Flying after diving… what are the guidelines?

Here’s a somewhat common scenario… perhaps one you have experienced yourself; or thought about at least.

Anyhow, here it is. You and your buddy are on a dive vacation someplace that requires airline travel… bummer, right!? Pack light. Hope the TSA doesn’t break anything on your way out. Hope customs at the destination doesn’t fuss over anything on the way in.

However, all those issues aside, every other piece of the planning puzzle is falling into place just fine except for one small issue. The flight home is scheduled wheels-up at O-Dark-Hundred in the morning, and there is an opportunity to dive something really, really cool the previous afternoon… late in the afternoon. The question is: Can you do that dive without getting bent like a pretzel on the flight home less than 12 hours later?

The whole issue of Pre-flight Surface Interval (PFSI) is a contentious one. The old-school guidelines were wait 24 hours after diving before jumping on a commercial flight. But that recommendation has been revisited in more recent studies and the PFSI shortened; with suggestions that various other factors such as breathing nitrox, the length of safety stops, gas breathed during safety stops, and the duration and depth of dive, can all influence by just how much the PFSI can be shortened.

A quick straw-poll of my dive buddies tells me that the definitive answer is a moving target. There is little agreement.

What we can take as read is that flying after diving has a strong potential to apply extra decompression stress on a diver and increases their risks of decompression sickness. There seems to be a direct relationship between the risk dropping and the amount of time spent out of the water increases allowing excess inert gas to be eliminated normally and harmlessly through the lungs. Some trials have estimated the PFSI necessary for a low DCS risk (read acceptable number of incidents of DCS) after relatively long single or repetitive no-decompression dive profiles sits between 11 and 16 hours.

The PFSI for dives requiring staged decompression stops, was around 22 hours. At first blush then, a 24-hour break after diving would seem in most sport-diving cases to be very conservative. But then again, what worked in a dry chamber on a couple of hundred test subjects, may not apply to the average dive tourist coming home from a week in paradise where the diving was punctuated with rum, grilled fish and late-night romps on the beach. Equally, it also may not apply to an informed technical diver who pads her/his decompression stops with extra time, and breathes pure oxygen for long periods during that PFSI!

Well worth the download and reading time is: The Influence of bottom time on preflight surface intervals before flying after diving, published by Undersea Hyperb Med. And authored by Vann RD, Pollock NW, Freiberger JJ, Natoli MJ, DeNoble PJ, Pieper CF. (2007). It is available from the ultimate diver’s research tool: http://archive.rubicon-foundation.org/xmlui/handle/123456789/7343.

The study’s conclusion suggests “that bottom time, repetitive diving, and a decompression stop may significantly influence the pre-flight surface intervals required for low DCS risk. Moreover, it highlighted the need for additional human trials to resolve the effects of exercise and immersion on DCS risk during flying after diving. Such information might assist in the calibration of dry, resting trials for the effects of immersion and exercise which would be useful as dry, resting trials are less expensive and faster to conduct because more subjects can be exposed per chamber dive. This might be of aid for improving the accuracy of existing flying after diving guidelines.”

Significant in that conclusion is the call for additional human trials to resolve the effects of exercise and immersion on DCS risk when flying after diving.

I volunteer.

However, I would be far from an average test subject since something seems to put me outside the bell-curve for DCS risk. For example, my experience with PFSI is far from what’s generally acceptable and my practices at times have been foolhardy. Furthermore, I fall outside the age category that most studies could ethically accept in any trial… but all that aside, I would love to be a guinea pig.

 

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