AeroMedical Factors - 항공 의학

A. How to obtain an appropriate medical certificate (standards; Part 67 Requirements and exceptions; part 61)
a. Medical certificates are required for most pilots except for sports pilots, gliders, and balloons to exercise their privileges

b. If no medical is required then they must write down that they have no known serious conditions that would prohibit them from exercising their pilot privileges.

c. The steps to make a medical
Fill out an application on Medxpress
Select an aviation medical examiner (AME) in your area.
At the appointment, the doctor will test out your:
Eye, hearing, mental, physical, and urine
For a complete list, refer to 14 CFR part 67
Once you pass then they will give you your medical on the spot

B. How to obtain a medical certificate in the event of a possible medical deficiency(67.401)
a. If you get denied, you can appeal to a federal medical examiner to prove that you can perform the duties for the medical certificate class you apply for.
  1) If you successfully persuade them to give you during a medical flight test, they can issue a  special issuance of medical certificates(authorization).
  2) The pilot takes the authorization to a local FSDO for a special medical flight test
  3) If you successfully complete the flight test, the medical certificate will be issued alongside with the authorization
    -This special issuance has an expiration date and must be renewed.
    - Issued for conditions that can be progressive.
  4) The surgeon can also issue a statement of demonstrated ability (SODA).
    - Lasts forever.
    - For conditions that are static or non-progressive like no limb
    - They still have to perform a medical flight test.

C. Hypoxia: The state of your body when there is a lack of oxygen
a. Hypoxic hypoxia: When the body is oxygen-deprived due to just a general lack of oxygen due to altitude or blocked airways.
b. Hypemic hypoxia: Lack of oxygen because the blood cannot transport the oxygen because there is no oxygen molecules in the blood due to loss of blood, blood donation, or when a person is anemic.
c. Stagnant hypoxia: Oxygen deprivation due to poor blood circulation due to artery blockages, cold, or pulling too much Gs.
d. Histotoxic hypoxia: Oxygen deprivation due to the cells not able to use oxygen properly due to drugs, alcohol.
e. The symptoms of Hypoxia include euphoria, lack of coordination, impaired judgment, blue fingertips, headaches, slurred speech, visual impairment, numb, tingling.
f. The corrective action includes: using supplemental oxygen, descending to a lower altitude

D. Hyperventilation: When the body has an excessive rate and depth of respiration which leads to too much loss of carbon dioxide in the blood.
a. It is caused by stress or flying at high altitudes without supplemental oxygen.
b. The symptoms can include lightheadedness, heavy breathing, headache, lack of judgment, unconsciousness, visual impairment, muscle spasm, tingling, and hot and cold sensations.
c. To relieve symptoms: blow into a bag, calm down, breathe slowly.

E. Middle ear problems: Ear pain and temporary reduction in the ability to hear due to difference differences from the outside and the ear cavity.
a. Due to the middle ear’s inability to equalize with the outside air pressure because the Eustachian tube might.
b. During descents (ascents), the middle ear has higher (lower) pressure while the outer ear has lower (higher), so this is where the slight difference in pressure comes from.
d. Colds, ear infections, and sore throats create congestions and swellings which prevents the eustachian tubes to be able to equalize the pressure.
d. The remedy is to force air into the tubes by pinching your nostrils and blowing gently into the mouth and nose. Yawning, chewing and using nasal spray work

F. Sinus problems
a. Air pressure in the sinuses is equalized through openings that connect the sinuses to the nasal passages.
b. Upper respiratory infections, colds, or sinusitis can produce enough congestion around an opening to slow the equalizations.
c. Differences in pressure between the sinuses and the cockpit will create blockages which will lead to pain over the sinus area, toothache, or bloody mucus.
d. The way to prevent this is to not fly when you have a respiratory infection or a cold and to descend slowly if you are flying.

G. Spatial disorientation: When the body is not oriented with the attitude and position of the aircraft.
a. The body has three ways to sense position
 - Visual system: Uses the eye to sense your position in space.
 - Somatosensory system: Uses the skin, muscles, and joints  to sense our position based on gravity, hearing, and feeling.
 - Vestibular system: uses the organs in the inner ear to sense position by the way we are balanced.  
b. Causes of spatial orientation include going into IMC conditions, bad weather, stress, lack of experience with instrument flying.
c. Prevention includes: trusting the instruments, maintaining VMC, getting an instrument license, better weather preparation, don’t fly, fly with an instrument pilot, avoid sudden attitude movements, physically tuned.

H. Vestibular illusions
a. The leans
After a prolonged and gradual turn, the pilot abruptly rolls out to level flight leads to the feeling that he has overbanked in the opposite direction which makes him want to correct the turn by turning to the original direction.
b. The Coriolis illusion
During a prolonged and gradual turn, the pilot moves his abruptly moves his head and makes the illusion that the plane’s attitude has changed dramatically so he will maneuver the plane to a dangerous attitude in an attempt to correct the aircraft’s perceived attitude.
c. Graveyard spiral
 - During a prolonged turn, the pilot rolls out suddenly which makes the illusion of turning in the opposite direction and tries to correct by turning back to the original direction. The pilot then thinks he needs to pull up since the plane tends to lose altitude while turning. So now he is in a spin since he is actually not in level flight and now is pulling up.
d. Somatogravic illusion: When the airplane accelerates suddenly, the pilot’s head nods up making an illusion of a nose-high and he will react by pushing the nose down.
e. Inversion illusion: When the plane in a nose-high attitude suddenly levels off and creates a backward tumbling effect which makes the illusion of a nose-high attitude so the pilot will pitch down.
f. Elevator illusion: Updrafts will make the pilot think the plane is in a nose-high attitude and responds by lowering the nose.
g. False horizons: Upsloping cloud and obscured horizon with city lights and stars will make the pilot confuse on which is the horizon.
h. Autokinesis: When a pilot focuses on a lighted object at night, it will start to move.

I. Motion sickness: When the brain is receiving conflicting messages and is confused on the state of the body.
a. Causes include turbulent flight, initial flights, anxiety and stress.
b. The symptoms are vomiting, headache, nausea, dizziness, and discomfort.
c. Looking outside, getting fresh air, getting attitude changes, shorter flights, and calm flights can relieve symptoms.
J. Carbon monoxide poisoning: When the body intakes too much carbon monoxide which will prevent hemoglobin from sending oxygen to the body cells.
a. The main cause is that there is a leak in the exhaust system which heats the air for the cabin.
b. The symptoms are similar to hypoxia and can lead to unconsciousness, delayed reaction, and uncoordinated.
c. Opening the air vents and using supplemental oxygen and terminating the flight is required to relieve the symptoms.

K. Fatigue: There are two types of fatigue that can lead to pilot errors.
a. Acute fatigue is short term and is normal especially after a strenuous effort, excitement or lack of sleep, mild hypoxia. Sleep, a good diet can cure this condition.
b. Chronic fatigue extends over a long period of time with psychological roots. It is caused by continuous high-stress levels. The symptoms can weakness, irritability, headache, pains throughout the body, intestinal problems, and emotional illness. Pilots need to consult a doctor.

L. Stress: The body’s reaction to physical and psychological demands placed upon it.
a. A stressor is any element that causes someone to experience stress and can include noises, work, or fatigue.
b. The symptoms include an increase in metabolism, widening of the eyes, and faster heartbeat.
c. People can cope with acute stress by triggering their fight or flight response.
d. Chronic stress prevents an intolerable burden and exceeds the ability of the person to cope with it.
e. People should consult a doctor.

M. Dehydration: A critical loss of water from the body.
Hot flight decks and flight lines, wind, humidity, and diuretic drinks cause it.
Common signs are headache, fatigue, cramps, sleepiness, heatstroke, and dizziness.
Drink two to four quarts a day and continuously drink enough fluids.
Limit intake of caffeine and alcohol
Keep flight deck cool

N. Alcohol
a. Impairs the efficiency of the human body and reduces the chances of completing a flight.
b. Impairs judgment, decrease sense of responsibility, affect coordination, constrict visual field diminish memory, reduce reasoning ability, and lower attention span.
c. Altitude multiplies the effect of alcohol on the body.
d. Flying while hungover is still under the influence.
e. No drinks eight hours before a flight.
f. Cannot have blood alcohol content over .04

O. Drugs
a. Part 61.53 prohibits acting as PIC or as a required crew while that person knows or has reason to know of any medical condition that would make that person unable to meet the requirement for the medical certificate for the pilot operation or is taking medication or receiving treatment for a medical condition that prevents him from meeting the requirements for the medical certificate necessary for the pilot operation
b. Part 91.17 prohibits the use of any drugs that affect the person’s faculties in any way contrary to safety.
c.All medications have some side effects and some drugs have different effects when taken at altitude.
d.Drugs can impair judgment, decision-making skills and performance. They can increase drowsiness, reduce alertness, and increase the chance of hypoxia.
e.Ask the AME.
f. IMSAFE checklist, don’t take unnecessary medications, eat balanced meals, maintain hydration, stay fit, and sleep well.

P. Nitrogen excess incurred during scuba diving
a. Scuba diving subjects the body to increased pressure, which allows more nitrogen to dissolve in body tissues and fluids.
b. If you ascend too fast the nitrogen can form bubbles in your blood (Just like when you open a bottle of coke.)
c. The recommended waiting time before going to flight altitudes of up to 8,000 feet is at least 12 hours after diving that does not require controlled ascent (nondecompression stop diving), and at least 24 hours after diving that does require controlled ascent (decompression stop diving). The waiting time before going to flight altitudes above 8,000 feet should be at least 24 hours after any scuba dive.