Policy Update 2014 Quay Snyder MD MSPH Aviation Medicine Advisory Service Business Aviation Safety Seminar April 16 2014 Overview 2 FAA Medical Standards amp Policies Significant Policy Changes ID: 695199
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FAA Medical Standards &
Policy Update 2014
Quay Snyder, MD, MSPH
Aviation Medicine Advisory Service
Business Aviation Safety Seminar
April 16, 2014Slide2
Overview2
FAA Medical Standards & Policies
Significant Policy Changes
Strategies to:
Minimize Risk – Maximize Safety
Questions? Public & Private
AMAS - Aviation Medicine Advisory Service - Quay Snyder, MDSlide3
FAA Medical Standards3
FAR Part 67 – Broadly defined
15 Mandatory Disqualifying Diagnoses
Guide to AME’s
Hundreds of Disqualifying Diagnoses
FAA Policy – rarely published, always evolving
FAR
61.53 – Self-certification decision every time
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FAR 61.53Not a Medical Regulation “Prohibition on operations during medical deficiency”“…shall not act as pilot in command, or in any other capacity as a
required flight crewmember…”Knows or has reason to know of any medical condition that would make the person unable to meet the requirements…”Is taking any medication or receiving treatment for a medical condition that makes the person unable to meet…”Required before EVERY flight
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I’M SAFEI - IllnessM - MedicationsS - StressA - AlcoholF - FatigueE - Eating / Hydration AIM 8-1-1
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Federal Air SurgeonDr. Fred Tilton Retired Jan 2014 “Issue whenever possible” Call to avoid deferralDr. James Fraser Appointed March 2014
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CACI’sConditions AME’s Can IssuePreviously required FAA approvalNow “Eligible”
AME worksheetPilot documentationMore to comeAMAS - Aviation Medicine Advisory Service - Quay Snyder, MD8Slide9
CACI’sArthritisAsthmaGlaucomaHepatitis CHypertensionHypothyroidismMigraine Headaches
Pre-DiabetesRenal CancerBPHColitisRenal CancerProstate CancerTesticular CancerAMAS - Aviation Medicine Advisory Service - Quay Snyder, MD
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AntidepressantsApril 2010 implementation“Amnesty” period overCelexa, Lexapro, Prozac, ZoloftSingle dose, single medicationReduced observation period to 6 monthsReduced Cognitive assessmentMore diagnoses allowed
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Eye SurgeriesLASIK / PRK Self ClearReport next AME visitIntraocular Lenses – CataractsSingle visionMultifocal / AccommodatingMonovision
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HypertensionAME can IssueAll meds allowed*No Stress test or lab reportsNo FAA letter
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Electrocardiogram10+ variants now allowedLess expensive evaluations Moving to digital vs. analog Fewer errors Faster review
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Heart SurgeryAngioplasty / Stent – 3 month waitBy-Pass / Valve Replacement – 6 monthEliminated repeat Radionuclide Stress TestPacer battery replacement – no 2 month waitHeart Transplant – Allowed 3rd class
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AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD16Slide17
MedicationsFAA Do Not Issue – Do Not Fly List5x maximum half-life or dosing intervalChantix – smokingMefloquine (Larium) – malariaScheduled medicationsDextromethorphan – 60 hoursMany others
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MedicationsAllergies – Allegra & Claritin onlySupplements – no Valerian or Kava-KavaValium – 24 hours / 48 hours / 21 daysMuscle relaxants – NoneSteroids – dose dependent / Nasal OKErectile Dysfunction Meds
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Sleep MedsAmbien / Ambien CREdluarIntermezzoLunestaRestorilRozeremSonataZolpimist
24 hours36 hours36 hours 30 hours72 hours24 hours 6 hours48 hoursAMAS - Aviation Medicine Advisory Service - Quay Snyder, MD
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AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD20Slide21
DUI’s – Mandatory DeferralBAC > 0.1499 mg%Refusal to test1 incident in last 2 years if 2nd one in lifetime2 incidents in last 10 years3 incidents in a lifetime
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DUI EvaluationArrest and Court recordsDriving records – all statesMilitary recordsPersonal statements (2)Substance Abuse Eval to FAA standardsQualified examiner
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DiabetesPre-Diabetes is CACINon-insulin – All classesSome medication combinations not OKInsulin – 3rd Class only – in CONUSADA petition for 1st
and 2ndUK, Australia, CanadaAMAS - Aviation Medicine Advisory Service - Quay Snyder, MD24Slide25
GA Pilot Protection ActVFR non-commercial US flights Valid US driver’s license6,000 pounds< 7 Seats< 14,000’ MSL< 250 kts5 year review
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Sequestration / ShutdownHiring Freeze – MD’s and support staffContractorsIT stoppageBacklog of cases – Tiger TeamsRetirement attrition ~ 15% of AMCD2-3 year training for new hiresPush workload to AME’s
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Sleep Apnea - PastDQ since 1996No screeningTesting requires 1+ sleep study - $$$$Dropped MWT / MSLTSleep Medicine physician approvalGrounded pending FAA approval - $$$$Annual FAA review
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Sleep Apnea - FutureScreening based on BMI + other factorsNot grounding*90 day evaluation by any physicianHome studies allowedTreatment options (4)AME clearanceCompliance data for renewal
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Fitness For DutyNew NBAA Safety Emphasis Area FAA “Cognitive Impairment” interestCauses –Physical / MedicalPsychologicalNeurologicalPharmacological
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Strategies to Keeping MedicalLong-term AME relationship“Easy” not always BestPrepare for Physical examMedical records/summaries availablePrescreen medications / conditionsSchedule early in month dueMedXPress
https://medxpress.faa.gov/ 10/1/1231AMAS - Aviation Medicine Advisory Service - Quay Snyder, MDSlide32
Strategies to Keeping MedicalDay of ExamDon’t go if sick (OK to let lapse)Minimal Caffeine Athletes – jog in place before ECGBring Special Issuance Authorization letterBring glasses and hearing aids
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Fly Safely! Stay Healthy!Questions ???????Now for PoliciesLater in Private for “Friends”AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD
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