4.7 Aviation Medicine

Question 1

DESCRIBE aviation flight personnel grounding procedures:

What is the purpose of the DD Form 2992?

Answer 1

Aeromedical,

Is to notify the commanding officer or officer in charge and other designated individuals that the named aircrew member is no longer medically recommended for flying duties.

Question 2

DESCRIBE aviation flight personnel grounding procedures:

Who may issue an Aeromedical Grounding Notice?

Answer 2

All medical department personnel,

Corpsmen,

Nurse Corps officers,

Etc.

Are authorized to issue an Aeromedical Grounding Notice.

Question 3

DESCRIBE aviation flight personnel grounding procedures:

In addition, the Aeromedical Grounding Notice will be noted in the member’s health record under what?

Answer 3

Special Duty Medical Abstract,

NAVMED 6150/2.

Question 4

DESCRIBE aviation flight personnel grounding procedures:

Aeromedical Grounding Notices will be issued to the following:

Personnel admitted to the what?

Answer 4

Sick list.

Question 5

DESCRIBE aviation flight personnel grounding procedures:

Aeromedical Grounding Notices will be issued to the following:

Those who are what?

Answer 5

Hospitalized.

Question 6

DESCRIBE aviation flight personnel grounding procedures:

Aeromedical Grounding Notices will be issued to the following:

Personnel determined to have what?

Answer 6

A medical problem that could impair performance of duties involving flight.

Question 7

DESCRIBE aviation flight personnel grounding procedures:

Aeromedical Grounding Notices will be issued to the following:

Administration of routine what?

Answer 7

Immunizations,

Which require temporary grounding.

Question 8

DESCRIBE aviation flight personnel grounding procedures:

Aeromedical Grounding Notices will be issued to the following:

What does not require issuance of an Aeromedical Grounding Notice?

Answer 8

Getting an immunization.

Question 9

DESCRIBE aviation flight personnel grounding procedures:

When issuing “Down Chits”, how many chits are made?

Answer 9

An original and two (2) copies are made.

Question 10

DESCRIBE aviation flight personnel grounding procedures:

The original “down chit,” goes to who?

Answer 10

The Commanding Officer or Officer in Charge

Question 11

DESCRIBE aviation flight personnel grounding procedures:

The first copy of the “down chit” goes to who?

Answer 11

The Operations Officer.

Question 12

DESCRIBE aviation flight personnel grounding procedures:

The second copy is for who?

Answer 12

Training Officer.

Question 13

DESCRIBE aviation flight personnel grounding procedures:

Additional copies should be made for who?

Answer 13

The Service Member,

Unit Safety or the NATOPs Officer,

And other designated personnel.

Question 14

DESCRIBE aviation flight personnel grounding procedures:

How long is a grounding status?

Answer 14

Remains in effect until the member has been examined by a flight surgeon and issued an,

Aeromedical Clearance Notice “Up-Chit.”

Question 15

DESCRIBE aviation flight personnel grounding procedures:

Who has the authority to issue an “Up Chit?”

Answer 15

IDC,

PA,

non-aviation trained MO,

if flight surgeon is not available; consultation must be obtained from a flight surgeon via email, verbal, or message prior to issuing clearance notice.

Question 16

DESCRIBE aviation flight personnel grounding procedures:

Disposition?

Answer 16

If sickbay/BAS/etc,. is detached from the unit,

A courtesy phone call should be made to the CO, XO, and OPS advising them that a “down chit” has been issued for named individuals.

Question 17

DESCRIBE aviation flight personnel clearance procedures:

Aviation Personnel Clearance Procedures:

All aviation personnel involved in flight duties are required to be evaluated when?

Answer 17

Annually and must be physically qualified (PQ) and aeronautically adapted (AA) for continued aviation duties as prescribed by current Navy Directives.

Question 18

DESCRIBE aviation flight personnel clearance procedures:

Aviation Personnel Clearance Procedures:

What does PQ mean?

Answer 18

Physically qualified.

Question 19

DESCRIBE aviation flight personnel clearance procedures:

Aviation Personnel Clearance Procedures:

What does AA mean?

Answer 19

Aeronautically adapted.

Question 20

DESCRIBE aviation flight personnel clearance procedures:

Aviation Personnel Clearance Procedures:

Following any period of medical grounding, aviation personnel must be evaluated by who?

Answer 20

A flight surgeon and issued a clearance notice prior to returning to aviation duties.

Question 21

DESCRIBE aviation flight personnel clearance procedures:

Following any period of medical grounding,

Aviation personnel must be evaluated by a flight surgeon and issued a clearance notice prior to returning to aviation duties,

The only exception to this, is what?

Answer 21

The self-limited grounding notice issued by a dental officer.

Question 22

DESCRIBE aviation flight personnel clearance procedures:

Purpose of the DD Form 2992 Medical Recommendation for Flying or Special Operations Duty,

The purpose of the clearance notice is to notify the commanding officer or officer in charge and other designated individuals that the named aircrew member is now what?

Answer 22

Medically cleared and recommended for flying duties.

Question 23

DESCRIBE aviation flight personnel clearance procedures:

Aeromedical Clearance Notices are what?

Answer 23

Medical recommendations only!

Question 24

DESCRIBE aviation flight personnel clearance procedures:

Aviation-designated personnel are restored to flying duties by who?

Answer 24

The Commanding Officer or Officer in Charge of the unit,

Also known as an “Up Chit.”

Question 25

DESCRIBE aviation flight personnel clearance procedures:

Physical standards:

All personnel engaged in duties involving flying and all candidates for such duty, must conform to the physical standards of what?

Answer 25

The NAVMED P-117, MANMED CH 15.

Question 26

Aeromedical Clearance Notices:

Who may issue aeromedical Clearance Notices prior to aircrew members returning to duty, involving flying?

Answer 26

Is the responsibility of the aviation trained medical officers,

Flight Surgeons or Aviation Medical Examiners.

Question 27

Aeromedical Clearance Notices:

The authority to issue an aeromedical clearance notice may be given to who?

Answer 27

IDC,

Physician assistant,

Non-aviation trained medical officer,

When flight personnel are stationed in remote or isolated locations where a flight surgeon is not available.

Question 28

An IDC, physician assistant, or non-aviation trained medical officer can issue an aeromedical clearance notice, but need what?

Answer 28

A consultation must be obtained from a flight surgeon, via:

E-mail,

Verbal communication,

Or message,

Prior to issuing the aeromedical clearance notice.

Question 29

What instructions govern the directives that specify the authority to issue an Aeromedical Clearance Notice by an IDC, physician assistant, or non-aviation trained medical officer?

Answer 29

NAVMED P-117,

BUMEDINST 6410.9,

OPNAVINST 3710.7V.

Question 30

Aircrew must be thoroughly evaluated by all medical providers to ensure what?

Answer 30

That they have fully recovered.

Then the “up-chit” may be issued with the consultation with a flight surgeon.

Question 31

Consult will be documented by an entry into the outpatient HR with the following info:

Consultation with DR?

Answer 31

Flight surgeon’s name,

Contact info, of FLT Surgeon’s command,

Occurred on (date),

Return to flying status was approved

Question 32

Aircrew member will not be issued an up-chit while under what?

Answer 32

Medication,

Without concurrence from FLT Surgeon.

Question 33

Documentation of an aeronautical clearance is noted where?

Answer 33

The member’s HR.

Question 34

Results of the medical evaluation for aviation duty clearance must be entered on what?

Answer 34

On the SF 600

Question 35

Medical evaluation clearance must also be noted under what?

Answer 35

The Special Duty Medical Abstract,

(NAVMED 6150/2).

Question 36

When issuing an Up Chit, how many copies are made?

Answer 36

An original and two copies.

Question 37

The original Up Chit, is sent to who?

Answer 37

To the CO or OIC.

Question 38

The 1st copy of the Up Chit, goes to who?

Answer 38

OPS.

Question 39

The 2nd copy of the Up Chit, goes to who?

Answer 39

Training Officer.

Question 40

Additional copies of the Up Chit, should be made for who?

Answer 40

The SM,

Unit safety or NATOPS officer,

Other designated personnel.

Question 41

Filing of Physical Examinations.

How are physical examinations filed when a member needs an Up Chit?

Answer 41

In sequence with other periodic examinations.

Question 42

How long are Up Chit physical examinations kept on file at the facility?

Answer 42

3 years.

Question 43

When AC (Air Crew) personnel are unable to meet required physical standards for periods exceeding 60 days, what needs to be done?

Answer 43

An aviation PE shall be completed.

Question 44

After the 60 day PE, a typed DD 2808 with appropriate consultations and FLT surgeon recommendations shall be forwarded to who?

Answer 44

NAVOPMEDINST DET NAVAEROMEDINST
(code 342)

For review and recommendation to BUPERS or CMC as appropriate.

Question 45

An Up Chit is always issued with what?

Answer 45

An expiration date.

Question 46

An Up Chits expiration, is timed to coincide with the validity of what?

Answer 46

Aviator annual or periodic examinations,

Which expire on the last day of the member’s birth month.

Question 47

Reissue of the “up-chit” as part of an aviator annual or periodic examination certifies that the member is in full compliance with what?

Answer 47

All waiver provisions,

Special submission requirements,

BUMED recommendations contained in the original waiver letter from the Naval Aerospace Medical Institute (NAMI).

Question 48

Aviation Mishap Investigation Procedures:

Search for who?

Answer 48

Survivors and treat all casualties first.

Question 49

Aviation Mishap Investigation Procedures:

Collect what?

Answer 49

Medical records of crew and passengers if possible.

Question 50

Aviation Mishap Investigation Procedures:

Perform required physical exam(s) and lab procedures on who?

Answer 50

On all survivors.

Question 51

Aviation Mishap Investigation Procedures:

Issue what?

Answer 51

Grounding Notices.

Question 52

Aviation Mishap Investigation Procedures:

Obtain what?

Answer 52

Statements.

Question 53

Aviation Mishap Investigation Procedures:

Coordinate and/or direct collection of what?

Answer 53

Survival gear and flight equipment.

Question 54

Aviation Mishap Investigation Procedures:

Coordinate with members of the aviation medical board in the collection of labeled sketches and photographs of crash sites, to include what?

Answer 54

Crash path,

Point of impact,

Wreckage,

Fatalities,

Photograph each survivors injuries.

Question 55

Aviation Mishap Investigation Procedures:

What is the checklist?

Answer 55

In place of the flight surgeon and aircraft mishap team you will be required to ensure that all the above duties are accomplished.

Preparing a checklist ahead of time will ensure that no items will be missed.

Question 56

Aviation Mishap Investigation Procedures:

What is the Aircraft Mishap Team?

Answer 56

At most crash sites the Aircraft Mishap Team will take over the duties of investigating the crash.

Question 57

Aviation Mishap Investigation Procedures:

The Aircraft Mishap Team will take over the investigation,

However, completing as much of the list of tasks as possible prior to their arrival will do what?

Answer 57

Expedite the investigation.

Question 58

Aviation Mishap Investigation Procedures:

Be sure to gather what?

Answer 58

All Flight Equipment and Survival Gear.

Question 59

Aviation Mishap Investigation Procedures:

Independent Duty Corpsman will gather all flight equipment and survival gear to include what?

Answer 59

Flight suits and/or uniforms.

Question 60

Aviation Mishap Investigation Procedures:

IDC’s will photograph how?

Answer 60

While intact and/or on person.

Question 61

Aviation Mishap Investigation Procedures:

Label with what?

FIX!

Answer 61

Name,

SSN,

Rank,

Date of incident.

Question 62

Aviation Mishap Investigation Procedures:

Identify all what?

Answer 62

Alterations you make,

Such as cutting off and moving.

Question 63

Aviation Mishap Investigation Procedures:

Take Pictures of what?

Answer 63

Flight Equipment and Survival Gear.

Question 64

Aviation Mishap Investigation Procedures:

Care of the patient always comes first,

However, if it does not interfere with your treatment of the patient, what should you do?

Answer 64

Pictures should be taken of the:

Flight equipment,

Survival gear,

Flight suites and/or uniforms on the victims and survivors.

Question 65

Aviation Mishap Investigation Procedures:

Photographs showing the condition of the equipment as worn is what?

Answer 65

Is essential to the investigation,

Caution survivors not to remove equipment until you have taken pictures.

Question 66

Aviation Mishap Investigation Procedures:

If the treatment of the patient requires that you cut off or remove the flight equipment and survival gear, document what?

Answer 66

The alterations you’ve made.

Question 67

Aviation Mishap Investigation Procedures:

Label each photograph as soon as possible with what?

Answer 67

Name,

SSN,

Rank,

Date of incident,

It’s also helpful to include the time the photographs were taken but is not required.

Question 68

Aviation Mishap Investigation Procedures:

Gather statements from each crash survivor the statements must cover the last how many hours?

Answer 68

72 hours.

Question 69

Aviation Mishap Investigation Procedures:

What is documented on the 72 hour report?

Answer 69

To include food and beverages consumed,

Hours of sleep,

Any activities done.

Question 70

Aviation Mishap Investigation Procedures:

What is FORM SIR 3750/15?

Answer 70

Chronological Account of Activities of Previous 72 Hours.

Question 71

Aviation Mishap Investigation Procedures:

Obtain statements when?

Answer 71

Early.

Question 72

Aviation Mishap Investigation Procedures:

It is important to obtain statements from survivors as soon as possible,

This will insure that the statements are what?

Answer 72

As accurate as possible and not influenced by other events.

Question 73

Aviation Mishap Investigation Procedures:

Emphasize to the survivors the need to do what with their statements?

Answer 73

As clear and precise as possible to assist in the investigation.

Question 74

Aviation Mishap Investigation Procedures:

The IDC must collect laboratory specimens from what?

Answer 74

The survivors to be used by the investigation.

Question 75

Aviation Mishap Investigation Procedures:

What are the list of the specimens that the IDC collects from the survivors?

Answer 75

2 gray top tubes,

2 purple top tubes,

3 red top tubes,

Urine sample 70 ml is optimum (no preservatives).

Question 76

Aviation Mishap Investigation Procedures:

All samples are to be labeled with what information?

Answer 76

Patient’s name,

Rank/Rate,

SSN,

Unit,

Date/Time of collection,

Tests.

Question 77

Aviation Mishap Investigation Procedures:

When getting specimens, what shouldn’t you use?

Answer 77

Do not use alcohol swabs when obtaining specimens.

Question 78

Aviation Mishap Investigation Procedures:

Remember that the specimens you have drawn will be part of an investigation into the causes of the aircraft mishap,

____ ____ ____ must be maintained for all the specimens you’ve drawn?

Answer 78

Chain of Custody.

Question 79

Over-the-Counter Drugs:

Commonly used medications are also referred to as what?

Answer 79

“Over-the-Counter” drugs.

Question 80

Over-the-Counter Drugs:

The majority of OTCs can be retrieved without a what?

Answer 80

Prescription from a provider.

Question 81

Over-the-Counter Drugs:

Because of the possibility of adverse side effects and unpredictable reactions,

The use of over-the-counter drugs by flight personnel is what?

Answer 81

Prohibited,

Unless specifically approved by a flight surgeon

Question 82

Over-the-Counter Drugs:

Ground support personnel shall be briefed on what?

Answer 82

The hazards of self-medication and should be discouraged from using such drugs.

Question 83

Over-the-Counter Drugs:

The effects that “Over-the-Counter” medications may have on an individual, may require the need for what?

Answer 83

Medical assistance.

Question 84

Over-the-Counter Drugs:

In addition, the symptoms of the effects of OTC, may not be what?

Answer 84

Apparent,

Until the individual is screened by qualified medical personnel,

With the necessary diagnostic equipment.

Question 85

Over-the-Counter Drugs:

Under no circumstances will an aircrew member be issued a clearance notice while on what?

Answer 85

Medication,

Without concurrence from a flight surgeon.

Question 86

Over-the-Counter Drugs, Effects, and Symptoms:

Asprin?

Answer 86

Affects the regulation of body temperature by acting on the hypothalamus,

Generates greater heat loss due to an increase in blood flow to the extremities and an increase in sweating,

Affects the acid-base balance of the body
Causes a variation in the rate and depth of respirations.

Question 87

Over-the-Counter Drugs, Effects, and Symptoms:

Nasal Decongestants?

Answer 87

Insomnia,

Fatigue,

Headaches,

Diarrhea,

Prolonged use increases blood pressure and pulse,

Dizziness,

Confusion,

Drowsiness,

Amnesia,

Possible depression

Dry mouth,

Euphoria,

Decreased accommodation (inability to focus),

Tachycardia,

Diplopia (double-vision),

Lassitude (weariness),

Tremors,

Nausea/Vomiting,

Decreased coordination,

Gastrointestinal effects.

Question 88

Over the-Counter Drugs, Effects, and Symptoms:

Cough Drops?

Answer 88

Depression of the CNS (Central Nervous System)

With high doses decreases reaction time.

Question 89

Over the-Counter Drugs, Effects, and Symptoms:

Throat Lozenges?

Answer 89

Local allergic reactions are not uncommon,

Can result in decreased air,

Can result in rapid swelling of the oral pharynx and respiratory tract.

Question 90

Over-the-Counter Drugs, Effects, and Symptoms:

Petroleum Jelly-Based Products?

Answer 90

Becomes crusty when exposed to 100% O2,

Can cause discomfort with O2 masks during flight.

Question 91

Over-the-Counter Drugs, Effects, and Symptoms;

Petroleum Jelly-Based Products?

Answer 91

Becomes crusty when exposed to 100% O2,

Can cause discomfort with O2 masks during flight.

Question 92

STATE the physiological effects of prescription drugs on flight safety:

The adverse effects of many self prescribed “over-the-counter” type medications,

As well as many drugs dispensed by prescriptions,

Have long been recognized as detrimental to what?

Answer 92

Flight safety,

Aircraft accidents caused by such medications have been documented,

Other complications unique to flying are inherent in many disease entities and treatment regiments.

Question 93

STATE the physiological effects of prescription drugs on flight safety:

It is necessary to assure that all flight personnel are what?

Answer 93

Physically qualified while engaged in flight operations.

Question 94

STATE the physiological effects of prescription drugs on flight safety:

NATOPS on Prescribed Drugs:

Taking drugs prescribed by competent medical authority shall be considered sufficient cause for recommendation of what?

Answer 94

Grounding unless their use is specifically approved by a flight surgeon.

Question 95

STATE the physiological effects of prescription drugs on flight safety:

NATOPS on Prescribed Drugs:

Taking drugs prescribed by competent medical authority shall be considered sufficient cause for recommendation of grounding,

Unless their use is specifically approved by a flight surgeon,

Or a waiver for specific drug use has been granted by who?

Answer 95

CHNAVPERS,

Or,

The Commandant of the Marine Corps.

Question 96

STATE the physiological effects of prescription drugs on flight safety:

Consideration shall be given to the removal of ground support personnel from critical duties,

For the duration of what?

Answer 96

The drug effects, if appropriate.

Question 97

STATE the physiological effects of prescription drugs on flight safety:

Medications such as antihistamines, antibiotics, tranquilizers sleeping pills, etc., shall be discarded if all are not used during what?

Answer 97

The period of medication.

Question 98

STATE the physiological effects of prescription drugs on flight safety:

ARWG on Medications:

In general, all medications require what?

Answer 98

Temporary grounding,

Unless specifically described as NCD for flight duties in the Aeromedical Reference and Waiver Guide (ARWG),

Chapter 18, Medications; you may contact the Naval Aerospace Medical Institute (NAMI), Code 342, if further guidance is needed.

Question 99

STATE the physiological effects of prescription drugs on flight safety:

Antibiotics:

Aviation personnel on approved antibiotics may be considered for what?

Answer 99

An “Up Chit” prior to the completion of the course of therapy,

As long as the condition being treated has resolved in all significant aspects with no adverse reaction that might compromise safety of flight or mission completion.

Question 100

DD Form 2992: Medical Recommendation
for Flying or Special Operations Duty:

Form Completion?

Answer 100

Date,

From: Medical Facility,

To: PTS Commanding Officer,

Name: PTS Name,

SSN: PTS SSN,

Rank: PTS Rank,

HR LOC: Location of the PTS Health Record,

Recommended subject individual be temporarily suspended from duty involving Flight due to (check box),

Failed Check-In/Annual Physical Exam,

Aircraft Mishap Evaluation,

Place on Sick/Ground List,

Other/Diagnosis,

Disposition (check box),

Hospitalized,

Sick in Quarters/No Duty,

May Participate in Non-Flying Duties,

May Participate in Simulator Training,

Expended Duration of Grounding (# of days),

Signature of Provider.

Question 101

DD Form 2992: Medical Recommendation
for Flying or Special Operations Duty:

Form Completion?

Answer 101

Date,

From: Medical Facility,

To: PTS Commanding Officer,

Class 1: Aviation Personnel Engaged in the Actual Control of Aircraft,

SNA: Student Naval Aviator,

SGI: Aviators Qualified for Unlimited or Unlimited or Unrestricted Flight Duties,

SGII: Aviators Restricted from Shipboard Aircrew Duties Except Helicopter,

SGIII: Aviators Restricted to Operating Aircraft Equipped with Dual Controls and Accompanied on all Flights by a Pilot or Copilot of Medical Service Group 1 or 2,

CLASS 2: Aviation Personnel not engaged in Actual Control of Aircraft, including Naval Flight officers, Technical Observers, Navy Flight Surgeons, Aerospace Physiologists, Naval Aircrew Members, and Other Persons ordered to Duty involving Flying,

Expiration Date of Clearance,

Clearance will expire on Due Date of the Member’s Next Annual Physical Exam which is normally the last day of the Member’s Birth Month,

It may also expire for other reasons such as a Temporary Clearance to allow a student to complete “Dunk Tank” Training.