Before we understand the basics about Hypoxia, please answer to the best of your knowledge

and understanding the following questions pertaining to Hypoxia in aviation.

1. What is the gaseous composition of atmosphere?

 (a) Nitrogen 77%, Oxygen 22% and Others Gases 1%
 (b) Nitrogen 78%, Oxygen 21% and Others Gases 1%
 (c) Nitrogen 79%, Oxygen 20% and Others Gases 1%
 (d) Nitrogen 78%, Oxygen 20% and Others Gases 2%

2. What is the percentage of Oxygen in the atmosphere at 33,000 ft?

 (a) 21%
 (b) 25%
 (c) 30%
 (d) 35%

3. What is the earliest indication of Hypoxia noticed by most aircrew?

 (a) Impending sense of doom and gloom
 (b) Vision impairment
 (c) Hypoxia creeps in stealthily without any warning or tell-tale signs
 (d) Impaired eye-hand coordination

4. What is the first action of a combat pilot in case of rapid decompression at an altitude of
40,000 feet?
 (a) Nothing is required, since Oxygen mask and on-board Oxygen system shall take care of it
 (b) Worry about decompression sickness
 (c) Call out aircraft emergency
 (d) Select 100% Oxygen and descend below 10,000 feet ASAP

5. What action is required by the Captain of a commercial airliner in the event of a cabin
decompression at FL340?
 (a) Start immediate descent below 10,000 feet
 (b) Make an announcement for the benefit of the passengers
 (c) Captain and FO to don their personal Oxygen masks and check Oxygen flow
 (d) Prepare for diversion to the nearest airfield

6. Which type of hypoxia is most commonly seen in aviation?

 (a) Hypoxic hypoxia
 (b) Anaemic hypoxia
 (c) Stagnant hypoxia
 (d) Histotoxic hypoxia

7. Smoking makes an individual more liable to suffer from hypoxia due to:-
 (a) False statement: smoking does not make anyone susceptible to hypoxia
 (b) Binding of haemoglobin with the Carbon monoxide present in the smoke
 (c) Effect of nicotine on the nervous system
 (d) Smoking affects only those with weak lungs

8. In commercial aircraft, cabin pressure is maintained at:-

 (a) MSL
 (b) Below 5000 feet
 (c) Between 6000 to 8000 feet
 (d) Above 8000 feet

9. Time of Useful Consciousness (TUC) is:-

 (a) Occurrence of Hypoxic insult on exposure to altitude
 (b) Time available to recognise the development of Hypoxia and to take corrective actions to
prevent its ill-effects affecting performance
 (c) Time from commencement of flight till Hypoxic effects compromise a pilot’s
performance
 (d) Several minutes of available emergency Oxygen supply to prevent Hypoxia.

10. military aircraft are equipped with this type of pressurisation system:-
 (a) Isobaric system.
 (b) Isobaric differential system
 (c) Both of the above
 (d) None of the above

Answers to the quiz:

1. (b); 2. (a); 3. (c); 4. (d); 5. (c); 6. (a); 7. (b); 8. (c); 9. (b); 10.
(b).

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 Aviation Medicine Quiz – Ejection and
Ejection Seats
 By Av Med in Aviation, Aviation Medicine, Aviation Medicine Quiz, Aviation Safety

Here is a quiz on Ejection and Ejection Seats. Please answer to the best of your knowledge
and understanding the following questions pertaining to Ejection.

1. Before invention of ejection systems, the only means of escape from a crippled aircraft was
to ‘bail out’. But jumping clear of aircraft was difficult, if not impossible, due to the
following:-
 (a) Injury, if any, and difficulty of egress from the confined cockpit
 (b) G forces
 (c) Airflow past the aircraft
 (d) All of the above

2. The first patent for an ejection system using compressed air was done in 1916.
Name the inventor?
 (a) Everard Calthrop, a British railway engineer and an early inventor of parachute
 (b) Anastase Dragomir, a Romanian inventor, who patented parachuted cell with Tănase
Dobrescu
 (c) Helmut Schenk, a German test pilot
 (d) Bengt Johansson, a Swedish military pilot

3. The ejection seats, powered by compressed air, were for the first time ever fitted in
this aircraft:-
 (a) Heinkel He 219 Uhu night fighter
 (b) Saab 17
 (c) Heinkel He 280 prototype jet fighter
 (d) Saab 21

4. The first aircraft to be fitted with a rocket-propelled seat was:-

 (a) F-106 Delta Dart
 (b) Gloster Meteor Mk III
 (c) Lockheed M-21
 (d) F-102 Delta Dagger

5. The only helicopter to be fitted with an ejection seat is:-

 (a) Light Combat Helicopter (LCH)
 (b) AH-64 Apache
 (c) Kamov Ka-50
 (d) Sikorsky X2

6. The following is true for the Minimum Safe Ejection Altitude (MSEA) quoted for an
ejection seat:
 (a) MSEA is only applicable to the aircraft in straight and level flight
 (b) For an aircraft in descent, the MSEA proportionately increases
 (c) A rule of thumb for MSEA is to divide the rate of descent by 12 and add the result to the
basic limitation of the seat
 (d) All of the above

7. The commonest ejection related injury is known to occur during this phase of
ejection:-
 (a) Egress
 (b) Windblast
 (c) Parachute opening
 (d) On landing

8. The personal survival packs (PSPs) are an essential part of the ejection seats. The
following is true for PSPs used in most of the ejection seats in use:-
 (a) PSPs must be packed correctly or else it may alter the ejection characteristics of the
ejection seat
 (b) PSP should be as hard as is compatible with sitting comfort
 (c) PSP can be separated from the man, during descent either automatically or by pulling on
a special ‘D’ ring
 (d) All of the above

9. A Zero-Zero ejection seat is capable of:-

 (a) Ejecting a normal sized pilot to a height of about 200 ft
 (b) The parachute must deploy fully give him a full chute in
 (c) Complete ejection sequence be accomplished in around three seconds
 (d) All of the above

10. The commonest cause of unsuccessful ejection is:-

 (a) Ejection at low altitude
 (b) Delay in decision to eject
 (c) Loss of consciousness
 (d) None of the above
 Answers to the quiz:

1. (d); 2. (a); 3. (c); 4. (d); 5. (c); 6. (d); 7. (a); 8. (d); 9. (d);

10. (b).

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Hyperventilation is a state of either an excessive rate or depth of breathing, or both, than the
requirement of the body. This results in excessive removal of Carbon dioxide than that
required to maintain an equilibrium within the body.

Whereas the normal blood PaCO2 ranges between 36 and 44 mm Hg, hyperventilation leads
to abnormally low levels of carbon dioxide in the blood (<36 mm Hg). This lowering of
PaCO2 and increase in the pH results in alkalosis within the body. This results in dilatation of
the blood vessels and a fall in blood pressure.

Effects of Hyperventilation The lower the PaCO2, the worse are the symptoms. The most
common symptoms of hyperventilation are numbness, tingling of the hands and feet,
muscular in-coordination, giddiness visual disturbances and fainting spell. The common signs
observed in those hyperventilating are:-
 Increased rate and depth of breathing
 Muscle twitching and tightness
 Paleness
 Cold clammy skin
 Muscle spasms

here are several causes that may lead to hyperventilation in aviation, which the pilots must
be aware of. This includes:-
 Breathing through mask in the initial stages, till the combat pilot gets accustomed to such
breathing
 Hypoxia
 Air Sickness
 High ambient temperature
 Vibrations and air turbulence
 Positive Pressure Breathing. The mechanics of respiration gets reversed during positive
pressure breathing where inspiration becomes passive and expiration becomes active. The
force that the individual has to exert in exhaling against the applied pressure results in
increase in rate and depth of breathing.
 Psychological stress. Fear, anxiety or unusual stress leads to hyperventilation. This is
frequently observed amongst trainee pilots, in combat flying and during hypoxia
indoctrination runs in decompression chamber.
 Another important thing to remember is that the signs and symptoms of hyperventilation can
easily be confused with those of hypobaric hypoxia. Diagnosis of hyperventilation in aircrew
is invariably determined by:-
 Narrative of individual/colleague/instructor (QFI) in a training sortie wherein the pilot is
noted to breathe rapidly before manifesting classical signs and symptoms
 Observing the Oxygen flow rates by Doll’s Eye of the Oxygen regulator in the cockpit
 Post sortie urine sample may be alkaline.

Though the mechanism of hypoxia and hyperventilation are distinct, the symptoms are very
similar. Thus it is difficult to distinguish between the two. There are however a few
distinctive differences between the two devils of aviation. In hyperventilation, the onset is
gradual, with the presence of pale, cold, clammy skin and the development of muscle spasm
and tetany. In hypoxia, the onset of symptoms is usually altitude-dependent, and the
individual has flaccid muscles and cyanosis. The symptoms of hyperventilation may persist
even after switching over to 100% oxygen while that of hypoxia will get relieved.

In-flight actions in case of HyperventilationHypoxia and hyperventilation are very similar

and both can rapidly lead to incapacitation. Hence the in-flight approach is to correct both
problems simultaneously. There are five steps for treatment in-flight in:
 Switch over to 100 percent oxygen if not already on it
 Check oxygen equipment to ensure proper functioning
 Control breathing – reduce the rate and depth
 Descend below 10,000 feet where hypoxia is an unlikely problem
 Communicate the problem to ground control.

1. A pilot, breathing rapidly during a sortie, complains of feeling light-headed with tingling at
the tips of the fingers and the toes. He may be suffering from:-
 (a) Hypoxic hypoxia or Hyperventilation
 (b) Hypoxia
 (c) Hyperventilation
 (d) Alkalosis

2. Hyperventilation occurs due to:-

 (a) Lack of oxygen in the body
 (b) Increase in carbon dioxide in the body
 (c) Excessive wash out of carbon dioxide from the body
 (d) Excessive intake of oxygen during flight

3. The normal blood PaCO2 ranges between:-

 (a) 36 to 44 mm Hg
 (b) 28 to 36 mm Hg
 (c) 44 to 52 mm Hg
 (d) 28 to 52 mm Hg

4. Lowering of blood PaCO2 leading to hyperventilation results in the following changes in

the body, except one:-
 (a) Increase in the pH (alkalosis within the body)
 (b) Dilatation of the blood vessels
 (c) Heightened state of alertness
 (d) Fall in blood pressure

5. Which of the following is not a cause of hyperventilation amongst combat pilots:-

 (a) Hypoxia
 (b) Vibrations and air turbulence
 (c) Positive Pressure Breathing
 (d) Flying as a passenger

6. If the symptoms of numbness, tingling, muscle in-coordination, giddiness or fainting spell

persists in flight despite of starting 100% oxygen, this is due to:-
 (a) Hypoxia
 (b) Hyperventilation
 (c) Hypoxia or Hyperventilation
 (d) Positive pressure breathing

7. Hyperventilation may occur during positive pressure breathing due to:-

 (a) Reversal in mechanics of respiration
 (b) Anxiety
 (c) Unaccustomed method of breathing
 (d) Stress

8. Which of the following situations is not likely to give rise to hyperventilation:-

 (a) Rookie pilots
 (b) Aerial combat
 (c) Hypoxia indoctrination in decompression chamber
 (d) General handling sortie
 9. If a pilot has symptoms of hyperventilation while flying at 5000 feet above MSL, what
remedial action is required by him?
 (a) Descend to MSL
 (b) Start breathing heavily
 (c) Take slow and not so deep breath
 (d) Remove oxygen mask

10. In case of suspected hyperventilation, which is the correct in-flight approach:-

 (a) Switch over to 100% oxygen
 (b) Reduce the rate and depth of breathing
 (c) Descend below 10,000 feet
 (d) All of the above

Answers to the quiz:

1. (a) 2. (c) 3. (d) 4. (c) 5. (a) 6. (c) 7. (d) 8. (a) 9. (c) 10. (d).

If