What is a sea-level medical flight?

What is a standard medical flight?

A medical flight could refer to repatriation via Air Ambulance. If this is the case, we’re talking about bringing a patient from one hospital to one in their own country, for them to receive the best care possible. 

It could also refer to a medevac flight; a specialised air transport service designed to quickly and safely evacuate patients that require urgent medical attention.

Both require an Air Ambulance, but the situation and destination are different.

Usual altitudes for standard flights

Most commercial jets fly at a cruising height of between 28,000ft and 38,000ft (8.5-11.5km) – typically around 35,000ft (10.5km). Private jets tend to fly a little higher, from 41,000ft to 45,000ft (12.5-13.7km). 

This atmospheric zone is known as the troposphere, and there are several good reasons why it’s considered to be a “sweet spot” for international flights. Reasons like less turbulence, fewer hazards like birds, and thinner air for more fuel-efficiency.

What’s the problem with altitude?

Flying high above ground level has some physical implications for our bodies. If you’ve ever heard climbers talk about summiting Everest (29,031ft / 8,848m), you’ll know they sometimes carry oxygen with them. This is because air pressure and density decrease with altitude, meaning the body is able to take in less oxygen the higher you go.

To compensate for this, jet cabins are pressurised. But the pressure is still higher than at ground level – on most commercial planes it’s equivalent to about 8,000ft (2.4km). Pressure changes also cause gases in the body to expand. For healthy people, this is usually not a problem.

But it can be an issue for some patients with serious medical issues.
 

What kinds of patients might be affected?

High-altitude flying can cause problems for people with certain lung and brain conditions, or who have had various kinds of major surgery. If you’ve suffered a serious head injury, for instance, pressurisation could potentially lead to a damaging increase in pressure within the cranial cavity. Other conditions with a higher risk factor include:

• Collapsed lung (pneumothorax)
• Air accumulation in the eye socket
• Abdominal obstructions
• Brain swelling (cerebral oedema)
• Bleeding on the brain (haematoma)
• Anaemia (lack of red blood cells)
• Recent surgical wounds

Sea-level medical flights are the solution

If the local doctors say someone isn’t “fit to fly” – i.e. they feel it would be unsafe, or too risky, for them to fly at high altitude – we can think about different modes of transport. 

We can precision-regulate the pressure on some of our intensive-care air ambulances and on certain kinds of private jets. 

However, if these options aren’t suitable, we may be able to arrange for your patient to “fly sea level” instead. 

A sea-level flight simply means the aircraft has been given clearance to travel well below the normal flying altitude. Not really sea level, but lower than usual, with a pressure environment that’s closer to ground-level conditions.

How would EMS arrange one of these flights?

If we think a sea-level flight might be possible, we’ll discuss it in detail with your local doctors. Our repatriation experts will then contact the aviation authorities to secure a low-altitude permit. We can also mobilize very quickly in emergency ICU situations if needed – often within hours of your call.
 

We’ll make sure the right medical specialists are able to travel with your patient on the flight, and that we’re carrying all the emergency equipment, oxygen canisters and medication they might need in transit. When the choice is between keeping your patient where they are and flying them to the hospital or medical team of your own choosing, that can mean a world of difference.