Review and recommends disposition of flying duty medical examinations and medical waivers for continued flying duty.

Transcription

1 What does the US Army Aeromedical Activity (AAMA) do? Review and recommends disposition of flying duty medical examinations and medical waivers for continued flying duty. What are Flight Surgeons (FS) considered to be? Physicians are considered to be rated crewmembers, NOT rated aviators. Flight Surgeons, Aeromedical PA s and Nurse Practitioners are responsible for what? Clinical and preventive medicine, unit readiness, staff function, clinical support Aeromedical psychologists are responsible for what? Clinical consultations and support to flight surgeons, consultatnt to commanders, education and training. What is the primary goal of Aviation Medicine Program? Preventative medicine services There are two broad categories of the Flying Duty Medical Examination (FDME). What are they? A. Initial FDME (class 1-4) accession purposes. Good for 18 months B. Comprehensive FDME (class 2-4) every 5 years < 50 years old then annually. Good for 12 months expiring on the last day of the soldiers birth month What is the requirement for a flight student s status to change from class 1 to 2 of FDHS? The physical must be completed by the last day of the birth month after the soldier completes flight school. However, the soldier may take the examination within a threemonth period preceding the end of the birth month. Ex. Q: If your B-day is Jan 20 th, what month/date can you begin to take the exam? A: November 1 st. What form is the Medical Recommendation for flying duty? DA Form 4186 or UPSLIP -An official document used to notify the aviation commander of the initial recommendation for certification of medical fitness for all classes of military and civilian aviation personnel.

2 Who is the final approval authority for the form in question #6? Unit Commander - may agree or disagree. -Remember UNIT Co. What is a temporary disqualification and what is it likely to result in? Imposed by the FS/APA for a temporary aero medical disqualifying condition, that are minor, self-limited and likely to result in re-qualification within 365 days. What are the temporary restrictions due to exogenous factors? Medications, Anesthesia, Dietary supplements, alcohol (12 hrs), immunization, tear gas exposure, blood or plasma donations, altitude chamber, diving, tobacco smoking, strenuous sporting activities, simulator sickness (12 hrs), centriguge runs (6 hrs) What is a medication under class 1 IAW AR40-8 that may be used without a waiver? Protein supplements, antacids, artificial tears, aspirin/acetophetomine, cough syrup, decongestant, pepto bismal, multiple vitamins, nasal sprays, Metamucil, throat losenges How many classes are under Herbals and Dietary Supplements? Class 1, Class 2, and Class 3 Which class of Herbal Supplements may be used without approval of a FS/APA? CLASS 1 -- most water soluble Which class may be used only with prior approval of the FS/APA? CLASS 2 What is an essential component of the Army Aviation Medicine Program? Occupational Medicine -- do not confuse this for the PRIMARY purpose of the Army Aviation Medicine Program (which is Preventative medicine services) What are the three types of hazards? Physical, Chemical, Biological What is exposure?

3 The actual contact of the harmful substance with the biological organism What is the exposure of an agent over a short period of time that can cause adverse health changes? Acute Exposure Route of Entry Principle: What are the 3 principle ways a toxin can enter the body? 1. Inhalation 2. Absorption 3. Ingestion What are the physiological principles related to toxins? Metabolism slows with age, amount of body fat, genetics What are the environmental principals related to toxins? Atmospheric pressure, temperature, humidity What is a product of incomplete combustion? Carbon Monoxide You re using JP8, what is toxic about it? Carbon monoxide What are the three protective measures needed to prevent or reduce toxic substance exposure? 1. Individual 2. Cockpit 3. General What are the four safety features provided by an aircraft? 1. Structural shell - prevent intrusion of structure in the occupiable living space 2. Landing gear and crashworthy seats 3. Personnel restraint system 4. Post-crash factors - crashworthy fuel systems, self sealing fuel cells, break free self sealing fuel lines, and fire extinguishing systems

4 Which one of the safety features are essential for survival? (Structural Shell) PROVIDED AN OCCUPIABLE LIVING SPACE What is an example of a safety feature of the aircraft? BREAK RESISTANT FUEL LINES (Post-crash factors) What are the ONLY 3 types of material that ARE allowed for underwear? COTTON WOOL NOMEX = flame resistant Can the three types of underwear material be combined? YES What MAY be used in the rinse cycle to remove body oils? FABRIC SOFTENERS What setting can you IRON the NOMEX flight suit and at what temperature? PERMANENT PRESS MEDIUM TEMPERATURE What temps can you wash flight suits and NOMEX? Flight suits < 180 NOMEX < 120 degrees What can you NOT wear on your flight suit? Metal Badges Define acceleration The rate of change of velocity with respect to time. What are the factors that determine the effects of acceleration on the human body? (BIRDI) Body Area and site Greater area = lesser effects Intensity increases effect

5 Rate of onset increases effect Duration -- increases effect Impact direction increases effect Define Inertia The resistance to a change in the state of rest or motion. What are low magnitude accelerations? G s that range from 1 to 10 G s and last for several seconds What are the factors that reduce the overall efficiency of the body, especially the circulatory system, to withstand G s called? Decremental factors What are the factors that enhance the ability of the body to withstand G-forces called? Incremental factors Name a criteria that occupant survivability is contingent upon during an accident? Occupiable living space: Two objects cannot occupy the same space What are aircraft design features that enhance crash survivability? (CREEP) Container Restraint System Encironment Energy Absorption Post Crash Factors is the mechanical radiant energy that is transmitted by pressure waves. Sound, longitudinal Noise is a that is,, or. Sound, loud, unpleasant, unwanted

6 4 NOISE effects are: 1. Annoyance 2. Fatigue 3. Speech Interference 4. Hearing loss True or False? Noise has measurable characteristics. TRUE What are the three measurable characteristics of NOISE? F.I.D Frequency Intensity Duration What is Sensorineural hearing loss? The cochlea is damaged (permanent hearing loss) What are the three types of stressors? Psychosocial stressors Cognitive Stressors Physiological stressors In Army aircraft, the overall noise levels are generally equal to or exceed what? 100 db What is Amplitude? The maximum displacement of an object from its position at rest What are the three components of VIBRATION? F.A.D

7 Frequency Amplitude Duration What are the short-term effects that vibration can cause? FCMDR- (flight commander) Fatigue Circulatory effects Motion sickness Disorientation Respiratory effects What are some long term effects of vibration? Raynauds disease Bachache/back pain Kidney/lung damage What are the physical divisions of the atmosphere? Troposphere - Extends to an Alt. Of 30,000 ft. at the poles and 60,000 ft. at the equator Tropopause boundary between troposphere and stratosphere Stratosphere tropopause to about 50 miles upward. Constant -55 degree C temp Ionosphere end of stratosphere upward to 600 miles Exo sphere end of ionosphere to about 1200 miles (true space) What are the three physiological zones of the atmosphere and at what altitudes? 1. Efficient Zone: Sea level to 10,000 ft. 2. Deficient Zone: 10,000ft. To 50,000 ft. 3. Space Equivalent Zone: Above 50,000 ft. Which physiological zone is lethal to humans? Space equivalent zone What is the standard sea level atmospheric pressure? 760mm/Hg (reduces by half at 18,000 ft)

8 What are the substances that make up the mixture of air? Nitrogen 78% Oxygen 21% Other 1% What are the functions of the circulatory system? Transport O2 and nutrients to cells Transport metabolic wastes to organ removal sites Assists in temperature regulation What are the components and functions of blood? Plasma transports CO2 in blood White Blood Cells fights infection Platelets aid in blood coagulation Red blood Cells (RBCs or erythrocytes) transports nearly 98.5% of all O2 in blood What are the functions of respiration? Provide O2 to cells Remove carbon dioxide from cells Assist in maintaining body temperature Assist in maintaining body acid-base balance What are the two phases of external respiration? Active - inhalation Passive - exhalation What are the four types of hypoxia? 1. Hypemic caused by anemia and blood loss 2. Stagnant - varicose veins, pooling of blood 3. Histotoxic interference with use of O2 by tissues usually due to poisons 4. Hypoxic - insufficient O2, partial pressure (most likely to be encountered at altitude) What are the four stages of hypoxia? (like ACDC)

9 1. Indifferent 2. Compensatory 3. Disturbance 4. Critical Which of the four stages of hypoxia is the most dangerous and kills the most soldiers? Indifferent What is the only significant effect of mild hypoxia at the indifferent stage? Night vision deteriorates at about 4,000ft. is an and of respiration leading to abnormal loss of from the blood. Hyperventilation, excessive rate, depth, CO2 What is the difference between signs and symptoms? Symptoms are observable by the individual and signs are observed by the crew members Distinguish the difference between hyperventilation and hypoxia. A. Above 10,000 ft. is. B. Below 10,000 ft. is. A. Hypoxia B. Hyperventilation Your co-pilot has pain in one tooth, what is it and what do you do? Barodontalgia (trapped gas disorders of the teeth). Land and seek dental care. What occurs as pressure decreases and gases dissolved in the body fluids are released as bubbles? Evolved Gas Disbars (decompression sickness) What are the primary symptoms Skin Manifestations where N2 bubbles are trapped under the skin?

10 Paresthesia which is a tingling and itching, reddish discoloration (occurs to the skin) What are the components of the human eye and their functions? 1. Cornea - protective tissue located over front of eye 2. Iris - regulates the amount of light entering the eye by adjusting pupil 3. Pupil - Center of iris, allows light to enter eye 4. Retina - contains the rod and cone cells - permit us to see What are the four common visual deficiencies? 1. Astigmatism 2. Myopia 3. Hyperopia 4. Presbyopia Which one of the four common visual deficiencies occurs with natural aging process? Presbyopia What occurs when the natural aging process causes the lens to harden and lose its elasticity? Presbyopia What are the four terms associated with spatial disorientation? 1. Vertigo 2. Sensory illusion 3. Spatial disorientation 4. Orientation or equilibrium What are the different Monocular Cues? 1. Geometric Perspectives (LAV) Linear Perspective, Apparent foreshortening, vertical position 2. Retinal Image Size (KITO) Known size, Increasing/Decreasing size, Terrestrial assoc, Overlapping 3. Arial Perspective 4. Motion Parralax

11 The sensory inputs that provide orientation and equilibrium are the,, and. Visual, vestibular and proprioceptive systems What is the most important bodily sense of orientation? Vision Role of visual cues: Orientation by vision requires what 3 things: R.I.P. Recognition Identification Perception What are the different visual illusions? False Horizon Fascination/Fixation Flicker Vertigo Confusion with Ground Lights -- Gives the aviator a false horizon thus descending Relative Motion Altered Planes of Reference wrong reference point Structural Illusions Height/Depth Perception Crater Illusion Size-Distance Autokinesis when a static light appears to move after staring at it for several seconds Reversible Perspective at night an aircraft may appear moving away instead of approach What visual confusion occurs when an aviator mistakes ground lights for stars? Confusion with ground lights What illusion promotes the aviator to place aircraft in an unusual attitude? confusion with ground lights What three major reasons make the function of the vestibular system extremely important? VOR (v for vestibular) 1. Visual tracking

12 2. Orientation in the absence of vision 3. Reflex information What are components of the vestibular system? Semicircular canals Otolith organs What are the three types of Vestibular illusions? The leans -- turning in wrong direction without knowing it Graveyard Spiral difficulty maintain straight flight after continuous curve Coriolis illusion rapid movement while feeling weightless What is the most dangerous vestibular illusion? Coriolis illusion What proprioceptive mechanism is unreliable in the absence of vision while in flight? Seat of the pants flying What type of spatial disorientation is the most dangerous and why? Type 1 (unrecognized) is the MOST DANGEROUS because the pilot doesn t perceive any indications of spatial disorientation. What are the 3 dynamics of spatial disorientation? 1. Visual dominance 2. Vestibular suppression 3. Vestibular opportunism How do you prevent spatial disorientation? Learn instruments What is the definition of sleep inertia. Sleep inertia is the short term grogginess experienced right after awakening. What are the factors that influence your sleep cycle.

13 (METAL) Medication Environment Timing of sleep Age Level of fatigue What is the best fatigue countermeasure. Strategic Napping What are the countermeasures for shift lag Reduce mental demands on night flights Minimize administrative duties after the shift Implement shorter continous periods at the controls Maximize every sleep opportunity Determine if circadian readjustment is neccessary Ensure the crew double checks everything.