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supply, nitrogen is stored in greater amounts in fat
tissues. Although fat represents only 15% of an adult
normal body, it stores over half of the total amount
of nitrogen (about 1 liter) normally dissolved in the
body.
Exercise
When a person is physically active while flying at
altitudes above 18,000 ft., there is greater risk of
altitude DCS.
Alcohol Consumption
The after-effects of alcohol consumption increase
the susceptibility to DCS.
Scuba Diving Before Flying
SCUBA diving requires
breathing air under
high pressure. Under
these conditions,
there is a significant
increase in the amount
of nitrogen dissolved in
the body (body nitrogen
saturation). The deeper the SCUBA dive, the greater
the rate of body nitrogen saturation. Furthermore,
SCUBA diving in high elevations (mountain lakes),
at any given depth, results in greater body nitrogen
saturation when compared to SCUBA diving at sea
level at the same depth. Following SCUBA diving, if
not enough time is allowed to eliminate the excess
nitrogen stored in the body, altitude DCS can occur
during exposure to altitudes as low as 5,000 ft. or
less.
WHAT TO DO WHEN ALTITUDE
DCS OCCURS
• Put on your oxygen mask immediately and switch
the regulator to 100% oxygen.
• Begin an emergency descent and land as soon as
possible. Even if the symptoms disappear during
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 officer, aviation medical examiner
(AME) military flight 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.
• Definitive 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 flight.
THINGS TO REMEMBER
• Altitude DCS is a risk every time you fly in an
unpressurized aircraft above 18,000 feet (or at
lower altitude if you SCUBA dive prior to the flight).
• Be familiar with the signs and symptoms of
altitude DCS (see Table 1) and monitor all aircraft
occupants, including yourself, any time you fly an
unpressurized aircraft above 18,000 ft.
• Avoid unnecessary strenuous physical activity
prior to flying an unpressurized aircraft above
18,000 ft. and for 24 hrs. after the flight.
• Even if you are flying a pressurized aircraft,
altitude DCS can occur as a result of sudden loss
of cabin pressure (inflight rapid decompression).
• Following exposure to an inflight rapid
decompressions do not fly 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
flight (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 confirm 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 fly again until
you are cleared to do so by an FAA medical officer,
an aviation medical examiner, a military flight
surgeon, or a hyperbaric medicine specialist.
• Allow at least 24 hrs. to elapse between SCUBA
diving and flying.
• 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
qualified 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
　
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