Professional Documents
Culture Documents
Formulas
ð 15 mg/hr/L alcohol elimination (60 mg / 100 ml à 0.6 promille à 0.15 promille / hr – 4 h)
ð Cardial output = pulse frequency x stroke volume
ð 1 m = 3.28 ft
ð 1 NM = 1.852 km
General
ð 78% nitrogen, 21% oxygen, 0.03% carbon dioxide, rest: rare gases
ð Temp initially remains constant in stratosphere and later increases up to stratopause
ð Ozone layer in stratosphere (ozone converter in cabin eliminate it)
ð Radiation records (ozone) are kept for flights above FL 490
ð Galactic radiation effect increases with altitude (from sea level and not from FL 490)
ð Galactic and solar the main sources of radiation
ð Cabin Air humidity is about 5 to 15%
ð Pressure drops faster at lower altitudes (in the first 0 – 8.000 ft)
ð Spin à predominating angular acceleration
ð Barotrauma most significant during descends
ð Capacity of concentration is limited as it requires cognitive resources
ð Swallowing as action to balance pressure gradient between middle and outer ear
ð Changes of blood pressure are measured by pressoreceptors
à A pair of sensors in the main arteries to the brain and another on the aorta at the
top of the heart.
à They are called carotid sinus and aortic arch pressoreceptors.
à Adaption in case of low pressure: constricting peripheral vessels, increase heart
rate and increase blood flow (cardiac output)
ð Normal pulse 60 – 80 (sometimes 100) beats per minute
ð Cardial output = pulse frequency x stroke volume
ð Normal cardial output is 5 liter per minute
ð UVA (long wave), UVB (medium wave), UVC (short wave – usually does not reach the
earth)
ð Physical exercise in high temperature (tropical climate) may cause painful muscle and
abdominal cramps
ð Metabolism à generation and utilization of energy by the body’s cells and tissues
Respiration
ð Boyle Mariotte – volume is inversely proportional to pressure
à Applicable for expansion of trapped gases in the body with increasing altitude
ð Dalton – total pressure is equal to the sum of the partial pressures
à Explains hypoxia
ð Henry – quantity of a gas in dilution is proportional to the pressure of the gas
à Explains decompression sickness
ð Graham – speed of discharge is the same pressure inversely proportional to sqrt(density)
ð Internal respiration
à Oxygen in cells is used and carbon dioxide (CO2) produced
ð External respiration
à Normal rate is 12 -16 cycles per minute
à 0.5 L are usually being exchanged during normal breathing cycle
ð Oxygen transfer in alveoli à diffusion
à Partial pressure of oxygen is a highly significant factor
à Depends on the partial pressure gradient
ð Thin walls of capillaries are permeable for gases
ð Total gas volume of lung is tidal, inspiratory, expiratory and residual
ð CO2 (carbon dioxide)
à In the blood regulates the breathing (rate and depth)
à Waste product of the metabolic process
à Too much à one will breathe deeper and faster
à Pressure in the alveoli is lower than in the blood (H à L pressure)
ð Artery: Away from heart (unless heart
muscle)
ð Veins: To the heart
ð Pulmonary artery: heartàlung (CO2)
LACK in OXYGEN
ð Arteries: blood heart à tissues
ð Veins: blood tissues à heart
ð Aorta: direct connection from heart (O2)
FL TUC
450 5 – 15 sec
400 15 - 20 sec
350 30 – 60 sec
300 1 – 2 min
250 2 – 4 min
220 4 – 8 min
200 20 - 30 min
Hyperventilation
ð PH level of blood more alkaline à PH value RISES (acidity level of blood reduced, level of
carbonic acid falls)
ð Lack of carbon dioxide in the blood. (NOT a high %tage of oxygen in blood!)
ð Breathing faster than necessary
à Reduce CO2
à Undersupply of O2 in brain and blood (but not reduction of partial O2 in brain!)
ð Cyanosis is not a symptom
ð Symptoms are dizzy feeling, muscular spasms, visual disturbances, lack of concentration,
euphoria, tingling (kribbeln) sensations
ð Is a normal compensatory reaction to a drop in partial oxygen pressure.
ð Caused by fear, anxiety, distress, strong pain and pressure breathing NOT jogging
ð In hyperventilation the respiration rate will be higher due to adrenalin; due to low levels of
CO2, the pH of the blood will be higher and the brain will stop the blood from reaching its
cells, to prevent damage, and that will induce hypoxia which is any situation inducing a deficit
of O2 reaching the cells and thus preventing the normal metabolism
Decompression sickness
ð Nitrogen is fundamentally responsibly
ð Over saturated nitrogen gas molecules dissolve in body tissues and fluids (not from joints)
ð Bends à Nitrogen bubbles in the joints
ð Creeps à the skin is itching (gas bubbles under the skin)
ð Chokes à Gas bubbles in the lungs
ð Staggers à bubbles affecting the nervous system
ð Prevention
à Avoid cabin altitudes > 18.000 ft
à Maintain cabin pressure at / below 8.000 ft during high altitude flights
à Breathing 100% oxygen for 30 minutes prior to and during the flight
ð Tolerance decreased by Scuba diving, obesity and age
ð Seek prompt aeromedical advice after decompression even if no symptoms occur
ð Prevent flying after scuba diving (> 10 m) for at least 24 hours
Accelerations
ð Effects depend on duration, onset rate, magnitude and direction
ð Positive (+Gz) – Upward motion
à Everything is pulled down (blood,
organs, …)
à Increased in heart rate to
compensate
à Pooling of blood in the lower
portions of the body thus reducing
blood in brain
à Greyout from +3 G
à Further stage tunnel vision
à Blackout from +4.5 G
à G-Loc from +5 G
ð Long duration acceleration lasts more than 1 second J
Carbon Monoxide
ð Binds up 200 times faster than oxygen to hemoglobin
ð Smokers are permanent carbon monoxide poisoned (lifting up their physiological altitude)
ð Initials Symptoms are not alarming, it’s colorless, odorless, highly toxic and cumulative
ð Loss of muscular power, headache, impaired judgement, loss of consciousness
ð CO in blood displaces oxygen from the blood corpuscles impairing oxygen transport
ð Several days are required to recuperate from the poisoning
Barotrauma
ð Equalization between middle ear and ambient is limited à Eustachian tube is blocked
ð Eustachian tube to equalize pressure between middle ear and ambient!!
ð Eustachian tube connects nasopharynx and middle ear
ð Suffered a cold: pain and damage of the eardrum, particularly during fast descends
à Can even cause vertigo when catched a cold and flying
à May even cause otic and sinus barotrauma
ð Trapped gases are more frequent to cause severe pain when flying above 18.000 ft in un-
pressurized aircraft
ð Valsalva is not a counter measure against barotrauma; it facilitates the pressure
equalization only.
ð Most likely to occur during rapid descends
ð Aerodontalgia does not occur during descent. Only during climb as gases expand.
ð Incapacitation caused by expansion of gases after decompression is associated with
digestive tract and not ears, eyes or sinuses
Common Health
ð High blood pressure, coronary problems and diabetes are usually associated with obesity
ð BMI = weight / height²
ð BMI up to 25 is normal / over 30 (male) / 29 (female) is obesity
ð Height in cm – 100 à the result in kg is the normal weight
à Ideal is 10% (men) 15% (woman) below
à 30% above à obesity
ð Body obtains energy from carbohydrates, protein and fats (usually not minerals and
vitamins)
ð Hypoglycemia (Unterzuckerung)
à Pilot should eat regularly and ensure a balanced diet
à Symptoms are headache and lack of concentration
ð Body looses water via skin, lungs and kidneys (Niere)
ð Complete adaption to heat environment take about fortnight (14 days)
ð Hep A, Cholera and Typhus through food and water which has been contaminated
ð Tetanus through bacteria via punctures
ð Yellow fever by a virus transmitted by an infected person / bites of mosquitos
ð One pack cigarettes a day à 5 – 8 % of hemoglobin capacity blocked
à Responsible for addiction (Abhgkt) is nicotine
à Carcinogen (responsible for cancer) is tar
ð Caffeine in excess of 250 mg/day is considered to be excessive (200 is moderate)
ð Maximum blood alcohol (JAA rule) is 20 mg / 100 ml of blood (1 promille = 0.001) -> 0.2
promille
ð Alcohol degrades paradoxical sleep
ð 15 mg / hour or 0.015% / hour alcohol metabolism
ð Excessive aspirin à gastric bleeding and blood thinning
ð Antihistamines cause dizziness and drowsiness
ð In flight fatalities à suffocation from fumes caused by aircraft furnishing and wiring
ð Most dangerous incapacitation develops slowly and gradually (hypoxia or CO poisoning)
ð Most common in-flight incapacitation - gastrointestinal disorders
Sleep
ð Circadian cycle is governed by body temperature
ð Sleep is facilitated by a decrease in body temperature (around 10 pm)
ð Wake up is facilitated by an increase in body temperature (around 6 am)
ð Temp is lowest in the early morning (0500) and highest in the evening (1800)
ð Duration of sleep is primarily governed by the time within your cycle at which you try to
sleep (too early à you will sleep less than usual)
ð 1 sleep cycle lasts 90 minutes and is
divided into 4 + 1 steps
à Light – normal transition between activity
and sleep (appr. 10 minutes)
à Early – muscular activity lowers lasts
about 20 minutes
à Metabolic rate falls, arterial blood
pressure falls and pulse rate decreases
à Orthodox (Non REM) – 75% of normal
sleep time. Physical recovery of fatigue /
resting muscles and restoring energy
reserves of neurons.
à Paradoxical (REM) – 70-90 minutes in
total sleep cycle (increases during the 2nd 4
hours of an 8 hours sleep cycle). Important
for memorization process and emotional
balance
à Interruption of REM may be harmful
Fatigue
ð Rhythm will resynchronize with 1 – 1.5 hours a day
ð Resynchronization is faster / easier for when travelling westwards
ð Biological clock is not disturbed after a bad nights sleep. Rather by east/west or west/east
flights
ð Irritability is the most noticeable psychological effect of fatigue
ð Sleep loss
à Unable to be aware of personal performance degration
à Performance loss present up to 20 minutes after a short sleep (nap)
ð Stop Over
à Long duration stays (> 48 hours) move to the new time as soon as possible
à Short duration stays (< 48 hours) stay on home time
Hypothermia
ð Pilots need for oxygen is increased as long as he is conscious
ð Sleepiness occurs with a feeling of contentment or apathy
ð Reasoning problems as soon as body temp falls below 37°C
ð Stages
Stage Description
1 ð Temp drop 1-2°
ð Mild to strong shivering
ð Unable to perform complex tasks with the hands
ð Blood vessels constrict / vasoconstriction
ð Quick and shallow breathing
ð Goose bumps form, raising body hair
ð Trouble Seeing
ð Apathy!
2 ð Temp drop 2-4°
ð Further shivering (some questions state the cease of shivering from
35°!!)
ð Lips, ears, fingers and toes become blue
3 ð Further temp drop (below approx. 32°C)
ð Shivering stops
ð Difficulty speaking and thinking
ð Amnesia
ð Cell metabolic process shut down
ð Whole skin becomes blue
ð Dead
ð Vestibular system
à Accelerations and vertical reference
à Semicircular canals – angular acc
à Saccule and utricle (otoliths) – linear acc
/ gravity
ð Noise induced hearing loss NIHL (> 90db) ð Cochlea is fluid filled and moves in
à Permanent nature for some frequencies respond to vibrations coming from middle
à Excessive noise damages the sensitive ear via oval window
membrane in the cochlea (inner ear) ð Lots of hair cells are set in motion
à NOT a damage to the eardrum or ossicles converting it into a electrical signal
ð Presbycusis
à Gradual loss of hearing with age (65 -75)
à Loss of high tones comes first
à Can be conductive or sensorineural
Errors / Illusions
ð Parallax is a reading error (looking onto (e.g. instruments) with an angular distance)
ð Myopia à nearsightedness à image focus in front of retina
ð Hypermetropia à farsightedness à image focus beyond retina
ð Astigmatism à unequal curvature of cornea
ð Presbyopia
à Ageing process, harden the lens, loss of ability to focus on near objects
à Far sightedness linked with age
à Decrease of accommodation
ð Glaucoma
à Affect optic nerve, raised intra-ocular pressure
à Can lead to total blindness, undetected reduction of visual field and reduces acuity
à Detected by pressure testing the eye ball
ð Color blindness
à May be subtle (Schleichend) and only detected by using specialized tests
à Mans are more affected
à Is a permanent condition
ð Cataract is caused by clouding of the lens
ð Empty field myopia
à Lack of distant focus point à eye focuses automatically in 1 meter distance à you
can not see objects further away from 1 meter
à Short sharp scans, periodically focused on a distant object such a wingtip or cloud
edge
ð Autokinesis – apparent movement of static single light when long stared (at night)
ð During taxiing relative movement and cockpit height above ground can cause illusions
à Vection illusion (movements of other vehicles are interpreted as our movement)
à The higher the cockpit is the slower you think you are
ð Flight in fog, snow or haze
à Low contrast
à Objects seems to be farther away
à One might get become too high during an approach follow by steep approach
ð Effects of high temperature
à Sweating
à Hairs on body remain flat
à Vaso-dilation of peripheral blood vessels (increase surface to evacuate more heat)
ð Resonance of body parts à 1 to 100 Hz
ð Illusion of obtaining greater height when suddenly flying over small trees after prolonged
flying over tall trees
ð Leans or Somatogyral: Unbanking after turn à turn in opposite direction or unnoticed
banking change during prolonged turn
ð Climbing or descending illusion during acceleration / deceleration à somatogravic
ð Coriolis Effect
à Simultaneous stimulation of several semicircular canals (not of the saccule and
utricle as they are stimulated from linear accelerations only)
à Head movement during aircraft maneuvers
ð Proprioceptive à Seat of the Pants Sense
à from Latin proprius, meaning "one's own" and perception
à Proprioceptors à inform about the relative motion and position of the body parts
ð Flying a coordinated turn gives pressure sensors feel of increase pressure along vertical
axis à climbing / pitching up
ð Pilot vertigo symptoms
à Dizziness, tumbling (Taumeln) sensations
à Contradictory impulses to the CNS
à Most likely to occur during banking
ð Trust the instruments and ignore illusions!
à Risk for spatial disorientation is growing when contradictory information between
instruments and vestibular organs
à Major protective measure against illusions is comprehensive briefings and de-
briefings
ð Black hole effect à illusion to high à low approach below safe glide slope à ground
contact
Runway Illusion Consequences
Wider than To low à Pilot corrects above
usual glide slope
à To high and to fast
à Long landing
à May lead to early or
high flare (round out)