Hypoxic Not enough oxygen pressure Altitude, lack of O² in the body Hypemic Reduction of the O² carrying capacity of the blood Carbon monoxide poison, smoking Stagnat Decrease in circulation, pooling of blood Medical conditions, extreme G forces Histotoxic Interference with the use of O² by body tissues Alcohol, drugs, cyanide poison

ICDC Indifferent Sea level - 10,000 ft PA 98-90% O² Compensatory 10,000 - 15,000 ft PA 89-80% O² Disturbance 15,000 - 20,000 ft PA 79-70% O² Critical \> 20,000 ft PA \< 69% O²

Signs are objective - observed by others Hyperventialation Cyanosis Mental confusion Poor judgement Muscle incoordination

Symptoms are felt by the individual: Air hunger Apprehension Fatigue Headache Dizziness Hot/cold flahses Tingling Numbness Tunnel vision Blurred vision Belligerence Euphoria

Administer 100% O² Descend to altitude below 10,000 ft PA

Fire Fire Fire CRASH CARS F: _Fascination/fixation_ Task saturation, focused inside (fascINation) Target fixation (outside) and ignore orientation cues F: _False horizons_ Confusion of cloud formation with the horizon or ground F: _Flicker vertigo_ Blades interrupting direct sunlight at 4-20 cycles per second Flashing anti-collision lights, especially in the clouds C: _Confusions with ground lights_ Ground lights perceived as celestial lights or vice versa R: _Relative motion_ Falsely preceived self-motion in relation to motion of another object A: _Altered planes of reference_ Inaccurate sense of altitude, attitude, or flight path in relation to a large object that replaces the horizon (mountains/valleys) S: _Size/distance_ Misinterpretation of an unfamiliar object's size H: _Height/depth perception_ Due to lack of visual cues, perception that aircraft is higher than it actually is, lose sight of the ground C: _Crater_ Illusion that aircraft is landing in a hole or crater Created when searchlight is positioned too far under the nose A: _Autokinesis_ Static lights appear to move after staring at them for several seconds R: _Reversible perspective_ Aircraft appears to be going away when it is actually approaching S: _Structural_ Curvature of windscreen causes refraction of light rays

Somatogyral - semicircular canals _Leans_: failure to preceive angular motion _Graveyard spin_: equilibrium, no preceived motion _Coriolis illusion_: intense sensation of tumbling Most dangerous of all vestibular illusions Somatogravic - otolith organs _Oculogravic_: accel/decel = nose high illusion _Elevator_: vertical up/down = nose high illusion _Oculoagravic_: vertical down = nose low illusions

Aeromed Flashcards by Stephen Lee

Flight restrictions due to exogenous factors

C-C-ASIA-PHDS-A-B-PHDA

0 hours:
- C: CS exposure - no restrictions with no residual systemic or local effects
6 hours:
- C: Centrifuge runs
12 hours:
- A: Alcohol - as long as no residual effects remain
- S: Simulator sickness - restriction starts after full resolution of symptoms
- I: Immunizations
- A: Anesthesia - local, regional, dental
24 hours:
- P: Plasma donation
- H: Hypobaric chamber > 25K
- D: Decompression experience > 10K
- S: SCUBA diving
48 hours:
- A: Anesthesia - general, spinal, epidural
72 hours:
- B: Blood donation - 200cc or more
Requires Flight Surgeon or APA approval:
- P: Performance enhancers
- H: Herbal supplements
- D: Dietary aids
- A: All medications except OTC listend in APL

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Definition of hypoxia

Condition where the body lacks oxygen

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Types of hypoxia

Hypoxic
- Not enough oxygen pressure
  - Altitude, lack of O² in the body
Hypemic
- Reduction of the O² carrying capacity of the blood
  - Carbon monoxide poison, smoking
Stagnat
- Decrease in circulation, pooling of blood
  - Medical conditions, extreme G forces
Histotoxic
- Interference with the use of O² by body tissues
  - Alcohol, drugs, cyanide poison

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Stages of hypoxia

ICDC

Indifferent
- Sea level - 10,000 ft PA
- 98-90% O²
Compensatory
- 10,000 - 15,000 ft PA
- 89-80% O²
Disturbance
- 15,000 - 20,000 ft PA
- 79-70% O²
Critical
- > 20,000 ft PA
- < 69% O²

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Signs of hypoxia

Signs are objective - observed by others
- Hyperventialation
- Cyanosis
- Mental confusion
- Poor judgement
- Muscle incoordination

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Symptoms of hypoxia

Symptoms are felt by the individual:
- Air hunger
- Apprehension
- Fatigue
- Headache
- Dizziness
- Hot/cold flahses
- Tingling
- Numbness
- Tunnel vision
- Blurred vision
- Belligerence
- Euphoria

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Prevention of hypoxia

PUL

Pressurize the cabin
Use supplemental O²
Limit time at altitude

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Treatment of hypoxia

Administer 100% O²
Descend to altitude below 10,000 ft PA

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Definition of spatial disorientation

An individual’s inability to determine position, attitude, and motion relative to a point of reference, usually the surface of the earth.

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Definition of vertigo

A spinning sensation usually caused by a peripheral vestibular abnormality in the ear.

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Types of spatial disorientation

Type I: Unrecognized
- Most dangerous
Type II: Recognized
Type III: Incapacitating

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3 types of sensory systems

Visual
- Provides 80% of orientation
Vestibular
- Otolith organs: gravity, linear accel/deceleration
- Semicircular canals: angular acceleration, roll/pitch/yaw
Proprioceptive
- Sensors in joints, muscle, and skin
- Flying by “seat of your pants”

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Visual illusions

Fire Fire Fire CRASH CARS

F: Fascination/fixation
- Task saturation, focused inside (fascINation)
- Target fixation (outside) and ignore orientation cues
F: False horizons
- Confusion of cloud formation with the horizon or ground
F: Flicker vertigo
- Blades interrupting direct sunlight at 4-20 cycles per second
- Flashing anti-collision lights, especially in the clouds
C: Confusions with ground lights
- Ground lights perceived as celestial lights or vice versa
R: Relative motion
- Falsely preceived self-motion in relation to motion of another object
A: Altered planes of reference
- Inaccurate sense of altitude, attitude, or flight path in relation to a large object that replaces the horizon (mountains/valleys)
S: Size/distance
- Misinterpretation of an unfamiliar object’s size
H: Height/depth perception
- Due to lack of visual cues, perception that aircraft is higher than it actually is, lose sight of the ground
C: Crater
- Illusion that aircraft is landing in a hole or crater
- Created when searchlight is positioned too far under the nose
A: Autokinesis
- Static lights appear to move after staring at them for several seconds
R: Reversible perspective
- Aircraft appears to be going away when it is actually approaching
S: Structural
- Curvature of windscreen causes refraction of light rays

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Vestibular illusions

Somatogyral - semicircular canals
- Leans: failure to preceive angular motion
- Graveyard spin: equilibrium, no preceived motion
- Coriolis illusion: intense sensation of tumbling
  - Most dangerous of all vestibular illusions
Somatogravic - otolith organs
- Oculogravic: accel/decel = nose high illusion
- Elevator: vertical up/down = nose high illusion
- Oculoagravic: vertical down = nose low illusions

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Prevention of spatial disorientation

VVTS - FASH²

V: visual, maintain references
V: VMC or IMC, not both
T: trust the instruments
S: self, avoid stressors
- F: Fatigue
- A: Anxiety
- S: Smoking
- H: Hypoglycemia
- H: Hypoxia

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Treatment of spatial disorientation

DIRT

D: delay intuitive reaction
I: incorporate a good cross-check
R: refer to instruments
T: transfer controls

Physiological altitude: Smoking

Hemoglobin of RBCs has a 200-300 times greater affinity for carbon monoxide than for oxygen
Loss of about 20% night vision at sea level
Physiological altitude of 5,000 ft at sea level

Physiological altitude: Alcohol

Creates histotoxic hypoxia
1 oz. of alcohol can have physiological affect of 2,000 ft at sea level

Definition of fatigue

The state of feeling tired, weary, or sleepy that results from prolonged mental or physical work, extended periods of anxiety, exposure to harsh environments, or loss of sleep.
Boring or monotonous tasks may increase fatigue.

3 types of fatigue

Acute
Chronic
Motivational exhaustion (burnout)

Fatigue: Acute

Increased mental or physical activity between two periods of sleep
Being awake 12-15 hours can result in loss of coordination and awareness of errors
Signs/symptoms
- Inattention
- Distractibility
- Errors in timing
- Neglect of secondary tasks
- Loss of accuracy
- Loss of control
- Lack of awareness of error accumulation
- Irritability
Can be overcome with a regular sleep period

Fatigue: Chronic

More serious type of fatigue
Occurs over a longer period and is typically a result of inadequate recovery from successive periods of acute fatigue
Causes physical and mental exhaustion
Can result in social problems such as family or financial
Signs/symptoms
- Insomnia
- Depressed mood
- Irritability
- Weight loss
- Poor judgement
- Loss of appetite
- Slowed reaction time
- Poor motivation and job performance
May take several weeks of rest to overcome

Fatigue: Motivational exhaustion

Also referred to as “burnout”
Occcurs when chronic fatigue proceeds untreated for too long
Results in individual “shutting down”
Can’t function occupationally or socially

Definition of stress

The nonspecific response of the body to any demand placed upon it

Self imposed stressors

**DEATH** * **D**: Drugs * **E**: Exhaustion * **A**: Alcohol * **T**: Tobacco * **H**: Hypoglycemia

Self imposed stressors: Drugs

**SOAPS-C** * **S**: Self medication * Unwanted side effects from OTC medications * **O**: Overdose * Medications should be taken as prescribed * **A**: Allergic reaction * Exaggerated or pathological reaction to medicine * **P**: Predictable side effects * Desirable effects that accompany the medication * **S**: Synergistic effects * Undesirable effects from combining medications * **C**: Caffeine * Potential for negative effects if not used in moderation

Middle ear discomfort

* **_Ascents_**: as barometric pressure decreases during ascent, expanding air in the middle ear begins to push agains the eardrum, causing it to bulge out * Air escapes through the Eustachian tube, equalizing pressure * Complicated by respiratory infections * **_Descents_**: pressure changes within the ear may not occur automatically, increase in barometric pressure cause outside air to push eardrum inward * If pressure differential increases rapidly, Eustachian tube may be pushed shut, preventing pressure equalization * To attempt to equalize pressure, swallow, yawn, tense throat, or perform Valsalva maneuver * If pain continues and pressure can't be equalized, ascend to a level at which pressure can be equalized and commence with a SLOW descent * DO NOT valsalva during ascent (creates over pressure) * After landing, if pressure has not equalized, see flight surgeon

Physical responses of stress

* Increase in adrenaline * Sweaty palms * Increased heart rate * Trembling * Shortness of breath * Gastrointestinal distress * Muscle tension * Sleep problems * Increased blood pressure

Signs of stress

* Behavioral * Emotional * Cognitive (mental)

Types of stressors

* Cognitive * Mental approach to situations * Physiological * Physical state of health * Psychosocial * External things with emotional impact * Environmental * Physical stress placed on the body (weather)

Methods for coping with stress

* Minimize stressors (most powerful technique) * Change thinking * Learn to relax * Breathing techniques