1. Enhanced Safety Utilizing Hypoxia Recognition and Recovery Training for Commercial Pilots and Cabin Crew Donna Murdoch Ph.D. CAsP Human Systems Solutions, Inc. Ramon, CA

2. This presentation was funded by Alaska Airlines The Reduced Oxygen Breathing Device 2 was supplied by Environics, Inc. I would like to thank the aircrew members from Alaska Airlines who participated in this study and Gary Crawley my co-author.

3. HELIOS AIRWAYS FLIGHT HCY522

4. SUBJECTS Alaska Airlines Aircrew Members Alaska Airlines Aircrew Members 13 Pilots (average flight time = 6125) 13 Pilots (average flight time = 6125) 7 had previous hypoxia training in an altitude chamber 7 had previous hypoxia training in an altitude chamber 3 reported being hypoxic in the aircraft 3 reported being hypoxic in the aircraft 15 Experienced Cabin Crew Members 15 Experienced Cabin Crew Members 4 had previous hypoxia training in an altitude chamber 4 had previous hypoxia training in an altitude chamber 5 reported being hypoxic in the aircraft 5 reported being hypoxic in the aircraft All had a current physical and were qualified to fly All had a current physical and were qualified to fly

5. METHODS Pilots Pilots Familiarization training for those with no previous hypoxia training Familiarization training for those with no previous hypoxia training Up to 4 minutes at 25K ft Up to 4 minutes at 25K ft Data collection training run Data collection training run 3 minutes at 10K ft, immediately followed by to 4 minutes at 25K ft 3 minutes at 10K ft, immediately followed by to 4 minutes at 25K ft Each subject performed a simulated flight using a desktop simulator with altitude changes, radio calls and frequency changes directed by a simulated air traffic controller Each subject performed a simulated flight using a desktop simulator with altitude changes, radio calls and frequency changes directed by a simulated air traffic controller Cabin Crew Cabin Crew Familiarization training for those with no previous hypoxia training Familiarization training for those with no previous hypoxia training Up to 4 minutes at 25K ft Up to 4 minutes at 25K ft Data collection training run Data collection training run 3 minutes at 10K ft while performing a simulated task requiring light exercise 3 minutes at 10K ft while performing a simulated task requiring light exercise Up to 4 minutes at 25K ft while performing a seated task simulating their flight duties Up to 4 minutes at 25K ft while performing a seated task simulating their flight duties The student was encouraged to treat themselves and turn on their emergency oxygen when they felt hypoxic but if it became evident that they could not they were coached to turn on their oxygen by the instructor. The level of coaching was recorded. The student was encouraged to treat themselves and turn on their emergency oxygen when they felt hypoxic but if it became evident that they could not they were coached to turn on their oxygen by the instructor. The level of coaching was recorded.

6. All data was collected using the Reduced Oxygen Breathing Device 2 computer controlled SpO2 and heart rate monitor mass flow controller technology mixes nitrogen and air to get the desired altitude 100% emergency oxygen is available

7. N=5 N=10 SpO2 Values During Simulation Training N=9 N=13 N=10 N=7 N=1

8. SpO2 Summary

9. COACHING REQUIRED TO TURN ON EMERGENCY OXYGEN

10. RESULTS Time to termination of training Time to termination of training Pilots - mean 66 (SD 24, range 0-197) Sec at 25K Pilots - mean 66 (SD 24, range 0-197) Sec at 25K 3 of 13 terminated before 30 Sec at 25K 3 of 13 terminated before 30 Sec at 25K Cabin Crew – mean 56 (SD 59, range 0-210) Sec at 25 K Cabin Crew – mean 56 (SD 59, range 0-210) Sec at 25 K 2 of 15 terminated at 10K and 4 more terminated just after arriving at 25K 2 of 15 terminated at 10K and 4 more terminated just after arriving at 25K Number feeling they were adequately trained 25 Number feeling they were adequately trained 25 3 felt that they needed additional training 3 felt that they needed additional training Interval of training required Interval of training required 17 thought that training should be given yearly 17 thought that training should be given yearly 3 felt that it should be given more frequently than yearly 3 felt that it should be given more frequently than yearly 7 felt that it should be given between 2 and 5 years 7 felt that it should be given between 2 and 5 years 1 felt that it should be given once in a career 1 felt that it should be given once in a career

11. Discussion Individual tolerances and workloads accounted for the wide range of exposure times and SpO2 levels. Individual tolerances and workloads accounted for the wide range of exposure times and SpO2 levels. A majority of the aircrew felt that they should receive this training at least yearly (20) thus indicating how valuable they thought it was. A majority of the aircrew felt that they should receive this training at least yearly (20) thus indicating how valuable they thought it was. A majority of the cabin crew members thought this training should be mandatory. A majority of the cabin crew members thought this training should be mandatory.

12. Conclusion Hypoxia recognition and recovery training provides another defense against catastrophic events resulting from a loss of cabin pressurization when all crew members are trained and crew coordination procedures are in place. This training should be conducted regularly for both pilots and cabin crew members. A more time sensitive measure of SpO2 should be developed.

13. QUESTIONS Donna Murdoch Human Systems Solutions, Inc. Murdochd.hss@cox.net 619-573-7106