Dehydration
Human need for 2-4 quarts of water a day. You become thirsty with a deficit of 1.5 quarts of body fluids or 2% of body weight. The deficit causes a reduction in blood volume and triggers thirst. Thirst arrives too late and can be mollified too easily. At 3% of body weight fluid loss fatigue and weakness occurs. Symptoms are headache, sleepiness, dizziness and weariness. Avoid diuretics such as coffee and alcohol. Don’t rely on thirst as drinking trigger. Measure fluid intake daily.
Ear Block
Caused when the Eustachian tube becomes blocked. Ear block or sinus blockages can cause differential air pressures to exist between cavities of the skull and the exterior. If it is not possible to equalize these pressures by slowing or removing the pressure changes severe pain results. Do not fly if you suspect such a condition exists or above 8,000’ within 24 hours of scuba diving. Gum chewing and jaw movement are preventives. The Valsalva maneuver consists of opening the mouth wide with the jaw wide, as though yawning. Do this over and over because opening the mouth helps open the Eustachian tubes. Next, pinch your nose closed, shutting the mouth, and blow gently as through your nose.
Hyperventilation
Stress, anxiety and fear cause hyperventilation. The person begins abnormal rapid breathing. Reduction of carbon dioxide causes lightheadedness, suffocation, drowsiness, tingling, and coolness. Leads to incapacitation, spasms, and unconsciousness. Symptoms resemble hypoxia. Can be corrected by controlled breathing in a paper bag.
Hypoxia
An adult will breath in 3,000 gallons (by volume) of air per day. This includes 600 (20% of total) gallons of oxygen. Your blood system has 25+ trillion (12 zeros) red blood cells (hemoglobin). Each one is capable of loading up four oxygen molecules for distribution throughout the body. when returning to the lungs for a refill they unload CO2 first.
Hypoxia is oxygen starvation. Lack of oxygen impairs the whole body but most importantly the brain. The first part of the body to show significant effect from oxygen deficiency is the retina of the eye. Every individual is affected but in different ways and to different degrees. The danger in hypoxia is that it occurs insidiously below the conscious threshold. Hypoxia makes you happy and such happiness in the cockpit is very dangerous. The best warning indicator for hypoxia is the altimeter. You will quickly recover by descent to a lower altitude.
Since hypoxia is due to reduced barometric pressure, low-grade hypoxia begins on takeoff. The percentage of oxygen is same but less is reaching the blood stream. Any stress or increase in activity requires more oxygen, up to 8 times more. Pilot performance deterioration begins at takeoff, as well. Slowed response times and inability to deal with complexities due to hypoxia compromise safety. Noticeable oxygen deficiency effects begins at 4000’ safety margins are beginning to erode. Hypoxic symptoms of difficulty breathing or headache may not be obvious or may not occur at all even though there are the foregoing changes in mental status.
I have seen complete personality changes occur after a couple of hours around 12,000’. Symptoms such as headache, drowsiness, dizziness, euphoria, tingling, perspiration, or belligerence are typical. Tunnel vision and blue fingernails occurs with times as little as 15 minutes above 15,000’. At 16,000’ disorientation, lapses of judgment, loss of impulse control, risk-taking behavior, decreased problem solving abilities, impaired memory, mood disturbances, and lowered coordination are common. Unconsciousness occurs in 10 minutes at 20,000’.
All effects are made worse and happen at lower altitudes with fatigue, age, smoking, health habits, and drinking. Oxygen recommended above 10,000 day and 5,000 night. If oxygen is being used, the pilot must be knowledgeable about the operation of the system and be able to recognize his and the system’s warnings of oxygen deficiency. FARs require oxygen if ½ hour above 12,500’, crew above 14,000’, everybody above 15,000’.
Smoking
The smoking of tobacco is a form of self imposed physical and psychological stress that constitutes an immediate and on-going threat to health and safety. A smoker may deny that drugs are a part of his life. He lies in the face of facts. The whole purpose of a cigarette is to get a nicotine fix. Different from cocaine or heroin? How? The person who smokes is a health and economic hazard to everyone. The residue remains on his person, clothes, possessions, and associates.
Susceptibility to CO poisoning increases with altitude due to the propensity of CO to enter blood. This prevents the blood from being able to transport adequate oxygen to the body’s cells. The hypemic hypoxia of the smoker reduces his oxygen intake by 5-10 % of normal capacity. The fact that smokers are hypoxic means that we can expect smokers to feel anxiety, forgetfulness, irritability, confusion, altered judgment with every cigarette. Judgment, math ability, and reasoning will be affected. The indication is that smokers are more likely to enter into personal arguments and show lack of both good judgment and logical reasoning ability in those arguments. Very small amounts of CO over a period of time will reduce a person’s ability to perform safely. It is the length of exposure as well as the amount that makes the critical difference. This lack of oxygen to the brain impairs judgment and diminishes the ability to make reasoned decisions.
Any onset of sluggishness, warmth, and tightness across the head is an early symptom of CO poisoning. A headache, weakness, dizziness and dimming of vision comes next. You won’t be aware when you lose strength, vomit, convulse, and enter a coma. A breath of fresh air will not revive you. Several days may be required for full recovery. The smoker is betting against a CO impairment that has already occurred and can only become worse. Carbon monoxide and other toxins in tobacco smoke interfere with the oxygen-carrying capacity of red blood cells. Less oxygen means less energy. Smoking causes an accumulation of mucus in the windpipe and bronchial tubes constricts blood vessels and reduces the supply of oxygen to cells.
The pilot who smokes is a hazard to himself and other pilots. The fact that smokers are hypoxic at relatively low altitudes means that we can expect smoking pilots to feel anxiety, forgetfulness, confusion, irritability, and altered judgment at relatively low altitudes. The applicable question is, should smoking pilots have any more right to fly than drinking pilots? Know your limitations. Don’t fly if you are not 100%.
Coffee
Half of the American population is addicted to coffee. 25% drink ten or more cups a day. Quitting coffee is both difficult and painful. At age 71 I dropped coffee primarily to lower my blood pressure. I had a two-week headache. Now I take afternoon naps. The lure and temptation of coffee still exists.
Coffee has some negatives:
1. Raises the adrenaline level.
2. Linked to heartburn and ulcers.
3. Leading cause of sleep disturbance.
4. Constricts blood vessels of the eyes.
5. Contains at least five cancer causing compounds.
6. Contains pesticides that are not allowed in the U.S.
7. Contributes to iron loss, zinc loss, and sex drive loss.
8. Increases risk of stroke by increasing blood pressure.
9. Blocks adenosine, a brain chemical that calms you down.
10. Can cause panic attacks by increasing lactate in the body.
11. Can addict babies whose mothers drank during pregnancy
12. In conjunction with diet, cold, anti-depressants will dramatically raise blood pressure.
13. Causes excretion of calcium, potassium, magnesium and sodium before being used by the body due to diuretic effect.
Spatial Disorientation
Spatial disorientation is the No. 1 cause of military aviation fatal accidents. Even the best pilot will become disoriented under the right conditions. Effects on inner ear can cause a mentally and physical compelling move in a given direction. This can be the after effect of a gradual turn, spiral, spin, acceleration, leveling off, updraft, false horizon, autokinesis, (lights that move), runway illusions.
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