Aviation Medicine Seminar Series Aviation Medicine Seminar Series Bruce R. Gilbert, M.D., Ph.D. Associate Clinical Professor of Urology •Weill Cornell Medical College •Stony Brook University Medical College •Head, Section of Male Reproduction •North Shore University Hospital •Aviation Medical Examiner (AME)
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Aviation Medicine SeminarSeries
Aviation Medicine SeminarSeries
Bruce R. Gilbert, M.D., Ph.D.
Associate Clinical Professor of Urology•Weill Cornell Medical College
•Stony Brook University Medical College
•Head, Section of Male Reproduction•North Shore University Hospital
•Aviation Medical Examiner (AME)
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Aviation Medicine Seminar SeriesAviation Medicine Seminar Series
• (1) How to Ace the Medical Exam• December 13, 2003
• AME training
• How to find a Medical Examiner
• What the exam involves
• The 15 disqualifying conditions…
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Aviation Medicine Seminar SeriesAviation Medicine Seminar Series
• (2) Spatial Disorientation-January 10, 2004• Vestibular based disorientation: What it is,
How to deal with it• Vision based disorientation: What it is, How
to deal with it
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Aviation Medicine Seminar SeriesAviation Medicine Seminar Series
• (3) Common Aeromedical Problems-• February 14, 2004
• Motion Sickness• Hyperventilation• Hypoxia• Carbon Monoxide• Trapped gas
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Aviation Medicine Seminar SeriesAviation Medicine Seminar Series
• (4) Advanced TopicsMarch 13, 2004
• Self imposed stress• Hypoxia/Oxygen use and abuse• Altitude induced decompression sickness• Trapped gas• Cabin pressurization
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�IntroductionSelf Imposed Stress
• Definition of Stress• Stress is the sum of biological reactions to any
adverse stimulus - be it physical, mental, emotional,internal or external - that tend to disturb the“Body’s Natural Balance”
• Although difficult to determine the fulleffect of stress on the pilot, it is importantto be aware of the stresses we can control
�Introduction
Self imposed stresses have adverseeffects on pilots and therefore can affectthe safety of flight
Each stress can deteriorate your pilotingskills and these stresses are cumulative
Self Imposed Stress
�Self Imposed Stresses
• Alcohol consumption
• Self medication
• Drug use
• Tobacco use
Self Imposed Stress
�Self Imposed Stresses
• Inadequate diet and nutrition
• Psychological stress
• Fatigue
• Poor physical fitness
Self Imposed Stress
�Alcohol
• Alcohol is a depressant, hypnotic,and addicting drug that in anyquantity will have adverse effects onyour flying ability
Self Imposed Stress
Alcohol and the FARsAlcohol and the FARs
• FAR 91.17• No person may operate or attempt to operate an
aircraft:• within 8 hours of consuming alcohol
within 24 hours if intoxication or IFR flying is involved(recommendation only)
• while under the influence of alcohol• with a blood-alcohol content of 0.04% or greater
Alcohol as a DrugAlcohol as a Drug
• Alcohol is a drug• Depressant
• Blocks impulses from the brain and decreases theability of the brain to use oxygen
• Majority of adverse effects are to brain, eyes andmiddle ear: Crucial organs for pilots
• 0.04%: markedly impaired performance (3standard alcoholic drinks for the averageperson)
Elimination of AlcoholApproximately 1/3 oz/hour
Elimination of AlcoholApproximately 1/3 oz/hour
0
1
2
3
4
5
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2 4 6 8 10 12 14 16
Hours to Clear Alcohol
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Hangover EffectsHangover Effects• After acute effects of alcohol intoxication• May last up to 48-72 hours after drinking alcohol• May be just as dangerous as intoxication itself• Includes: impaired judgement, fatigue, irritability,
headache, dizziness, dry mouth, stuffy nose, upsetstomach, sensitivity to light.
Alcohol and Aircraft Accidents• Approximately 6 to 9%
of GA accidents arecaused by alcohol eachyear.
• 0.04% (40mg/dl) FAAlimit.
• 0.02% (20mg/dl)detectable & reportedby CAMI.
�Alcohol
• Impairments In; - Reaction time - Reasoning - Judgment - Memory - Brain oxygen utilization a. Hypemic Hypoxia
The use of alcohol and drugs isregulated FAR 91.17
- Persons may not operate, or attempt tooperate, an aircraft when they arecurrently under the influence of alcohol - Have consumed alcohol within thepast 8 hours
Self Imposed Stress
�Alcohol
• The use of alcohol and drugs isregulated FAR 91.17
- Have a blood alcohol content of .04%or greater
- Are using any drug that adverselyaffects flight
Self Imposed Stress
�Over-The-Counter Medications
• You should be aware that over-the-counter medications as well asprescription medications can affectthe safe operation of your aircraft
Self Imposed Stress
�Over-The-Counter Medications
• Some drugs effects can be intensified when taken to altitude
• Consult your local Aviation Medical Examiner that a medication might have on you as a pilot
Self Imposed Stress
� Diet
• A balanced meal consist of - Carbohydrates (50-55%) a. Breaks down to glucose - Proteins (15-20%) a. Basic building block of all cells - Fats (30%) a. Concentrated source of energy
• Psychological stresses involvephysiological mental, and emotionalresponses to sociocultural, familyand job related situations
Self Imposed Stress
�Psychological Stress
Personal life changes that cause stress - Death of a spouse
- Divorce
- Moving or changing jobs
- Marriage
- Being fired
- Changes in health
Self Imposed Stress
�Flying as a Stress
Examples of flying events that can be a direct cause of stress
Flying in bad weatherNight operationsPerforming an instrument approach to
minimumsFlying in high density traffic areaFlying in to unfamiliar airports
Self Imposed Stress
�Flying as a Stress
Examples of flying events that can bea direct cause of stressBecoming temporarily lost in flightEquipment malfunctionsConflicts with other crewmembers or ATCBeing subject to flight checks
• Grinding teeth• Cold sweat• Increased smoking or over-eating• Alcohol and drug use or abuse
Self Imposed Stress
�How To Deal with Stress
• Define the source of stress• Evaluate available resources• Explore possible solutions• Take action
Self Imposed Stress
�How To Deal with Stress
• Evaluate outcome• Make corrections or changes• Try again
Self Imposed Stress
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• PHYSICS OF THE ATMOSPHERE• RESPIRATION & CIRCULATION• HYPOXIA• HYPERVENTILATION• TRAPPED GAS• DECOMPRESSION SICKNESS• SELF-IMPOSED STRESS• OXYGEN EQUIPMENT
Flying HighFlying High
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The atmosphere is the gaseous envelopeThe atmosphere is the gaseous envelopewhich surrounds the earth.which surrounds the earth.
It extends from the earth to approximately It extends from the earth to approximately 1,000 nautical miles out with most 1,000 nautical miles out with most flights below 50,000 feet (approx 8.2 nm)flights below 50,000 feet (approx 8.2 nm)..
•• The combined weight of all the The combined weight of all theatmospheric gases creating a forceatmospheric gases creating a forceupon the surface of the earth.upon the surface of the earth.
•• The force is caused by gravity pulling The force is caused by gravity pullingmolecules earthward and can bemolecules earthward and can bemeasured at any specific altitude.measured at any specific altitude.
Atmospheric PressureAtmospheric Pressure
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If you were to expose a vacuum tubeIf you were to expose a vacuum tubewith mercury in it to sea level pressurewith mercury in it to sea level pressureunder standard atmospheric conditionsunder standard atmospheric conditionsit would rise it would rise 29.9229.92 inches of mercury inches of mercury