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II. Technical Subject Areas
B. Aeromedical Factors
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II. Technical Subject Areas
B. Aeromedical Factors
a. Oxygen deficiency of body enough to impair
brain and other organ function
b. High altitude hypoxia is due to reduced barometric pressure c. Signs and symtoms related to cabin pressure altitude
1) 5,000 feet: deterioration in night vision
2) 12,000 to 15,000 feet: impairment of judgment, memory, alertness, coordination and ability to make calculations, plus headache, drowsiness, dizziness and either euphoria or belligerence 3) 15,000 feet: performance can seriously deteriorate in 15 minutes 4) Above 15,000 feet: tunnel vision, cyanosis 5) 18,000 feet: ability to take corrective action lost in 20-30 minutes 6) 20,000 feet: ability to take corrective action lost in 5-12 minutes, followed by unconsciousness
d. Factors that lower altitude at which
significant effects of hypoxia may occur (increase susceptibility to hypoxia)
1) Carbon monoxide
2) Anemia 3) Medications/drugs
a) Alcohol
b) Antihistamines c) Sedatives, tranquilizers d) Analgesics
4) Extreme cold, heat or fever
5) Anxiety
e. Ability to recognize hypoxia can be
improved by experiencing simulatied flight in an altitude chamber, provided
by the FAA (FAA Airman Education Programs Branch (AAM-420), Civil Aeromedical
Institute, Mike Monroney Aeronautical Center, Post Office Box 25082, Oklahoma
City, Oklahoma 73125; telephone 405-954-6212)
f. Preventive measures
1) Refrain from alcohol, and do not smoke
prior to flight
2) Use only medications prescribed by a fight surgeon or aviation medical examiner 3) Do not fly above 10,000 feet without supplemental oxygen on board 4) Use supplemental oxygen at higher altitudes
a) 14 CFR 91.211
i) Pilots of unpressurized aircraft use
supplemental oxygen when flying higher than 12,500 feet MSL for 30 minutes or
more and at all times above 14,000 feet MSL
ii) Every aircraft occupant must be provided supplemental oxygen above 15,000 feet MSL
b) Use of supplemental oxygen is
recommended (AIM 8-1-2) above
i) 10,000 feet during the day
ii) 5,000 feet at night
References:
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II. Technical Subject Areas
B. Aeromedical Factors
a. Abnormal increase in volume of air breathed
in and out of lungs leading to abnormally low levels of carbon dioxide (CO2)
in the blood
b. May occur subconsciously when a stressful situation is encountered
c. Symptoms and signs
b. May occur subconsciously when a stressful situation is encountered
c. Symptoms and signs
1) Lightheadedness
2) Feeling of suffocation
3i) Drowsiness
4) Tingling of extremities
5) Incoordination
6) Disorientation
7) Painful muscle spasms
8) Unconsciousness
2) Feeling of suffocation
3i) Drowsiness
4) Tingling of extremities
5) Incoordination
6) Disorientation
7) Painful muscle spasms
8) Unconsciousness
d. Treatment
1) Symptoms subside within a few minutes after
rate and depth of breathing are consciously brought back under control
2) Build up of CO2 back to normal levels can be hastened by controlled breathing in and out of a paper bag held over nose and mouth
2) Build up of CO2 back to normal levels can be hastened by controlled breathing in and out of a paper bag held over nose and mouth
e. Hypoxia and hyperventilation
1) Early symptoms are similar
2) Both may occur at the same time
3) If pilot is using oxygen (O2) system when symtoms occur
2) Both may occur at the same time
3) If pilot is using oxygen (O2) system when symtoms occur
a) Immediately set O2 system to
deliver 100% O2, then
b) Check O2 system to assure proper function, before
c) Giving attention to rate and depth of breathing
b) Check O2 system to assure proper function, before
c) Giving attention to rate and depth of breathing
Reference:
II. Technical Subject Areas
B. Aeromedical Factors
a. Ear block
1) During ascent, expanding air in middle ear
normally opens eustachian tube, escapes through it to the nasal passages,
equalizing middle ear and cabin pressures
2) During descent, pilot must periodically open eustachian tube to equalize pressures by
2) During descent, pilot must periodically open eustachian tube to equalize pressures by
a) Swallowing
b) Yawning
c) Tensing muscles in the throat
d) Valsalva maneuver (attempt to blow through closed nostrils)
b) Yawning
c) Tensing muscles in the throat
d) Valsalva maneuver (attempt to blow through closed nostrils)
3) Upper respiratory infection (URI)
("cold" or sore throat) or nasal allergic condition can produce
enough congestion around eustachian tube, so that difference in pressure
between middle ear and cabin may build to level that holds eustachian tube
closed, making equalization of pressure difficult or impossible, a condition
commonly referred to as "ear block"
4) Symptoms/signs of ear block
4) Symptoms/signs of ear block
a) Severe ear pain
b) Loss of hearing
c) May last hours to several days
d) Rupture of ear drum can occur in flight or after landing
e) Fluid can accummulate in middle ear and become infected (otitis media)
b) Loss of hearing
c) May last hours to several days
d) Rupture of ear drum can occur in flight or after landing
e) Fluid can accummulate in middle ear and become infected (otitis media)
5) Prevention of ear block
a) Don't fly with a URI or nasal allergic
condition
b) Decongestant sprays/drops usually do not provide adequate protection
c) Beware: oral decongestants may have side effects that impair pilot performance
b) Decongestant sprays/drops usually do not provide adequate protection
c) Beware: oral decongestants may have side effects that impair pilot performance
6) Consult physician if ear block does not clear
shortly after landing
b. Sinus block
1) During ascent and descent, air pressure in
sinuses normally equalizes with cabin pressure through opening into the nasal
passages
2) URI, nasal allergic condition or sinusitis can cause enough congestion around these openings so that the pressure difference between the sinuses and the cabin increases until the openings are plugged, a condition referred to as "sinus block" which occurs most frequently during descent
3) Usually produces excruciating pain over the sinuses (frontal and/or maxillary), pain in the upper teeth (maxillary), and, sometimes, bloody nasal discharge
4) Prevention
2) URI, nasal allergic condition or sinusitis can cause enough congestion around these openings so that the pressure difference between the sinuses and the cabin increases until the openings are plugged, a condition referred to as "sinus block" which occurs most frequently during descent
3) Usually produces excruciating pain over the sinuses (frontal and/or maxillary), pain in the upper teeth (maxillary), and, sometimes, bloody nasal discharge
4) Prevention
a) Don't fly with a URI, nasal allergic
condition or sinusitis
b) Decongestant sprays/drops usually do not provide adequate protection
c) Beware: oral decongestants may have side effects that impair pilot performance
b) Decongestant sprays/drops usually do not provide adequate protection
c) Beware: oral decongestants may have side effects that impair pilot performance
5) Consult physician if sinus block does not
clear shortly after landing
References
II. Technical Subject Areas
B. Aeromedical Factors
a. A state of confusion due to misleading
information being sent to the brain from various sensory organs, resulting in
a lack of awareness of the aircraft position in relation to a
specific reference point
b. Sensory systems for orientation
b. Sensory systems for orientation
1) Eyes
a) The major orientation source
b) Visual cues usually prevail over false sensations from other sensory systems
c) Instrument meteorological conditions (IMC)
b) Visual cues usually prevail over false sensations from other sensory systems
c) Instrument meteorological conditions (IMC)
i) False, disorienting sensations may arise from
nonvisual sensory systems
ii) Use your eyes to determine aircraft attitude: look at and rely totally on the flight instruments
ii) Use your eyes to determine aircraft attitude: look at and rely totally on the flight instruments
2) Ears
a) Semicircular canals
i) Detect angular acceleration of the body
ii) Consist of 3 tubes at right angles to each other, each in one of the axes: pitch, roll, or yaw
iii) Filled with endolymph fluid
iv) In center of each canal is gelatinous cupola resting upon sensory hairs at the end of the vestibular nerve
v) In a turn, the relative motion of the endolymph moves the cupola which stimulates the sensory hairs to provide the sensation of turning
vi) As the turn continues for approximately 20 seconds or more the endolymph fluid has accelerated and is moving at the same speed as the semicircular canal so the sensation of turning ceases
vii) When this turn stops, the fluid continues to move the cupola for a while after the canal has stopped moving, creating the sensation of turning in the opposite direction (even though the turn has stopped)
ii) Consist of 3 tubes at right angles to each other, each in one of the axes: pitch, roll, or yaw
iii) Filled with endolymph fluid
iv) In center of each canal is gelatinous cupola resting upon sensory hairs at the end of the vestibular nerve
v) In a turn, the relative motion of the endolymph moves the cupola which stimulates the sensory hairs to provide the sensation of turning
vi) As the turn continues for approximately 20 seconds or more the endolymph fluid has accelerated and is moving at the same speed as the semicircular canal so the sensation of turning ceases
vii) When this turn stops, the fluid continues to move the cupola for a while after the canal has stopped moving, creating the sensation of turning in the opposite direction (even though the turn has stopped)
b) Otolith organs
i) Detect linear acceleration and gravity
ii) Consists of gelatinous membranes containing chalk-like crystals covering sensory hairs at the end of the vestibular nerve
iii) Tilting the head backward or forward cause movements of the crystals and membrane that are similar to those caused by accelerating or decelerating the head
iv) Forward acceleration may cause the illusion of the head tilting backward
ii) Consists of gelatinous membranes containing chalk-like crystals covering sensory hairs at the end of the vestibular nerve
iii) Tilting the head backward or forward cause movements of the crystals and membrane that are similar to those caused by accelerating or decelerating the head
iv) Forward acceleration may cause the illusion of the head tilting backward
3) Nerves
a) Forces created in turns can lead to false
sensations of the true direction of gravity
b) Uncoordinated, especially climbing, turns can send misleading signals to the brain
c) Skids and slips can give the sensation of banking or tilting
d) Fatigue or illness can exacerbate these sensations and lead to subtle incapacitation
b) Uncoordinated, especially climbing, turns can send misleading signals to the brain
c) Skids and slips can give the sensation of banking or tilting
d) Fatigue or illness can exacerbate these sensations and lead to subtle incapacitation
c. Illusions leading to spatial disorientation
1) Inner ear
a) The leans
i) Created by entering turn so slowly that
semicircular tubes are not stimulated and then rolling out relatively abuptly
to straight and level flight (SLF)
ii) Creates illusion, on roll out to SLF, of turn in opposite direction
iii) Disoriented pilot may bank aircraft back into the original turn, or, if SLF maintained, feel compelled to "lean" in that direction until the illusion subsides
ii) Creates illusion, on roll out to SLF, of turn in opposite direction
iii) Disoriented pilot may bank aircraft back into the original turn, or, if SLF maintained, feel compelled to "lean" in that direction until the illusion subsides
b) Coriolis illusion
i) In long stabilized turn, move head relatively
abruptly in different plane
ii) May create illusion of turning or accelerating on an entirely different axis
iii) To help avoid, develop instrument scan (and other actions) with minimal head movement (move eyes, not head)
ii) May create illusion of turning or accelerating on an entirely different axis
iii) To help avoid, develop instrument scan (and other actions) with minimal head movement (move eyes, not head)
c) Graveyard spiral or spin
i) Recover to SLF after prolonged coordinated,
constant-rate turn
ii) Pilot experiences turning in the opposite direction (the leans) and may return aircraft to the original turn
iii) Not sensing the turn, but noting the loss of altitude that may result from the normal loss of lift seen in a turn, the disoriented pilot may pull back on the control wheel
iv) These actions may lead to a tightening turn or spiral with increasing loss of altitude
ii) Pilot experiences turning in the opposite direction (the leans) and may return aircraft to the original turn
iii) Not sensing the turn, but noting the loss of altitude that may result from the normal loss of lift seen in a turn, the disoriented pilot may pull back on the control wheel
iv) These actions may lead to a tightening turn or spiral with increasing loss of altitude
d) Somatographic illusion
i) Rapid acceleration, such as experienced
during takeoff may create illusion of nose pitching up
ii) Disoriented pilot may push the nose low into a dive attitude
iii) Rapid deceleration may have opposite effect, with disoriented pilot pulling the nose up into a climb or even stall attitude
ii) Disoriented pilot may push the nose low into a dive attitude
iii) Rapid deceleration may have opposite effect, with disoriented pilot pulling the nose up into a climb or even stall attitude
e) Inversion illusion
i) Abrupt change from climb to SLF may creat
illusion of tumbling backwards
ii) Disoriented pilot may rapidly lower aircraft nose, possibly intensifying the illusion
ii) Disoriented pilot may rapidly lower aircraft nose, possibly intensifying the illusion
f) Elevator illusion
i) Abrupt vertical acceleration, as in an
updraft, may create illusion of climbing
ii) Disoriented pilot pushes aircraft nose low
iii) Abrupt downward acceleration, as in a downdraft, may have the opposite effect, with disoriented pilot pulling aircraft nose up
ii) Disoriented pilot pushes aircraft nose low
iii) Abrupt downward acceleration, as in a downdraft, may have the opposite effect, with disoriented pilot pulling aircraft nose up
2) Visual
a) False horizon
i) Sloping cloud formation
ii) Obscured horizon
iii) Aurora borealis
iv) Dark scene spread with ground lights and stars
ii) Obscured horizon
iii) Aurora borealis
iv) Dark scene spread with ground lights and stars
b) Autokinesis
i) In the dark, a stationary light appear to
move about when stared at for many seconds
ii) Disoriented pilot may attempt to align aircraft with these false movements
ii) Disoriented pilot may attempt to align aircraft with these false movements
3) Postural
a) Many false sensations can occur due to
acceleration forces overpowering gravity
b) This may occur in uncoordinated turns, climbing turns and turbulence
b) This may occur in uncoordinated turns, climbing turns and turbulence
d. Demonstrating spatial disorientation
1) Objectives
a) Teach pilots to understand their
susceptibility to spatial disorientation
b) Show that bodily sensations cannot be reliably used to determine aircraft attitude
c) Lessen the occurrence and degree of disorientation through understanding the relationship between aircraft motion, head motion and resulting disorientation
d) Instill confidence in relying on the flight instruments to determine true aircraft attitude
b) Show that bodily sensations cannot be reliably used to determine aircraft attitude
c) Lessen the occurrence and degree of disorientation through understanding the relationship between aircraft motion, head motion and resulting disorientation
d) Instill confidence in relying on the flight instruments to determine true aircraft attitude
2) Caution: never conduct these demonstrations
at a low altitude or without an instructor or appropriate safety pilot
3) Climbing while accelerating
3) Climbing while accelerating
i) Accelerate in SLF (student pilot's eyes
closed)
ii) Creates illusion that aircraft is climbing
ii) Creates illusion that aircraft is climbing
4) Climbing while turning
i) Slowly enter coordinated 1.5 G (approximately
50° bank) turn for 90°
ii) Usual illusion is that of a climb
ii) Usual illusion is that of a climb
5) Diving while turning
i) Slowly enter coordinated 1.5 G turn for 90°
and start recovery
ii) Usual illusion is that the aircraft is diving
ii) Usual illusion is that the aircraft is diving
6) Tilting to right or left
i) In SLF, execute moderate or slight skid with
wings level
ii) Usual illusion is that body is being tilted opposite the skid
ii) Usual illusion is that body is being tilted opposite the skid
7) Reversal of motion
i) In SLF, smoothly roll to 45° bank while
maintaining heading and pitch
ii) Usual illusion is strong sense of rotation in opposite direction
ii) Usual illusion is strong sense of rotation in opposite direction
8) Diving or rolling beyond the vertical plane
i) May produce extreme disorientation
ii) Start coordinated roll to 30 or 40° of bank
iii) Student pilot should tilt head forward, look to right or left, then immediately return head to upright position
iv) Time maneuver so roll is stopped just as student returns head to upright
v) Usually produces intense illusion of falling downwards into the direction of roll
ii) Start coordinated roll to 30 or 40° of bank
iii) Student pilot should tilt head forward, look to right or left, then immediately return head to upright position
iv) Time maneuver so roll is stopped just as student returns head to upright
v) Usually produces intense illusion of falling downwards into the direction of roll
9) May also be beneficial for some students to
do the flying, closing eyes, following instructor's directions, then attempt to
establish correct attitude with eyes still closed, thus actually experiencing
the disorientation while flying the aircraft
e. Coping with spatial disorientation
1) Understand the illusions and remain
constantly alert for them
2) Always obtain preflight weather briefing
3) Do not continue flight into adverse weather, dusk or darkness until proficient in the use of the flight instruments
4) Use only those outside visual references that are reliable, fixed points on the Earth's surface
5) Avoid sudden head movements, especially during takeoffs, turns, approaches and landings
6) Remember that susceptibility to spatial disorientation is increased by illness, medication, alcohol, fatigue, sleep loss and mild h ypoxia
7) Become proficient in the use of and rely on the flight instruments
2) Always obtain preflight weather briefing
3) Do not continue flight into adverse weather, dusk or darkness until proficient in the use of the flight instruments
4) Use only those outside visual references that are reliable, fixed points on the Earth's surface
5) Avoid sudden head movements, especially during takeoffs, turns, approaches and landings
6) Remember that susceptibility to spatial disorientation is increased by illness, medication, alcohol, fatigue, sleep loss and mild h ypoxia
7) Become proficient in the use of and rely on the flight instruments
f. Optical illusions
1) Runway width illusion
i) Narrow runway can create illusion that
aircraft is higher than actual, causing pilot to fly too low on approach
ii) Wide runway may look closer than actual, so pilot may approach too high, level out high and land hard or overshoot the runway
ii) Wide runway may look closer than actual, so pilot may approach too high, level out high and land hard or overshoot the runway
2) Runway and terrain slopes illusion
i) Upsloping runway and/or terrain may create
illusion that aircaft is higher than actual, so pilot may fly too low
ii) Downsloping runway and/or terrain may have opposite effect
ii) Downsloping runway and/or terrain may have opposite effect
3) Featureless terrain illusion ("black
hole approach")
i) Absence of ground features, as in an approach
over water, darkened areas or snow may create illusion that aircraft is too
high
ii) Pilot may thus approach too low iii) Don't get sucked into the black hole on approach
ii) Pilot may thus approach too low iii) Don't get sucked into the black hole on approach
4) Water refraction
i) Rain on windscreen can create illusion that
aircraft is higher than actual
ii) Too low approach may be flown
ii) Too low approach may be flown
5) Haze
i) May create illusion of being at a greater
than actual distance from runway
ii) Pilot will tend to be high on the approach
iii) Beware tendency to fly long, too low approach in extremely clear air when the runway may appear closer than actual
iv) Diffusion of light by water particles adversely affects depth perception
ii) Pilot will tend to be high on the approach
iii) Beware tendency to fly long, too low approach in extremely clear air when the runway may appear closer than actual
iv) Diffusion of light by water particles adversely affects depth perception
6) Fog
i) Penetration of fog can create illusion of
pitching up
ii) Disoriented pilot may abruptly steepen approach
ii) Disoriented pilot may abruptly steepen approach
7) Ground lighting illusions
i) Line of lights along roads, trains may be
mistaken for runway or approach lights
ii) Bright runway and approach lights may create illusion of being too close, leading pilot to fly a higher approach
ii) Bright runway and approach lights may create illusion of being too close, leading pilot to fly a higher approach
g. How to prevent landing errors due to visual
illusions
a) Anticipate possibility of visual illusions
(consult airport diagrams and Airport/Facility Directory for
runway information)
b) Refer to altimeter frequently, especially during approach, day and night
c) Conduct aerial visual inspection of unfamiliar airports before landing
d) Use VASI, PAPI or electronic glide slope whenever available
e) Use the visual descent point (VDP) found on many nonprecision instrument approach charts
f) Recognize that chance of approach error increases when distracted by an emergency or other activity
g) Maintain optimum prociency in landing procedures
b) Refer to altimeter frequently, especially during approach, day and night
c) Conduct aerial visual inspection of unfamiliar airports before landing
d) Use VASI, PAPI or electronic glide slope whenever available
e) Use the visual descent point (VDP) found on many nonprecision instrument approach charts
f) Recognize that chance of approach error increases when distracted by an emergency or other activity
g) Maintain optimum prociency in landing procedures
References:
II. Technical Subject Areas
B. Aeromedical Factors
a. A physiological disorder including a sense of
not feeling well (malaise) plus nausea that may lead to vomiting,
and maybe headache and sweating that occur with movement
b. Caused by sympathetic reaction of the stomach to conflicting vestibular, visual, and postural sensations experienced by some people when they are removed from their usual one-positive G environment
c. Emotional state may contribute to occurrence and severity
d. Unrelated to physical conditioning, pilot skills, desire to fly
e. Factors increasing probability of motion sickness
b. Caused by sympathetic reaction of the stomach to conflicting vestibular, visual, and postural sensations experienced by some people when they are removed from their usual one-positive G environment
c. Emotional state may contribute to occurrence and severity
d. Unrelated to physical conditioning, pilot skills, desire to fly
e. Factors increasing probability of motion sickness
1) Head cold
2) Medication
3) Hypoxia
4) Fatigue
5) Discomfort or stress in the flying environment
6) Warm cockpit
7) Lack of fresh air
8) Seats with no view of horizon
9) Turbulence or vibration
2) Medication
3) Hypoxia
4) Fatigue
5) Discomfort or stress in the flying environment
6) Warm cockpit
7) Lack of fresh air
8) Seats with no view of horizon
9) Turbulence or vibration
f. Some pilots may experience air sickness as a
reaction to stress
g. Preventing air sickness
g. Preventing air sickness
1) Passengers may consult physician for
prescription or take an over-the-counter medication (i.e., Dramamine®, Bonine®,
Marezine®, etc.)(pilots should not take any medication without consulting an
AME)
2) Take extra time briefing air-sickness-prone students before flights to minimize sources of stress
3) Provide complete briefing to air-sickness-prone passengers to minimize surprises
4) Avoid/minimize turbulence
5) Keep all maneuvers gentle with minimal pitch and bank changes
6) Cabin temperature a bit cool
7) Provide plenty of fresh air
8) Remind air-sickness-prone passenger to keep visual contact with the natural horizon and keep head relatively still
9) In order to increase resistance to air-sickness, land at the first sign of uneasiness, before illness occurs
10) Keep supply of sealable air sickness bags out of sight
11) In larger aircraft, sit over the wings where motion is least
2) Take extra time briefing air-sickness-prone students before flights to minimize sources of stress
3) Provide complete briefing to air-sickness-prone passengers to minimize surprises
4) Avoid/minimize turbulence
5) Keep all maneuvers gentle with minimal pitch and bank changes
6) Cabin temperature a bit cool
7) Provide plenty of fresh air
8) Remind air-sickness-prone passenger to keep visual contact with the natural horizon and keep head relatively still
9) In order to increase resistance to air-sickness, land at the first sign of uneasiness, before illness occurs
10) Keep supply of sealable air sickness bags out of sight
11) In larger aircraft, sit over the wings where motion is least
h. Treating air sickness
1) Look outside at the horizon (not
inside) to help minimize effect of conflicting sensory signals
2) Administer fresh air. A few breaths of oxygen may be helpful
3) Keep sick person cool rather than warm. Loosen tight-fitting clothing
4) Recline seat back to reduce effects of any up-and-down motions
5) Land as soon as practicable
2) Administer fresh air. A few breaths of oxygen may be helpful
3) Keep sick person cool rather than warm. Loosen tight-fitting clothing
4) Recline seat back to reduce effects of any up-and-down motions
5) Land as soon as practicable
References:
Instrument Flying Handbook, FAA-H-8083-15, 1999
An Invitation to Fly, Basics for the Private Pilot, Seventh Edition Dennis Glaeser, Sanford Gum and Bruce Walters, 2004, Brooks/Cole
An Invitation to Fly, Basics for the Private Pilot, Seventh Edition Dennis Glaeser, Sanford Gum and Bruce Walters, 2004, Brooks/Cole
II. Technical Subject Areas
B. Aeromedical Factors
a. It is recommended that
alcohol should be avoided 24 hours prior to flight, though CFR
91.17 requires only 8 hours "from bottle to throttle"
b. 14 CFR 91.17 Alcohol or Drugs
b. 14 CFR 91.17 Alcohol or Drugs
(a) No person may act or attempt to act as a
crewmember of a civil aircraft—
(1) Within 8 hours after the
consumption of any alcoholic beverage;
(2) While under the influence of alcohol;
(3) While using any drug that affects the person's faculties in any way contrary to safety; or
(4) While having 0.04 percent by weight or more alcohol in the blood.
(2) While under the influence of alcohol;
(3) While using any drug that affects the person's faculties in any way contrary to safety; or
(4) While having 0.04 percent by weight or more alcohol in the blood.
(b) Except in an emergency, no pilot of a civil
aircraft may allow a person who appears to be intoxicated or who demonstrates
by manner or physical indications that the individual is under the influence of
drugs (except a medical patient under proper care) to be carried in that
aircraft.
(c) A crewmember shall do the following:
(c) A crewmember shall do the following:
(1) On request of a law enforcement officer,
submit to a test to indicate the percentage by weight of alcohol in the blood,
when—
(i) The law enforcement officer is authorized
under State or local law to conduct the test or to have the test conducted; and
(ii) The law enforcement officer is requesting submission to the test to investigate a suspected violation of State or local law governing the same or substantially similar conduct prohibited by paragraph (a)(1), (a)(2), or (a)(4) of this section.
(ii) The law enforcement officer is requesting submission to the test to investigate a suspected violation of State or local law governing the same or substantially similar conduct prohibited by paragraph (a)(1), (a)(2), or (a)(4) of this section.
(2) Whenever the Administrator has a reasonable
basis to believe that a person may have violated paragraph (a)(1), (a)(2), or
(a)(4) of this section, that person shall, upon request by the Administrator,
furnish the Administrator, or authorize any clinic, hospital, doctor, or other
person to release to the Administrator, the results of each test taken within 4
hours after acting or attempting to act as a crewmember that indicates
percentage by weight of alcohol in the blood.
(d) Whenever the Administrator has a reasonable
basis to believe that a person may have violated paragraph (a)(3) of this
section, that person shall, upon request by the Administrator, furnish the
Administrator, or authorize any clinic, hospital, doctor, or other person to
release to the Administrator, the results of each test taken within 4 hours
after acting or attempting to act as a crewmember that indicates the presence
of any drugs in the body.
(e) Any test information obtained by the Administrator under paragraph (c) or (d) of this section may be evaluated in determining a person's qualifications for any airman certificate or possible violations of this chapter and may be used as evidence in any legal proceeding under section 602, 609, or 901 of the Federal Aviation Act of 1958.
(e) Any test information obtained by the Administrator under paragraph (c) or (d) of this section may be evaluated in determining a person's qualifications for any airman certificate or possible violations of this chapter and may be used as evidence in any legal proceeding under section 602, 609, or 901 of the Federal Aviation Act of 1958.
c. As little as one ounce of liquor, one beer or
four ounces of wine can impair flying skills
d. After moderate drinking, a pilot can be severely impaired for many hours by hangover
e. Pilot performance can be impaired by many prescription and over-the-counter medicatons and by the conditions for which the mediations are taken
f. Judgment, memory, alertness, coordination, vision and ability to make calculations may be impaired by
d. After moderate drinking, a pilot can be severely impaired for many hours by hangover
e. Pilot performance can be impaired by many prescription and over-the-counter medicatons and by the conditions for which the mediations are taken
f. Judgment, memory, alertness, coordination, vision and ability to make calculations may be impaired by
1) Tranquilizers
2) Sedatives
3) Strong pain relievers
4) Cough suppressants
5) Antihistamines
6) Blood pressure medications
7) Muscle relaxants
8) Agents to control diarrhea
9) Agents to control motion sickness
2) Sedatives
3) Strong pain relievers
4) Cough suppressants
5) Antihistamines
6) Blood pressure medications
7) Muscle relaxants
8) Agents to control diarrhea
9) Agents to control motion sickness
g. Any medication that depresses the central
nervous system (e.g., sedative or antihistamine) increases susceptibility
to hypoxia
h. Safest policy is not to fly if taking any medication within 24 hours of flight unless approved by an AME
i. Smoking cigarettes, one pack per day, causes symptoms of hyoxia to be experienced as much as 5,000 feet lower than in a nonsmoker
h. Safest policy is not to fly if taking any medication within 24 hours of flight unless approved by an AME
i. Smoking cigarettes, one pack per day, causes symptoms of hyoxia to be experienced as much as 5,000 feet lower than in a nonsmoker
References:
Instrument Flying Handbook, FAA-H-8083-15, 1999
An Invitation to Fly, Basics for the Private Pilot, Seventh Edition Dennis Glaeser, Sanford Gum and Bruce Walters, 2004, Brooks/Cole
14 CFR 91.17
AIM 8-1-1
An Invitation to Fly, Basics for the Private Pilot, Seventh Edition Dennis Glaeser, Sanford Gum and Bruce Walters, 2004, Brooks/Cole
14 CFR 91.17
AIM 8-1-1
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II. Technical Subject Areas
B. Aeromedical Factors
7. Carbon monoxide (CO) poisoning
a. CO is a colorless, odorless gas present in
engine exhaust fumes
b. Exhaust fumes usually contain other gases that can be detected by odor c. Blood hemoglobin (Hgb) has much greater attraction to CO than to O2 and Hgb that has CO attached cannot carry O2, so CO poisoning causes hypoxia d. Symptoms of CO poisoning
1) Feeling of vague uneasiness (rather than
euphoria)
2) Dizziness (usually without lightheadedness) 3) Mental confusion 4) More severe and faster building headache (compared to other hypoxic headache) 5) Unconsciousness 5) Death
e. Countermeasures
1) Always mix fresh outside air with
heated air used in the cockpit
2) If CO poisoning suspected (and/or odor of exhaust fumes detected)
a) Turn off heater (the most
common source of CO)
b) Open outside air vents and flood cabin with fresh outside air c) Use O2 immediately d) Land as soon as practicable e) If symptoms severe or continue after landing, seek medical assistance
3) Use CO detectors
a) Low-cost plastic cards have a brown
chemical spot that darkens in the presence of CO, and must be replaced every
1-2 months
b) More expensive electronic CO detectors do not lose sensitivity
References:
Instrument Flying Handbook, FAA-H-8083-15, 1999
An Invitation to Fly, Basics for the Private Pilot, Seventh Edition Dennis Glaeser, Sanford Gum and Bruce Walters, 2004, Brooks/Cole AIM 8-1-4 |
 |
Greg Gordon MD, CFII
Updated: 30 September 2006 |
II. Technical Subject Areas
B. Aeromedical Factors
a. During scuba diving, ambient pressures become
greater than the pressure of gases in the blood and nitrogen is absorbed into
the tissues
b. If ambient pressue is decreased too rapidly too soon after scuba diving, nitrogen may evolve again as bubbles in the muscles causing decompression sickness, or the bends (body frequently bends over in pain)
c. AIM recommendations
b. If ambient pressue is decreased too rapidly too soon after scuba diving, nitrogen may evolve again as bubbles in the muscles causing decompression sickness, or the bends (body frequently bends over in pain)
c. AIM recommendations
1) Before flying (up to and) below 8,000
feet MSL wait at least
a) 12 hours after dive which
did not require a controlled ascent (nondecompression stop dive)
b) 24 hours after dive which required a controlled ascent (decompression stop dive)
b) 24 hours after dive which required a controlled ascent (decompression stop dive)
2) Before flight above 8,000 feet MSL
(altitude NOT cabin pressure) wait at least 24 hours after any
scuba dive
d. Safest recommendation: put at least 24
hours between any dive and any takeoff
References:
Instrument Flying Handbook, FAA-H-8083-15, 1999
An Invitation to Fly, Basics for the Private Pilot, Seventh Edition Dennis Glaeser, Sanford Gum and Bruce Walters, 2004, Brooks/Cole
AIM 8-1-2
An Invitation to Fly, Basics for the Private Pilot, Seventh Edition Dennis Glaeser, Sanford Gum and Bruce Walters, 2004, Brooks/Cole
AIM 8-1-2
II. Technical Subject Areas
B. Aeromedical Factors
a. Stress, psychological or bodily tension, is a
by-product of living
b. Sources of stress
b. Sources of stress
1) Environment
a) Stress commonly comes from trouble
i) At home
ii) At work, on the job
iii) With interpersonal relationships
ii) At work, on the job
iii) With interpersonal relationships
b) Common stresses in pilots
i) Apprehension related to fear of the unknown
ii) Anxiety based on desire to perform well in an unfamiliar area or doubts about one's own abilities
iii) Frustration stemming from failure to progress as fast as one might want
ii) Anxiety based on desire to perform well in an unfamiliar area or doubts about one's own abilities
iii) Frustration stemming from failure to progress as fast as one might want
2) Body
1) Acute (short-term) fatigue
a) Occurs after a few nights with inadequate
sleep
b) Prevent with adequate rest and sleep, regular exercise, proper nutrition
b) Prevent with adequate rest and sleep, regular exercise, proper nutrition
2) Chronic (long-term) fatigue
a) Occurs after more prolonged functioning in a
fatigued condition and leads to
i) Slowed reaction time
ii) Inattention to detail
iii) Generally ambivalent attitude, even towards safety
ii) Inattention to detail
iii) Generally ambivalent attitude, even towards safety
b) Recovery requires a prolonged period of rest
d. Dealing with stress using the relaxation
response
1) Recognize the first indicators of excess
stress
a) Increased heart rate
b) Perspiration
c) Increased breathing rate
d) Muscular tension
b) Perspiration
c) Increased breathing rate
d) Muscular tension
2) Take immediate action with a relaxation
response:
a) Take a deep breath or sigh
b) Follow with regular, even breathing
c) Dissipate muscular tension
b) Follow with regular, even breathing
c) Dissipate muscular tension
i) Reposition arms and legs, hands and feet
ii) Wiggle fingers and toes
ii) Wiggle fingers and toes
d) Let stressful thoughts dissipate and be
replaced with new, relaxed and confident thoughts
3) Relaxation response may be augmented by
a) Meditaion
b) Exercise
c) Biofeedback
d) Breathing control programs
b) Exercise
c) Biofeedback
d) Breathing control programs
e. Learn to recognize when you are stressed and
fatigued and be able to decide not to fly
f. Use the I'M SAFE self check, looking for signs of trouble from
f. Use the I'M SAFE self check, looking for signs of trouble from
Illness
Medication
Stress
Alcohol
Fatigue
Emotions
Medication
Stress
Alcohol
Fatigue
Emotions
References:
Instrument Flying Handbook, FAA-H-8083-15, 1999
An Invitation to Fly, Basics for the Private Pilot, Seventh Edition Dennis Glaeser, Sanford Gum and Bruce Walters, 2004, Brooks/Cole
AIM 8-1-1
An Invitation to Fly, Basics for the Private Pilot, Seventh Edition Dennis Glaeser, Sanford Gum and Bruce Walters, 2004, Brooks/Cole
AIM 8-1-1
|
II. Technical Subject Areas
B. Aeromedical Factors
|
|
II. Technical Subject Areas
B. Aeromedical Factors
a. Oxygen deficiency of body enough to impair
brain and other organ function
b. High altitude hypoxia is due to reduced barometric pressure c. Signs and symtoms related to cabin pressure altitude
1) 5,000 feet: deterioration in night vision
2) 12,000 to 15,000 feet: impairment of judgment, memory, alertness, coordination and ability to make calculations, plus headache, drowsiness, dizziness and either euphoria or belligerence 3) 15,000 feet: performance can seriously deteriorate in 15 minutes 4) Above 15,000 feet: tunnel vision, cyanosis 5) 18,000 feet: ability to take corrective action lost in 20-30 minutes 6) 20,000 feet: ability to take corrective action lost in 5-12 minutes, followed by unconsciousness
d. Factors that lower altitude at which
significant effects of hypoxia may occur (increase susceptibility to hypoxia)
1) Carbon monoxide
2) Anemia 3) Medications/drugs
a) Alcohol
b) Antihistamines c) Sedatives, tranquilizers d) Analgesics
4) Extreme cold, heat or fever
5) Anxiety
e. Ability to recognize hypoxia can be
improved by experiencing simulatied flight in an altitude chamber, provided
by the FAA (FAA Airman Education Programs Branch (AAM-420), Civil Aeromedical
Institute, Mike Monroney Aeronautical Center, Post Office Box 25082, Oklahoma
City, Oklahoma 73125; telephone 405-954-6212)
f. Preventive measures
1) Refrain from alcohol, and do not smoke
prior to flight
2) Use only medications prescribed by a fight surgeon or aviation medical examiner 3) Do not fly above 10,000 feet without supplemental oxygen on board 4) Use supplemental oxygen at higher altitudes
a) 14 CFR 91.211
i) Pilots of unpressurized aircraft use
supplemental oxygen when flying higher than 12,500 feet MSL for 30 minutes or
more and at all times above 14,000 feet MSL
ii) Every aircraft occupant must be provided supplemental oxygen above 15,000 feet MSL
b) Use of supplemental oxygen is
recommended (AIM 8-1-2) above
i) 10,000 feet during the day
ii) 5,000 feet at night
References:
|
II. Technical Subject Areas
B. Aeromedical Factors
a. Abnormal increase in volume of air breathed
in and out of lungs leading to abnormally low levels of carbon dioxide (CO2)
in the blood
b. May occur subconsciously when a stressful situation is encountered
c. Symptoms and signs
b. May occur subconsciously when a stressful situation is encountered
c. Symptoms and signs
1) Lightheadedness
2) Feeling of suffocation
3i) Drowsiness
4) Tingling of extremities
5) Incoordination
6) Disorientation
7) Painful muscle spasms
8) Unconsciousness
2) Feeling of suffocation
3i) Drowsiness
4) Tingling of extremities
5) Incoordination
6) Disorientation
7) Painful muscle spasms
8) Unconsciousness
d. Treatment
1) Symptoms subside within a few minutes after
rate and depth of breathing are consciously brought back under control
2) Build up of CO2 back to normal levels can be hastened by controlled breathing in and out of a paper bag held over nose and mouth
2) Build up of CO2 back to normal levels can be hastened by controlled breathing in and out of a paper bag held over nose and mouth
e. Hypoxia and hyperventilation
1) Early symptoms are similar
2) Both may occur at the same time
3) If pilot is using oxygen (O2) system when symtoms occur
2) Both may occur at the same time
3) If pilot is using oxygen (O2) system when symtoms occur
a) Immediately set O2 system to
deliver 100% O2, then
b) Check O2 system to assure proper function, before
c) Giving attention to rate and depth of breathing
b) Check O2 system to assure proper function, before
c) Giving attention to rate and depth of breathing
Reference:
II. Technical Subject Areas
B. Aeromedical Factors
a. Ear block
1) During ascent, expanding air in middle ear
normally opens eustachian tube, escapes through it to the nasal passages,
equalizing middle ear and cabin pressures
2) During descent, pilot must periodically open eustachian tube to equalize pressures by
2) During descent, pilot must periodically open eustachian tube to equalize pressures by
a) Swallowing
b) Yawning
c) Tensing muscles in the throat
d) Valsalva maneuver (attempt to blow through closed nostrils)
b) Yawning
c) Tensing muscles in the throat
d) Valsalva maneuver (attempt to blow through closed nostrils)
3) Upper respiratory infection (URI)
("cold" or sore throat) or nasal allergic condition can produce
enough congestion around eustachian tube, so that difference in pressure
between middle ear and cabin may build to level that holds eustachian tube
closed, making equalization of pressure difficult or impossible, a condition
commonly referred to as "ear block"
4) Symptoms/signs of ear block
4) Symptoms/signs of ear block
a) Severe ear pain
b) Loss of hearing
c) May last hours to several days
d) Rupture of ear drum can occur in flight or after landing
e) Fluid can accummulate in middle ear and become infected (otitis media)
b) Loss of hearing
c) May last hours to several days
d) Rupture of ear drum can occur in flight or after landing
e) Fluid can accummulate in middle ear and become infected (otitis media)
5) Prevention of ear block
a) Don't fly with a URI or nasal allergic
condition
b) Decongestant sprays/drops usually do not provide adequate protection
c) Beware: oral decongestants may have side effects that impair pilot performance
b) Decongestant sprays/drops usually do not provide adequate protection
c) Beware: oral decongestants may have side effects that impair pilot performance
6) Consult physician if ear block does not clear
shortly after landing
b. Sinus block
1) During ascent and descent, air pressure in
sinuses normally equalizes with cabin pressure through opening into the nasal
passages
2) URI, nasal allergic condition or sinusitis can cause enough congestion around these openings so that the pressure difference between the sinuses and the cabin increases until the openings are plugged, a condition referred to as "sinus block" which occurs most frequently during descent
3) Usually produces excruciating pain over the sinuses (frontal and/or maxillary), pain in the upper teeth (maxillary), and, sometimes, bloody nasal discharge
4) Prevention
2) URI, nasal allergic condition or sinusitis can cause enough congestion around these openings so that the pressure difference between the sinuses and the cabin increases until the openings are plugged, a condition referred to as "sinus block" which occurs most frequently during descent
3) Usually produces excruciating pain over the sinuses (frontal and/or maxillary), pain in the upper teeth (maxillary), and, sometimes, bloody nasal discharge
4) Prevention
a) Don't fly with a URI, nasal allergic
condition or sinusitis
b) Decongestant sprays/drops usually do not provide adequate protection
c) Beware: oral decongestants may have side effects that impair pilot performance
b) Decongestant sprays/drops usually do not provide adequate protection
c) Beware: oral decongestants may have side effects that impair pilot performance
5) Consult physician if sinus block does not
clear shortly after landing
References
II. Technical Subject Areas
B. Aeromedical Factors
a. A state of confusion due to misleading
information being sent to the brain from various sensory organs, resulting in
a lack of awareness of the aircraft position in relation to a
specific reference point
b. Sensory systems for orientation
b. Sensory systems for orientation
1) Eyes
a) The major orientation source
b) Visual cues usually prevail over false sensations from other sensory systems
c) Instrument meteorological conditions (IMC)
b) Visual cues usually prevail over false sensations from other sensory systems
c) Instrument meteorological conditions (IMC)
i) False, disorienting sensations may arise from
nonvisual sensory systems
ii) Use your eyes to determine aircraft attitude: look at and rely totally on the flight instruments
ii) Use your eyes to determine aircraft attitude: look at and rely totally on the flight instruments
2) Ears
a) Semicircular canals
i) Detect angular acceleration of the body
ii) Consist of 3 tubes at right angles to each other, each in one of the axes: pitch, roll, or yaw
iii) Filled with endolymph fluid
iv) In center of each canal is gelatinous cupola resting upon sensory hairs at the end of the vestibular nerve
v) In a turn, the relative motion of the endolymph moves the cupola which stimulates the sensory hairs to provide the sensation of turning
vi) As the turn continues for approximately 20 seconds or more the endolymph fluid has accelerated and is moving at the same speed as the semicircular canal so the sensation of turning ceases
vii) When this turn stops, the fluid continues to move the cupola for a while after the canal has stopped moving, creating the sensation of turning in the opposite direction (even though the turn has stopped)
ii) Consist of 3 tubes at right angles to each other, each in one of the axes: pitch, roll, or yaw
iii) Filled with endolymph fluid
iv) In center of each canal is gelatinous cupola resting upon sensory hairs at the end of the vestibular nerve
v) In a turn, the relative motion of the endolymph moves the cupola which stimulates the sensory hairs to provide the sensation of turning
vi) As the turn continues for approximately 20 seconds or more the endolymph fluid has accelerated and is moving at the same speed as the semicircular canal so the sensation of turning ceases
vii) When this turn stops, the fluid continues to move the cupola for a while after the canal has stopped moving, creating the sensation of turning in the opposite direction (even though the turn has stopped)
b) Otolith organs
i) Detect linear acceleration and gravity
ii) Consists of gelatinous membranes containing chalk-like crystals covering sensory hairs at the end of the vestibular nerve
iii) Tilting the head backward or forward cause movements of the crystals and membrane that are similar to those caused by accelerating or decelerating the head
iv) Forward acceleration may cause the illusion of the head tilting backward
ii) Consists of gelatinous membranes containing chalk-like crystals covering sensory hairs at the end of the vestibular nerve
iii) Tilting the head backward or forward cause movements of the crystals and membrane that are similar to those caused by accelerating or decelerating the head
iv) Forward acceleration may cause the illusion of the head tilting backward
3) Nerves
a) Forces created in turns can lead to false
sensations of the true direction of gravity
b) Uncoordinated, especially climbing, turns can send misleading signals to the brain
c) Skids and slips can give the sensation of banking or tilting
d) Fatigue or illness can exacerbate these sensations and lead to subtle incapacitation
b) Uncoordinated, especially climbing, turns can send misleading signals to the brain
c) Skids and slips can give the sensation of banking or tilting
d) Fatigue or illness can exacerbate these sensations and lead to subtle incapacitation
c. Illusions leading to spatial disorientation
1) Inner ear
a) The leans
i) Created by entering turn so slowly that
semicircular tubes are not stimulated and then rolling out relatively abuptly
to straight and level flight (SLF)
ii) Creates illusion, on roll out to SLF, of turn in opposite direction
iii) Disoriented pilot may bank aircraft back into the original turn, or, if SLF maintained, feel compelled to "lean" in that direction until the illusion subsides
ii) Creates illusion, on roll out to SLF, of turn in opposite direction
iii) Disoriented pilot may bank aircraft back into the original turn, or, if SLF maintained, feel compelled to "lean" in that direction until the illusion subsides
b) Coriolis illusion
i) In long stabilized turn, move head relatively
abruptly in different plane
ii) May create illusion of turning or accelerating on an entirely different axis
iii) To help avoid, develop instrument scan (and other actions) with minimal head movement (move eyes, not head)
ii) May create illusion of turning or accelerating on an entirely different axis
iii) To help avoid, develop instrument scan (and other actions) with minimal head movement (move eyes, not head)
c) Graveyard spiral or spin
i) Recover to SLF after prolonged coordinated,
constant-rate turn
ii) Pilot experiences turning in the opposite direction (the leans) and may return aircraft to the original turn
iii) Not sensing the turn, but noting the loss of altitude that may result from the normal loss of lift seen in a turn, the disoriented pilot may pull back on the control wheel
iv) These actions may lead to a tightening turn or spiral with increasing loss of altitude
ii) Pilot experiences turning in the opposite direction (the leans) and may return aircraft to the original turn
iii) Not sensing the turn, but noting the loss of altitude that may result from the normal loss of lift seen in a turn, the disoriented pilot may pull back on the control wheel
iv) These actions may lead to a tightening turn or spiral with increasing loss of altitude
d) Somatographic illusion
i) Rapid acceleration, such as experienced
during takeoff may create illusion of nose pitching up
ii) Disoriented pilot may push the nose low into a dive attitude
iii) Rapid deceleration may have opposite effect, with disoriented pilot pulling the nose up into a climb or even stall attitude
ii) Disoriented pilot may push the nose low into a dive attitude
iii) Rapid deceleration may have opposite effect, with disoriented pilot pulling the nose up into a climb or even stall attitude
e) Inversion illusion
i) Abrupt change from climb to SLF may creat
illusion of tumbling backwards
ii) Disoriented pilot may rapidly lower aircraft nose, possibly intensifying the illusion
ii) Disoriented pilot may rapidly lower aircraft nose, possibly intensifying the illusion
f) Elevator illusion
i) Abrupt vertical acceleration, as in an
updraft, may create illusion of climbing
ii) Disoriented pilot pushes aircraft nose low
iii) Abrupt downward acceleration, as in a downdraft, may have the opposite effect, with disoriented pilot pulling aircraft nose up
ii) Disoriented pilot pushes aircraft nose low
iii) Abrupt downward acceleration, as in a downdraft, may have the opposite effect, with disoriented pilot pulling aircraft nose up
2) Visual
a) False horizon
i) Sloping cloud formation
ii) Obscured horizon
iii) Aurora borealis
iv) Dark scene spread with ground lights and stars
ii) Obscured horizon
iii) Aurora borealis
iv) Dark scene spread with ground lights and stars
b) Autokinesis
i) In the dark, a stationary light appear to
move about when stared at for many seconds
ii) Disoriented pilot may attempt to align aircraft with these false movements
ii) Disoriented pilot may attempt to align aircraft with these false movements
3) Postural
a) Many false sensations can occur due to
acceleration forces overpowering gravity
b) This may occur in uncoordinated turns, climbing turns and turbulence
b) This may occur in uncoordinated turns, climbing turns and turbulence
d. Demonstrating spatial disorientation
1) Objectives
a) Teach pilots to understand their
susceptibility to spatial disorientation
b) Show that bodily sensations cannot be reliably used to determine aircraft attitude
c) Lessen the occurrence and degree of disorientation through understanding the relationship between aircraft motion, head motion and resulting disorientation
d) Instill confidence in relying on the flight instruments to determine true aircraft attitude
b) Show that bodily sensations cannot be reliably used to determine aircraft attitude
c) Lessen the occurrence and degree of disorientation through understanding the relationship between aircraft motion, head motion and resulting disorientation
d) Instill confidence in relying on the flight instruments to determine true aircraft attitude
2) Caution: never conduct these demonstrations
at a low altitude or without an instructor or appropriate safety pilot
3) Climbing while accelerating
3) Climbing while accelerating
i) Accelerate in SLF (student pilot's eyes
closed)
ii) Creates illusion that aircraft is climbing
ii) Creates illusion that aircraft is climbing
4) Climbing while turning
i) Slowly enter coordinated 1.5 G (approximately
50° bank) turn for 90°
ii) Usual illusion is that of a climb
ii) Usual illusion is that of a climb
5) Diving while turning
i) Slowly enter coordinated 1.5 G turn for 90°
and start recovery
ii) Usual illusion is that the aircraft is diving
ii) Usual illusion is that the aircraft is diving
6) Tilting to right or left
i) In SLF, execute moderate or slight skid with
wings level
ii) Usual illusion is that body is being tilted opposite the skid
ii) Usual illusion is that body is being tilted opposite the skid
7) Reversal of motion
i) In SLF, smoothly roll to 45° bank while
maintaining heading and pitch
ii) Usual illusion is strong sense of rotation in opposite direction
ii) Usual illusion is strong sense of rotation in opposite direction
8) Diving or rolling beyond the vertical plane
i) May produce extreme disorientation
ii) Start coordinated roll to 30 or 40° of bank
iii) Student pilot should tilt head forward, look to right or left, then immediately return head to upright position
iv) Time maneuver so roll is stopped just as student returns head to upright
v) Usually produces intense illusion of falling downwards into the direction of roll
ii) Start coordinated roll to 30 or 40° of bank
iii) Student pilot should tilt head forward, look to right or left, then immediately return head to upright position
iv) Time maneuver so roll is stopped just as student returns head to upright
v) Usually produces intense illusion of falling downwards into the direction of roll
9) May also be beneficial for some students to
do the flying, closing eyes, following instructor's directions, then attempt to
establish correct attitude with eyes still closed, thus actually experiencing
the disorientation while flying the aircraft
e. Coping with spatial disorientation
1) Understand the illusions and remain
constantly alert for them
2) Always obtain preflight weather briefing
3) Do not continue flight into adverse weather, dusk or darkness until proficient in the use of the flight instruments
4) Use only those outside visual references that are reliable, fixed points on the Earth's surface
5) Avoid sudden head movements, especially during takeoffs, turns, approaches and landings
6) Remember that susceptibility to spatial disorientation is increased by illness, medication, alcohol, fatigue, sleep loss and mild h ypoxia
7) Become proficient in the use of and rely on the flight instruments
2) Always obtain preflight weather briefing
3) Do not continue flight into adverse weather, dusk or darkness until proficient in the use of the flight instruments
4) Use only those outside visual references that are reliable, fixed points on the Earth's surface
5) Avoid sudden head movements, especially during takeoffs, turns, approaches and landings
6) Remember that susceptibility to spatial disorientation is increased by illness, medication, alcohol, fatigue, sleep loss and mild h ypoxia
7) Become proficient in the use of and rely on the flight instruments
f. Optical illusions
1) Runway width illusion
i) Narrow runway can create illusion that
aircraft is higher than actual, causing pilot to fly too low on approach
ii) Wide runway may look closer than actual, so pilot may approach too high, level out high and land hard or overshoot the runway
ii) Wide runway may look closer than actual, so pilot may approach too high, level out high and land hard or overshoot the runway
2) Runway and terrain slopes illusion
i) Upsloping runway and/or terrain may create
illusion that aircaft is higher than actual, so pilot may fly too low
ii) Downsloping runway and/or terrain may have opposite effect
ii) Downsloping runway and/or terrain may have opposite effect
3) Featureless terrain illusion ("black
hole approach")
i) Absence of ground features, as in an approach
over water, darkened areas or snow may create illusion that aircraft is too
high
ii) Pilot may thus approach too low iii) Don't get sucked into the black hole on approach
ii) Pilot may thus approach too low iii) Don't get sucked into the black hole on approach
4) Water refraction
i) Rain on windscreen can create illusion that
aircraft is higher than actual
ii) Too low approach may be flown
ii) Too low approach may be flown
5) Haze
i) May create illusion of being at a greater
than actual distance from runway
ii) Pilot will tend to be high on the approach
iii) Beware tendency to fly long, too low approach in extremely clear air when the runway may appear closer than actual
iv) Diffusion of light by water particles adversely affects depth perception
ii) Pilot will tend to be high on the approach
iii) Beware tendency to fly long, too low approach in extremely clear air when the runway may appear closer than actual
iv) Diffusion of light by water particles adversely affects depth perception
6) Fog
i) Penetration of fog can create illusion of
pitching up
ii) Disoriented pilot may abruptly steepen approach
ii) Disoriented pilot may abruptly steepen approach
7) Ground lighting illusions
i) Line of lights along roads, trains may be
mistaken for runway or approach lights
ii) Bright runway and approach lights may create illusion of being too close, leading pilot to fly a higher approach
ii) Bright runway and approach lights may create illusion of being too close, leading pilot to fly a higher approach
g. How to prevent landing errors due to visual
illusions
a) Anticipate possibility of visual illusions
(consult airport diagrams and Airport/Facility Directory for
runway information)
b) Refer to altimeter frequently, especially during approach, day and night
c) Conduct aerial visual inspection of unfamiliar airports before landing
d) Use VASI, PAPI or electronic glide slope whenever available
e) Use the visual descent point (VDP) found on many nonprecision instrument approach charts
f) Recognize that chance of approach error increases when distracted by an emergency or other activity
g) Maintain optimum prociency in landing procedures
b) Refer to altimeter frequently, especially during approach, day and night
c) Conduct aerial visual inspection of unfamiliar airports before landing
d) Use VASI, PAPI or electronic glide slope whenever available
e) Use the visual descent point (VDP) found on many nonprecision instrument approach charts
f) Recognize that chance of approach error increases when distracted by an emergency or other activity
g) Maintain optimum prociency in landing procedures
References:
II. Technical Subject Areas
B. Aeromedical Factors
a. A physiological disorder including a sense of
not feeling well (malaise) plus nausea that may lead to vomiting,
and maybe headache and sweating that occur with movement
b. Caused by sympathetic reaction of the stomach to conflicting vestibular, visual, and postural sensations experienced by some people when they are removed from their usual one-positive G environment
c. Emotional state may contribute to occurrence and severity
d. Unrelated to physical conditioning, pilot skills, desire to fly
e. Factors increasing probability of motion sickness
b. Caused by sympathetic reaction of the stomach to conflicting vestibular, visual, and postural sensations experienced by some people when they are removed from their usual one-positive G environment
c. Emotional state may contribute to occurrence and severity
d. Unrelated to physical conditioning, pilot skills, desire to fly
e. Factors increasing probability of motion sickness
1) Head cold
2) Medication
3) Hypoxia
4) Fatigue
5) Discomfort or stress in the flying environment
6) Warm cockpit
7) Lack of fresh air
8) Seats with no view of horizon
9) Turbulence or vibration
2) Medication
3) Hypoxia
4) Fatigue
5) Discomfort or stress in the flying environment
6) Warm cockpit
7) Lack of fresh air
8) Seats with no view of horizon
9) Turbulence or vibration
f. Some pilots may experience air sickness as a
reaction to stress
g. Preventing air sickness
g. Preventing air sickness
1) Passengers may consult physician for
prescription or take an over-the-counter medication (i.e., Dramamine®, Bonine®,
Marezine®, etc.)(pilots should not take any medication without consulting an
AME)
2) Take extra time briefing air-sickness-prone students before flights to minimize sources of stress
3) Provide complete briefing to air-sickness-prone passengers to minimize surprises
4) Avoid/minimize turbulence
5) Keep all maneuvers gentle with minimal pitch and bank changes
6) Cabin temperature a bit cool
7) Provide plenty of fresh air
8) Remind air-sickness-prone passenger to keep visual contact with the natural horizon and keep head relatively still
9) In order to increase resistance to air-sickness, land at the first sign of uneasiness, before illness occurs
10) Keep supply of sealable air sickness bags out of sight
11) In larger aircraft, sit over the wings where motion is least
2) Take extra time briefing air-sickness-prone students before flights to minimize sources of stress
3) Provide complete briefing to air-sickness-prone passengers to minimize surprises
4) Avoid/minimize turbulence
5) Keep all maneuvers gentle with minimal pitch and bank changes
6) Cabin temperature a bit cool
7) Provide plenty of fresh air
8) Remind air-sickness-prone passenger to keep visual contact with the natural horizon and keep head relatively still
9) In order to increase resistance to air-sickness, land at the first sign of uneasiness, before illness occurs
10) Keep supply of sealable air sickness bags out of sight
11) In larger aircraft, sit over the wings where motion is least
h. Treating air sickness
1) Look outside at the horizon (not
inside) to help minimize effect of conflicting sensory signals
2) Administer fresh air. A few breaths of oxygen may be helpful
3) Keep sick person cool rather than warm. Loosen tight-fitting clothing
4) Recline seat back to reduce effects of any up-and-down motions
5) Land as soon as practicable
2) Administer fresh air. A few breaths of oxygen may be helpful
3) Keep sick person cool rather than warm. Loosen tight-fitting clothing
4) Recline seat back to reduce effects of any up-and-down motions
5) Land as soon as practicable
References:
Instrument Flying Handbook, FAA-H-8083-15, 1999
An Invitation to Fly, Basics for the Private Pilot, Seventh Edition Dennis Glaeser, Sanford Gum and Bruce Walters, 2004, Brooks/Cole
An Invitation to Fly, Basics for the Private Pilot, Seventh Edition Dennis Glaeser, Sanford Gum and Bruce Walters, 2004, Brooks/Cole
II. Technical Subject Areas
B. Aeromedical Factors
a. It is recommended that
alcohol should be avoided 24 hours prior to flight, though CFR
91.17 requires only 8 hours "from bottle to throttle"
b. 14 CFR 91.17 Alcohol or Drugs
b. 14 CFR 91.17 Alcohol or Drugs
(a) No person may act or attempt to act as a
crewmember of a civil aircraft—
(1) Within 8 hours after the
consumption of any alcoholic beverage;
(2) While under the influence of alcohol;
(3) While using any drug that affects the person's faculties in any way contrary to safety; or
(4) While having 0.04 percent by weight or more alcohol in the blood.
(2) While under the influence of alcohol;
(3) While using any drug that affects the person's faculties in any way contrary to safety; or
(4) While having 0.04 percent by weight or more alcohol in the blood.
(b) Except in an emergency, no pilot of a civil
aircraft may allow a person who appears to be intoxicated or who demonstrates
by manner or physical indications that the individual is under the influence of
drugs (except a medical patient under proper care) to be carried in that
aircraft.
(c) A crewmember shall do the following:
(c) A crewmember shall do the following:
(1) On request of a law enforcement officer,
submit to a test to indicate the percentage by weight of alcohol in the blood,
when—
(i) The law enforcement officer is authorized
under State or local law to conduct the test or to have the test conducted; and
(ii) The law enforcement officer is requesting submission to the test to investigate a suspected violation of State or local law governing the same or substantially similar conduct prohibited by paragraph (a)(1), (a)(2), or (a)(4) of this section.
(ii) The law enforcement officer is requesting submission to the test to investigate a suspected violation of State or local law governing the same or substantially similar conduct prohibited by paragraph (a)(1), (a)(2), or (a)(4) of this section.
(2) Whenever the Administrator has a reasonable
basis to believe that a person may have violated paragraph (a)(1), (a)(2), or
(a)(4) of this section, that person shall, upon request by the Administrator,
furnish the Administrator, or authorize any clinic, hospital, doctor, or other
person to release to the Administrator, the results of each test taken within 4
hours after acting or attempting to act as a crewmember that indicates
percentage by weight of alcohol in the blood.
(d) Whenever the Administrator has a reasonable
basis to believe that a person may have violated paragraph (a)(3) of this
section, that person shall, upon request by the Administrator, furnish the
Administrator, or authorize any clinic, hospital, doctor, or other person to
release to the Administrator, the results of each test taken within 4 hours
after acting or attempting to act as a crewmember that indicates the presence
of any drugs in the body.
(e) Any test information obtained by the Administrator under paragraph (c) or (d) of this section may be evaluated in determining a person's qualifications for any airman certificate or possible violations of this chapter and may be used as evidence in any legal proceeding under section 602, 609, or 901 of the Federal Aviation Act of 1958.
(e) Any test information obtained by the Administrator under paragraph (c) or (d) of this section may be evaluated in determining a person's qualifications for any airman certificate or possible violations of this chapter and may be used as evidence in any legal proceeding under section 602, 609, or 901 of the Federal Aviation Act of 1958.
c. As little as one ounce of liquor, one beer or
four ounces of wine can impair flying skills
d. After moderate drinking, a pilot can be severely impaired for many hours by hangover
e. Pilot performance can be impaired by many prescription and over-the-counter medicatons and by the conditions for which the mediations are taken
f. Judgment, memory, alertness, coordination, vision and ability to make calculations may be impaired by
d. After moderate drinking, a pilot can be severely impaired for many hours by hangover
e. Pilot performance can be impaired by many prescription and over-the-counter medicatons and by the conditions for which the mediations are taken
f. Judgment, memory, alertness, coordination, vision and ability to make calculations may be impaired by
1) Tranquilizers
2) Sedatives
3) Strong pain relievers
4) Cough suppressants
5) Antihistamines
6) Blood pressure medications
7) Muscle relaxants
8) Agents to control diarrhea
9) Agents to control motion sickness
2) Sedatives
3) Strong pain relievers
4) Cough suppressants
5) Antihistamines
6) Blood pressure medications
7) Muscle relaxants
8) Agents to control diarrhea
9) Agents to control motion sickness
g. Any medication that depresses the central
nervous system (e.g., sedative or antihistamine) increases susceptibility
to hypoxia
h. Safest policy is not to fly if taking any medication within 24 hours of flight unless approved by an AME
i. Smoking cigarettes, one pack per day, causes symptoms of hyoxia to be experienced as much as 5,000 feet lower than in a nonsmoker
h. Safest policy is not to fly if taking any medication within 24 hours of flight unless approved by an AME
i. Smoking cigarettes, one pack per day, causes symptoms of hyoxia to be experienced as much as 5,000 feet lower than in a nonsmoker
References:
Instrument Flying Handbook, FAA-H-8083-15, 1999
An Invitation to Fly, Basics for the Private Pilot, Seventh Edition Dennis Glaeser, Sanford Gum and Bruce Walters, 2004, Brooks/Cole
14 CFR 91.17
AIM 8-1-1
An Invitation to Fly, Basics for the Private Pilot, Seventh Edition Dennis Glaeser, Sanford Gum and Bruce Walters, 2004, Brooks/Cole
14 CFR 91.17
AIM 8-1-1
|
II. Technical Subject Areas
B. Aeromedical Factors
7. Carbon monoxide (CO) poisoning
a. CO is a colorless, odorless gas present in
engine exhaust fumes
b. Exhaust fumes usually contain other gases that can be detected by odor c. Blood hemoglobin (Hgb) has much greater attraction to CO than to O2 and Hgb that has CO attached cannot carry O2, so CO poisoning causes hypoxia d. Symptoms of CO poisoning
1) Feeling of vague uneasiness (rather than
euphoria)
2) Dizziness (usually without lightheadedness) 3) Mental confusion 4) More severe and faster building headache (compared to other hypoxic headache) 5) Unconsciousness 5) Death
e. Countermeasures
1) Always mix fresh outside air with
heated air used in the cockpit
2) If CO poisoning suspected (and/or odor of exhaust fumes detected)
a) Turn off heater (the most
common source of CO)
b) Open outside air vents and flood cabin with fresh outside air c) Use O2 immediately d) Land as soon as practicable e) If symptoms severe or continue after landing, seek medical assistance
3) Use CO detectors
a) Low-cost plastic cards have a brown
chemical spot that darkens in the presence of CO, and must be replaced every
1-2 months
b) More expensive electronic CO detectors do not lose sensitivity
References:
Instrument Flying Handbook, FAA-H-8083-15, 1999
An Invitation to Fly, Basics for the Private Pilot, Seventh Edition Dennis Glaeser, Sanford Gum and Bruce Walters, 2004, Brooks/Cole AIM 8-1-4 |
|
|
Greg Gordon MD, CFII
Updated: 30 September 2006 |
II. Technical Subject Areas
B. Aeromedical Factors
a. During scuba diving, ambient pressures become
greater than the pressure of gases in the blood and nitrogen is absorbed into
the tissues
b. If ambient pressue is decreased too rapidly too soon after scuba diving, nitrogen may evolve again as bubbles in the muscles causing decompression sickness, or the bends (body frequently bends over in pain)
c. AIM recommendations
b. If ambient pressue is decreased too rapidly too soon after scuba diving, nitrogen may evolve again as bubbles in the muscles causing decompression sickness, or the bends (body frequently bends over in pain)
c. AIM recommendations
1) Before flying (up to and) below 8,000
feet MSL wait at least
a) 12 hours after dive which
did not require a controlled ascent (nondecompression stop dive)
b) 24 hours after dive which required a controlled ascent (decompression stop dive)
b) 24 hours after dive which required a controlled ascent (decompression stop dive)
2) Before flight above 8,000 feet MSL
(altitude NOT cabin pressure) wait at least 24 hours after any
scuba dive
d. Safest recommendation: put at least 24
hours between any dive and any takeoff
References:
Instrument Flying Handbook, FAA-H-8083-15, 1999
An Invitation to Fly, Basics for the Private Pilot, Seventh Edition Dennis Glaeser, Sanford Gum and Bruce Walters, 2004, Brooks/Cole
AIM 8-1-2
An Invitation to Fly, Basics for the Private Pilot, Seventh Edition Dennis Glaeser, Sanford Gum and Bruce Walters, 2004, Brooks/Cole
AIM 8-1-2
II. Technical Subject Areas
B. Aeromedical Factors
a. Stress, psychological or bodily tension, is a
by-product of living
b. Sources of stress
b. Sources of stress
1) Environment
a) Stress commonly comes from trouble
i) At home
ii) At work, on the job
iii) With interpersonal relationships
ii) At work, on the job
iii) With interpersonal relationships
b) Common stresses in pilots
i) Apprehension related to fear of the unknown
ii) Anxiety based on desire to perform well in an unfamiliar area or doubts about one's own abilities
iii) Frustration stemming from failure to progress as fast as one might want
ii) Anxiety based on desire to perform well in an unfamiliar area or doubts about one's own abilities
iii) Frustration stemming from failure to progress as fast as one might want
2) Body
1) Acute (short-term) fatigue
a) Occurs after a few nights with inadequate
sleep
b) Prevent with adequate rest and sleep, regular exercise, proper nutrition
b) Prevent with adequate rest and sleep, regular exercise, proper nutrition
2) Chronic (long-term) fatigue
a) Occurs after more prolonged functioning in a
fatigued condition and leads to
i) Slowed reaction time
ii) Inattention to detail
iii) Generally ambivalent attitude, even towards safety
ii) Inattention to detail
iii) Generally ambivalent attitude, even towards safety
b) Recovery requires a prolonged period of rest
d. Dealing with stress using the relaxation
response
1) Recognize the first indicators of excess
stress
a) Increased heart rate
b) Perspiration
c) Increased breathing rate
d) Muscular tension
b) Perspiration
c) Increased breathing rate
d) Muscular tension
2) Take immediate action with a relaxation
response:
a) Take a deep breath or sigh
b) Follow with regular, even breathing
c) Dissipate muscular tension
b) Follow with regular, even breathing
c) Dissipate muscular tension
i) Reposition arms and legs, hands and feet
ii) Wiggle fingers and toes
ii) Wiggle fingers and toes
d) Let stressful thoughts dissipate and be
replaced with new, relaxed and confident thoughts
3) Relaxation response may be augmented by
a) Meditaion
b) Exercise
c) Biofeedback
d) Breathing control programs
b) Exercise
c) Biofeedback
d) Breathing control programs
e. Learn to recognize when you are stressed and
fatigued and be able to decide not to fly
f. Use the I'M SAFE self check, looking for signs of trouble from
f. Use the I'M SAFE self check, looking for signs of trouble from
Illness
Medication
Stress
Alcohol
Fatigue
Emotions
Medication
Stress
Alcohol
Fatigue
Emotions
References:
Instrument Flying Handbook, FAA-H-8083-15, 1999
An Invitation to Fly, Basics for the Private Pilot, Seventh Edition Dennis Glaeser, Sanford Gum and Bruce Walters, 2004, Brooks/Cole
AIM 8-1-1
An Invitation to Fly, Basics for the Private Pilot, Seventh Edition Dennis Glaeser, Sanford Gum and Bruce Walters, 2004, Brooks/Cole
AIM 8-1-1
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