The student should display an understanding of aeronautical decision making, aeromedical factors and human factors.

Medical Certificates (Part 67)…Issued by AME

Valid for…. 6mo/12mo/24mo/60mo

Reasons for Medical Certificate Denial or Special Issuance…

• Diabetes mellitus requiring oral hypoglycemic medication or insulin
• Angina pectoris
• Coronary heart disease that has been treated or, if untreated, that has been symptomatic or clinically significant
• Myocardial infarction
• Cardiac valve replacement
• Permanent cardiac pacemaker
• Heart replacement
• Psychosis
• Bipolar disorder
• Personality disorder that is severe enough to have repeatedly manifested itself by overt acts
• Substance dependence (including alcohol)
• Substance abuse
• Epilepsy
• Disturbance of consciousness and without satisfactory explanation of cause
• Transient loss of control of nervous system function(s) without satisfactory explanation of cause

BasicMED (Part 68)…Limited to 6,000 lbs GW, 6 Pax Seats, <250 KIAS, <18,000 FT MSL, inside the US.

Pilots operating under BasicMED must have the medical checklist & certificate of course completion available when flying.

See: Spatial Disorientation and Illusions

Rods are 10,000 more sensitive to light than cones.

Must look 5 degrees off center to see an object at night (

The rods can take approximately 30 minutes to fully adapt to darkness. (PHAK Ch 17)

Exposure to bright light can reset dark adaptation.

Night flight can be more fatiguing and stressful than day flight, and many self- imposed stressors can limit night vision.

Effects of drugs & alcohol are worse at night.

Pilots who become fatigued during a night flight will not be mentally alert and will respond more slowly to situations requiring immediate action. Exhausted pilots tend to concentrate on one aspect of a situation without considering the total requirement.

Insufficient consumption of vitamin A may also impair night vision

See hypoxia_hyperventilation_co

See oxygen_requirements

Decompression sickness (DCS) describes a condition characterized by a variety of symptoms resulting from exposure to low barometric pressures that cause inert gases (mainly nitrogen), normally dissolved in body fluids and tissues, to come out of physical solution and form bubbles. Nitrogen is an inert gas normally stored throughout the human body (tissues and fluids) in physical solution. (PHAK Ch 17)

• Put on oxygen mask immediately and switch the regulator to 100 percent oxygen.
• Begin an emergency descent as soon as possible. Even if the symptoms disappear during descent, land and seek medical evaluation while continuing to breathe oxygen.
• If one of the symptoms is joint pain, keep the affected area still; do not try to work pain out by moving the joint around.
• Upon landing, seek medical assistance from an FAA medical officer, AME, military flight surgeon, or a hyperbaric medicine specialist. Be aware that a physician not specialized in aviation or hypobaric medicine may not be familiar with this type of medical problem.
• Definitive medical treatment may involve the use of a hyperbaric chamber operated by specially-trained personnel.
• Delayed signs and symptoms of altitude-induced DCS can occur after return to ground level regardless of
• presence during flight.

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 (non-decompression 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.

During a climb, middle ear air pressure may exceed the pressure of the air in the external ear canal causing the eardrum to bulge outward. Pilots become aware of this pressure change when they experience alternate sensations of fullness or clearing. Resolve by holding your nose and blowing.

“Sinus block” occurs most frequently during descent. Slow descent rates can reduce the associated pain. A sinus block can occur in the frontal sinuses, located above each eyebrow, or in the maxillary sinuses, located in each upper cheek. It usually produces excruciating pain over the sinus area.

Do not fly with upper respiratory infections or sinus infections to avoid Sinus Block.

Stress is the body’s response to physical and psychological demands placed upon it.

Stress falls into two broad categories: acute (short term) and chronic (long term).

Examples of stressors include physical stress (noise or vibration), physiological stress (fatigue), and psychological stress (difficult work or personal situations).

61.53 prohibits acting as pilot-in-command or in any other capacity as a required pilot flight crewmember, while that person:

1. Knows or has reason to know of any medical condition that would make the person unable to meet the

requirement for the medical certificate necessary for the pilot operation, or

1. Is taking medication or receiving other treatment for a medical condition that results in the person being

unable to meet the requirements for the medical certificate necessary for the pilot operation.

91.17 prohibits the use of any drug that affects the person’s faculties in any way contrary to safety.

Some of the most commonly used OTC drugs, antihistamines and decongestants, have the potential to cause noticeable adverse side effects, including drowsiness and cognitive deficits. (PHAK Ch. 17)

Many medications, such as tranquilizers, sedatives, strong pain relievers, and cough suppressants, have primary effects that may impair judgment, memory, alertness, coordination, vision, and the ability to make calculations. (PHAK Ch. 17)

Tylenol, asprin, ibprofin generally have no serious consequences.

Flying is almost always precluded while using prescription analgesics, such as drugs containing propoxyphene (e.g., Darvon), oxycodone (e.g., Percodan), meperidine (e.g., Demerol), and codeine, since these drugs are known to cause side effects, such as mental confusion, dizziness, headaches, nausea, and vision problems. (PHAK Ch 17)

Alcohol is a sedative and its use impairs both coordination and judgment. As a result, pilots who are impaired by alcohol fail to apply the proper techniques of night vision. They are likely to stare at objects and to neglect scanning techniques. The amount of alcohol consumed determines the degree to which night vision is affected. The effects of alcohol are long lasting and the residual effects of alcohol can also impair visual scanning efficiency. (PHAK Ch 17)

See AF 201B Unit 24 Orientation Lesson 9 - ADM