Federal Air Surgeon's
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Federal Air Surgeon’s Medical Bulletin Aviation Safety Through Aerospace Medicine 02-4 For FAA Aviation Medical Examiners, Office of Aerospace Medicine U.S. Department of Transportation Winter 2002 Personnel, Flight Standards Inspectors, and Other Aviation Professionals. Federal Aviation Administration Best Practices This article launches Best Practices, a new series of HEADS UP profiles highlighting the shared wisdom of the most A Dean Among Doctors senior of our senior aviation medical examiners. 2 Editorial: Research By Mark Grady Written by one of Dr. Moore’s pilot medical and Aviation Safety General Aviation News certification applicants, this article appeared in the November 22, 2002, issue of General Avia- 3 Certification Issues OCTOR W. DONALD MOORE of tion News. —Ed. and Answers Coats, N.C., knows a lot of pilots 6 Bariatric D— many quite intimately. After Surgery: all, as an Federal Administra- morning just to give medical exams for pilots in the area. How Long tion Aviation Administration- approved medical examiner, He estimates he’s given more to Wait? he’s poked and prodded quite than 12,000 flight physicals a few of them during his more over the past 41 years. 7 Checklist for than 40 years of making sure “I’ve given an average of Pilot they meet the FAA’s physical 300 flight physicals a year since Physical requirements for flying. 1960,” he says, noting those He also knows what it’s like exams have been in addition to fly, because he flew for 40 to running a busy general 8 Palinopsia Case years. medical and obstetrics Report Moore began giving FAA Dr. Moore, shown in his practice. Coats, N.C., office 9 Factors in Human physicals in 1960, the same While he majored in Greek Error year he learned to fly. Now and English at Wake Forest, 11 Hydrocephalus Case 83 years old, he is not as active at his Moore was always interested in the sci- Report medical clinic as he once was, but he still ences. He couldn’t escape an interest in ventures in for an hour or two each 12 AAM News Continued on page 5 13 AME Seminars 14 Health of Pilots: Quick Fix Your By Richard F. Jones, MD, MPH Heart & Exercise PROBLEM 16 Index of Student pilots are sometimes receiving an FAA Form 8500-9, Medical Certifi- 2002 Stories cate, instead of an FAA Form 8420-2, Medical Certificate and Student Pilot Certificate, at the time of their FAA medical examination. Another part of this problem is where an applicant has requested a combined Medical and Student Pilot Certificate in block 1 on the 8500-8 form, but the aviation medical examiner (AME) indicates in block 62 of the form that only a Medical Certificate has been issued. RESULT SHARE If only a Medical Certificate is issued, student pilots are flying without valid With certificates and are subject to disciplinary action when caught. These student This Information pilots are often very hostile toward the AME who failed to issue the appropriate YourPatients Staff and certificate. Continued on page 10... Aerospace Medical Research: Making Air Travel Safer The Federal Air Surgeon’s Column O MANY PERSONS outside the Fed- is accomplished quietly and without a Teral Aviation Administration great deal of fanfare. I can assure you, (FAA), the Office of Aerospace however, that the contributions these Medicine’s greatest visibility relates to organizations make to system safety our administration of the airman medi- provides a big “bang” for the relatively cal certification system. There is good small expenditure of dollars that go to reason for this since ensuring that air- their support. men meet sound medical criteria and Human Resources. Research psy- are free of drugs and alcohol have long chologists and supporting staff com- By Jon L. Jordan, MD, JD been considered our highest priorities. prise the Human Resources Research Sometimes overlooked are the signifi- Division. Their goal is to improve aero- cant contributions and support our re- space safety and workforce performance hard work by the staff at CAMI, what search organizations provide, not only through human factors research. In began as a cast-off hunk of metal has to the certification process but also to plain language, these folks play a major become a unique, multi-purpose, highly the overall safety of the national air- role in identifying environmental and sophisticated, research facility. space system. other factors that impact pilot and air Thus far, the facility has been used The FAA is blessed with having two traffic controller performance and cause for a number of research tasks. In- “World Class” research organizations or contribute to accidents. Among oth- cluded among these is the training of at the Civil Aerospace Medical Insti- ers things, the research includes human aircraft accident investigators as well as tute (CAMI). Much of the work carried performance under various conditions security personnel for dealing with hi- out by these two research organizations of impairment, human error analysis jackers and unruly passengers. The fa- and impact of advanced automation cility is equipped to investigate cabin systems on personnel performance. airflow that will define molecular, par- Federal Air Surgeon’s Medical Research. The other divi- ticulate, and microorganism dispersion Medical Bulletin sion, the Aerospace Medical Research and aid in studies of contamination of Division, is composed of a more het- cabin and cockpit air from a variety of erogeneous group of scientists. Among potential sources, including possible Secretary of Transportation others, included are re- acts of terrorism. Most Norman Y. Mineta search physicians, chem- recently, the facility was FAA Administrator ists, and engineers. To used to determine the Marion C. Blakey name just a few, these time required to secure a Federal Air Surgeon folks engage in accident passenger cabin follow- Jon L. Jordan, MD, JD investigation from the ing a warning of air tur- medical perspective, bulence. This research Editor look for ways to improve was in support of NASA Michael E. Wayda occupant protection and for the development of The Federal Air Surgeon’s Medical Bulletin survival in the event of an early-warning system is published quarterly for aviation medical an accident or other life- for air turbulence. Fu- examiners and others interested in aviation threatening event, and Wide-Body Research ture potential uses for safety and aviation medicine. The Bulletin is identify physiological, Facility at CAMI the facility are virtually prepared by the FAA’s Civil Aerospace Medi- psychological, and per- limitless. cal Institute, with policy guidance and support formance factors that threaten safety. from the Office of Aerospace Medicine. An Those of you who have had the Internet on-line version of the Bulletin is It is impossible to cover in this col- opportunity to visit CAMI recently are available at: http://www.cami.jccbi.gov/ umn all the important aviation safety familiar with the current high level of AAM-400A/fasmb.html contributions being made by our two sophisticated research going on there. research organizations. I feel compelled, For others who have never been there or Authors may submit articles and photos for however, to mention at least one. This have only a dim recollection of our publication in the Bulletin directly to: is the wide-body environmental research research activities, I simply wanted to Editor, FASMB facility that was completed in 2001. let you know or remind you of the FAA Civil Aerospace Medical Institute The wide-body research facility was dedicated and highly professional staff AAM-400 developed through refurbishing the hull that— in many ways— is working to P.O. Box 25082 Oklahoma City, OK 73125 of a scrap Boeing 747 aircraft. Through make air travel as safe as it can be. e-mail: [email protected] ingenuity in securing funds and a lot of JLJ 2 The Federal Air Surgeon's Medical Bulletin • Winter 2002 Certification A 22-y/o airman has a single epi- An airman who last had an FAA sode of spontaneous pneumothorax and medical certificate in 1992 has a history Issues and applies for a 1st-class medical certifi- of chronic tension headaches. He writes 1 ® cate. What do you need to provide the 9in Block 17 that he takes Ultram Answers AMCD? Can you grant medical certi- (tramadol hydrochloride) and Flexeril® fication? (cyclobenzaprine HCL) for the head- A 45 y/o airman develops a bout aches. He has been averaging four head- By Warren S. Silberman, DO, MPH of paroxysmal supraventricular tachy- aches per month, and they seem to 2cardia. Can you issue a 3rd class medical occur when his boss “gets on his case” certificate for this? about things. The headaches are linked ne of our hard-working med- Does the AMCD grant medical with nausea and photophobia. Noises ical review physicians, Larry certification after an airman suffers a seem to make them worse. He must get O F. Wilson, MD, is in the Okla- pulmonary embolus? What if the air- to a dark room and try to rest when he homa Army National Guard and has 3man is still on Coumadin®? gets one of them. He claimed that he been mobilized for at least one-year [see An airman comes to your office only takes the Flexeril® when he has to, story, page 12]. This has resulted in for an initial flying examination. On but the Ultram® works quite well. You quite a strain on our other physicians, examination, you note that he has a issue an unlimited medical certificate. and we pray for his safe return. 4scar from childhood that goes across Were you right? I am requesting that you aviation his orbit, and the cicatrix essentially What are the five mental health- medical examiners who regularly call resulted in a profound ptosis of the related specifically disqualifying the Aerospace Medical Certification eyelid.