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it may afford relief. If trouble persists several hours after landing, consult your aeromedical advisor.
Note.— If you develop symptoms of a cold when airborne, you may possibly avoid trouble by using a
nasal spray, kept as part of the flight kit. Take aviation medicine advice before purchasing one.
Panic
The development of panic in inexperienced pilots is a process which can give rise to a vicious circle and
lead to unwise and precipitous actions. If lost or in some other predicament, forcibly take stock of
yourself and do not allow panic to mushroom. Panic can be controlled. Remember, to prevent panic, think
straight. Fear is a normal protective reaction, and occurs in normal individuals. If you believe it occurs
frequently or too easily to you, seek medical advice – there are techniques that can be learned and used to
reduce the effects.
Underwater diving
If you go flying after scuba diving or any underwater activity using compressed air, you should be aware
that if insufficient time has elapsed between surfacing and take-off, the medical consequences can be
serious or even fatal. Due to greatly increased pressures underwater, nitrogen is absorbed into the blood
and tissues. The amount depends on the depth and duration of exposure. If take-off follows the dive too
soon to allow the body to rid itself normally of this excess nitrogen, the gas may form bubbles in the
blood or tissues causing discomfort, pain, difficulty in breathing, or even death, at altitudes of 7 000 feet
(2 135 metres) or less, altitudes attained by most light planes. Older or overweight individuals are more
susceptible to this condition. As a general rule, individuals should not fly within 24 hours following
diving.
Occasionally a medical emergency arises as a result of compressed air diving, when a diver has been
unable to adequately decompress before surfacing. In some of these cases air-evacuation is the only
feasible method of getting the patient to a decompression chamber in time to treat the condition, and it
should not be excluded. Flight, however, should be at the lowest possible altitude to avoid aggravating the
condition. Information concerning diving, decompression and flying is readily available from various
diving organizations, such as the Professional Association of Diving Instructors (PADI):
http://www.padi.com/padi/default.aspx
Blood donations
Following a blood donation, time off flying is needed for the body to readjust. Allow 24 hours before
flying after donation unless you have received specific medical advice that this period can be safely
ICAO Preliminary Unedited Version — October 2008 V-2A-5
shortened.
Hyperventilation
Hyperventilation, or over-breathing, is a disturbance of respiration that may occur in individuals as a
result of emotional tension or anxiety. Under conditions of emotional stress, fright or pain, the breathing
rate may increase, causing increased lung ventilation. More carbon dioxide is exhaled from the lungs than
is produced by the body and as a result, carbon dioxide is “washed out” of the blood. The most common
symptoms of hyperventilation are: dizziness; hot and cold sensations; tingling of the hands, legs and feet;
muscle spasms; nausea; sleepiness; and finally unconsciousness.
In an individual who is behaving in an unusual manner, and you suspect hyperventilation or
hypoxia (the initial symptoms are similar, assume the condition is hypoxia and supply oxygen.
Select 100 per cent oxygen, check the oxygen supply, oxygen equipment and flow mechanism. If the
condition was hypoxia, recovery is rapid. If the symptoms persist, consciously slow the breathing rate
until symptoms clear and then resume normal breathing rate. Breathing can be slowed by breathing into a
paper bag, and this increases the amount of carbon dioxide taken into the lungs, since expired carbon
dioxide is re-breathed.
— END —
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Manual of Civil Aviation Medicine 2(162)
