By Hidde Deketh
Aviation Medicine, also called flight medicine or aerospace medicine, is a preventive or occupational medicine in which the patients are passengers, pilots, aircrew members or even persons involved in spaceflight.
This subspecialty strives to treat or prevent conditions to which aircrew members are particularly susceptible, applies medical and environmental knowledge to human factors in aviation and is thereby a critical component in aviation safety. Aviation medicine is also applied to advise/regulate safe and proper transport of sick passengers by commercial airliners or air ambulances. A military practitioner of aviation medicine is called a "Flight Surgeon" and a civilian practitioner is called an "Aviation Medical Examiner (AME)."
Broadly defined, this subspecialty endeavours to discover and prevent various adverse physiological responses to hostile biological and physical stresses encountered in the aerospace environment, such as low atmospheric pressures, low levels of oxygen or even cosmic radiation. The problems range from a painful, blocked ear in a child in a commercial aeroplane to a serious, unstable patient in an air ambulance, as well as cabin/cockpit crew having to fly the aeroplane with certain medical conditions.
Atmospheric physics potentially affects all air travellers, regardless of the aircraft used. As humans ascend through the first 10,000 metre (35.000 ft), the temperature drops at a rate of 2° C per 300 metre (1,000 ft). At cruising altitude of 10 km, the temperature will then be as slow as – 55° C (-70° F). The pressure and humidity also fall and we are exposed to increased cosmic radiation, vibration and acceleration forces, and the latter called the "G"-forces.
To cushion these hostile elements, the cabins are heated, pressurized and oxygenated, otherwise we would not be able to live and breathe up there. Military pilots need to wear the so called "G"-suits, to squeeze the blood from legs to the brain to compensate for excessive G-forces and thereby avoiding black-out during extreme aircraft manoeuvers.
Every factor contributing to a safe flight has a failure rate. Standards of risk are applied to airframes, avionics and all systems used for flying an aeroplane. For the crew operating an aircraft, it is no different. Aviation medicine aims to keep this human factor risk as low as possible. This is also one of the reasons why it is mandatory to operate larger aircraft with two pilots instead of just one.
Aeromedical Examinations aim at screening for any elevated risk for sudden incapacitation, for example, epileptic seizures, heart attacks or diabetes. The goal of these Aeromedical Examinations is to protect the life and health of pilots and passengers by making a reasonable medical assurance that an individual is fit to fly. The AME will screen for identifiable medical conditions that could lead to problems while performing airborne duties.
For the pilots, for example, the AME will make sure there is no colour blindness, that the vision is excellent and that the pilots are fit to operate an aircraft despite the stresses mentioned as well as jetlag, irregular meals and work related stress.
For sick passengers in commercial aeroplanes, the AME advises the airline company on how to assist this particular passenger with the type of seat or even stretcher, wheelchair/buggy at the terminals, supportive oxygen or medical escorts, for example.
It will be reassuring for you all to know that when you are leaving SXM in an aeroplane, there are specialized doctors looking after the health and fitness of the pilots, ensuring they steer your aeroplane safely towards your destination.
Have a safe and worry-free flight next time around!
To all my (para)medical colleagues, I look forward to see you this coming Friday and Saturday at the Aviation Medicine Conference at Belair Community Center! (See Ad.)
Hidde Deketh is a General Practitioner, Chief Medical Officer of Princess Juliana International Airport (SXM); Authorized Medical Examiner for FAA (USA); JAA (Europe); Transport Canada, CAA St. Maarten. Travel Clinic, listed in the International Society of Travel Medicine (ISTM); Member of the Aerospace Medical Association and the Civil Aviation Medical Association. For more information, call 1 (721) 545-4280, email This email address is being protected from spambots. You need JavaScript enabled to view it. or visit www.mulletbayclinic.com
