.
• Allow at least 24 hrs. to elapse between SCUBA
diving and ying.
• Be prepared for a future emergency by
familiarizing yourself with the availability of
hyperbaric chambers in your area of operations.
However, keep in mind that not all of the available
hyperbaric treatment facilities have personnel
qualied to handle altitude DCS emergencies. To
obtain information on the locations of hyperbaric
treatment facilities capable of handling altitude
DCS emergencies, call the Diver’s Alert Network at
(919) 684-8111.
For More Information
If you are interested in learning more about altitude
DCS, as well as the other stressors that may affect
your performance and/or your health during ight,
we encourage you to enroll in the Physiological
Training Course offered by the Aeromedical
Education Division (Airman Education Programs)
at the FAA Civil Aerospace Medical Institute in
Oklahoma City. A similar course is also available at
US military physiological training facilities around the
country through an FAA/DOD Training Agreement.
For more information about any of these courses,
call us at (405) 954-4837.
Medical Facts for Pilots
Publication AM-400-95/2
Written by: J. R. Brown & Melchor J. Antuñano, MD
Prepared by: Federal Aviation Administration
Civil Aerospace Medical Institute
Aeromedical Education Division
To order copies of this brochure and
others listed below, contact
FAA Civil Aerospace Medical Institute
Shipping Clerk, AAM-400
P.O. Box 25082
Oklahoma City, OK 73125
(405) 954-4831