This book is included in the Medical Specialties, Veterinary Medicine & Emergency Situations section.
UNITED STATES ARMY CORRESPONDENCE COURSE
AVIATION SUBCOURSE 593
AVIATION MEDICINE
CONTENTS
INSTRUCTIONS TO STUDENTS
INTRODUCTION
LESSON 1. AVIATION MEDICINE PROGRAM
General
Flight Surgeon Roles
Flying Restrictions
Medical Subjects for Safety Meetings
REVIEW EXERCISE
REVIEW EXERCISE SOLUTIONS
LESSON 2. NIGHT VISION IN AVIATION
General
Eye Structure
Eye Anatomy and Physiology
Night Vision Limitations and Capabilities
Meteorological Effects on Night Vision
Hazards to Night Vision
Preparing for Night Flight
REVIEW EXERCISE
REVIEW EXERCISE SOLUTIONS
LESSON 3. PERCEPTUAL LIMITATIONS
General
Perceptions
Depth Perception and Flight
Other Illusions and Flight
Overcoming Illusions
REVIEW EXERCISE
REVIEW EXERCISE SOLUTIONS
LESSON 4. SPATIAL DISORIENTATION
General
Mechanisms of Equilibrium
Spatial Disorientation and Visual Illusions
Spatial Disorientation and Vestibular Illusions
Spatial Disorientation and Proprioceptive Illusions
Prevention of Spatial Disorientation
Treatment of Spatial Disorientation
REVIEW EXERCISE
REVIEW EXERCISE SOLUTIONS
INTRODUCTION
Aviation medicine and vision are integral to any
aviation safety program. Understanding the requirements and capabilities of the
aviation medicine program will enhance safety training and safety performance.
Under-standing
the capabilities and limitations of night vision, perceptual limitations and
spatial disorientation will also facilitate aviation unit safety and safety
training.
Supplementary training material to be provided--none.
Material to be provided by the student--none.
Material to be provided by the unit or supervisor--none.
Supervision required--none.
Seven credit hours are awarded for successful completion of this subcourse.
Successful completion requires a grade of at least 70 percent on the
examination.
LESSON 1. AVIATION MEDICINE PROGRAM
TASK: To evaluate an
aviation medicine program recognizing the duties and responsibilities of the
flight surgeon and medical restrictions to flight.
OBJECTIVES: You will know
the aims of the aviation medicine program, the functions of the flight surgeon
and be able to list the factors that require flight restriction.
CONDITION: You may use the
text and references to complete the review exercise.
STANDARD: You must answer
correctly at least 8 of 10 review exercise questions.
REFERENCES: AR 40-5 (Sep
84)(with changes), AR 40-8 (Aug 76), AR 385-95 (Dec 82)(with changes), U.S. Army
Safety Center Publication, Aeromedical Aspects of Aviation Safety (Jun 80).
LESSON TEXT
1. GENERAL
Man and his environment are stable with respect to each other. The human animal,
as we know him, has evolved over thousands of years to become an efficiently
functioning organism under the conditions as present on the
surface of the earth (gravity and atmospheric pressure). However, man has been
released from the bonds of earth by flight and is traveling into space and even
to the moon. While aircraft and aircraft systems have steadily improved, the
human body and mind have remained essentially unchanged with little change
expected during the next several centuries. This leaves us with an aviation
subsystem (man) that possesses known limitations around which aircraft must be
designed and operated. Since the human operator is an integral subsystem, it
becomes obvious that the individual deserves the same care and attention as
other subsystems. If a few basic rules and guidelines are disregarded an
accident can occur. This is not to say that the individual is always
responsible, but man is frequently the weak link in the man-machine
relationship.
a. Aviation Medicine Program Requirements.
The requirements for the procurement (initial entry physical qualification),
inspection (annual physical examination), maintenance (physiologic and physical
fitness training) and repair (clinical care) of aircrew members are established
by AR 40-5. The aviation medicine program is a vital part of the Army aviation
safety program and is designed to reduce the number of accidents resulting from
human error. This program is also designed to minimize injury and illness due to
an aviation environment.
b. Aviation Medicine Program Aim.
The specific aim of the program is to promote health and safety through
preventive practices. These practices include physical examinations; clinical
care; hygiene and physical fitness; education and training of aircrew members;
and inspection of the living and working environment of aviation personnel.
2. FLIGHT SURGEON ROLES
Most aircrew members view the flight surgeon only as the person to whom they go
when they are sick or need a flight physical. However, the duties of the flight
surgeon are more complex and demanding. In any week a flight surgeon may be
required to perform in one or all of the following capacities.
a. Perform Physical Examinations.
All soldiers receiving proficiency pay for flight must be given physical
examinations.
(1) Initial flying physicals:
Before a soldier can be trained as an Army aviator or perform duties as crew
member on an Army aircraft he must be given an initial physical. During this
physical the flight surgeon must determine if the soldier meets the physical
requirements for flying duty and if he is able to cope with the psychological
stress of flight.
(2) Annual flying physicals:
All Army aviators and flight crew members must be given annual physicals. During
this physical the flight surgeon must ensure the crew member is physically and
emotionally able to continue his duties.
(3) Post-mishap physicals:
All crew members aboard an aircraft at the time of an
accident mishap must be given a physical before being allowed to continue flying
duties.
b. Provide Medical Care to Include Prevention and
Treatment of Illness.
(1) Crew member sick call:
The flight surgeon will be available to diagnose and treat all crew members
suffering from illness or injury.
(2) Family practice:
The flight surgeon may, as part of a hospital staff, be required to perform
services in family practice or other hospital clinics.
c. Act as an Advisor to the Commander.
The flight surgeon will act as a consultant to aviation unit commanders on
individual and unit health problems that could compromise flying safety. He will
also maintain liaison with the command to implement the aviation medicine
program.
d. Act as a Board Member.
(1) Accident investigation
boards: A flight surgeon is a required member of
accident investigation boards. He will make recommendations to improve the human
factors compatibility, crashworthiness and survival features of the aircraft.
These recommendations will be based upon the accident investigation or from
observations made while performing other aeromedical functions.
(2) Flying evaluation boards.
(3) Unit safety council.
e. Supervision. Supervise
the fitting and use of safety equipment for aviation personnel and monitor the
survival and physiological training of aviation crew members.
f. Safety Meetings and Training.
Participate in unit safety meetings and training to educate crew members on the
aeromedical aspects of flight.
g. Flying. Fly as a crew
member to observe flight operations and to monitor the interactions of other
crew members, aircraft and environment.
h. Unit Preaccident Plan.
Ensure the medical portion of the unit preaccident plan is adequate.
i. Monitoring. Monitor the
physical and mental well-being of aviation personnel, including drug or alcohol
abuse and self-medication problems.
j. Records. Maintain
aviation medical records.
k. Assistance. Assist in
and advise on hearing and eyesight conservation programs.
3. FLYING RESTRICTIONS
Flight crew members must be in top physical and psychological condition to
perform their duties. Physical fitness may be affected by a variety of outside
factors (for example, medications), some of which may not be noticeable in
nonflying activities, that may impact considerably on their flying safety.
Flight crew members partaking of any substance or medical procedure likely to
provoke an adverse systemic reaction will, by regulation (AR 40-8), be
restricted from flying duties until declared fit by a flight surgeon. The flight
surgeon on his own does not have the authority to ground an aviator (the aviator
must be grounded by the commander). However, the flight surgeon will inform the
commander of the required restrictions from flight based on the individual's
physical condition or any medication that is being taken.
a. Flight Safety Requirements.
Flight safety requires that the medical
treatment of all crew members be under the supervision of a flight surgeon
who is aware of the effects of medication on flying duties.
b. Crew member Requirements.
Crew members are required by regulation
to inform their flight surgeon when they have participated in activities or
received treatment which may require the imposition of a flying restriction.
c. Medical Restrictions.
Appropriate medical restrictions from flying
will be made under the following conditions.
(1) Administration of drugs:
Flight crew members who are taking a drug which has a systemic effect will be
restricted from flying duties until convalescence or rehabilitation is complete.
This does not mean that crew members are prohibited from being prescribed
medication after aeromedical evaluation by appropriate medical authority. Drugs
and medication will be dispensed by or with the consent of a qualified flight
surgeon. Individuals
receiving medication or drugs will be restricted flying duties as listed.
(a)
Alcohol. Individuals using alcohol will be restricted
from flight for 12 hours after their last drink or until no residual effects
(hangover) remain.
(b)
Antihistamines and barbiturate. Individuals using
antihistamines or barbiturates will be restricted from flight starting with use
and for a period of 24 hours from the time usage is discontinued. This time
period may be extended until side effects are no longer present.
(c) Mood
altering and tranquilizing drugs. Individuals using
these drugs will be restricted from flight during use and for a period of four
weeks following discontinuance of use.
(2) Immunizations:
Medical restriction from flying will be for a minimum of 12 hours following all
immunizations (except smallpox) or for the duration of systemic or severe local
reaction(s), whichever is longer.
(3) Blood donation:
Blood donations (200cc or more) require a restriction from flight for a period
of 72 hours from the time of donation.
(4) Decompression:
Crew members will be restricted from flying duties when
symptoms or reactions occur during or following decompression. If symptoms from
decompression are present the crew member will be restricted until evaluated and
released by a flight surgeon. Crew members engaging in low-pressure altitude
chamber flights (regardless of altitude reached) will be restricted from flying
for 12 hours following decompression.
(a)
Decompression sickness. The incidence of decompression
sickness during flight is considerably higher after exposure to an environment
(scuba diving) with higher than standard atmospheric pressure.
(b) Scuba
diving or compressed air dives. Crew members will not
perform flying duties for a period of 24 hours following scuba diving or
compressed air dives. If operational requirements dictate, personnel may fly
during this period provided no symptoms have developed and they are cleared by a
flight surgeon to perform flying duties.
d. Other Conditions or Situations Causing
Restriction. Other conditions or situations that may be
cause for restriction or may limit flight duties include the use of tobacco,
strenuous sporting activities and corrective lenses for vision.
(1) Tobacco smoking:
Crew members are discouraged from smoking at all times, but those who do smoke
should be warned of the special effects smoking has on vision and flying at
altitude. Smoking degrades the ability
of the eyes to adjust to reduced lighting (such as at night). Smoking also
increases the level of carbon monoxide in the blood which will compound the
hypoxic effect of flying at altitude. For example, the average cigarette smoker
will experience hypoxic effects equivalent to adding 5,000 feet to his actual
flight altitude.
(2) Strenuous sporting
activities: The effects of strenuous physical activity
should be considered when assigning (or restricting) flight duties immediately
following physical activity. It should be remembered that what may not be
strenuous to some individuals may be strenuous to others.
(3) Corrective lenses for
vision: Personnel requiring corrective lenses to
achieve 20/20 vision shall be restricted from flying duties unless they are
using the prescribed lenses. Contact lenses will not be worn by crew members.
4. MEDICAL SUBJECTS FOR SAFETY MEETINGS
As part of the aviation medicine program the flight surgeon is not only required
to monitor but also to conduct certain types of training. Aeromedical subjects
that would be of value to aviation units that should be presented by the flight
surgeon include the following:
a. Aviation Accidents in Which
Human Factors Were Involved.
b. Proper Fitting and Use of Safety Clothing and Equipment.
c. Physiological Problems of Night Flight.
d. Perceptual Limitations.
e. Spatial Disorientation.
f. Physical Fitness and Aircrew Performance.
g. Crew Endurance Limitations.
h. Medical Aspects of Drug and Alcohol Abuse.
i. Other Subjects. Other subjects
the flight surgeon, commander or aviation safety officer feel would enhance the
safety training of the unit.
End of Preview.
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