Flying with Pneumothorax

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A pneumothorax (or collapsed lung) occurs when air enters the pleural space between the lung and the chest wall. This build-up of air hinders the expansion of one or both lungs and breathing becomes laboured. A severe pneumothorax can be life-threatening. It is often caused by an injury to the ribcage – for example, after a car accident.


The changes in air pressure that are experienced by the body when flying can have a negative impact on a pneumothorax. That's why the question often arises as to whether flying with pneumothorax is even possible without risk. Flying commercially with a pneumothorax is not recommended, or even not possible because of the dangers to the patient’s health.

Here, we will clarify how problems arise and under what circumstances a flight can be considered. First, here is the good news: under the right conditions, flying with pneumothorax is possible.

Pneumothorax and scheduled flights

In a plane at cruising altitude, the air pressure is the same as that on a 2,400-metre mountain peak. This significant difference from the air pressure at ground level can cause expansion of the air trapped in the patient's pleural space and a worsening of existing pneumothorax. Therefore, if you have an acute pneumothorax, taking a scheduled flight is normally not advisable.

After successful treatment, the recommendations differ as to how long a patient needs to wait before taking a scheduled flight again. In its 2003 guidelines, the Aerospace Medical Association Medical Guidelines Task Force advises waiting two to three weeks after the successful treatment of a pneumothorax before boarding a scheduled airliner.

In 2011, a British research group recommended a waiting period of at least a week after the successful treatment of a pneumothorax. If the pneumothorax was caused by an injury, the researchers advised a waiting period of two weeks.

Ambulance flights for pneumothorax patients

Therefore, while a scheduled flight is out of the question for someone with an acute or recently treated pneumothorax, the patient can still be transported in an ambulance aircraft. This kind of ambulance aircraft is usually only provided for a single patient. An experienced flight doctor and his or her team take care of medical safety for the flight. The medical equipment on board the ambulance aircraft is similar to that in a modern intensive care unit, to enable the patient to be cared for in the best possible way.

The decisive factor that makes an ambulance flight for pneumothorax patients possible, is the ability to adjust the cabin pressure to suit the patient's condition. In an ambulance aircraft, the cabin pressure can be regulated using a combination of reduced flight altitude and technical measures so that there is no difference from the air pressure on the ground. These so-called sea-level flight conditions do not affect existing air trapped in the pleural space and therefore the pneumothorax does not worsen.

Safe return flight from holiday for patients with pneumothorax

Anyone who suffers a pneumothorax in their home country will probably postpone any upcoming trips, so they can concentrate fully on their recovery. However, the situation is different if the patient has suffered a pneumothorax while on holiday. If acute stabilisation measures are necessary these must, of course, be carried out in the holiday country. However, many patients wish to return home as quickly as possible to continue their treatment and further recovery. In their home country, they hope for better medical conditions, effective communication with the hospital staff in their own language and the support of friends and relatives.

If the patient does not want to wait until a scheduled flight presents no problems from a medical point of view, the only option is to use an ambulance aircraft. These are usually ready to deploy on the same day or the next, anywhere in the world, and enable the safe transport of patients. In addition, ambulance aircraft are significantly smaller than scheduled airliners and are therefore not dependent on the major passenger airports. They can also use regional airports close to the patient, thereby significantly reducing the length of stressful ground transports.

Flying after pneumothorax- when can you fly after surgery

The dangers of flying commercially with pneumothorax have made it clear that an air ambulance flight is among the safest traveling options for patients. What about flying after pneumothorax? Is it possible to fly after resolution of the pneumothorax? 

While a small pneumothorax may heal on its own, the usual treatment involves inserting a needle or chest tube between the ribs to remove the excess air. Generally, patients can travel approximately 2 weeks after a successful drainage of the pneumothorax with full expansion of the lung. In cases of major thoracic surgery (chest surgery), it is recommended to delay flying for 6 at least weeks.

Important: Always ask your doctor if you are fit to fly before making any travel plans or opt for an air ambulance flight.

Will the insurance pay for the flight home?

In principle, a travel insurance policy with international health cover should cover the cost of an ambulance flight. Anyone who does not have appropriate insurance cover has to bear the costs themselves. However, even having a travel insurance policy that includes medical cover does not guarantee that the flight costs will be covered. Rather, the insurance company checks in each individual case whether the pneumothorax can be treated where the patient is staying.

  • If the patient cannot get appropriate treatment locally, a medically necessary flight home comes into play. The travel insurance company would usually pay for a medically necessary flight.
  • Is treatment in the patient's holiday country possible in principle, but treatment at home is likely to deliver a better outcome? Then we are talking about a medically reasonable repatriation flight. Some insurance companies would also cover the costs in such cases. It is worth checking the relevant section of the insurance policy here.
  • If the individual case is deemed to be neither medically necessary, nor medically reasonable, the insurance company will not cover the costs of the patient's transport home.

How much does it cost to fly home in an air ambulance?

If the cost of an air ambulance flight is not covered by the insurance company it must be borne privately. In such cases, we would be happy to produce an individual non-binding quotation for you, taking into account the flight route and the desired number of accompanying persons. The urgency of the request also influences the price – for short-notice requests, an ambulance aircraft from further away may be available to transport the pneumothorax patient and would therefore have to make a longer, hence more expensive, positioning flight.  

You are in safe hands with Medical Air Service

If you or your loved one require medical repatriation following pneumothorax, you are in safe hands with Medical Air Service. During the flight planning phase, our experienced team will relieve you of the worry and organisational burden as much as possible. In almost all cases, we can communicate with local doctors in their mother tongue and thereby overcome any language barriers. Our ambulance aircraft can be made ready for take-off anywhere in the world, so the pneumothorax patient can begin their flight home without any unnecessary delays.

Thanks to our 'bed-to-bed' service [link] we are a one-stop shop for your patient transfer. We can pick up the patient from their holiday home, hotel or local hospital in an ambulance or emergency vehicle and take them to the airport in good time for their flight. Upon landing in the patient's home country, an ambulance or emergency vehicle will be ready and waiting to drive them safely to the destination hospital. Of course, all our ground transports are accompanied by medical staff. By coordinating all the patient pick-up and handover times, we can eliminate unnecessary delays. In this way, we can transport even pneumothorax patients quickly, safely and reliably.

Any further questions?

If you have any questions about ambulance flights and how they are organised, we recommend that you take a look at our FAQ.

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