2. ALTITUDE PHYSIOLOGY

3. OUTLINE Classifications of Hypoxia Signs and symptoms of Hypoxia Stages of Hypoxia Prevention of Hypoxia Provisions of AR 95-1 Provisions of AR 40-8

4. REFERENCES FM 1-301, Aeromedical Training for Flight Personnel, May 1987 AR 95-1, Flight Regulations, september 1997 AR 40-8, Temporary Flying Restrictions Due to Exogenous Factors

5. Hypoxia State of oxygen [O 2 ] deficiency in the blood cells and tissues sufficient to cause impairment of function.

6. Types of Hypoxia l Hypemic l Stagnant l Histotoxic l Hypoxic

7. Hypemic Hypoxia Inability of the blood to accept oxygen in adequate amounts + + + + + + + + + + + + + + +

8. Stagnant Hypoxia Reduced blood bloodflow Blood moving slowly adequateoxygen Red blood cells not replenishing tissue needs fast enough

9. Red blood cells Red blood cells retain oxygen retain oxygen Inability of the cell to accept or use oxygen Histotoxic Hypoxia Poisoned tissue adequateoxygen

10. Hypoxic Hypoxia Reduced pO 2 in the lungs (high altitude) Body tissue Red blood cells

11. Hypoxia Symptoms Subjective: Feel Air hunger Hot and Cold Flashes Apprehension Euphoria Fatigue Belligerence Nausea Blurred vision Headache Numbness Dizziness Tingling Denial Air hunger Hot and Cold Flashes Apprehension Euphoria Fatigue Belligerence Nausea Blurred vision Headache Numbness Dizziness Tingling Denial

12. Hypoxia Signs Objective: See HyperventilationCyanosis Mental confusion Poor Judgment Lack of muscle coordination

13. Stages of Hypoxia l Indifferent Stage l Compensatory Stage l Disturbance Stage l Critical Stage

14. Indifferent Stage l Altitudes Air: 0 - 10,000 FEET l Symptoms: decrease in night vision @ 4000 feet

15. Compensatory Stage l Altitudes Air :10,000 - 15,000 FEET l Symptoms: impaired efficiency drowsiness poor judgment decreased coordination

16. CAUTION! Failure to recognize symptoms and take corrective action may result in an aircraft mishap Failure to recognize symptoms and take corrective action may result in an aircraft mishap

17. Disturbance Stage l Altitudes Air:15,000 - 20,000 FEET

18. Disturbance Stage symptoms W Sensory l Vision l Touch & pain l Hearing

19. Disturbance Stage Disturbance Stage symptoms W Mental l Memory l Judgment l Reliability l Understanding

20. Disturbance Stage symptoms W Personality l Happy Drunk versus the l Mean Drunk

21. Disturbance Stage symptoms W Performance l Coordination l Flight Control l Speech l Handwriting

22. put back on oxygen Time off Oxygen 1 minute 2 minutes 3 minutes 4 minutes 5 minutes 6 minutes

23. CAUTION!CAUTION! Failure to recognize symptoms and take corrective action may result in an aircraft mishap Failure to recognize symptoms and take corrective action may result in an aircraft mishap

24. Disturbance Stage W Signs l Hyperventilation l Cyanosis

25. Critical Stage l Altitudes Air:20,000 FEET and above l Symptoms: loss of consciousness convulsions death

26. WARNING! When hemoglobin saturation falls to serious cellular dysfunction occurs; and if prolonged, can cause death WARNING! 65%

27. Factors modifying hypoxia symptoms l Pressure altitude l Rate of ascent l Time at altitude l Temperature l Physical activity l Individual factors l Physical fitness l Self-imposed stresses

28. Alcohol it’s a no brainer! Tobacco keep self imposed stresses out of the aircraft Drugs Exhaustion Hypoglycemia

29. 2000 feet B U Z Z 1 ounce = alcohol

30. Expected Performance Times FL 430 & above9-12 seconds FL 40015 - 20seconds FL 35030 - 60 seconds FL 3001 - 2 minutes FL 2802 1/2 - 3 minutes FL 2503 - 5 minutes FL 2208 - 10 minutes FL 18020 - 30 minutes

31. Expected performance time for a crew member flying in a pressurized cabin is reduced approximately one-half following loss of pressurization such as in a: RD rapid decompression

32. Hypoxia u Prevention limit time at altitude breathing oxygen l pressurized cabin

33. Hypoxia u Treatment oxygen descend to a safe altitude

34. AR 95-1 Altitude Restrictions and Oxygen Requirements 14,000 10,000 12,000 1 Hour Total 30 Min Total Unpressurized Pressurized 10,000 14,000 25,000 Maintain Cabin PA at or below 10,000 10 Min Supply of O2 for all occupants Crew O2 masks readily available Supplemental Oxygen Required

35. AR 95-1 Altitude Restrictions and Oxygen Requirements  If pressurization is lost above 14,000’, an immediate descent will be made to a cabin pressure altitude of 10,000’ or below.  Then unpressurized restrictions apply

36. AR 40-8 Flight Restrictions Due to Exogenous Factors Flying duty is prohibited for 24 hours after SCUBA diving Aircrew members will not be regular blood donors. After blood donation, aircrew members will be restricted from flying for 72 hours Performance of flying duty is prohibited for 12 hours after any altitude chamber flight

37. Questions?