General Medical Officer (GMO) Manual: Administrative Section

Care and Disposition of Aviation Personnel

Department of the Navy
Bureau of Medicine and Surgery

Aircrew members operate in a uniquely stressful environment, and require special handling from a medical standpoint. Aircrew are exposed to reduced ambient pressures with altitude, hypoxia, extremes of heat and cold, high acceleration and G-forces, angular rotations, and sensory illusions, to name a few. See the section on altitude-related illness for discussion on one of these. In addition to general medical standards, special duty medical standard also apply.

Medications, even over the counter (OTC) drugs, may have unpredictable side effects when combined with these stressors. The aircraft environment is very confining and can produce discomfort with reduced mobility, especially during extended operations. Furthermore, flying aircraft demands that the aviator be at peak performance. Any diminished mental or physical capacity impacts the safety of flight in this most unforgiving of environments. A simple upper respiratory infection, mild gastroenteritis, or musculoskeletal discomfort, which might be inconsequential on the ground, may have significant consequences during flight. For these reasons, all but the most trivial illnesses in the flight crew require that they be grounded and given a "down chit." Any provider may ground aircrew members when medically indicated; flight surgeon consultation is not required. However, only flight surgeons or aviation medical officers are authorized to return grounded aircrew to flight status following an illness. Any use of medications while flying absolutely requires flight surgeon approval. These same principles apply to air traffic controllers, even though they aren’t actually flying aircraft. Every time aviation personnel visit a sick call clinic or emergency room, their aeromedical disposition MUST be addressed. The general medical officer is often the responsible party for providing health care to aviation personnel and he or she must determine whether the condition requires grounding. In general, injuries, illnesses, and any use of medication will require that the patient be given a "down chit." This is accomplished by:

Occasionally, flight personnel may call upon the GMO to provide an annual flight physical exam. However, according to Manual of the Medical Department, article 15-65, flight physicals are performed only by aviation authorized medical officers. Since the extent of the exam to be conducted and the special duty medical standards to be applied are a function of the type of duty to be performed, coordination with a local or theater flight surgeon is required.

1. MANMED 15-65