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Health and Medical issues

Page history last edited by Béatrice H. Alves 5 years, 1 month ago





Lexical domain

Health problems

symptoms, first aid, aircraft interior, type of medical assistance, medical background of passengers, diversion, airport installation, ground services, sickness, discomfort, wounds, epidemics, medical equipment, blood (group, transfusion, etc.), medical advice, the human body, forensic surgeon, quarantine, food poisoning, food, vaccines, medical staff, medicines and artificial limbs

Pilot's temporary disability

health problems, aircraft controls and instruments, pilot's actions/behaviour, airfield environment, airport installations


Pilot incapacitation


Pilot Incapacitation is the term used to describe the inability of a pilot, who is part of the operating crew, to carry out their normal duties because of the onset, during flight, of the effects of physiological factors.


Death is the most extreme example of incapacitation, usually as a result of a heart attack, but is not necessarily the most hazardous. Although most recorded deaths of operating pilots in flight have been found to be due to cardiovascular disease, by far the most common cause of flight crew incapacitation is gastroenteritis.

Incapacitation may occur as a result of:

  • The effects of Hypoxia (insufficient oxygen) associated with an absence of normal pressurisation system function at altitudes above 10,000 ft.
  • Smoke or Fumes associated with an In-Flight Fire or with contamination of the air conditioning system.
  • Gastro-intestinal problems such as severe Gastroenteritis potentially attributable to Food Poisoning, or to Food Allergy.
  • Being asleep.
  • A medical condition such as a heart attack, stroke or seizure, or transient mental abnormality.
  • Bird Strike or other event causing incapacitating physical injury.
  • A malicious or hostile act such as assault by an unruly passenger, terrorist action or small arms fire, or possibly malicious targeting of aircraft with high powered lasers by persons on the ground.

Unless the incapacitation occurs on a single pilot operation, incapacitation of one pilot may not be immediately obvious, become only progressively evident, or escape notice altogether until an unexpected absence of response or action occurs.

Read more about it on Skybrary

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Dealing with Pilot Incapacitation

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Captain incapacitated by panic attack

Incident: Jetblue A320 near Amarillo on Mar 27th 2012, captain incapacitated by panic attack

By Simon Hradecky, created Tuesday, Mar 27th 2012 18:06Z, last updated Tuesday, Mar 27th 2012 18:10ZA Jetblue Airbus A320-200, registration N796JB performing flight B6-191 from New York JFK,NY to Las Vegas,NV (USA), was enroute at FL340 about 55nm north of Amarillo,TX (USA) when the captain suffered a panic attack and behaved entirely incoherent forcing the first officer to seek assistance by cabin crew and passengers to overpower the captain, lock him out of the cockpit and have him restrained in the passenger cabin. Another Jetblue pilot flying as passenger assisted the first officer while diverting to Amarillo for a safe landing about 20 minutes later.

The airline confirmed the flight diverted because of a medical condition with the captain. Another captain travelling as passenger on the flight joined the first officer in the cockpit. The ill captain was taken to a local hospital. A replacement aircraft is going to be dispatched to Amarillo to continue the flight.

Read more about it here.


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Getting help during Captain's incapacitation



When Gongol reached the cockpit, it was clear the captain was in trouble. Passengers and crew were helping him out of the cockpit. A cot had been set up. The captain looked pale and clammy from an apparent heart attack, Gongol remembered.

Pipe bursts on plane, soaks p        Gongol stepped onto the flight deck and came eye to eye with the first officer.

"There was a moment," he recalled. "We both had about five seconds to size each other up. She was wondering about my level of experience. Was I a Cessna driver -- or a professional pilot?

"I wanted to make sure she was OK. I had a feeling she was -- she was better than OK. She had already made the decision to turn the plane toward the nearest airport."

Gongol strapped himself in and did what he could to help get the plane to the airport in Omaha.

Never taking the controls, Gongol acted as a backup for the first officer. He worked the radio, communicating with air traffic controllers -- updating them on the condition of the captain, passengers and the aircraft.



Read more about it on CNN


First officer incapacitation

Incident: Jettime AT72 near Billund on Jul 31st 2016, first officer incapacitated

By Simon Hradecky, created Thursday, Sep 1st 2016 19:03Z, last updated Thursday, Sep 1st 2016 19:03Z


A Jettime Avions de Transport Regional ATR-72-212A, registration OY-JZC performing flight SK-1289 from Copenhagen to Billund (Denmark), was enroute about half way into the flight when the first officer began to complain about stomach pain, became pale and developed cold sweat. The captain took control of the aircraft as well as radio communication, called cabin crew to assist the first officer, tie and shirt were loosened, the shoulder harness locked and wet towels provided. The captain informed ATC and requested medical services to meet the aircraft after landing. The aircraft landed safely in Billund, paramedics stabilized the first officer in the ambulance and took him to a hospital.

Denmark's HCL rated the occurrence a serious incident and opened an investigation.

Read comments on the Aviation Herald 

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Pilots and Medication



The captain lost his arm

A pilot lost control of a passenger plane after his artificial arm became detached as he was coming in to land, an accident report has said.

The Flybe flight from Birmingham, with 47 passengers on board, was approaching Belfast City Airport in gusty conditions on 12 February.

It landed heavily but no-one was hurt and the plane was not damaged.

The pilot said he would be more cautious in future about checking his attachment, according to the report.

In a statement, Flybe said the senior captain was one of its "most experienced and trusted pilots", and the safety of passengers and crew had not been compromised in any way.

Shortly before beginning to land the Dash 8 aircraft, the 46-year-old had checked that his prosthetic lower left arm was securely attached to the clamp that he used to fly the aircraft, with the latching device in place.

The Air Accidents Investigation Branch (AAIB) report said the captain had disconnected the autopilot and was manually flying the aircraft.

However, as he made the flare manoeuvre - a stage of the landing shortly before touchdown - "his prosthetic limb became detached from the yoke clamp, depriving him of control of the aircraft".

Read more about it on BBC News

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Dealing with a medical emergency


Cosmic radiations

Pilots and Cabin crew, but also passengers, are exposed to a natural source of radiation: cosmic radiation. High levels of exposure represent a risk for health (cancer, chromosomal (genetic) damage, cataract, etc.). Experts from the European Cockpit Association are preparing to lobby to improve the protection for crews against excessive exposure to radiation in Europe.

Pilots are more exposed to radiation than the average population. It is usually considered that there is no significant risk for health under 1mSv/year. However, the average annual exposure of pilots to radiation is between 3 and 4.5 mSv. According to the International Atomic Energy Agency, this figure could exceed 6 for long-distance flights at high altitudes1. Airline pilots are the largest professional group exposed to radiation. This problem is internationally recognised and the World Health Organisation (WHO) and the International Labour Organisation recommend that air crews should be considered occupationally exposed to cosmic radiation.

The WHO indicates that the radiation exposure at conventional aircraft flight altitudes of 30.000- 40.000 feet is about 200 times higher than on the ground. Indeed, at higher altitudes, the natural protection provided by the atmosphere against cosmic ionising particles is reduced. Other factors contribute as well, e.g. geographical latitude (the exposure to radiation at the poles is twice that at the equator) or solar activity (when the solar activity is high, the exposure is lower); moreover, solar storms can lead to sudden increases in radiation levels (up to 10mSv) in one single flight.

Read more on Eurocockpit 



"Stork strike"

Incident: Air Canada A333 near Dublin on Nov 30th 2010, "stork strike"

By Simon Hradecky, created Thursday, Dec 2nd 2010 14:57Z, last updated Thursday, Dec 2nd 2010 14:57Z

An Air Canada Airbus A330-300, registration C-GFAJ performing flight AC-875 from Frankfurt/Main (Germany) to Montreal,QC (Canada), was enroute at FL360 about 10nm north of Belfast International,NI (UK) when the crew decided to divert to Dublin (Ireland) after a woman (25) pregnant in her 37th week went into labour. The aircraft landed safely on runway 10 about 21 minutes later, the woman was taken to a hospital, where she gave birth to her baby. Baby and mother are reported in good condition.

The airplane departed again after about 3 hours on the ground and reached Montreal with a delay of 3:45 hours.


Read more here

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Listening to passengers' health problems


ATC dealing with Pilot's Hypoxia


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Pilot Incapacitation

An air hostess helped land a jet carrying 146 passengers after the co-pilot had an apparent mental breakdown over the Atlantic Ocean, investigators revealed today.

The UK-bound plane made an emergency diversion to Shannon Airport, in Ireland, last January after the Air Canada flight officer began a ‘rambling and disjointed’ conversation, said an official report.

Another attendant suffered wrist injuries as the crew forcibly removed the co-pilot from the cockpit controls and restrained him in a seat in the cabin.
Air Canada


Read the details here


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Great ATC

Only recording - no image


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Flying passengers with special medical needs


By James Wynbrandt - August 2007

Maybe you’d like to fly a wheelchair-bound relative to a family function. Or perhaps a member of your management team has contracted a bad case of the flu during a business trip. Flights with passengers like these–or anyone with a significant health issue–necessitate special planning.

“Many medical conditions require people to think before they travel,” said Jennifer Garr, manager of medical operations for Tempe, Ariz.-based MedAire, which provides medical information to flight departments and charter companies. “We assess everything from a cough to someone who just had a cast put on,” Garr said.

The demand for MedAire’s services underscores the need to consult a doctor or other health professional if a medical issue could affect a passenger’s flight. Make sure the physician understands that cabin altitudes can affect some medical conditions. If the doctor green lights the flight, consider the basic rules governing fitness to fly without an attendant: “The individual has to be able to follow commands, sit on a seat and [wear] a seat belt,” said George Martinez, director of flight programs at Fort Lauderdale, Fla.-based National Jets and National Air Ambulance....

Read more......


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Prozac Pilots May Fly as FAA Drops Ban on Medicines (Update1)

April 02, 2010, 8:01 AM EDT


By John Hughes

April 2 (Bloomberg) -- Pilots taking Prozac will be permitted to fly as U.S. regulators drop a decades-old ban on four antidepressants including the Eli Lilly and Co. drug.

Risks from side effects, such as drowsiness, associated with the medications used to treat depression don’t pose a safety threat, the Federal Aviation Administration said today.

Read more



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Looking for a doctor on board


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Describing symptoms


Dr Rumack, Mr Hammond ate fish, and Randy said there are five more cases 
and they all had fish too.
And the co-pilot had fish, what did the navigator have?
He had fish.
Alright, now we know what we're up against. 
Every passenger on this plane who had fish for dinner will become violently ill in the next half hour 

Just how serious is it Doctor?

Extremely serious. 
It starts with a slight fever and dryness of the throat. 
When the virus penetrates the red blood cells, the victim becomes dizzy,  begins to experience an itchy rash. 
From there the poison goes to work on the central nervous system, causing severe muscle spasms 
followed by the inevitable drooling. 
At this point, the entire digestive system collapses accompanied by uncontrollable flatulence. 
Until finally, the poor bastard is reduced to a quivering wasted piece of jelly.



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Outcomes of Medical Emergencies on Commercial Airline Flights


Worldwide, 2.75 billion passengers fly on commercial airlines annually. When in-flight medical emergencies occur, access to care is limited. We describe in-flight medical emergencies and the outcomes of these events.

Full Text of Background...


We reviewed records of in-flight medical emergency calls from five domestic and international airlines to a physician-directed medical communications center from January 1, 2008, through October 31, 2010. We characterized the most common medical problems and the type of on-board assistance rendered. We determined the incidence of and factors associated with unscheduled aircraft diversion, transport to a hospital, and hospital admission, and we determined the incidence of death.

Full Text of Methods...


There were 11,920 in-flight medical emergencies resulting in calls to the center (1 medical emergency per 604 flights). The most common problems were syncope or presyncope (37.4% of cases), respiratory symptoms (12.1%), and nausea or vomiting (9.5%). Physician passengers provided medical assistance in 48.1% of in-flight medical emergencies, and aircraft diversion occurred in 7.3%. Of 10,914 patients for whom postflight follow-up data were available, 25.8% were transported to a hospital by emergency-medical-service personnel, 8.6% were admitted, and 0.3% died. The most common triggers for admission were possible stroke (odds ratio, 3.36; 95% confidence interval [CI], 1.88 to 6.03), respiratory symptoms (odds ratio, 2.13; 95% CI, 1.48 to 3.06), and cardiac symptoms (odds ratio, 1.95; 95% CI, 1.37 to 2.77).


Read the full article on the New England Journal of Medicine

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Signs of fatigue


The 2012 Barometer on Pilot Fatigue brings together several surveys on pilot fatigue

carried out by Member Associations of the European Cockpit Association. Between 2010

and 2012, more than 6.000 European pilots have been asked to self-assess the level of

fatigue they are experiencing.

The surveys confirm that pilot fatigue is common, dangerous and an under-reported

phenomenon in Europe.

Over 50% of surveyed pilots experience fatigue as impairing their ability to perform

well while on flight duty.

4 out of 5 pilots have to cope with fatigue while in the cockpit, according to polls

carried out in Austria (85%), Sweden (89%), Germany (92%) and Denmark (93%).

A common indicator of the problem is that fatigued pilots are prone to fall asleep

or experience episodes of micro-sleep in the cockpit. In the UK (43%), Denmark

(50%), Norway (53%) and Sweden (54%) the surveyed pilots reported falling asleep

involuntarily in the cockpit while flying. In the UK, a third of the pilots said to have

woken up finding their colleague sleeping as well. 65% of Dutch and French pilots

stated they have trouble with “heavy eyelids” during flight.

Yet, fearing disciplinary actions or stigmatization by the employer or colleagues, 70-

80% of fatigued pilots would not file a fatigue report or declare to be unfit to fly. Only

20-30% will report unfit for duty or file a report under such an occurrence.

More than 3 out of 5 pilots in Sweden (71%), Norway (79%) and Denmark (80-90%)

acknowledge to have already made mistakes due to fatigue, while in Germany it was

4 out of 5 pilots.

Being the first of its kind, this Barometer is a first step towards closing the gap between

operational reality – as assessed by airline pilots – and official statistics that so far have

failed to capture this phenomenon and its potential impact on flight safety.


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