HALO and HAHO

(PHYSIOLOGICAL EFFECT OF HIGH ALTITUDE

MILITARY FREE-FALL OPERATIONS)

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 CURRICULUM VITAE

 NAMA : Dr. Ir. SOVIAN ARITONANG, S.Si, M.Sc

 PANGKAT / NRP : KOLONEL KESEHATAN / 519726
 TEMP/TGL LAHIR: DELI SERDANG SUMUT, 18 JUNI 1968
 STATUS : NIKAH, ANAK 4
 DIKMIL : PAPK II TA. 1995, AKMIL MAGELANG
: SUSORMAT 1995, WINGDIKUM
: PTO 1996, LAKESPRA S
: KURSUS ALAT HC, 2000, PARIS
: SEKKAU A-80, 2006
: SESKOAU A-48, 2011
 DIKUM : S-1 FISIKA TEORI USU MEDAN, LULUS 1991
: S-2 FISIKA REKAYASA BIO MATERIAL UI, LULUS 2005
: S-3 FISIKA REKAYASA BIO MATERIAL UI, LULUS 2010
 PENGALAMAN : DOSEN USU, US XII, 1990 S/D 1994
 DOSEN UNIV : DOSEN UNIV. SURYADARMA, 2005
: DOSEN TIDAK TETAP S-2 FISIKA MEDIS FMIPA UI, 2008
: DOSEN TIDAK TETAP PPDS KEDOKTERAN PENERBANGAN FKUI, 2010
: DOSEN TIDAK TETAP ATKP SURABAYA, 2012
: DOSEN TIDAK TETAP LP3B, 2013 DAN PRAMUGARI
: DOSEN TIDAK TETAP UNIV PATRIA ARTHA, MAKASSAR, 2013
: DOSEN TETAP KETAHANAN ENERGI DAN INDUSTRI PERTAHANAN, UNHAN
2015
 NIDN : 4718066801
 JAB. AKADEMIS : LEKTOR/ LULUS SERTIFIKASI DOSEN PROFESIONAL KEMRISTEKDIKTI, 2016
 DOSEN DINAS : DOSEN SUSDOKBANG, 1997 SAMPAI SEKARANG
: DOSEN SUSWATUD, 1997 SAMPAI SEKARANG
: DOSEN SUSKESBANGAN, 2005 SAMPAI SEKARANG
: DOSEN NON ORGANIK SEKKAU, 2006
 SATUAN : UNIVERSITAS PERTAHANAN SENTUL, BOGOR
 JABATAN : DOSEN TETAP KETAHANAN ENERGI, dan INDUSTRI PERTAHANAN, 2015-2016
: Plt. KAPRODI INDUSTRI PERTAHANAN UNHAN SEPT 2016
: PENELITI MADYA BELA NEGARA LP2M UNHAN DES 2016
: KAPRODI DAYA GERAK, AGUSTUS 2017
INTRODUCTION…
Machine Media
(Air Craft Performance/ (Flight Environment )
Aerodynamic, Cabin Pressure,
Automation, etc) Atmosphere
Man P Bar <<
PO2 Partial <<
G-Force
SDO
Evolved gas (Land Creature, physiologically relative constant) Hypoxia
Emerg Esc
Fatigue
Trapped gas
Evolved gas
Human Performance <<<

Unsafe action
Defense Defense

Success
Fail
Incident
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 Health and Physiological Factors Affecting Air
Crew Performance
• Some important medical factors that a Air
Crew should be aware of include hypoxia,
hyperventilation, middle ear and sinus
problems, spatial disorientation, motion
sickness, carbon monoxide (CO) poisoning,
stress and fatigue, dehydration, and heat
stroke. Other subjects include the effects of
alcohol and drugs, anxiety, and excess
nitrogen in the blood after scuba diving.
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The Composition of Atmosphere
Other Oxygen
1% 21%

Nitrogen
78%
Although pressure changes with
altitude, this percentage relationship
remains constant 5
 Physiological Zones of the
Atmosphere
 0 - 10,000ft:
The Physiological
Zone

The Physiologically
 10 000 - 50,000ft:
Deficient Zone

 50,000 ft +: The Space

Equivalent Zone
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Standard Pressure and Temperature Values at 40
Degrees Latitude for Specific Altitudes

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 Hypoxia:
a lack of oxygen to the tissues sufficient to
cause impairment of function

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 Types of Hypoxia
Atmosphere

Trachea & Bronchi

HYPOXIC
(Aviation)

Alveoli
Hypaemic

Stagnant Blood

Histotoxic Tissues
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 Symptoms & Signs

• 10,000 - 15,000 feet

Few signs/symptoms
Performance impairment
Headache
Poor work capacity

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 Symptoms & Signs
• 15,000 - 20,000 feet
- Loss of judgement
- Poor neuromuscular control
- Emotional changes
- Slow thought processes
- Visual symptoms

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Possible Signs and Symptoms Individual of Hypoxia
Must Be Recognized
SYMPTOMS SIGNS
(SUBJECTIVE) (OBJECTIVE)
Air Hunger Hiperventilation
Apprehension Cyanosis
Fatigue Mental Confusion
Headache & Dizziness Poor Judgment
Lost Of Muscle
Hot & Cold Flashes
Coordination
Euphoria & Belligerance
Blurred Vision &
Tunnel Vision
Tingling & Numbness
UNCONSCIOUSNESS
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FACTORS MODIFYING HYPOXIA
SYMPTOMS
TIME of USEFUL CONSCIOUSNESS

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Hyperventilation
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 Preliminary principles of
hyperventilation:
 Normal respiratory rate is between 12 and 20 cycles per
minute (average is 16). You will recall that control of respiration is
mediated reflexly through the chemoreceptors in the aorta and
the carotid artery by arterial oxygen deficiency in conditions of
hypoxia

 In normal individuals the amount of CO2 produced by the

tissues and the amount of CO2 eliminated from the lungs are in
perfect balance. This balance is maintained mostly by the blood
buffers, which resist any tendency to alter blood pH. It becomes
obvious that excessive elimination of CO2 can cause a much-too-
rapid fall in H2CO3. The result is an elevation in blood pH
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 Symptoms
• Light-headed
• Dizzy
• Anxiety
• Tunnelling of vision
• Muscle spasms
• Decreasing consciousness
• Loss of consciousness
• Recovery is usual 17
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DYSBARISM

FL. 450

FL. 250
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• Altitude-Induced Decompression Sickness (DCS)
DCS describes a condition characterized by a variety of
symptoms resulting from exposure to low barometric pressures
that cause inert gases (mainly nitrogen), normally dissolved in
body fluids and tissues, to come out of physical solution and
form bubbles. Nitrogen is an inert gas normally stored through
out the human body (tissues and fluids) in physical solution.
When the body is exposed to decreased barometric pressures
(as in flying an unpressurized aircraft to altitude, or during a
rapid decompression), the nitrogen dissolved in the body
comes out of solution. If the nitrogen is forced to leave the
solution too rapidly, bubbles form in different areas of the
body, causing a variety of signs and symptoms. The most
common symptom is joint pain, which is known as “the bends.”

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80k
Gas Expansion at Altitude

10 x

53k
4x

34k
2x

18k
1x

0 22
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VALSALVA MANEUVER

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 3. Invagination of tymp memb, with
1. Normal right tympanic membrane
congestion along the handle of malleus

2. Tympanic membrane invaginated, 4. Attic congestion resulting from

with min congestion, during descent a relatively mild otitic barotrauma 26
5. Scattered intersttial haemorr in tymp membr 7. Marked congestion, with fresh haemorrage
these are generally residual in nature into the middle ear

6. Unresolved otitic barotrauma. The bubbles

indicate attempts to ventilate the ear via the 8. Rupture of the anterior portion
of the tymp membrane 27
Eustachian tube
 Valsalva Manoeuvre (VM)
• Forced expiration with closed nose/mouth
• Forces air up Eustachian tube and
overpressurises the middle ear
• Other techniques - swallowing, chewing, jaw
movement
• NB: If pressure differential exceeds 90-120
mmHg, VM ineffective - so clear ears
frequently
AVOID GAS- FORMING FOODS

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 FATIQUE
BASIC CAUSE OF FATIGUE
a. SLEEP LOSS
b. WORK INDUCED
c. CIRCADIAN RHYTHM DISRUPTION

FACTORS TO BE CONSIDRED IN ESTIMATION OF FATIQUE

POTENSTIALS

a. LENGTH OF FLIGHT h. TOXIC FACTORS.

b. LAY OVER FACILITIES j. LEADERSHIP AND TEAM
SPIRITS.
c. RELIABILITY OF RADIO AIDS
k. PERSONAL FACTORS.
d. UNCOMFORTABLE
PERSONAL EQUIPMENT l. DIURNAL RHYTHM
FACTORS.
e. WEATHER
m. UNFORSEEN
f. PHYSICAL CONDITION
EMERGENCIES.
g. HUMAN FACTORS DESIGN
ENGINERRING

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 SPATIAL DISORIENTATION (SDO)

INPUT ERROR : When Errorneous Or Inadequae

Sensory Information Is Transmitted To The Brain

CENTRAL ERROR : When There Is An Errorneous Or

Inadequae Perception Of Correct Sensory
Information By Brain – Coning Attention, Fascination,
Error Expectancy.

SPATIAL DISORIENTATION : Somatogravic Illusion,

Somatogyral Illusion,occulogravic Illusion, Occulo
Gyral Illusion, Corriolis Illusion, G Excess Illusion,
Lean, Graveyard Spin, Graveyard Spiral , Black Hole
Illusion, Out Brake Phenomen, Giant Hand Phenomen,
Visual Illusion, Etc
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Graveyard Spiral
Graveyard Spiral

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Graveyard Spin

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 MOTION SICKNESS
Motion sickness, or airsickness, is caused by
the brain receiving conflicting messages about
the state of the body. A pilot may experience
motion sickness during initial flights, but it
generally goes away within the first few
lessons. Anxiety and stress, which may be
experienced at the beginning of flight training,
can contribute to motion sickness. Symptoms
of motion sickness include general discomfort,
nausea, dizziness, paleness, sweating, and
vomiting.
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THANKs FOR YOUR
ATTENTION

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