IMSAFE checklist
– It’s not just for aircrew
Dr Richard Ronan Murphy, MBChB
FAA Designated Aviation Medical Examiner
CAP Medical Officer, Paine Field Squadron
IMSAFE Checklist
•
•
•
•
•
•
I
M
S
A
F
E
- Illness
- Medication
- Stress
- Alcohol
- Fatigue
- Enough (food, water,other)
Illness
IMSAFE
Illness
• CFR 61.53
– Prohibition on operations during medical deficiency.
• (1) (The Pilot) Knows or has reason to know of any medical condition that
would make the person unable to meet the requirements for medical
certificate necessary for pilot operation.
– Responsibility rests with the pilot
– Online resources include AOPA, FAA website, Google
– Or call your local AME
Light Sport, Glider & Everything Else
• CFR 61.53
– Prohibition on operations during medical deficiency.
• 2(b) Operations that do not require a medical certificate. For operations
provided for in Sec. 61.23(b) of this part, a person shall not act as pilot in
command, or in any other capacity as a required pilot flight crewmember,
while that person knows or has reason to know of any medical condition
that would make the person unable to operate the aircraft in a safe
manner.
Responsibility rests with the pilot
You are responsible for ensuring your health is good
You are responsible for your health
Any medical condition that would make the person unable to
operate the aircraft in a safe manner.
•
•
•
•
•
Flu/Cold
Medical Illness
Wearing corrective lenses when required
Contacts – are you going to be in a dusty, windy environment?
Do you have medications needed to treat known medical
conditions? (e.g. inhaler, epi-pen)
Medication
IMSAFE
Medication
• CFR 61.53
– Prohibition on operations during medical deficiency.
• (2) Is taking medication or receiving other treatment for a medical
condition that results in the person being unable to meet the
requirements for the medical certificate necessary
• What medications?
– Anything that make the person unable to operate the
aircraft in a safe manner.
Medication
• Medications that may cause drowsiness or dizziness.
• Many Over-the-counter medications can cause drowsiness or
sedation, especially:
– Most antihistamines
– Many cold medicines (contain antihistamines)
– Motion sickness medication
FAA Allowed Medications
• Over the counter non-steroidal antiinflammatories (Tylenol, Ibuprofen Naproxen)
• Non-sedating antihistamines:
– Loratidine (Claritin)
– Desloratidine (Clarinex)
– Fexofenadine (Allegra)
• AFTER an adequate initial “trial period”
Antihistamine Trial Period
• “Nonsedating” antihistamines are allowed, but even these
may affect some individuals. It is recommended to take the
medication for at least a couple of days before deciding if it is
safe to fly.
• If you have taken an antihistamine medication that is not
allowed, you need to wait “5 half lives”, or 5 times the
maximum dosing interval before flying.
• For example, if recommended dose is once or twice per day,
you must wait 5 days after the last dose before you can legally
fly.
• Call your local AME if you need advice on a medication.
Motion sickness medicine
• None are allowed by the FAA for PIC
• Scopolamine+Dextroamphetamine (ScopDex)allowed for military pilots, but not CAP
pilots.
• Scopolamine patch may be used by pilots in
initial training, but not when acting as pilot in
command.
• Prevention…?
Motion Sickness Prevention
• Eat a light meal before flying(or other travel) –
an empty stomach makes it worse
• Avoid Alcohol, >24 hours preferable
• Do not smoke
• Be prepared for the flight (or travel) – reduces
stress, increases safety
• Relax – flying is fun, enjoy it
STRESS!!!
IMSAFE
Emotional
Physical
Situational
STRESS
Stress
• Physiological or Physical
– Environmental
– Illness and Fatigue
• Emotional
– Relationships, Family
• Situational/Social
– Work, School, Finances, Obligations
Stress affects judgment and concentration.
Stress
Fatigue
Alcohol
and other drugs
IMSAFE
Alcohol
• Title 14 CFR 91.17
• (a) No person may act or attempt to act as a
crewmember of a civil aircraft—
– (1) Within 8 hours after the consumption of any alcoholic
beverage;
– (2) While under the influence of alcohol;
– (3) While using any drug that affects the person's faculties
in any way contrary to safety; or
– (4) While having an alcohol concentration of 0.04 or
greater in a blood or breath specimen. Alcohol
concentration means grams of alcohol per deciliter of
blood or grams of alcohol per 210 liters of breath.
Alcohol
• Title 49 C.F.R. PART 655—PREVENTION OF
ALCOHOL MISUSE AND PROHIBITED DRUG
USE IN TRANSIT OPERATIONS
• No covered employee tested under this
subpart who is found to have an alcohol
concentration of 0.02 or greater but less than
0.04 shall perform or continue to perform
safety-sensitive functions for an employer
Alcohol
• Alcohol is removed from the body slowly;
about 0.04%BAC, or about one half of a beer
per hour.
• The effects on concentration and thinking
linger longer. Motion sickness may increase.
• 8 hours is not enough time. 12h is better, 24h
may be needed after drinking to intoxication.
Alcohol and flying just don’t mix
Fatigue
IMSAFE
Fatigue
• Lack of sleep impairs concentration and
working memory i.e. Makes you stupid ;-)
• Sleep deprivation may be “acute” – i.e. not
enough sleep over one night, or “chronic” – a
little bit at a time over many nights.
• Fatigue may also occur as a result of
prolonged stress, even with normal sleep.
Fatigue
• Sleep deprivation may not cause obvious
tiredness all the time, especially if over time.
• Warning signs of sleep deprivation.
– Feeling tired, not constant, but intermittently
– Needing daytime naps
– Missing items on checklists
– Missing radio calls
• It can take several days, to more than a week
of EXTRA sleep to recover.
Duty limits
• CAP regulation 60-1, 2.2(d) Operation limits.
– Updated March 24th 2011
• Maximum duty time for pilots in one day is 14 hours
• Pilots will not plan to fly more than 8 hours without a
period of rest.
• Pilots must have 10 hours of rest between duty cycles
• Wing commander or higher may approve a flight for
duty cycle of greater than 8 hours, provided the PIC
agrees
• PIC and commander must assess risk
*** Responsibility rests with the pilot ***
Duty limits
• Crew duty day begins when commencing official
CAP activity and ends upon completion of the
CAP duty
• Non CAP work time or flight is no longer included
in the CAP regulation
• Just because it is legal, does not necessarily make
it a good idea – always assess risk
• Whatever activity you plan to do, make sure you
get enough rest in advance.
*** Responsibility rests with the pilot ***
Enough …
physical requirements
IMSAFE
As a memory aid, consider:
“The 4 classical elements”
•Fire
•Water
•Earth
Fitness
Food
Fluids
Oxygen
•Air
Enough …
• Food - Nutrition, Healthy diet
• Water
– Altitude is dehydrating, physical activity, hot OR dry
environment increases needs.
– Even mild dehydration impairs your cognitive
performance.
– (more about dehydration later)
• Air – High altitude is dehydrating
• Physical fitness
– Physical condition is directly linked to mental
performance.
Enough
• The body has basic needs
– In aviation it is just as important to consider if
these are being met as it is to consider if there is
fuel, oil, etc. in an aircraft
• The body needs to be kept in good condition
– This is necessary for safe flight, just as it is
important to mechanically maintain an aircraft
Enhanced Learning
IMSAFE
Review/Questions
“I” stands for?
IMSAFE
Illness
Who has responsibility in determining if illness is
causing a problem with safety?
A) The pilot or individual
B) The medical officer or AME
C) Any other person involved in the operation
D) All of the above
Illness
Who has responsibility in determining if illness is causing a
problem with safety?
A) The pilot or individual
B) The medical officer
C) Any other person involved in the operation
D) All of the above
The pilot or individual is always responsible.
But, if you see a problem in a colleague, you should make it
known (part of medical illness e.g dehydration may include
difficulty in recognizing the problem).
It is OK to ask an individual with medical knowledge for advise
if in any doubt.
“M” Stands for?
IMSAFE
Medication
I took a Benadryl (Diphenhydramine)
The directions say:
–
–
–
–
–
take every 4 to 6 hours
do not take more than 6 times in 24 hours
adults and children 12 years and over:1 to 2 tablets
children 6 to under 12 years1 tablet
children under 6 years do not use this product in
children under 6 years of age
How long do I have to wait before I can fly?
Benadryl
• This is a sedating medication
• Must wait 5x longest dosing interval
• Dosing interval says “take every 4-6 hours”
• I must wait 30 hours before I can fly as PIC
• How does this apply to other CAP activities?
“S” Stands for
IMSAFE
Stress
I have to get this plane back to KPAE by 6pm, its
is 4pm now, and I am in Centralia.
The pilot who is due to fly the plane next just
called me and said I better not be late, or he’ll
give me “what for”!
Am I safe to fly?
Emotional
Physical
Situational
STRESS
“A” stands for?
IMSAFE
Alcohol
AND OTHER DRUGS
Fatigue
IMSAFE
Fatigue
I have been studying for a difficult exam.
I stayed up late last few nights, cramming.
I took the exam this morning.
I feel relieved now that the exam is over.
I want to fly, or participate in other CAP activity
where my good performance is critical, this
afternoon
Stress
Fatigue
“E” stands for?
IMSAFE
Enough
I’m out of shape.
I had a Twinkie and a Mountain Dew for lunch.
Have I been drinking enough fluids?
Have I planned enough for this activity?
Have I had enough rest?
What Questions Do You have?