ADDITIONAL CONSIDERATIONS

For air evacuation of HAI casualties, pilots should fly at the lowest allowable elevation possible. All efforts should be made to avoid flying at higher elevations than the point of injury unless the cabin is pressurized to an altitude lower than point of injury.

Individuals who conduct dive operations should refrain from flying and ascending to high altitudes for at least 12 to 24 hours after the last dive due to increased risk of decompression sickness.42

Underwater diving operations at altitude compound the inherent risks of diving operations at sea-level. These risks are beyond the scope of this guideline. Consult your Dive Medical Officer or Master Diver to discuss alternative decompression tables and considerations when executing dive missions at altitude.43

Physiologic changes that take place at altitude can unmask previously subclinical conditions, such as seizure disorders, brain masses, and vascular malformations. New onset focal neurologic deficits at altitude should be evaluated by a qualified medical provider for consideration of evacuation with further neurologic workup once at higher level of care.3-4

Sickle cell disease and sickle cell trait have not been described as risk factors for HAI; however, these individuals are at increased risk of vaso-occlusive crisis and splenic infarction at altitude.3-4

Pregnant women should not participate in non-routine high altitude military operations without first talking to a medical officer about the risks.