FAA Medical Certification - Flight Safety Foundation

FAA Medical Certification - Flight Safety Foundation

FAA Medical Standards & Policy Update 2014 Quay Snyder, MD, MSPH Aviation Medicine Advisory Service Business Aviation Safety Seminar April 16, 2014 Overview FAA Medical Standards & Policies Significant Policy Changes Strategies to: Minimize Risk Maximize Safety Questions? Public & Private AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD

2 FAA Medical Standards FAR Part 67 Broadly defined 15 Mandatory Disqualifying Diagnoses Guide to AMEs Hundreds of Disqualifying Diagnoses FAA Policy rarely published, always evolving FAR 61.53 Self-certification decision every time AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 3

FAR 61.53 Not 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 AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 4

IM SAFE I - Illness M - Medications S - Stress A - Alcohol F - Fatigue E - Eating / Hydration AIM 8-1-1

AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 5 AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 6 Federal Air Surgeon Dr. Fred Tilton Retired Jan 2014 Issue whenever possible

Call to avoid deferral Dr. James Fraser Appointed March 2014 AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 7 CACIs Conditions AMEs Can Issue

Previously required FAA approval Now Eligible AME worksheet Pilot documentation More to come AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 8 CACIs

Arthritis Asthma Glaucoma Hepatitis C Hypertension Hypothyroidism Migraine Headaches

Pre-Diabetes Renal Cancer BPH Colitis Renal Cancer Prostate Cancer Testicular Cancer AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD

9 AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 10 Antidepressants April 2010 implementation Amnesty period over Celexa, Lexapro, Prozac, Zoloft Single dose, single medication Reduced observation period to 6 months

Reduced Cognitive assessment More diagnoses allowed AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 11 Eye Surgeries LASIK / PRK Self Clear Report next AME visit Intraocular Lenses Cataracts Single vision Multifocal / Accommodating

Monovision AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 12 Hypertension AME can Issue All meds allowed* No Stress test or lab reports No FAA letter AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD

13 Electrocardiogram 10+ variants now allowed Less expensive evaluations Moving to digital vs. analog Fewer errors Faster review AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 14 Heart Surgery

Angioplasty / Stent 3 month wait By-Pass / Valve Replacement 6 month Eliminated repeat Radionuclide Stress Test Pacer battery replacement no 2 month wait Heart Transplant Allowed 3rd class AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 15

AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 16 Medications FAA Do Not Issue Do Not Fly List

5x maximum half-life or dosing interval Chantix smoking Mefloquine (Larium) malaria Scheduled medications Dextromethorphan 60 hours Many others AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 17 Medications

Allergies Allegra & Claritin only Supplements no Valerian or Kava-Kava Valium 24 hours / 48 hours / 21 days Muscle relaxants None Steroids dose dependent / Nasal OK Erectile Dysfunction Meds AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 18

Sleep Meds Ambien / Ambien CR Edluar Intermezzo Lunesta Restoril Rozerem

Sonata Zolpimist 24 hours 36 hours 36 hours 30 hours

72 hours 24 hours 6 hours 48 hours AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 19 AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 20

DUIs Mandatory Deferral BAC > 0.1499 mg% Refusal to test 1 incident in last 2 years if 2nd one in lifetime 2 incidents in last 10 years 3 incidents in a lifetime AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 21 DUI Evaluation

Arrest and Court records Driving records all states Military records Personal statements (2) Substance Abuse Eval to FAA standards Qualified examiner AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 22

AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 23 Diabetes Pre-Diabetes is CACI Non-insulin All classes Some medication combinations not OK

Insulin 3rd Class only in CONUS ADA petition for 1st and 2nd UK, Australia, Canada AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 24 GA Pilot Protection Act

VFR non-commercial US flights Valid US drivers license 6,000 pounds < 7 Seats < 14,000 MSL < 250 kts 5 year review AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 25 Sequestration / Shutdown

Hiring Freeze MDs and support staff Contractors IT stoppage Backlog of cases Tiger Teams Retirement attrition ~ 15% of AMCD 2-3 year training for new hires Push workload to AMEs AMAS - Aviation Medicine

Advisory Service - Quay Snyder, MD 26 AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 27 Sleep Apnea - Past

DQ since 1996 No screening Testing requires 1+ sleep study - $$$$ Dropped MWT / MSLT Sleep Medicine physician approval Grounded pending FAA approval - $$$$ Annual FAA review AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 28

Sleep Apnea - Future Screening based on BMI + other factors Not grounding* 90 day evaluation by any physician Home studies allowed Treatment options (4) AME clearance

Compliance data for renewal AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 29 Fitness For Duty New NBAA Safety Emphasis Area FAA Cognitive Impairment interest Causes Physical / Medical Psychological Neurological Pharmacological AMAS - Aviation Medicine

Advisory Service - Quay Snyder, MD 30 Strategies to Keeping Medical Long-term AME relationship Easy not always Best Prepare for Physical exam Medical records/summaries available Prescreen medications / conditions Schedule early in month due MedXPress https://medxpress.faa.gov/ 10/1/12 AMAS - Aviation Medicine Advisory Service - Quay Snyder,

MD 31 Strategies to Keeping Medical Day of Exam Dont go if sick (OK to let lapse) Minimal Caffeine Athletes jog in place before ECG Bring Special Issuance Authorization letter Bring glasses and hearing aids AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 32

AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 33 Fly Safely! Stay Healthy! Questions ??????? Now for Policies Later in Private for Friends AMAS - Aviation Medicine Advisory Service - Quay Snyder, MD 34

Aviation Medicine Advisory Service a Division of Virtual Flight Surgeons Inc. 9800 S. Meridian Blvd., Suite 125 Englewood, CO 80112 866 AEROMED www.Aviationmedicine.com

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