Comments on: Hypoxic but saved

By: Margaret Medford RRT, CPFT

Margaret Medford RRT, CPFT — Fri, 20 Nov 2009 00:07:04 +0000

Just wanted to point out that the mask pictured is attached to a small volume nebulizer used to give bronchodilator and other respiratory medication treatments. This would not be used to deliver O2 in an airplane as it has many small, unnecessary pieces that could be easily disconnected and lost. I would think that a simple mask running on at least 6 lpm O2 flow or a nasal cannula with 6 or less lpm O2 flow would be used.

By: Peter Row

Peter Row — Sat, 14 Nov 2009 17:16:52 +0000

I agree wholeheartedly with Mr. Alburn.

A simple pulse oximeter can be purchased for $50 to $75. One of the key benefits to the pulse oximeter is that it measures the ultimate parameter: oxygen in your blood. Thus, it detects failures in your mechanical oxygen delivery system, as well as failures in your biological oxygen delivery system. Generally, the only thing that will “fake-out” the pulse oximeter is carbon monoxide. Ideally, your pulse oximeter would also have an audible alarm, so that you don’t have to be looking at it (or more importantly interpreting its numbers) when you are hypoxic.

You should make a personal commitment that you are descending if the alarm goes off, even if you have to declare an emergency with ATC to get the descent clearance.

Peter L. Row, MD, EMT-P, FACEP
Commercial, Multi, Instrument pilot

By: Rich Romaine

Rich Romaine — Fri, 13 Nov 2009 14:35:23 +0000

When I look at the typical O2 system for non-pressurized aircraft I wonder how many failure modes there are in the vinyl tubing, connectors and valves for what is a single string system to keep the pilot alive/functional. As a former tactical aviator (lots of O2 and pressure chamber time), current pilot and systems engineer (in my day job) it surprises me that there isn’t at least a failure warning requirement…hypoxia can be very subtle in a gradual failure.

By: Cary Alburn

Cary Alburn — Wed, 11 Nov 2009 00:17:03 +0000

Forty plus years ago I had the opportunity as an AFROTC cadet to go through the high altitude training at Buckley AFB, CO. Although I was a resident of Laramie, WY (elev. 7377) and supposedly accustomed to higher elevations, my abilities at higher altitudes simulated in the altitude chamber were little better than the other guys, many of whom came from much lower elevations. At 18,000′ simulated, I was pretty useless.

As I’ve gotten older, I have realized that my physical ability to process oxygen has deteriorated to some extent. While I once regularly flew without supplemental oxygen at the 11 and 12,000′ level, I now check my pulse ox with my pulse oximeter any time I’m flying above 8500′, and often I need supplemental oxygen just to bring my O2 percentage to 90% at elevations as low as 9000′. Lower oxygen levels compromise mental acuity and significantly affect night vision. I understand that anything less than 90% is likely to cause mental “fuzziness”, and I can attest that it is true.

Part of the issue is that the FAA rule mandating O2 for pilots (12,500′ or higher for more than 30 minutes, or 15,000′ or higher) is unrealistic and fails to take into account density altitude. Just like an airplane’s engine is affected by density altitude, so is the pilot’s “engine.” There are many other reasons why an individual pilot might require supplemental oxygen at lower altitudes: if a smoker; if even slightly ill with a disease that compromises lung function; if slightly anemic; or just being older.

Any of us is subject to needing supplemental O2, even at relatively low altitudes. Being aware of the possibility is the first step. Knowing when to use supplemental oxygen is the second step, and only a pulse oximeter can determine necessity. Purchasing and using supplemental oxygen when needed is the third. For less than a thousand dollars, a good supplemental oxygen setup and a quality pulse oximeter can be purchased, and it’s money well spent.

Cary