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2.1.5The effects of hypoxia are usually quite
difficult to recognize, especially when they occur
gradually. Since symptoms of hypoxia do not vary in
an individual, the ability to recognize hypoxia can be
greatly improved by experiencing and witnessing the
effects of hypoxia during an altitude chamber
flight." The FAA provides this opportunity through
aviation physiology training, which is conducted at
the FAA Civil Aeromedical Institute and at many
military facilities across the U.S. To attend the
Physiological Training Program at the Civil
Aeromedical Institute, Mike Monroney Aeronautical
Center, Oklahoma City, OK, contact by telephone
(405) 954−6212, or by writing Aerospace Medical
Education Division, AAM−400, CAMI, Mike
Monroney Aeronautical Center, P.O. Box 25082,
OklahomaCity, OK 73125.
NOTE−
To attend the physiological training program at one of the
military installations having the training capability, an
application form and a fee must be submitted. Full
particulars about location, fees, scheduling procedures,
course content, individual requirements, etc., are
contained in the physiological training application, Form
Number AC−3150−7, which is obtained by contacting the
Accident Prevention Specialist or the Office Forms
Manager in the nearest FAA office.
2.1.6Hypoxia is prevented by heeding factors that
reduce tolerance to altitude, by enriching the inspired
air with oxygen from an appropriate oxygen system
and by maintaining a comfortable, safe cabin
pressure altitude. For optimum protection, pilots are
encouraged to use supplemental oxygen above
10,000 feet during the day, and above 5,000 feet at
night. The Federal Aviation Regulations require that
the minimum flight crew be provided with and use
supplemental oxygen after 30 minutes of exposure to
cabin pressure altitudes between 12,500 and
14,000feet, and immediately on exposure to cabin
pressure altitudes above 14,000. Every occupant of
the aircraft must be provided with supplemental
oxygen at cabin pressure altitudes above 15,000 feet.
2.2Ear Block
2.2.1As the aircraft cabin pressure decreases during
ascent, the expanding air in the middle ear pushes the
eustachian tube open and, by escaping down it to the
nasal passages, equalizes in pressure with the cabin
pressure. But during descent, the pilot must
periodically open the eustachian tube to equalize
pressure. This can be accomplished by swallowing,
yawning, tensing muscles in the throat or, if these do
not work, by the combination of closing the mouth,
ENR 1.15−4 AIP
15 MAR 07 United States of America
Nineteenth Edition Federal Aviation Administration
pinching the nose closed and attempting to blow
through the nostrils (Valsalva maneuver).
2.2.2Either an upper respiratory infection, such as a
cold or sore throat, or a nasal allergic condition can
produce enough congestion around the eustachian
tube to make equalization difficult. Consequently, the
difference in pressure between the middle ear and
aircraft cabin can build up to a level that will hold the
eustachian tube closed, making equalization difficult
if not impossible. This problem is commonly referred
to as an ear block."
2.2.3An ear block produces severe ear pain and loss
of hearing that can last from several hours to several
days. Rupture of the ear drum can occur in flight or
after landing. Fluid can accumulate in the middle ear
and become infected.
2.2.4An ear block is prevented by not flying with an
upper respiratory infection or nasal allergic condition.
Adequate protection is usually not provided by
decongestant sprays or drops to reduce congestion
around the eustachian tubes. Oral decongestants have
side effects that can significantly impair pilot
performance.
2.2.5If an ear block does not clear shortly after
landing, a physician should be consulted.
2.3Sinus Block
2.3.1During ascent and descent, air pressure in the
sinuses equalizes with the aircraft cabin pressure
through small openings that connect the sinuses to the
nasal passages. Either an upper respiratory infection,
such as a cold or sinusitis, or a nasal allergic condition
can produce enough congestion around an opening to
slow equalization and, as the difference in pressure
between the sinus and cabin mounts, eventually plug
the opening. This sinus block" occurs most
frequently during descent.
2.3.2A sinus block can occur in the frontal sinuses,
located above each eyebrow, or in the maxillary
　
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