Aeromedical (Private Pilot)

Medical Certificate

FAA Airman Medical Certificate is required for all pilots including student pilots to carry a medical certificate at all times, which allows the pilot to act as pilot in command (PIC) of an airplane.

During the medical examination, the AME is an FAA approved medical physician, which will test your vision, hearing, general health, cardiovascular, and have the applicate do a drug test. In addition, the AME will determine if the pilot applicate has any other conditions that will make the pilot incapacitated during flight.

Special Issuance:

A statement of Demonstrated Ability (SODA) is a wavier for individuals with a static defect that cannot be changed. Examples for a SODA is for a person that maybe blind in one eye, upper or lower limb amputees.

More details on medical certificates see the Certificates and Documents lesson

 

4 Types of Hypoxia

Hypoxia means the lack of oxygen to any bodily tissue or the brain. Hypoxia can be caused by several different affects such as; the insufficient supply of oxygen, inadequate transportation of oxygen to the bodies tissues.

Hypoxia can be very dangerous to pilots, if any reduction in metal function occurs, and can be life-threatening. Pilots need to be aware of the types of hypoxia, there cause, and there symptoms.

There are four types of hypoxia:

Hypoxic Hypoxia:

Hypoxic hypoxia is insufficient or not enough oxygen to the whole body. A common cause is the partial pressure of oxygen at higher altitudes. As an aircraft ascends there are few air molecules available at the pressure required, these results in the body being unable to inhale in enough oxygen. 

Hypemic Hypoxia:

Hypemic means that there is not enough blood. This happens when the blood in the body is unable to transport enough oxygen to the cells in the body or the brain. This can happen due to a few different factors, such as: a blood disease like anemia or from severe bleeding, as well as donating blood.

One of the most common forms of hypemic hypoxia is from carbon monoxide (CO) poisoning. 

Stagnant Hypoxia:

Stagnant basically not flowing or moving.  The oxygen enriched blood in the lungs is flowing to the bodies’ tissues or brain.  An example of stagnant hypoxia is when your arm or leg goes to sleep, because the blood flow was stopped.

Stagnant Hypoxia can occur during rapid acceleration of gravity or pulling G-forces (G’s). When a pilot (fighter pilots) is pulling G’s, the blood in the body is forced to the lower extremities and is unable to flow to the brain, causing a pilot to pass out.

Histotoxic Hypoxia:

“Histo” means tissues or cells and “toxic” means poisonous. This type of hypoxia is caused by the tissues or the brain rejecting the oxygen, due to the use of alcohol or drugs, (in the case of aviation, proscription drugs). It is very important that pilots avoid alcohol and or any proscription drugs prior to flight.

Hypoxia Symptoms:

Symptoms of hypoxia very with each individual, commons symptoms are:

  • Cyanosis or the bluing of fingernails or finger tips and lips.

  • Headaches

  • Vision impairment

  • Impaired judgment

  • Drowsiness

  • Lightheaded or dizziness

  • Numbness, tingling in fingers and toes

Types of Corrective Actions:

  • Descend to a lower altitude

  • Use approved aviation oxygen mask

 

Hyperventilation

Hyperventilation is the excessive rate and heavy deep breathing, leading to the loss of carbon dioxide from the blood. This condition is more frequent in pilots, when they encounter an unexpected stressful situation.

Symptoms of hyperventilation is very similar to those of hypoxia. If using supplemental oxygen, check to make sure the flow rate is correct, and the symptoms are not hypoxia related.

Common symptoms of hyperventilation are:

  • Vision impairment

  • Unconsciousness

  • Lightheaded or dizziness

  • Tingling sensations

  • Hot and cold sensations

  • Muscle spasms

To treat hyperventilation, we need to restore the proper amount of carbon dioxide in to the body. The best prevention and cure is to breathe normally. Also, breathing in to a paper bag or talking out load, helps to cure hyperventilation. 

 

Middle Ear & Sinus

During climbs and descents, gas in the body expands due to the pressure difference between the air from outside of the body and within the body. Pressure differences between the middle ear and the outside are equalized by a tube leading from the inside of each ear to the back of the throat on each side, this is called the Eustachian tube.

If the gas is unable to escape, the pressure builds up in the cavities and becomes painful. Trapped gases that expands, causes the ear pain and sinus pain, and a temporary reduction in being able to hear.

Some ways to clear or equalize the pressure in the middle ears is to try yawning, chewing, or even swallowing. If that doesn’t work try pinch the nostrils shut, close the mouth and lips, and blow slowly and gently into the mouth and nose.

Upper respiratory infection from a cold or an allergic condition can slow the equalization in the sinuses. Just like the middle ear, it is also caused by the pressure differences between the sinuses and the flight deck. A sinus block occurs in the frontal sinuses above the eyebrows, or in the maxillary of the upper cheeks.

Avoid flying with an upper respiratory infection or nasal allergies. If sinus congestion or blockage does not clear after landing, consult a physician. Sinus blockage mostly occurs during descent, and can be painful. To help reduce the pain, try to make a slower descent. 

Pilots should be aware that decongestant medicines’ have side effects that can impair a pilot’s performance. 

 

Spatial Disorientation

Spatial Disorientation means the lack of orientation in regard to position, altitude or any movement of the aircraft. There are three systems, the body uses together to ascertain orientation and movement.

  • Vestibular – organs in the inner ear that sense position, by the way we are balanced.

  • Somatosensory – nerves in the skin, muscles, joints and hearing sense position by gravity, feeling along with sounds.

  • Visual – using the eyes to sense position by sight.

During visual meteorological conditions (VMC) flight, pilots use their eyes which are the major orientation source. But, when flying in instrument meteorological conditions (IMC), the visual cues are removed which gives false sensations.

Inside of both the left and right inner ear is the vestibular system, which allows pilots to sense movement in the surrounding environment. There are three semicircular canals are positioned at approximate right angles to each other. Inside are tiny hairs that deflect when acceleration in any direction, which sends a message to the brain.

When there is visual reference of the horizon and the ground the inner ear identifies the pitch, roll, and yaw movements of the aircraft. If for any reason visual reference of the horizon and ground are lost the vestibular system in the inner ear becomes unreliable.

If a pilot is not instrument rated or has many flight hours flying on instrument, it is best to avoid flight at night or in low visibility when the horizon is visible.

 

Leans

The leans is a common illusion that happens during flight, caused by a sudden return to level flight after a gradual or prolong turn that went unnoticed by a pilot. This happens when the human body is exposed to a shallow turn of 2 degrees per second or less, which is below the detection of the semicircular canals in the inner ear.

A pilot may lean in the direction of the turn, to correct the perception of vertical posture.

 

Runway Illusions

If flying in to an airport with a narrow-than-usual runway, which can create an illusion that the aircraft is at a higher altitude than it actually is. Pilot need to be aware of this illusion, to avoid flying a lower approach, which can have the risk of striking objects on short final such as, power lines, trees, poles, towers etc.

Up sloping runways and up sloping terrain, even both can give the illusion that the aircraft is at a higher altitude than it actually is. Pilots that do not recognize this illusion will fly a lower approach. Pilots should also be aware that down sloping runways and terrain have an opposite effect.

Thing a pilot can do to prevent landing errors caused by optical illusions:

  • Recommend to fly an aerial visual inspection of any unfamiliar airport prior to landing.

  • Always use either a Visual Approach Slope Indicator (VASI) or a Precision Approach Path Indicator (PAPI) when available.

  • Rely on your instruments and reference the altimeter frequently.

 

Motion Sickness

Also known as airsickness is caused by the brain receiving mixed signals about the state of the body. Usually student pilots will experience this on the first flight lesson, it will go away after a couple of lessons.

Some symptoms of motion sickness are: discomfort, nausea, dizziness, sweating, and vomiting.

 

TIP:

If you are prone to motion sickness, let the flight instructor know, he or she will give you a few techniques to overcome motion sickness.

Dramamine is not a good medication to take as a pilot, it can cause drowsiness.

 

Stress

It is the body’s response to physical and psychological demands. The body reacts to stress by increasing the blood sugar and blood pressure, heart rate, and breathing.

Some types of examples that can cause stress are; physical stress such as noise or vibration, physiological like fatigue, and work or personal stress.

Acute Stress:

Acute stress is short term, it is an immediate threat, it triggers a “fight or flight” in individuals.

Chronic Stress:

Chronic stress is long term stress, it is a level of stress that presents a burden, and exceeds the ability for an individual to cope with, causing his or her performance to fall sharply.

 

Fatigue

Fatigue is becoming more frequent in aviation, mainly pilots. Some of the effects of fatigue are; degradation of attention and concentration, impaired coordination and lack of communication.

Fatigue is very similar to stress by having two categories.

Acute fatigue:

Acute fatigue is also short term and is the type of fatigue that people face in everyday life, such as after a period of strenuous effort, excitement, or just lack of sleep.

Chronic fatigue:

Chronic fatigue is the type that last for an extended period of time. Continues high-stress levels are a cause of this type of fatigue.

 

Alcohol and Drugs

Alcohol:

Alcohol impairs the efficiency of the human body. When someone is intoxicated that means the amount of alcohol in the bloodstream. Intoxication is measured in a percentage by weight in the blood.

FAR Part 91.17, says that the blood alcohol level must be less than .04% and it has been over 8 hours since the last drink before piloting an aircraft. If the level is over .04% after an 8 hour period, pilots may not fly an aircraft, and pilots are not to fly if hungover.

A good way to remember that is, “8 hours bottle to throttle.”

Drugs:

FAR Part 61.53 and 91.17 prohibits the use of drugs that may affect the safety of an aircraft or person’s.

Simply put, it is illegal to act as pilot in command of an aircraft under the influence of drugs. Also it is not a good idea to fly, if using curtain proscription drugs prescribe by a doctor.

The FAA does not have a list of approved medications, suitable for use while flying. If the pilot is unsure about a certain prescribed medication and being able to fly, he or she should always consult a doctor.

 

Decompression Sickness (DCS) & Scuba Rule

Decompression sickness:

Decompression sickness is a condition when the body is exposed to rapid decompression of flying at high altitudes in an unpressurized aircraft. The nitrogen the bodies’ fluids and tissues come out of solution, resulting into forming bubbles in curtain areas of the body. One if the most common symptoms is joint pain, known as “the bends”.

Treating DCS:

  • Put on an approved oxygen mask and set regulator to 100% oxygen flow.

  • Emergency descent and land as soon as possible.

  • Seek medical attention immediately from an FAA medical office, aviation medical examiner (AME), military flight surgeon. (Note: a physician may not be familiar with aviation medicine)

 

Scuba Rule:

Aeronautical Information Manuel (AIM) states that if a pilot or passengers want to fly after scuba diving, they need to have sufficient rest time after a dive. To allow their body to rid of any nitrogen build up in their body during diving.

The recommended rest times are as follows:

  • Altitudes up to 8,000 feet MSL (measured sea level), you should rest for at least 12 hours after diving.  (No decompression stops)

  • Altitudes, 8,000 feet MSL and above, you should rest for at least 24 hours.

 

I'M SAFE Checklist

It is always a good idea to run an IM SAFE checklist prior to each flight.

  • Illness

  • Medication

  • Stress

  • Alcohol

  • Fatigue

  • Emotion/Eat

 

More details on the IM SAFE Checklist

 

References

Private Pilot ACS PA.I.H.K1 – PA.I.H.K3

PHAK FAA-H-8083-25 (Ch. 17) 

AIM 8-1-2(d) (Effective Dec. 31, 2020)

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