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HPL (17 Personal Health and Hygiene (Back Pain (SCIATICA: Irritation or…

- - - - The pain/numbness can go from leg all the away up to neck
  - - - Men: 5units daily, 21 units per
      - Women: 3 units daily,14 units per week
    - - The max amount allowed 20mg per 100ml of blood (0.2 promile)
      - Need to wait 8hrs from last drink to next duty
  - - - Under 18.5 = Underweight
        
        18.5 - 25 = Normal
        
        26 - 30 = Overweight (25 male / 24 female)
        
        31 - 35 = Obese (over 30 male / 29 female )
        
        35 and over = morbidly obese
  - - - Carbs: Pasta, rice, cereals, potatoes
      - Don’t miss breakfast
    - - Symptoms of hypoglycaemia - when blood sugar levels drop below 50mg per 100ml of blood
  - - - ommonly found in young children or since birth
        
        Deficiency in insulin or the pancreas isn’t producing insulin
        
        Insulin pen to inject insulin must be done daily to help regulate the blood sugar levels
    - - More commonly discovered later in life with adults related to poor diet, obesity
        
        With diet with too much sugar we may not be producing enough insulin to break it down
        
        Eat better and exercise can be a treatment
    - - Thirst
        
        Urine and breath can smell sweet
        
        Fatigue
        
        Lethargy
        
        Frequently have skin, gum and bladder infections
        
        Irritability
        
        Gout
    - - hypertension
        
        neuropathy - numbness
        
        blurred vision
        
        Can lead to complete kidney failure
        
        Diabetic coma
        
        Hypoglycemia - too little blood sugar
- - - - Barotrauma
      - Aerodontalgia
  - - - Lungs have constant partial pressure 47mmHG due to water vapour
      - O2 proportion falls from 21% to 13.7% (to accommodate CO2 and water vapour)
      - 55mmG (12,000ft)
        
        Min partial press fo O2 saturation
    - - < 10,000 Nothing
        
        <33,700 O2 and Air mix
        Increasing O2 with altitude Keeps body at SL
        *<=40,000 100% O2 required
        Keep body at 10,000ft
        40, 000 GREATER THAN!!!!!
        
        100% O2 under pressure
        
        Keep body at 10,000ft
      - Cabin pressure/altitude are between 6-8000ft
    - - Barorecpetors (Carotid Artery)
      - Internal Respiration
        
        Metabolism
      - External Respirations
        
        16-20 breaths
      - Lung Volumes
        
        tidal volume 500ml
        
        Average volume of air inhaled and exhaled in one normal breathe i.e. 500ml in , 500 out
        
        Inspiratory reserve volume 3100ml
        
        the additional volume of air that we can forcibly inhale after inhaling normally i.e. our tidal volume
        
        Expiratory reserve volume 1200ml
        
        the additional volume of air that we can now forcibly exhale after exhaling our normal tidal volume
        
        Residual volume 1200ml-1400ml
        
        the amount of air remaining in your lunges after exhaling your expiratory reserve volume
  - - - Hypoxic Hypoxia
        
        ICDC / RDC
        
        TUC
        
        Treatment - Pure O2 and land as soon as possible
      - Anaemic Hypoxia
      - Stagnant Hypoxia
      - Histotoxic hypoxia
    - - Treatment
        
        Regulation of breathing rate….breath slower. Talk to them, distract them.
        
        Breathe into a paper bag - increases the amount of CO2 that they are breathing in
    - - Treatment
        
        100% O2
        
        go to MSA
- - - - Made in bone marrow
      - Plasma:
        
        Salty yellow/transparent fluid.
        
        Helps transports Carbonic acid.
        
        Helps regulate the acidity of the blood
      - Red cells:
        
        Contains haemoglobin and thus carries the O2
      - White blood cells:
        
        immune system fights off any infections/bacteria
      - Platelets
        
        Helps with clotting/coagulation
      - Anaemias -lack of iron
  - - - Cardiac output = Heart Rate x Stroke Volume
        = 5-5.5 litres
    - - measuring the amount of glucose and CO2 and adrenalin
      - Exercise can increase pulse rate in short term but reduce over time
        
        Temp, food, stress can all affect the pulse rate
    - - Coronary Heart Disease
      - Angina
      - Heart Attack
  - - - Treatment
        
        100% O2
        
        Turn off the cabin heat
        
        Open any windows/vents if possible
        
        Land ASAP
    - - Smoking affects
        
        hypoxia severity and our night vision
        
        decompression sickness
        
        coronary heart disease - makes use more prone to heart attacks
        
        greater chance of CO poisioning
        
        reduces G force tolerance
        
        can cause emphysema - damage or enlarge the alveoli making it difficult to breathe
  - - - heart rate
      - elasticity of the arterial walls
      - peripheral resistance (causes by clogging of arteries etc..)
      - viscosity of the blood
    - - Average healthy adult BP should be 120mmHg
      - if we increase the peripheral resistance increases the systolic BP
    - - Average healthy adult BP should be 80mmHG
    - - Hypertension - high BP i.e. 140/90
      - Hypotension - if lower than 90/60
    - - BP lowest in the head - as gravity can help push it down
      - BP highest in the feet
  - - - Seek advice from AME (Aeromedical Expert)
      - Drink plenty of fluids
      - Lie down for 15 to 20 minutes
- - - - Blood pooling into the Feet
        
        Tunnelling
        
        Grey out
        
        G-Loc (G induced loss of consciousness) Black out
    - - Red Out
  - - - Worse on Descent
    - - Ascent and Descent
  - - - Drink bottled water
      - Clean teeth with bottled water
      - Wash hands often
      - Avoid ice in drinks and ice-cream
      - Avoid salads unless you know its washed in treated water
      - Thoroughly wash fruit with bottled water
      - Avoid shellfish
- - - - The on the spot type of stress
        
        Caused by a situation or demand at that time
        
        Our bodies very quickly mobilise any resources needed to cope with that situation
    - - Long term exposure to stress can damage the body
  - - - Poor concentration
      - Increased errors
      - * Fixation/Tunnelling of attention
      - Reversion to old habits
      - * Situational awareness degrades (Situational Awareness = being aware of everything internal and external to you, these should match)
      - * Confirmation bias - where we ignore every piece of information telling us our idea/perception is wrong
    - - Aggressive or withdrawn
      - Change in appetite
      - Drinking more alcohol, smoking more, drugs , etc
    - - Depressed
      - Tearful
  - - - Too Cold: Normal body temp 36-37C
        
        If we drop below 35C we get hypothermia
        
        Shaking/shivering - using up O2 and energy
        
        Pale
        
        Cyanosis
        
        Can lead to frostbite on extremities due to lack of O2
        
        Breathing rate increases
        
        Can find it difficult to speak, words blurred
        
        Apathy (aka content)
        
        If we drop below 32C
        
        We stop shivering, loss consciousness and die
      - Too hot: Heat Exhaustion > Heat Stroke
        
        HEAT EXHAUSTION
        
        We sweat when we get too hot, sweat salts, water, electrolytes can cause us to get dehydrated, then diarrhoea which can mean losing more water. Headache, dizzy, muscle cramps
        
        HEAT STROKE (about 43C) the brain swells
        
        IF not treated loss consciousness and can lead to death
      - Noise and vibrations:
        
        1-4Hz (up to4 i.e. 3.99)
        
        Vibrations can interfere with breathing
        
        Visual acuity reduced
        
        4-10Hz
        
        Chest and abdominal pain
        
        8-12Hz
        
        Back ache
        
        10-20Hz
        
        Headache
        
        Pain in the eye
        
        Pain in throat, speech difficulties
      - Humidity
        
        40-60% RH is ideal for humans
        
        In flight it’s 5-15%
        
        Dry skin, nose, mouth, throat, etc…
        
        Recommended to keep hydrated
        
        EXAM: Take 2 weeks to acclimatise to a warmer and more humid climate - the body adapts
    - - Illness
        
        Fatigue
        
        Hunger
        
        Thirst
        
        Pain
    - - Definition = When the perceived demand of a task is greater than our perceived ability to cope with the task
        
        Effects
        
        We tend to rush things i.e. not good if on the flight deck
    - - * EXAM: Death of a spouse (is the #1 cause of domestic stress)
        
        Relationships
        
        Financial worries
        
        Death of a family member
    - - Fears
        
        Phobias
        
        Don’t feel you have control of anything
    - - Work - LACK OF INSUFFICIENT HANDS ON FLYING (Top for Exam), rosters, scheduling, workload, performance, fuel policies, turn arounds
  - - - Sympathetic NS
        
        Increases arousal
        
        Causes the activation or response in the body to cope with a stressor. It does this by:
        
        Increase heart rate, respiration rate, BP, secretion of Adrenalin, inhibits flow of saliva
      - Parasympathetic NS
        
        Decrease arousal , brings it back to normal i.e. does the opposite
    - - 3 STAGES
        
        ALARM (REACTION) stage:
        
        Can affect our mental/cognitive abilities - we tend to just concentrate on the problem, memories come to us quickly to help us solve the problem. Decision making is increased
        
        Sympathetic NS kicks in - increase in BP, HR, breathing rate, etc…- more blood sugars into the blood stream, might sweat a bit more, digestion and bladder function are slowed down
        
        RESISTANCE stage:
        
        Parasympathetic NS starts to recover the body from it’s initial reaction. It will also try repair any damage that has been done.
        
        If we are still continuing to fight the stressor, more glucose can now be put into the blood stream , fats can be burned into sugars giving us more energy.
        
        Cortisone (hormone) can be secreted into the blood stream - Cortisone acts as a pain killer and helps us go through the pain barrier i.e. if we are tired when running
        
        EXHAUSTION stage:
        
        Any muscles or organs used in stages 1 and 2 go into the exhaustion stage - used all our energy, glucose supplies, etc.
        
        The chemical reactions from previous stages if haven’t been removed can cause damage i.e. lactic acid
        
        Effects:
        
        Hypertension
        
        Heart disease
        
        Indigestion or digestive problems
        
        Ulcers (stomach)
        
        Death - if in the stage for too long
      - 3 REACTIONS
        (linked to stage 2)
        
        PSYCHOLOGICAL REACTION: The brain is registering the fact that there is a threat or a danger
        
        PSYCHOSOMATIC REACTION: The brain is triggering the release of hormones and other chemicals into the blood
        
        SOMATIC REACTION: The body is now reacting to the chemicals that are now in the blood
  - - - We are removing the stressor completely or altering it so it becomes less demanding
      - IE. leave the job or stress
    - - We are trying to rationalise the situation or emotionally detach ourselves from the situation
      - i.e. self pep-talk before an exam or interview
    - - We remove the symptoms but not the stressor
      - i.e. instead of removing what is making us stressed we turn to alcohol or drug
  - - - Endorphins help us cognitively
    - - Can help with cognitive coping and direct action coping
- - - - Lack of directional control
        
        CFIT - controlled flight into Terrain is the most common within this area - GPWS (Ground Proximity Warning System) was designed in the 1980s = the largest reduction in accidents
      - Poor Judgement
      - Not maintaining the correct airspeed
      - Poor pre-flight planning
      - Not maintaining ground clearance
- - - - Controls all our involuntarily actions i.e breathing, temp control, digestion, heart rate, sweating, gastrointestinal movements, internal organs basically….
      - ANS is a neuro-hormonal control system , highly self regulating and is constantly trying to control our internal environment (Homeostasis)
        
        Temp 37C, ph 7.35, blood sugar
    - - responsible for body movement, sensing external stimuli, etc..
- - - - 3 Semi circular canals - yaw, pitch, roll and sensing angular acceleration
    - - Graveyard Spin
    - - About 80% of accidents caused by spatial disorientation are fatal
    - - Causes:
        
        an infection …possibly in the eusation tube
        
        a contradictory sensory information
        
        alcohol
        
        Through Coriolis you can cause the sensation of vertigo, minimise head movements, monitor the instruments or look at the horizon
- - - - Free running - last 25hrs
        (No Zeitgebers)
      - Endogenous - lasts 24hrs
        
        Zeitgebers - external factors that control our endogenous rhythm
        
        Meal times
        
        Alarms,
        
        Work schedules
        
        Traffic outside
        
        Body Temp
        
        Easiest to sleep when lowest
        
        Sunrise/Sunset - Most important
      - Circadian LOW: 2-5am
        
        our body tmp at lowest, we find it best to sleep, easiest to sleep BUT our performance is the worst
    - - 1hr sleep = e gain 2 sleep credits
        
        16 = max amount of sleep credits you can gain (2 * recommended 8hrs!!)
        
        Lose 1 sleep credit per hour when awake
        
        If in Sleep Debit
        
        1 sleep debit you need to sleep for 2hrs
        
        Performance Degrades
        
        Lethargic
        
        Fatigue
        
        Irritable
        
        Mood swings
        
        Concentration level reduces
        
        More error prone
    - - Feel drowsy - transition stage between being awake and falling asleep
      - Light sleep - EEG would be fast high freq. brain waves
        
        50% of our sleep is spent in stage 2
      - Deeper Sleep (aka SLOW WAVE, ORTHODOX Sleep)
      - DEEPER SLEEP (aka SLOW WAVE, ORTHODOX Sleep)
        
        we are in our most relaxed, muscles completely relaxed, slower pulse, drop in BP, rhythmic breathing
      - REM sleep (aka paradoxical sleep): in this stage we dream. Their eyes are moving behind their eyelids.
        
        EEG for REM sleep is the same as EEG for person when they are awake
        
        Paralysis can occur
        
        This is where you have dreams and nightmares
    - - We need both types
      - Rebound Effect
        
        Brains ability to determine how much orthodox and paradoxical sleep we need
        
        Orthosdox/Slow Wave
        
        Body repair/Cell restoration
        
        Paradoxical/REM
        
        Mind repair - organise and refresh the brain i.e. important for memories
      - Sleep Cycle
        
        We are constantly going in and out of the different sleep cycles
        
        Start awake to first rem cycle
        
        1.5hr/90min = average sleep cycle aka how long before the first stage of REM (~10min)
        
        Start awake > stages 1 to 4 > 4 to 1 > REM
        
        As we go through our 8hrs of sleep the duration of REM increases
        
        An average night can be between 4-5 cycles of REM
    - - Nap
        
        10min = min time for a nap to be restorative
        
        20min+ = recovery time for a nap
        
        To not still be suffering from performance loss, you need to wait 20min
        
        Responses and reactions very slow 5min after waking up from a nap
      - Microsleep
        
        fraction of a second - 2-3seconds
        
        Your body forces it upon you, dangerous as you don’t always know it happens
        
        Microsleep are NOT restorative
    - - WEST IS BEST
      - Jet lag and recovery is SUBJECTIVE
      - Handling Jet lag
        
        <24hr
        Stay on your own home circadian rhythm
        
        *>24hr
        Adjust to the new local time zone
        *=24hr
        Nap when first arrive then plan your long sleep, 8hr, to wake up just before your next duty time
    - - Remove blue light - screens
        
        Don’t eat close to bed time….as BP , temp, heart rate increases
        
        Should be 2hrs before
        
        Don’t drink alcohol as it affects your REM
        
        No mental stress or physical exertion
      - Any relaxation - Good
        
        Hot milky drinks - Good
    - - Narcolepsy
        
        Falling asleep without warning
      - Sleep Apnea (secs - minutes)
        
        Blocked airway
      - Sleep walking (Somnambulism) /Sleep talking (Somniloquism)
        
        More common in children than adults
      - Insomnia - 2 types
        
        Situational Insomnia
        
        Caused by the situation that you are in i.e. jet lag, noise, temp, stress, etc
        
        Short term
        
        Clinical Insomnia
        
        On going long term stress
  - - - Short term fatigue - Acute Fatigue
        
        Causes:
        
        Lack of sleep
        
        Exercise
        
        Jet lag
        
        Being overexcited
        
        Affects:
        
        Concentration is reduced
        
        More Error prone
        
        Communication is degraded
        
        Fixation/tunnelling of attention
        
        Reversion to old habits
        
        Cure:
        
        Sleep
      - Chronic fatigue - long term fatigue
        
        Causes:
        
        Ongoing stress
        
        Ongoing Work pressures
        
        Ongoing Personal problems
        
        Affects:
        
        Can see long term psychological and physiological issues
        
        Might start gastrointestinal problems
        
        Coronary problems
        
        Cure:
        Declare yourself unfit to fly
      - Avoiding and managing fatigue
        
        no caffeine, alcohol before bed
        
        relaxation techniques
- - - - Each can see left to right 120degrees meaning 60degree over lap in the central area - known as binocular
        
        Each eye can also see 150degrees up and down (75 up and 75 down)
    - - Far away = pale, small, high contrast,
      - Motion - closer = faster
      - Overlapping (Obscuration)
    - - Empty Field Myopia
      - Blind Spot
      - Parallax Error (monocular viz)
      - Myopia
      - Hypermetropia
      - Presbyopia
      - Astigmatism
      - Cataracts
      - Glaucoma
      - Colour Vision
        
        common in men 7% of men suffer, only 0.1% of women
      - Flash Blindness