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I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:1 AFMOA Instructor Guidelines You have the freedom to tailor this presentation to your local.

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Presentation on theme: "I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:1 AFMOA Instructor Guidelines You have the freedom to tailor this presentation to your local."— Presentation transcript:

1 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:1 AFMOA Instructor Guidelines You have the freedom to tailor this presentation to your local audience. Please read the note pages carefully. They include the details you will need to be properly prepared to present this important information. If you are using USAF official mishap data, you are required to show the AFI Disclaimer Slide. Many thanks to MSgts Doug Schmidt (Aviano AB), Mark Brandt (Lakenheath AB), and Darryl Swartz (Spangdahlem AB) for their work in creating this presentation

2 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:2 AFMOA Instructor Guidelines For Official Use Only All limited-use safety mishap investigation reports are for official, mishap prevention use only. Unauthorized disclosure of the information in the reports is a criminal offense under article 92, uniform code of military justice. See AFI , paragraphs and for restrictions. Destroy according to AFI when no longer needed for mishap prevention

3 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:3 For more questions or further instructor guidance, please or phone the MAJCOM points of contact: HQ: Col Susan AETC: Col Kent Magnusson: AMC: Col Al Hartzell: AFMC: Col James Dooley: ACC: LtC Daniel Caulkins: SPACE:Maj Joe Balas: USAFE: Maj James Lasswell: PACAF:Maj Rick Fofi: AFSOC:Capt Randy McCalip: Further points of contact: LtC Don White: Capt Nereyda Sevilla: MSgt Doug Schimidt: AFMOA Instructor Guidelines

4 I n t e g r i t y - S e r v i c e - E x c e l l e n c e Cassandra D Howard, Col, FS, MC, TNANG 164 MDG/CC, Memphis, TN AANGFS, Vice-President As of:4 Photo source: ANG Creative, Health Professions Recruiting Campaign

5 I n t e g r i t y - S e r v i c e - E x c e l l e n c e Headquarters U.S. Air Force As of:5 Endurance Management Ground Initiative Air Force Medical Operating Agency

6 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:6 You Must Not Needlessly Fatigue The Troops Napoleon Bonaparte

7 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:7 Basic Sleep Physiology Sleep or Die

8 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:8 Impact of Fatigue Sleep Physiology Circadian Rhythm Consequences Recognition No-Go Pills Overview

9 I n t e g r i t y - S e r v i c e - E x c e l l e n c e Impact of Fatigue FedEx Flight 1478 American Flight 1420 Korean Air Flight 801 China Air Flight people injured, AC major structural damage228 killed, AC destroyed 11 killed, AC destroyed 3 severely injured, AC destroyed Fatigue Related Crashes

10 I n t e g r i t y - S e r v i c e - E x c e l l e n c e Impact of Fatigue As of:10 Major Accidents Three Mile Island Challenger Space Shuttle Exxon Valdez The Cost

11 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:11 The Evidence Major Accidents Annual Cost Military Strategy Human Performance Impact of Fatigue

12 I n t e g r i t y - S e r v i c e - E x c e l l e n c e Aeromedical Causal Factors

13 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:13 Exploit the Enemys Weakness While remembering our own limitations Military Strategy

14 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:14 Exploit the Enemys Weakness While remembering our own limitations Military Strategy

15 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:15 Monday Night Football

16 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:16 Effect of operations on sleep and circadian physiology FATIGUE Sleep loss Circadian rhythms Types of Fatigue Acute: Work induced Chronic: Repeated sleep loss Subjective: Stress induced Circadian Rhythm: Shift Work or Jet lag Causes of Fatigue

17 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:17 Sleep – A Vital Physiological Function Sleepiness Affects Waking Performance, Vigilance, and Mood Sleep Loss Accumulates Into A Sleep Debt Physiological Versus Subjective Sleepiness The Circadian Pacemaker Basic Human Physiology: Sleep & Circadian Rhythms

18 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:18 Stages 1 & 2 Stages 3 & 4 Physical Restoration Hormone Production Tissue Repair Dreams Muscle Twitching Rapid Eye Movement Problem Solving Short- to Long-Term Memory NREM Sleep REM Sleep Physiology of Sleep

19 I n t e g r i t y - S e r v i c e - E x c e l l e n c e NREM Sleep REM Sleep WakeREM Stage 1 Stage 2 Stage 3 Stage Whats Supposed To Happen (Normal Sleep Histogram)

20 I n t e g r i t y - S e r v i c e - E x c e l l e n c e Wake REM Stage 1 Stage 2 Stage 3 Stage REM - Mental restoration NREM - Physical restoration Sleep Histogram

21 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:21 Circa = Approximately or about Dian = 24-hour period or a day Circadian Rhythm

22 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:22 Sleep-Wake Temperature Mental Performance Hormones Digestion Types of Physiological Rhythms

23 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:23 Sleep No Sleep MaximumSleepiness Body Temperature

24 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of: High Low MaximumAlertness Alertness Level

25 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:25 After 17 hours of sustained wakefulness, performance decreased to a level similar to.05 BAC After 24 hours of sustained wakefulness, performance decreased to a level similar to.10 BAC Center for Sleep Research, University of South Australia, and University of Adelaide, South Australia (Nature, 1997) Fatigue, Alcohol and Performance

26 I n t e g r i t y - S e r v i c e - E x c e l l e n c e Fatigue, Alcohol and Impairment

27 I n t e g r i t y - S e r v i c e - E x c e l l e n c e Wake REM Stage 1 Stage 2 Stage 3 Stage Alcohol-Induced Sleep

28 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:28 Forgetful Poor decisions Slowed reaction time Reduced vigilance Poor communication Fixated Apathetic Lethargic Bad mood Nodding off Fatigue Signs & Symptoms

29 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:29 Physiological mechanisms underlie fatigue Just like water and food, sleep is a physiological necessity Fatigue can have severe consequences Financial Human performance Take sleep and fatigue seriously If You Remember Nothing Else…

30 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:30 Fight The Good Fight Combating Fatigue

31 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:31 Preventive Strategies Minimizing sleep loss Naps Good sleep habits Effects of food, alcohol, and exercise Sleep environment Circadian strategies Fatigue Countermeasures: Personal Strategies

32 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:32 Preventive Strategies: Sleep Loss & Strategic Napping Sleep Requirements and Debt Strategic Napping (Prior to Duty) Can Acutely Improve Alertness Limit Nap: Minutes Decreases Continuous Wakefulness Some Sleep is Better Than None

33 I n t e g r i t y - S e r v i c e - E x c e l l e n c e Wake REM Stage 1 Stage 2 Stage 3 Stage Best method to minimize fatigue Limit to 10 or 20 minutes Try not to nap within 5 hours bedtime Avoid sleep inertia Disorientation and lethargy for 5-20 mins Sleep Histogram

34 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:34 Preventive Strategies: Good Sleep Habits Regular Sleep/Wake Schedule Develop/Practice Regular Pre-Sleep Routine Avoid Heavy Meals Avoid Alcohol and Caffeine Physical/Mental Relaxation Techniques No Sleep in 30 Minutes…Get Out of Bed

35 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:35 Preventive Strategies: Sleep Environment Dark, Quiet Room White Noise Comfortable Temperature Comfortable Sleep Surface Large Meals & Indigestion Lack of Food

36 I n t e g r i t y - S e r v i c e - E x c e l l e n c e Self-Medication

37 I n t e g r i t y - S e r v i c e - E x c e l l e n c e 2000 B.C….Here, eat this root A.D….Roots are heathen. Say this prayer A.D….Prayer is superstition. Drink this potion A.D….That potion is snake oil. Swallow this pill A.D….That pill is ineffective. Take this antibiotic A.D….That antibiotic is artificial. Here, eat this root. Supplements and the Human Trend

38 I n t e g r i t y - S e r v i c e - E x c e l l e n c e Effects of Medications Desired Effects – treats the symptoms Side Effects – other effects on the body Allergic Reactions Combined Effect – = 3 Companies combine antihistamines and decongestions to off set each other Over-the-Counter Medications Antihistamines = sedation, drowsiness Decongestants = nervous, dizzy, sleepy Cold preps = most contain alcohol Self-Medication

39 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:39 Personal Strategies: Operational Countermeasures Physical Activity Combats Sleepiness Social Interaction and Conversation Diet and Hydration Bright Lights Strategic Caffeine Consumption

40 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:40 Strategic Caffeine Use 15 to 30 minutes to take effect Effects can last for up to 3-4 hours Chocolate 1-35 mg caffeine 1 oz Pepsi 36 mg caffeine12 oz Coke 46 mg caffeine12 oz Mt Dew 54 mg caffeine12 oz Instant Coffee mg caffeine 5 oz Drip Coffee mg caffeine 5 oz

41 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:41 Sleep Food Carbohydrates Pasta Corn White Bread Potatoes

42 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:42 Alert Foods Protein Nuts and Seeds Meats/Cold Cuts Peanut Butter Cheese Eggs Fish Yogurt Beans Protein Nuts and Seeds Meats/Cold Cuts Peanut Butter Cheese Eggs Fish Yogurt Beans

43 I n t e g r i t y - S e r v i c e - E x c e l l e n c e Optimize Sleep Dark, cool room Warfighter Sleep Kit AMMO Alertness Management in Military Operations or

44 I n t e g r i t y - S e r v i c e - E x c e l l e n c e No Go Pills AF guidance (vol 3) <= 7 consecutive days (Sonata <=10 consecutive days) <= 20 in a 60 day period (Sonata <= 28 in a 60 day period) FS Recommendations As little as needed (but they can help jet lag) Bad sleep is not an Ambien deficiency Melatonin is a no-go thats a no-go MedicationDoseHalf-lifeGrounding Temazepam (Restoril®)15 or 30 mg h12 hours Zolpidem (Ambien®)10 mg h6 hours Zaleplon (Sonata®)10 mg 1.0 h4 hours Ground testing required prior to operational use.

45 I n t e g r i t y - S e r v i c e - E x c e l l e n c e Smart Phone Apps As of:45 AndroidiPhone Bedtime Calculator (Free) - REM cycle monitoring Crew Alert ($29.99) - Your wildest dreams come true! Sleepy Time (Free) - Chromotherapy Sleep Science Alarm ($.99) - REM cycle monitoring Sleep Watcher (Free) - Daily fatigue estimation Fatigue Calculator (Free) - Daily fatigue estimation Relax and Sleep Plus (Free) - Ambient noises aSleep 3 ($.99) - REM cycle monitoring - Chromotherapy Sleep Now! (Free) - Ambient noises Circadian Alarm ($.99) - REM cycle monitoring

46 I n t e g r i t y - S e r v i c e - E x c e l l e n c e As of:46 Summary Impact of Fatigue Sleep Physiology & Circadian Rhythms Consequences & Recognition Preventive Strategies Operational Countermeasures No Silver Bullet, No Magic Pill


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