When Is It Safe to Repatriate Someone After a Brain Bleed or Head Injury?

Types of Brain Injuries and Their Implications

Not all brain injuries are the same. Here are some of the most common types we encounter during repatriation planning:

• Subdural Haematoma: Bleeding between the brain and its outer covering. Often results from trauma.
• Subarachnoid Haemorrhage: Bleeding into the space between the brain and the surrounding membrane. Often spontaneous or from aneurysm rupture.
• Contusions and Concussions: Less severe but still risky to fly immediately post-injury.
• Traumatic Brain Injury (TBI): A broad category that includes open and closed injuries with varying severity.

Each of these conditions has different healing timelines and flight risk factors. Repatriation decisions must consider the type, severity, and location of the injury, as well as the patient’s recovery progress.

Who Decides if the Patient is Fit to Fly?

This is a common and important question. While hospital doctors abroad can advise on stability, it is SkyCare’s own repatriation doctors who ultimately determine whether the patient is fit to fly. Our medical team is highly trained in altitude medicine and aviation physiology—specialist areas that most ward-based clinicians are not familiar with.

When a hospital says a patient is “not fit to fly,” this usually refers to standard commercial flights. It does not necessarily mean the patient cannot travel safely in a specialist air ambulance, especially with a sea-level cabin pressure environment.

We perform a detailed, case-by-case review with the treating team, and then our flight doctors issue the final clearance for medical transport. In some cases, we can move patients even when local doctors assume it’s not possible—because our aircraft and team can provide the level of care they’re unfamiliar with.

Air Travel and Cabin Pressure Considerations

At altitude, changes in cabin pressure can affect oxygen levels and intracranial pressure. For brain-injured patients, even minor shifts can have neurological consequences. This is why flying commercially—even with a medical escort—is often not suitable.

SkyCare’s air ambulances are fitted with life support and ICU-level monitoring. Most importantly, we can configure the cabin to remain at sea-level pressure for the entire journey. This dramatically reduces the risks associated with brain injuries in flight.

How Long After a Brain Injury Can Someone Be Repatriated?

It’s a common question, but there’s no one-size-fits-all answer. The timelines often quoted—such as “wait 7 to 21 days”—typically refer to fitness to fly on a commercial aircraft. These are conservative estimates made by local doctors, and often do not account for the capabilities of a fully equipped ICU air ambulance operating at sea-level cabin pressure.

In many cases, SkyCare can repatriate patients far earlier than commercial guidelines suggest. That’s because we provide hospital-grade care in the air, tailored to complex neurological conditions. However, this depends on a full review of the patient’s medical status.

Our doctors make the final fit-to-fly decision, based on:

• Detailed medical records and imaging
• Diagnosis and neurological stability
• Risk of seizures, swelling, or rebleed
• Cabin pressure and oxygenation needs

Repatriation may be possible much sooner than expected, but only after careful assessment by our altitude-trained medical team. We work in partnership with the treating hospital abroad, but the decision is based on aviation medical safety—not assumptions about standard flights.

Advanced Monitoring During Transport

SkyCare deploys a highly trained team of doctors, flight nurses, and paramedics. For brain injury cases, we often provide:

• Continuous neurological and vital signs monitoring
• Anti-seizure medication and intracranial pressure management
• Specialised equipment for sea-level cabin control

This allows even complex neurological cases to be transported safely, with hospital-grade care en route.

If Repatriation Must Be Delayed

In some cases, a short delay may be necessary while we await key medical reports, imaging, or stabilisation of the patient’s condition. However, SkyCare’s doctors can often make a same-day fit-to-fly decision once we receive full clinical notes. We act fast—much faster than traditional commercial airline clearance processes that can take up to 72 hours.

While awaiting clearance or documentation, we provide full support to the patient and their family, including:

• Daily medical updates and clinical translation if needed
• Help arranging local accommodation and visas
• Transfers to higher-level hospitals abroad, if appropriate

We never leave families waiting in the dark. Our team stays in close contact and moves swiftly the moment it’s medically safe to proceed.

Insurance, Costs and Support

Most repatriations following a brain bleed are covered under travel or international health insurance. SkyCare works with all major insurers, embassies, and corporate medical schemes. For self-pay clients, we provide transparent fixed quotes and no-obligation consultations.

Why Families and Hospitals Trust SkyCare

We specialise in complex neurological repatriations and are known internationally for our safety-first approach. With SkyCare, you benefit from:

• Doctors trained in altitude medicine making all clearance decisions
• Fully equipped ICU-level air ambulances
• Sea-level flight configuration for brain-injured patients
• Door-to-door service including ground ambulance

Brain injury cases demand expertise beyond hospital walls. We bring that expertise to the air.

Need Urgent Advice?

If you have a loved one abroad with a brain injury, our medical coordination team is available 24/7. We’ll talk you through your options and, if safe, move quickly to bring them home.

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