AVIATION MEDICAL EXAMS E.A. MASTRANGELO, M.D., CAME, AME
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I'M SAFE Checklist

17/4/2016

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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    
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THE CHECKLIST

7/8/2015

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Why "The Checklist"?

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I selected "The Checklist" as the title of this blog because I value checklists. To be embarrassingly honest, I am a bit of an obsessive compulsive. I believe that, to a certain degree, this is a good thing in many fields. We all hope that any individual we put our trust in (pilot, doctor, design engineer, etc.) pays close attention to details. An oversight, even a seemingly insignificant oversight, can have disastrous consequences. Checklists have been shown in numerous studies to greatly reduce the risk of “accidents”. They have proven invaluable in many fields including medicine, but were initially developed for use in aviation by pilots. Checklists enhance safety in a simple manner. They do not add complexity.

The following is a description of the birth of the checklist, adapted from chapter 2 of Atul Gawande’s New York Times Bestseller, The Checklist Manifesto. How to Get Things Right. It will also be found in numerous historical accounts of the event.

On October 30, 1935 at Wright Air Field in Dayton Ohio, the U.S. Army Air Corps held a flight competition for manufacturers vying to build the military’s next-generation long range bomber. Many felt it was only a formality. The Boeing Corporation’s model 299 was the superior aircraft. It could fly faster and farther than previous bombers with 5 times the bomb capacity requested by the military.

With a small group of Army brass and corporation executives observing, the sleek and impressive model 299 test plane with a 103 foot wingspan and 4 engines (versus the usual 2), taxied into position. It roared down the runway, smoothly lifted off and sharply climbed to three hundred feet. Then it stalled, turned on one wing and crashed. Two of the five member crew were killed, including the pilot, Major Ployer P. Hill.

The accident investigation concluded there was no mechanical failure. The crash was attributed to “pilot error”. This new plane was more complex than previous aircraft. The pilot was required to attend to multiple tasks including each of the four engines, retractable landing gear, wing flaps, electric trim tabs requiring adjustment to maintain stability at different airspeeds, constant speed propellers requiring their pitch be regulated with hydraulic controls, and more. While performing all these tasks, Major Hill forgot to release a new locking mechanism on the elevator and rudder controls. The model was deemed by many as “too much airplane for one man to fly”.

Even so, the army purchased a few from Boeing. Some insiders remained convinced that the airplane was flyable. A group of test pilots set about the task of finding a solution.

What they decided against doing is almost as interesting as the solution they came up with. They decided against longer pilot training. They reasoned that few pilots, if any, had more experience and expertise than Major Hill, the air corps’ chief of flight testing. But this new plane was too complicated to be left to the memory of any one person, regardless of experience or expertise.

The simple, yet ingenious, solution they did come up with was……the pilot’s checklist! They designed checklists for each phase of flight….take off, flight, landing and taxiing. They were simple, brief, to the point and short enough to fit on an index card.

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As aircraft (and spacecraft) have become more complex, the checklists have become even more important. 

For those readers interested in a more detailed and in depth study of the impact checklists have had in all areas of human endeavour, I strongly recommend The Checklist Manifesto--How to Get Things Right (2009) by Atul Gawande.

Everyone has personal experiences and everyone has a story to tell. We learn from experience. When it comes to bad experiences, it is wise to learn from the experience of those who have gone before us and heed their advice. This is why pilots have adopted the use of checklists and others have wisely followed.

 If you would like to share your knowledge and experience with the community in general, and the aviation community in particular, I welcome your contributions.  

Stay well. Stay safe.

Armando

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AVIATION SAFETY AND AEROMEDICAL TRAINING PROGRAMS FOR PILOTS

30/7/2015

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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




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    E. A. MASTRANGELO M.D., CAME (CANADA) , AME (FAA, USA)

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