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Learning Outcomes?
- • List the relevant policy documents that regulate imposition and lifting of TMUFF restrictions.
- • Explain which authorities may impose and reverse TMUFF for the conditions outlined in AAP 8000.010 (AM1) Section 5.
- • Describe the TMUFF requirements for medical and other conditions outlined in AAP 8000.010 (AM1) Section 5.
- • Describe the "I'M SAFE" pre-flight checklist for flying fitness.
- • Apply the requirements of AAP 8000.010 (AM1) Section 5 to the imposition and reversal of Temporary Medical
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Unfitness to Fly.?
- General principles TMUFF
- • Good health is essential for aircrew duties
- • The first pre-flight check is on the aircrew themselves
- • Short term self imposed TMUFF may prevent longer term grounding
- • Even minor illness may impact on flying safety & operational effectiveness
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SCOPE:?
- • Activities, conditions and factors that may adversely affect an Aircrew member’s short-term medical or dental fitness to fly, or an Aircraft Controller’s fitness to control aircraft;
- • Duration of the TMUFF period;
- • Circumstances where AVMO or Dental Officers are to be consulted before flight to determine the duration of the TMU period; and
- • When necessary, TMUFF as related to infrequent flyers.
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Who can impose TMUFF?
- • Any health care provider
- • Authorising Officers and Flight Commanders
- • Individual aircrew member (self- imposed)
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TMUFF Reversal?
- • Ultimate authority is with CO based on:
- • Risk assessment
- • Operational needs
- • Advice from AVMO
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Medical TMUFF?
- • AVMO assessment required for reversal of medical TMUFF
- • Source of frequent complaint
- • What if there is no AVMO?
- • Non-AVMO, but must consult with an AVMO
- • If no MO, Nursing Officers; must consult AVMO
- • SSAMA available on call for advice
- • BFTS – CASA DAME
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Administrative TMUFF?
- • Administrative TMUFF reversal does not need AVMO
- • Existing policies in place:
- • alcohol
- • fatigue
- • simulators
- • HUET
- • diving
- • vaccinations etc
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Common TMUFF Reversal Challenges and FAQs?
- • “I can’t get an appointment with an AVMO”
- • Facilitate easier access, especially morning through sick parade
- • “It was only a cold and I’m fine now”
- • AAP 8000.010 (AM1) Section 5 requires AVMO review
- • Discuss review options with AVMO/HSF
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Contents of AAP 8000.010 (AM1) Section 5 Chapter 5?
- • Medical and dental procedures
- • Administration of medication
- • Ingestion of alcoholic beverages
- • Immunisation procedures
- • Blood donation
- • Psychosocial conditions
- • Diet and meals
- • Fatigue
- • Involvement in an aircraft incident or accident
- • Exposure to high altitude/hypobaric environments
- • Exposure to hyperbaric environments
- • Aircraft simulator training
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Medical Procedures?
- • Where local anaesthetics used:
- • TMUFF minimum 8 hours
- • Includes topical eye drops
- • Otherwise determined clinically by:
- • Type of procedure
- • Pain
- • Limitation
- • Dilating eye drops: 24 hr TMUFF
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Dental Procedures?
- • Local anaesthetics:
- • Minimum 8 hours TMUFF
- • Then as advised by dentist/AVMO when ongoing requirement for medication
- • Health Policy Directive 411—Aviation and Diving—Dental Considerations.
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Medications – Prescribed and OTC?
- • Must be taken in accordance with Health Directive 311 –Use of medication by aircrew and air traffic controllers
- • In general terms:
- • Severity of the medical condition may preclude flying anyway
- • Most drugs require a “Ground Trial” (TMUFF period)
- • A few drugs need little/no ground trial
- • Many drugs cannot be used at all
- • Consider herbal same as prescribed – AVMO advice
- • Always assume medications are hazardous
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Ingestion of Alcohol?
- • Before undertaking aviation or controlling related duties:
- • BAL must be ZERO
- • No symptoms of hangover
- • Observe minimum abstinence period
- • TMUFF self-imposed or by medical/supervisors
- • References:
- • DI(G) PERS 15-4 Alcohol Testing in the ADF
- • ADF Safety Critical Areas
- • DI(G) OPS 22-2 Temporary Medical Unfitness for Flying
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Minimum Abstinence Period Prior To Duty?
- Number of standard drinks consumed
- Minimum period of abstinence from the last drink to commencement of duty (hrs)
- 1–4 8
- 5–6 12
- 7–10 18
- 11–20 30
- >20 48
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Vaccinations?
- • Mitigate risk of localised or generalised reactions
- • Administrative 12 hrs TMUFF
- • 72 hrs after JEV (old vacc)
- • If unwell, must see AVMO first
- • Ref: Australian Defence Force Publication 1.2.2.1—Immunisation Procedures
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Blood donation?
- • Administrative TMUFF
- • 72 hrs TMUFF after donation
- • Member’s CO must approve
- • 24 hrs TMUFF for JBAC and ACO
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Psychosocial Issues?
- • Medical TMUFF
- • May be imposed by psychologist or counsellor
- • Must be assessed by AVMO
- • Includes return to flying after critical incidents/accidents
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Fatigue?
- • Covered in AVMO Course Topic 5 “Human factors and Accident Response”
- • Aircrew and ACOs must:
- • abide by the crew-rest, crew duty and rostering limitations set by Single-Service authorities.
- • be TMUFF if these limits are breached.
- • References:
- • Defence Instruction (Air Force) OPS 6–6—
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Crew Duty Limits SAFETYMAN, volume 3, chapter 21?
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Fatigue?
- • Where fatigue is still suspected despite appropriate provision of crew-rest, personnel must be TMUFF until a cause and solution to the fatigue can be identified.
- • Consult an MO if suffering chronic fatigue or circadian dysrhythmia
- • Extension of crew-duty day possible only if:
- • Pressing operational requirement
- • Command approval given
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Use of hypnotics – HD 311?
- • Temazepam:
- • TMUFF 12 hours after dose
- • Reduce to 8 hours withAVMO review
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• Zolpidem:?
• TMUFF 8 hours after dose
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Diet and Meals?
- • Concern about:
- • Dietary causes of incapacitation
- • gas producing foods
- • high glycaemic index foods
- • Must eat adequate meal within 6 hrs of flying
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Diet and Meals?
- • To avoid food poisoning:
- • Exercise caution with food choices, especially overseas
- • Practice good hygiene and food handling
- • Two pilots - different meals at different times
- • Investigate episodes of food poisoning
- • Take samples
- • Raise an ASOR
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Flight Safety Incidents?
- Aircrew must be cleared by an AVMO following:
- • Proven or suspected hypoxia
- • DCI or severe trapped gas causing incapacitation
- • Hyperventilation
- • Spatial disorientation with unusual attitude;
- • LOC for any cause, including GLOC
- • Unintentional rapid decompression;
- • Toxicological exposures
- • Other physiological, pathological, physical, psychological or psychiatric conditions during or after simulated or actual flight
- • Aircraft accident or critical aircraft incident
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For Aircraft Controllers:?
- • Any physical, psychological or psychiatric problems while controlling or separating aircraft or physical, psychological or psychiatric consequences as a result of a critical incident
- involving controlled aircraft.
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High Altitude Exposure?
- • Risk of DCI above 21, 000 feet
- • Flight above 25,000 ft prohibited(AVMED approval only)
- • Pre-oxygenation 20 mins >21,000 ft
- • Time limits above 21,000 ft
- • Re-exposure limits
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High Altitude Exposure?
- TIME (MINUTES) CABIN ALTITUDE (FT)
- 45 24 000–25 000
- 70 23 000–23 999
- 120 22 000–22 999
- 200 21 000–21 999
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Aircraft Simulator Training “Simulator Sickness”?
• Aircrew must self-impose TMUFF as dictated by single-Service regulations.
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Diving?
- • Reference Defence Instruction (General) OPS 22–1— Altitude Restrictions following Hyperbaric Exposures including Flying after Underwater Diving.
- • Aircrew must self-impose TMUFF for:
- “I’M SAFE” Checklist!
- • Illness
- • Medication
- • Stress
- • Alcohol
- • Fatigue
- • Eating
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Quiz question 26:?
- • Medically imposed TMUFF applies to:
- a. Vaccinations
- b. Blood donations
- c. Consumption of alcohol
- d. Post-operative recovery
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