Time of useful consciousness (TUC), also effective performance time (EPT), is defined as the amount of time an individual is able to function effectively (e.g. perform flying duties) in an environment of inadequate oxygen supply. [1] It is the period of time from the interruption of the oxygen supply or exposure to an oxygen-poor environment to the time when useful function is lost, and the individual is no longer capable of taking proper corrective and protective action. It is not the time to total unconsciousness. At the higher altitudes, the TUC becomes very short; considering this danger, the emphasis is on prevention rather than cure.
For orbital altitudes and above, that is, direct exposure to space, 6–8 seconds of consciousness is expected. [2]
There are many individual variations of hypoxia, even within the same person. Generally, old age tends to reduce the efficiency of the pulmonary system, and can cause the onset of hypoxia symptoms sooner. [3] Smoking drastically reduces oxygen intake efficiency, and can have the effect of reducing tolerance by 1,000–2,000 metres (3,300–6,600 ft). [4] Hypoxia can be produced in a hypobaric chamber. This can be useful for identifying individual symptoms of hypoxia, along with rough estimates of the altitude that causes problems for each person. Identifying symptoms is often helpful for self-diagnosis in order to realize when altitude should be reduced.
The table below shows average TUCs as documented by the Federal Aviation Administration; a rapid ascent results in a lower TUC. [5] The TUCs for any given individual may differ significantly from this. Aerobic exercise during the TUC period will reduce the TUCs considerably; so will exercise immediately prior to the TUC as this induces an oxygen debt prior to exposure. [6]
Altitude (measured barometrically) | TUC (normal ascent) | TUC (rapid decompression) |
---|---|---|
FL 180 (18,000 ft; 5,500 m) | 20 to 30 minutes | 10 to 15 minutes |
FL220 (22,000 ft; 6,700 m) | 10 minutes | 5 minutes |
FL250 (25,000 ft; 7,600 m) | 3 to 5 minutes | 1.5 to 3.5 minutes |
FL280 (28,000 ft; 8,550 m) | 2.5 to 3 minutes | 1.25 to 1.5 minutes |
FL300 (30,000 ft; 9,150 m) | 1 to 2 minutes | 30 to 60 seconds |
FL350 (35,000 ft; 10,650 m) | 30 to 60 seconds | 15 to 30 seconds |
FL400 (40,000 ft; 12,200 m) | 15 to 20 seconds | 7 to 10 seconds |
FL430 (43,000 ft; 13,100 m) | 9 to 12 seconds | 5 to 6 seconds |
FL500 (50,000 ft; 15,250 m) | 8 to 10 seconds | 5 seconds |
Hypoxia is a condition in which the body or a region of the body is deprived of adequate oxygen supply at the tissue level. Hypoxia may be classified as either generalized, affecting the whole body, or local, affecting a region of the body. Although hypoxia is often a pathological condition, variations in arterial oxygen concentrations can be part of the normal physiology, for example, during strenuous physical exercise.
Decompression sickness is a medical condition caused by dissolved gases emerging from solution as bubbles inside the body tissues during decompression. DCS most commonly occurs during or soon after a decompression ascent from underwater diving, but can also result from other causes of depressurisation, such as emerging from a caisson, decompression from saturation, flying in an unpressurised aircraft at high altitude, and extravehicular activity from spacecraft. DCS and arterial gas embolism are collectively referred to as decompression illness.
Altitude sickness, the mildest form being acute mountain sickness (AMS), is a harmful effect of high altitude, caused by rapid exposure to low amounts of oxygen at high elevation. People's bodies can respond to high altitude in different ways. Symptoms of altitude sickness may include headaches, vomiting, tiredness, confusion, trouble sleeping, and dizziness. Acute mountain sickness can progress to high-altitude pulmonary edema (HAPE) with associated shortness of breath or high-altitude cerebral edema (HACE) with associated confusion. Chronic mountain sickness may occur after long-term exposure to high altitude.
Generalized hypoxia is a medical condition in which the tissues of the body are deprived of the necessary levels of oxygen due to an insufficient supply of oxygen, which may be due to the composition or pressure of the breathing gas, decreased lung ventilation, or respiratory disease, any of which may cause a lower than normal oxygen content in the arterial blood, and consequently a reduced supply of oxygen to all tissues perfused by the arterial blood. This usage is in contradistinction to localized hypoxia, in which only an associated group of tissues, usually with a common blood supply, are affected, usually due to an insufficient or reduced blood supply to those tissues. Generalized hypoxia is also used as a synonym for hypoxic hypoxia This is not to be confused with hypoxemia, which refers to low levels of oxygen in the blood, although the two conditions often occur simultaneously, since a decrease in blood oxygen typically corresponds to a decrease in oxygen in the surrounding tissue. However, hypoxia may be present without hypoxemia, and vice versa, as in the case of infarction. Several other classes of medical hypoxia exist.
Aviation medicine, also called flight medicine or aerospace medicine, is a preventive or occupational medicine in which the patients/subjects are pilots, aircrews, or astronauts. The specialty strives to treat or prevent conditions to which aircrews are particularly susceptible, applies medical knowledge to the human factors in aviation and is thus a critical component of aviation safety. A military practitioner of aviation medicine may be called a flight surgeon and a civilian practitioner is an aviation medical examiner. One of the biggest differences between the military and civilian flight doctors is the military flight surgeon's requirement to log flight hours.
An uncontrolled decompression is an undesired drop in the pressure of a sealed system, such as a pressurised aircraft cabin or hyperbaric chamber, that typically results from human error, structural failure, or impact, causing the pressurised vessel to vent into its surroundings or fail to pressurize at all.
A breathing apparatus or breathing set is equipment which allows a person to breathe in a hostile environment where breathing would otherwise be impossible, difficult, harmful, or hazardous, or assists a person to breathe. A respirator, medical ventilator, or resuscitator may also be considered to be breathing apparatus. Equipment that supplies or recycles breathing gas other than ambient air in a space used by several people is usually referred to as being part of a life-support system, and a life-support system for one person may include breathing apparatus, when the breathing gas is specifically supplied to the user rather than to the enclosure in which the user is the occupant.
An oxygen mask is a mask that provides a method to transfer breathing oxygen gas from a storage tank to the lungs. Oxygen masks may cover only the nose and mouth or the entire face. They may be made of plastic, silicone, or rubber. In certain circumstances, oxygen may be delivered via a nasal cannula instead of a mask.
Cabin pressurization is a process in which conditioned air is pumped into the cabin of an aircraft or spacecraft in order to create a safe and comfortable environment for humans flying at high altitudes. For aircraft, this air is usually bled off from the gas turbine engines at the compressor stage, and for spacecraft, it is carried in high-pressure, often cryogenic, tanks. The air is cooled, humidified, and mixed with recirculated air by one or more environmental control systems before it is distributed to the cabin.
Hyperoxia is the state of being exposed to high levels of oxygen; it may refer to organisms, cells and tissues that are experiencing excessive oxygenation, or to an abnormally high oxygen concentration in an environment.
Diving disorders, or diving related medical conditions, are conditions associated with underwater diving, and include both conditions unique to underwater diving, and those that also occur during other activities. This second group further divides conditions caused by exposure to ambient pressures significantly different from surface atmospheric pressure, and a range of conditions caused by general environment and equipment associated with diving activities.
A hypobaric chamber, or altitude chamber, is a chamber used during aerospace or high terrestrial altitude research or training to simulate the effects of high altitude on the human body, especially hypoxia and hypobaria. Some chambers also control for temperature and relative humidity.
Ebullism is the formation of water vapour bubbles in bodily fluids due to reduced environmental pressure, usually at extreme high altitude. It occurs because a system of liquid and gas at equilibrium will see a net conversion of liquid to gas as pressure lowers; for example, liquids reach their boiling points at lower temperatures when the pressure on them is lowered. The injuries and disorder caused by ebullism is also known as ebullism syndrome. Ebullism will expand the volume of the tissues, but the vapour pressure of water at temperatures in which a human can survive is not sufficient to rupture skin or most other tissues encased in skin. Ebullism produces predictable injuries, which may be survivable if treated soon enough, and is often accompanied by complications caused by rapid decompression, such as decompression sickness and a variety of barotrauma injuries. Persons at risk are astronauts and high altitude aviators, for whom it is an occupational hazard.
The Armstrong limit or Armstrong's line is a measure of altitude above which atmospheric pressure is sufficiently low that water boils at the normal temperature of the human body. Exposure to pressure below this limit results in a rapid loss of consciousness, followed by a series of changes to cardiovascular and neurological functions, and eventually death, unless pressure is restored within 60–90 seconds. On Earth, the limit is around 18–19 km above sea level, above which atmospheric air pressure drops below 0.0618 atm. The U.S. Standard Atmospheric model sets the Armstrong limit at an altitude of 63,000 feet (19,202 m).
On October 25, 1999, a chartered Learjet 35 business jet was scheduled to fly from Orlando, Florida, United States to Dallas, Texas, United States. Early in the flight, the aircraft, which was climbing to its assigned altitude on autopilot, lost cabin pressure, and all six on board were incapacitated by hypoxia, a lack of oxygen in the brain and body. The aircraft continued climbing past its assigned altitude, then failed to make the westward turn toward Dallas over North Florida and continued on its northwestern course, flying over the southern and midwestern United States for almost four hours and 1,500 miles (2,400 km). The plane ran out of fuel over South Dakota and crashed into a field near Aberdeen after an uncontrolled descent, killing all six on board.
The effects of high altitude on humans are mostly the consequences of reduced partial pressure of oxygen in the atmosphere. The medical problems that are direct consequence of high altitude are caused by the low inspired partial pressure of oxygen, which is caused by the reduced atmospheric pressure, and the constant gas fraction of oxygen in atmospheric air over the range in which humans can survive. The other major effect of altitude is due to lower ambient temperature.
On 4 September 2000, a chartered Beechcraft 200 Super King Air departed Perth for a flight to the mining town of Leonora, Western Australia. The aircraft crashed near Burketown, Queensland, Australia, resulting in the deaths of all eight occupants. During the flight, the aircraft climbed above its assigned altitude. When air traffic control (ATC) contacted the pilot, the pilot's speech had become significantly impaired, and he was unable to respond to instructions. Three aircraft intercepted the Beechcraft, but were unable to make radio contact. The aircraft continued flying on a straight north-easterly heading for five hours, before exhausting its fuel and crashing 40 mi (65 km) south-east of Burketown. The crash became known in the media as the "ghost flight".
Hypobaric decompression is the reduction in ambient pressure below the normal range of sea level atmospheric pressure. Altitude decompression is hypobaric decompression which is the natural consequence of unprotected elevation to altitude, while other forms of hypobaric decompression are due to intentional or unintentional release of pressurization of a pressure suit or pressurized compartment, vehicle or habitat, and may be controlled or uncontrolled, or the reduction of pressure in a hypobaric chamber.
To prevent or minimize decompression sickness, divers must properly plan and monitor decompression. Divers follow a decompression model to safely allow the release of excess inert gases dissolved in their body tissues, which accumulated as a result of breathing at ambient pressures greater than surface atmospheric pressure. Decompression models take into account variables such as depth and time of dive, breathing gasses, altitude, and equipment to develop appropriate procedures for safe ascent.
Human physiology of underwater diving is the physiological influences of the underwater environment on the human diver, and adaptations to operating underwater, both during breath-hold dives and while breathing at ambient pressure from a suitable breathing gas supply. It, therefore, includes the range of physiological effects generally limited to human ambient pressure divers either freediving or using underwater breathing apparatus. Several factors influence the diver, including immersion, exposure to the water, the limitations of breath-hold endurance, variations in ambient pressure, the effects of breathing gases at raised ambient pressure, effects caused by the use of breathing apparatus, and sensory impairment. All of these may affect diver performance and safety.