The first BLOG in this series was titled "The Checklist". It discussed how pilots were the first to recognize the importance of checklists and develop them for aviation. Checklists were soon developed for all phases of flight as well as for mechanical and technical aircraft procedures. They have proven invaluable and have prevented countless accidents and deaths. They have also been adopted by many other disciplines (such as medicine) due to their utility and effectiveness in preventing errors and ensuring the best possible outcomes in almost any given situation or set of circumstances.

More recently, a checklist has been developed for a vital aircraft operating component...the pilot. This checklist is as important and valuable as any of the other checklists. It should be used by the pilot for each and every flight. It is referred to as the "I'M SAFE" checklist and is generally introduced in the early portion of most flight training programs. The mnemonic stands for:
I: Illness
M: Medication
S: Stress
A: Alcohol
F: Fatigue
E: Eating and Emotion (The FAA defines "E" as Eating - to include proper nutrition and hydration) Some other international aviation authorities define "E" as Emotion - referring to emotional and psychological state.

For further information check out the excellent article by Sarina Houston, aviation contributor for about.com, The I'm SAFE Checklist, Pilot Risk Management:There's a Checklist for That  click hiere    

 According to Transport Canada's Guide for Aviation Medical Examiners: "On any visit, a blood pressure level of 180 mmHG or more systolic or 105 mmHg or more diastolic, precludes medical certification". This is, without doubt, a dangerously high level of blood pressure. The guide also states that levels between 140 and 180 mmHg systolic and / or 90 and 105 mmHg diastolic require further evaluation.

"An applicant whose pressure does not exceed 155 mm mercury systolic and 95 mm mercury diastolic maximum pressure, who has not used antihypertensive medication for 30 days, and who is otherwise qualified should be issued a medical certificate by the Examiner."
Blood pressure readings in excess of these values will require the examiner to defer certification.

Regardless of what the agencies deem as acceptable blood pressure levels, the important point to be aware of is that hypertension is a thief and a killer. Over time, it will rob you of your health and then bring about a premature death. This knowledge had just begun to be realized when I was a medical student. Many slightly older physicians were not aware of this and did not believe it was necessary to treat high blood pressure. In their defense, it should be noted that the available antihypertensive medications of the day had many unpleasant side effects. Patients felt worse taking medication. In addition, there were no studies to prove that lowering the blood pressure with these medications was actually beneficial.

Since that time, many new medications have been developed and numerous high quality studies have shown unequivocally that lowering the blood pressure with these medications is extremely beneficial.

Perhaps just as important to the pilot or air traffic controller is the fact that many of these medications are acceptable to both Transport Canada and the FAA with no restriction to the medical certification.

The take home message: Adequately treated,  hypertension will not result in loss or restriction of your medical certificate. However, the complications of untreated hypertension very likely will.​

Fortunately, there are many things you can do to reduce high blood pressure if you are above the acceptable limits set out in the guidelines. These include lifestyle changes such as:

• weight loss
• exercise
• low salt and low fat diets
• quite smoking
• reduce caffeine

If necessary, there are many medications to control hypertension that are approved by both Transport Canada and the FAA.

The most important thing to remember is high blood pressure does not need to prevent you from being a pilot or air traffic controller. A single elevated reading is not enough for a diagnosis of hypertension. Anxiety, stress, fatigue, time of day may all affect a blood pressure reading, and if this occurs, several readings need to be done to obtain an average. Do not let fear prevent you from discussing this important issue with your doctor.
DO THE SMART THING!

For further reading from Hypertension Canada click here and from The American Heart Organization click here

This platform is intended to provide interesting and important information on various medical topics with particular emphasis on topics related to pilots and aviation medicine.

Today I would like to inform those of you who may not be aware, of the availability of free aeromedical training programs for general aviation pilots.

The FAA offers free aviation safety and physiology training courses to any person 18 years of age and over with a valid Class 1, 2, or 3 medical certificate. U.S. citizenship or residency is NOT a requirement. It is being graciously and generously offered to anyone wishing to attend. Security clearance must be obtained prior to arrival for the program. The only costs to the applicant are transportation and accommodation.

The programs are given at the Civil Aerospace Medical Institute (CAMI) located in the Mike Monroney Aeronautical Center in Oklahoma City, Oklahoma.

I had the pleasure and privilege of spending a day at CAMI during a recent Aviation Medical Examiners seminar in Oklahoma City. The educational staff was very knowledgeable and experienced with an obvious passion for their important work. There is no doubt in my mind that the existence of this program has prevented numerous aviation incidents and accidents and saved lives.

To the best of my knowledge, no similar program for general aviation civilian pilots exists in Canada. In my opinion, every pilot or student pilot would benefit greatly from such training.

For details on the program and application procedure click on the following links:

http://www.faa.gov/pilots/safety/pilotsafetybrochures/media/physiologc.pdf

http://www.faa.gov/pilots/training/airman_education/aerospace_physiology/cami_enrollment/how_to/
 

I have selected “THE CHECKLIST” as the title for this platform. The reason for this choice will be described in a future post.

Constructive comments and criticism regarding any posts are welcome. I will also consider posting suggestions or articles you might wish to provide. Simply e-mail me at

[email protected]

 

Stay well. Stay safe.

Armando

E. A. Mastrangelo M.D., CAME, AME