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TP 13312 - Handbook for Civil Aviation Medical Examiners

Дата публикации: 2017-06-11 20:35

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Davies RR, Goldstein LJ, Coady MA, et al. Yearly rupture or dissection rates for thoracic aortic aneurysms: simple prediction based on size. Ann Thorac Surg 7557 78:67–77.

Occasionally a medical emergency results when a diver ascends to the surface too rapidly, causing a bubble formation. In such cases the diver must be reexposed to a greater pressure as quickly as possible and then brought back to the surface. Sometimes the diver is too ill to undertake another dive and must be transported to a hyperbaric chamber for treatment as quickly as possible. Pilots transporting such individuals should be cautioned that increases in altitude will worsen the patient's condition. If pressurized aircraft are not available, flights should be made at the lowest safe altitude. Recompression treatment tables are outlined in textbooks of Diving medicine.

It is, therefore, quite important that these concerns are adequately addressed in the post-operative period before a return to active operational flying or air traffic controller duties is permitted.

It must be emphasized that these guidelines are to be used only as a guide to practice and evaluation of licensed aviation personnel. No publication can hope to keep up with all the advances in this rapidly evolving field and each licence holder’s individual situation must be investigated and evaluated in light of the most up-to-date clinical guidance. These guidelines should not be confused with the medical regulations set out in the Canadian Aviation Regulations part 979 published by Transport Canada.

Category 8
Medical Certification will be considered on a case-by-case basis after review of the required elements outlined below.

Follow-up requirements for acceptable applicants are outlined below.

For the assessment of medical fitness in pilot applicants, it is important that hypertension be controlled. If pressures remain at or above 665 mmHg systolic or 655 mmHg diastolic, it is strongly recommended that drug treatment be initiated. Treatment should also be considered when the diastolic pressure is between 95 and 655 mmHg in the presence of macrovascular target organ damage or other independent cardiovascular risk factors. The goal of systolic blood pressure treatment is 695 mmHg and 95 mmHg for diastolic blood pressure. For anyone with diabetes as well as non-diabetic chronic kidney disease, the target blood pressure is 685/85 mmHg.

A patent foramen ovale should not be considered a risk factor for stroke according to recent trials, unless associated with an atrial septal aneurysm.

TC’s Medical Advisors cannot direct prospective candidates to a specific service provider. There are many providers available, using a variety of techniques and having a wide range of experience and success. Anyone considering a procedure should spend some time investigating the procedure and the provider. The watchword should be “Caveat emptor” - BUYER BEWARE.

Return to flying must be delayed until TC/CAM has reviewed the results of the surgery. A follow-up report should be submitted 85 days after the procedure. You can fax or mail the report to the local RAMO and you should receive prompt notification that you can return to flying if all is satisfactory.

Gilon D, Buonanno FS, Joffe MM, et al. Lack of evidence of an association between mitral-valve prolapse and stroke in patients. N Engl J Med 6999 896:8-68.