• Hypoxic - Affects body as whole: reduced partial pressure of oxygen at altitude
• Hypemic - Blood unable to transport oxygen: smoking, bleeding or anemic factors, CO poisoning, blood donation
• Stagnant - Lack of flow (ischemia): heart issues, G forces, cold temps
• Histotoxic - Cells cannot use oxygen: alcohol, drugs, poisons (1 oz alcohol is 2000 ft)

• Euphoria, carefree feeling
• Cyanosis (blue fingernails)
• Headache
• Impaired judgement
• Visual impairment
• Drowsiness
• Lightheaded, dizzy
• Tingling in fingers and toes
• Numbness

• Visual impairment
  
• Unconsciousness
• Lightheaded dizzy
• Tingling sensations
• Hot and cold sensations
• Muscle spasms

• Crew: 12,500 to 14,000 if longer than 30 minutes, always 14,000 and above
• Passengers: 15,000 and above
• Recommended 10,000 and above for everyone, 8,000 and above at night for crfew

• Wait 12 hours if 8,000 ft or lower and no decompression stop required during dive
• Wait 24 hours if 8,000 ft or higher or if a decompression stop was required during the dive
• Excessive nitrogen absorbed during dive can embolize at high altitudes (reduced pressures) and cause the "bends" (Decompression Sickness or "DCS")

• Immediately shut off the heater
• Open all outside air vents (including "eyeball" vents)
• If significant impairment suspected, land and seek medical attention

• Headache
• Drowsiness
• Dizziness
• Confusion
• Cyanosis (blue fingernails)

• Colorless, odorless, and tasteless gas found in exhaust fumes
• Significantly reduces ability to blood to transport oxygen (ties up the hemoglobin molecules)
• Effects of hypoxia occur

• Eight hours bottle to throttle
• Under the influence (?? impaired ??)
• Below .040 BAC (this seems high!)
• Excellent rule is 12 to 24 hours

• Open the air vents
• Loosen clothing
• Use supplemental oxygen
• Focus outside aircraft
• Avoid unnecessary head movements
• Abandon flight and land ASAP if severe

• Nausea and disorientation
• Desire for food is lost
• Saliva collects in mouth, maybe drooling
• Begins to perspire freely (diaphoretic)
• Vomiting
• Headache
• Pilot may become incapacitated!

The inability to correctly interpret aircraft attitude, altitude, or airspeed in relation to the Earth or point of reference.

http://www.faa.gov/pilots/safety/pilotsafetybrochures/media/SpatialD.pdf

• Use of supplemental oxygen above 10,000 ft or above 5,000 ft at night.
• Heeding factors that reduce tolerance to altitude

• Eustachian tube blocked so cannot equalize pressure between outside and inner ear
• More common in descent or increasing cabin pressure because air must flow into the inner ear

• Swallowing
• Yawning
• Valsalva maneuver (often more effective)
• Avoid flight with upper respiratory or nasal allergies or infections

Abnormal increase in volume of air being breathed, causing a significant decrease in the carbon dioxide content of the blood. 

• Lightheadedness
• Tingling
• Coolness
• Disorientation
• Suffocation
• Muscle spasms
• Unconsciousness

• Bring breathing back under control - relax 
• Controlled breathing in and out with a paper bag held over nose and mouth

• Smoking (CO inhalation)
• Anemia (lowered hemoglobin)
• Some medications (??)
• Alcohol, even small amounts!
• Sedatives, even low doses!
• Undiagnosed heart problems (e.g. bradycardia)

• Onset from 12,000 to 15,000 feet
• Impairs judgement, memory, coordination, multi-tasking, and ability to make calculations
• Can cause drowsiness, euphoria, even belligerence (I have seen all of these!)

IMSAFE

Illness

Medication

Stress

Alcohol

Fatigue

Emotion

Part 67

Medical Standards and Certification

• Illness
• Medications
• Stress
• Alcohol
• Fatigue
• Eating