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89 th Physiological Training Flight DSN 857-4654. Aerospace Medicine Topics. Overview. Medical Standards Fatigue and Performance Spatial D Awareness. Medical Standards. Ensure acquisition and retention of members who are medically fit for military duty Standard med exam required before:
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89th Physiological Training Flight DSN 857-4654 Aerospace Medicine Topics
Overview • Medical Standards • Fatigue and Performance • Spatial D Awareness
Medical Standards • Ensure acquisition and retention of members who are medically fit for military duty • Standard med exam required before: • Entry into special duty • Periodically as required • Termination of service when specified • but not for retirement • if current and health status unchanged, don’t need physical
Medical Standards • Periodic med exam required for controllers • annually within 3 months (max of 6) preceding the last day of the birth month • Periodic Health Assessment (PHA) • focus on member’s age, sex, health risk factors, medical history and occupation to determine the scope of the assessment
Medical Standards • Responsibilities • Member’s commander • Ensure member is available for examination until all processing is complete • Member • Meet scheduled appt as directed • Report to FSO medical/dental treatment obtained through civilian sources and • Report to FSO any medical condition that hinders/may hinder duty performance
Medical Standards • Causes for DNIC • Use of any medication whose known actions may affect alertness, judgement, cognition, special sensory function, mood, or coordination • Exacerbation of any medical condition for which a waiver has been granted
Medical Standards • Causes for DNIC • Air Traffic Controllers cannot perform controller duties for at least 8 hours after receiving a local or regional anesthetic agent • Blood donation requires a verbal DNIC for 8 hours and does not require flight surgeon clearance to return to duties
Causes of Fatigue • Sleep Loss • Poor Quality Sleep • TDY/Travel • Circadian desynchrony • Jet Lag • Shift Work
Fatigue and Performance • Studies show sleep loss results in: • Increased reaction time • Decreased vigilance • Cognitive slowing • Memory problems • Time-on-task decrements • Let’s talk about sleep...
Sleep Requirements 5 hours 8% of population 5-6 hours 15% 6-8 hours 64% 8-10 hours 13%
Stages of Sleep • Rapid Eye Movement (REM) sleep • increased physiological and mental activity • Non-Rapid Eye Movement (NREM) sleep • slowed physiological and mental activity • stages 1 and 2 - light sleep • stages 3 and 4 - deep sleep
Normal Sleep, Brain Pattern Awake REM Stage 1 Stage 2 Stage 3 Stage 4
Many Factors Can Disrupt Sleep • Environmental (temperature, noise, light) • Alcohol (more than 2 drinks) • Caffeine prior to bedtime • Jet lag • Medical conditions (sleep apnea, restless legs) • Medications
Circadian Rhythm • Natural “body clock” • Influences performance, sleepiness • Influenced by hormones, body temp, eating patterns • Reset by environmental zeitgebers • light!
Circadian Rhythms • Body clock resynchronized by external cues • the most studied and accepted is bright light • others may include social cues, temperature, exercise, and diet • poorly timed exposure to bright light may prolong or worsen circadian desynchrony
Circadian Rhythms • Cyclical fluctuations in biologic activities • results in peaks and troughs in function/performance • sleepiness is normally increased twice per circadian day • 3-5 A.M. • 3-5 P.M.
Circadian Rhythms Fatigue -related vehicular accidents by time of day International Data (N=6,052) 1200 1100 1000 900 800 Number of accidents 700 600 500 400 300 200 100 Midnight 6 a.m. Noon 6 p.m. Midnight Time of day
Recovery from Operational Fatigue • Effects of sleep loss are under-appreciated • adverse effects of fatigue often attributed to other factors (inattention, performance errors, poor judgement, etc.) • Yes motivation helps, but it is impossible to will yourself fully alert • if sufficiently sleep deprived, individual may experience unintended sleep episodes
Preventive Strategies - One technique Report Time Midnight Noon Midnight Duty Day 12 Hr Off Duty Sleep Sleep Awake Awake Early Sunlight Limit sunlight during day Caffeine Avoid Caffeine during day Exercise Limit activity during day
Operational Strategy-Caffeine • Tasteless substance • Powerful CNS stimulant • Addictive • Be aware of how much you’re taking in
Caffeine Content* TEA COFFEE BREWED …………...…. 80-135 mg INSTANT ………………. 65-100 CAPPUCCINO (16 oz) ..70 DECAF .....……………... 3-5 GREEN..………….. 30 mg LEAF/BAG ....….... 50 SNAPPLE(16 oz) .. 48 COFFEE, GRANDE (16oz) STARBUCKS …. 550 mg MOUNTAIN DEW .......…... 55 mg COKE (12 oz) ...............…. 45 WATER JOE (16 oz) .…….60-70 Recommended Maximum Intake for 24 Hours = 200 - 250 mg *From: Barone, J.J. and Roberts, H. R. 1996. “Caffeine Consumption.” Food Chemistry and Toxicology, vol. 34, p 119-129.
Too Much Caffeine • ANXIETY • DEHYDRATION • DEPRESSION • FAULTY THINKING/FALSE SENSE OF ALERTNESS • FINGER TREMOR • INSOMNIA • FATIGUE/SLEEP LOSS
Considerations to minimize problems associated with shift work: • Ensure good exposure to sunlight during the day • Take proper “lunch” breaks during night shifts • Avoid a heavy meal • Napping on lunch breaks • Lighting techniques/temperature control • Take extreme care when driving home after shift • Physical activity (take walks, drink water, get fresh air, etc…)
Strategies - Sleep Hygiene • Try to maintain consistent bedtime habits to set stage for sleep (pre-sleep routines) • Muscle relaxation techniques may help with stress reduction and sleep onset • Avoid heavy meals, caffeine and alcohol prior to sleep • Ensure a good sleep environment • Cool, dark, quiet… • If you can’t sleep within 30 minutes of getting in bed get up.
VISUAL VESTIBULAR SEAT-OF-THE-PANTS AUDITORY Balance and Orientation
Types of Disorientation • Type I - Unrecognized • Type II - Recognized • Type III - Incapacitating
Factors conducive to SDO • Poor outside references (dusk to dawn, clouds, haze, etc) • High G, sustained/high roll rate • High workload, distraction • runway change, short approach, IFE, etc. • Fatigue
How Can Controllers Help? • Query significant flying deviations • Query significant communications lapses or miscommunications • BE ASSERTIVE AND SPECIFIC!!!
How Can Controllers Help? • At night/in Wx: • minimize heading and altitude changes • use short phrases • use calm, unhurried communications • If the pilot reports a problem with SDO: • while maneuvering for approach, direct pilot out of Wx, if possible • Offer PAR or ASR if available
SDO can happen... • To who? • Anyone • When? • Day or Night • Good Wx or Bad
You can... • Be aware of SDO • Crosstalk with wing pilots • Treat high risk conditions with caution
Questions?... 1Lt Kristina Rustad 89 PTF 7-4654 89th PHYSIOLOGICAL TRAINING FLIGHT