16 September 2011. Reno, Nevada saw the tragic crash of a P-51Mustang [1] during the Reno Air Races. The findings of the National Transportation Safety Board suggests that the pilot had lost consciousness due to ‘overwhelming’ G forces [2]. This occurrence in a modified 1940’s vintage aircraft is no surprise, considering its high thrust to weight ratios amongst its contemporaries, with a structural strength of -2G to +9G, making it likely that G induced loss of consciousness (G-LOC) could have been the cause of this tragedy, where besides the pilot, 10 spectators also perished [2, 3]. Continue reading
G-LOC – Then and Now…
There is LASER in my eye!
There is a spurt in the incidence of Laser devices aimed at aircraft during low level flying or while making an approach to land [1, 2]. Despite punitive actions against culprits, including sentence up to 10 years in Germany or 20 years in US, it shows no signs of abating [2, 3, 4]. Those shining the handheld laser pointers into the aircraft cockpits are unaware that transient visual effects of laser are “a threat to safe aircraft operations”. This may also have a potential for permanent damage to the retina of aircrew [5].
Pilot Incapacitation: Extent of the Problem.
The study by Evans et.al. highlighted a linear trend in incapacitation rates from the pilots in 20s to those in their 60s, with those in 60s accounting for 15% of incapacitation [4]. Both cardio- and cerebro-vascular conditions being responsible for 50% (18/36) of incapacitation events, including 2 of the 4 sudden deaths, endorse the present practice of screening for underlying coronary artery disease by aviation medical regulators the world over. However an interesting fact that emerged is the number of psychiatric episodes of incapacitation and impairment. Though not life threatening to the individual suffering from, say, panic attacks it is definitely a hazard for flight safety! Does it warrant that the regulators must pay increased attention to such maladies of the mind in the future? Continue reading
Pilot Incapacitation: What is?
Common medical causes of in-flight incapacitation amongst airline pilots in U.K were cardiovascular (heart attacks, rhythm disturbances) and neurological (epileptic seizures) [10]. Another study in U.S. identified several causes of in-flight incapacitation. This included loss of consciousness; causes related to the gut viz., gallbladder stones, gastroenteritis or discomfort due to expansion of trapped intestinal gases; besides kidney stones and other neurological or cardiovascular causes [11]. Invariably incapacitation caused by the ‘heart attack’ resulting in sudden death leads to fatal outcome in single cockpit operations [12] but the usefulness of minimal two crew operations in commercial aviation is more than evident in all the three cases of pilots’ death in flight enumerated above [1, 2, 3]. Continue reading
Pilot Incapacitation: Debate on Assessment, 1% Rule etc.
Reuters reported on 15 February 2012 that the captain of a Czech Airlines plane collapsed and died in flight from Warsaw to Prague. The plane carrying 46 passengers made a safe landing with the co-pilot on controls [1]. In another case, a Qatar Airways captain passed away in October 2010 on a flight from Manila, Philippines to Doha, Qatar [2]. Still earlier in 2009, the 60 year old captain of a Continental Airlines flight from Brussels to Newark died in mid-flight [3]. Such news items may be a cause of concern for the flying passengers despite of stringent periodic medical assessment instituted by the aviation regulators. But, it is more important to note that all those flights landed safely, thus proving the wisdom of allowing multi crew composition in commercial aviation while effectively applying Evidence Based Medicine in the Aeromedical Decision Making (ADM) while determining the medical fitness of pilots by the regulatory medical authorities. Continue reading