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AVMO > Motion Sickness > Flashcards

Motion Sickness Flashcards

1
Q

Define motion sickness

A

Is a normal response to real or apparent motion to which a person in unfamiliar and hence un-adapted

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2
Q

What are the symptoms of motion sickness

A 
Cardinal - highly predictable
- Pallor > cold sweats > Nausea > Vomiting
Variable symptoms
- salivation
- belching/flatulence
- Stomach awareness
- sighing/yawning
- warm flushes
- Drowsiness 
- lightheaded ness
- Headache
- Depression and apathy
- Long term may cause dehydration, anorexia
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3
Q

What causes motion sickness

A

Neural mismatach theory
- Conflict between different sensory inputs or between sensory input and expect motion. Can adapt if unadaptiing internal model.

Treisman’s theory

  • Is motion sickness similar to the physiological response to poisoning?
  • getting out of favour
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4
Q

Examples of visual-vestibular mismatches

A

Using binoculars
Reading in flight
Fixed base simulators/VR games

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5
Q

Examples of canal-otolith mismatches

A

Head movement in rotation
Microgravity/space sickness
Flight turbulence
Pressure vertigo

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6
Q

Who is at risk of aviation

A 
Student pilots
Back-Enders
Paratroopers
Passengers
Sea survival
Experience
Role
Aircraft characteristics
Flying environment
Motion environment
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7
Q

Impact during flying training from motion sickness

A 
Modify or about sorties
Delay progress
Affects
- enthusiasm
- performance
- Self esteem
- motivation
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8
Q

Impact on flying operation

A

Trained aircrew

  • loss of performance and effectiveness
  • aborted mission
  • flying safety hazard
  • loss of motivation

Passengers

  • Nuisance value
  • dehydration
  • “ contagious”
  • decreased effectiveness of airdrop force
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9
Q

Who get simulator sickness

A

Trained aircrew

Can be atypical symptoms

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10
Q

What factor increase risk of motion sickkness

A

Linear acceleration
- horizontal 0.2 Hz maximally provocative
- Higher and lower frequencies less provocative
Rotation
- constant rotation, hardly provocative
- head movement during constant rotation (Coriolis) Most provocative

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11
Q

What predicts susceptibility

A

Receptivity,
Retentivity
Adaptability

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12
Q

Summary contributing factors

A

Individual
- anxiety, lack of experience, out of practice, lack of tx, Age <12 or >60, female gender,

Environmental
- lack of visual cues, weather, sea state, aircraft manoeuvres, other vomiting

Descrease susceptibility

  • activity/distraction
  • Cold air
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13
Q

Treatment of motion sickness - step wise approach

A 
Behavioural strategies
Self adaptation
Medical/psychological tests
Medication
Desensitisation
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14
Q

Phase 0: Behavioural strategies

A 
Don’t fly if unwel
Tell someone
Minimise head movements
Stay occupied - fly the plane
Close eyes or view horizon
Lie down 
Cool air
Try to relax
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15
Q

Allow time for adaption

A

Freq exposure and re exposure
Start with gentle manoeuvres
Progress to aerobatics

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16
Q

Phase 1 medical assessment

A

History AE 849
- motion stimulus: provocation, frequency, severity, duration
- RF: susceptibility factors, anxiety, stress, compliance with prevention strategies
Clinical examination (ENT, Psych)
- ENT pathology
- Fear of flying, anxiety, adjustment

17
Q

How to rate motion sickness

A 
No symptoms = 0
Any symptoms, no nausea = 1
Nausea - mild = 2
Nausea - moderate but can continue = 3
Nausea - severe, want to stop = 4
Vomiting = 5

Score 4 or more for 3 identical flight: seek medical advice

18
Q

Rules around using medication

A

Combine with behavioural strategies
Only for initial trainees on a temporary basis
Maximum 8 sorties with QFI or as pax
No solo flying or in command
48 hr ground trial required
Failure of medication trial requires referral to RAAF IAM

19
Q 
Which of the following decreases susceptibility to motion sickness
A. Keeping busy/occupied
B. Anxiety
C. Hot environments
D. Poor outside visual cues
A

A keeping busy/occupied

20
Q

Pharmacology approved for motion sickness

A 
Central anticholinergics
- Hyoscine - scopolamine
—- Tavacalm original - onset 15-30min last 8 hours 
—- Kwells - short acting drug, action last 4 hours
- Cinnarizine
- Promethazine
Antihistaminics
- Promethazine HCI - phenergan
-Promethazine theoclate - avomine
—-in combination with pseudoephidrine to counter the sediation
Sympathomimetics
- Ephedrine
- pseudoephedrine
- dexamphetamine
21
Q

Alternative therapies

A

Little proven benefit

  • acupressure
  • acupuncture
  • magnetotherapy
  • Herbal preparations

Some proven benefit
- ginger tablets

22
Q

Phase 2

A

SAVMO review

  • assess compliance with preventative strategies
  • Assess motivation
  • Liaise with SQN regarding suitability
  • Refer to ENT and Psychological support if not already done
23
Q

Phase 3

A

Ground based desensitisation

  • At ESL
  • 3 days of desensitisation using cross-couple coriolis
  • record on AE 850
  • return to flying within 48h
24
Q

Phase 4

A

Ongoing desensitisation

  • provocative flight in the morning the
  • cross-coupled coriolis in the afternoon
  • 3 further days
  • return to flying within 48 hr
25
Q

Phase 5

A

Referral to institute of aviation medicine
Motion sickness desensitisation program
- forces adaptation with cross-coupled stimuli
- 5 week program
— 3 week ground phase - 4 session/day with 2 hr intervals
— increase rpm based on vertigo and symptoms.
— frequent coriolis stimulation
— 10 sortie PC-21 airborne phase
——aileron roll, Cuban eights, slow roll, vertical roll
— immediate return to flying

26
Q 
Which of the following decreases susceptibility to motion sickness
A. Keeping busy/occupied
B. Anxiety
C. Hot environments
D. Poor outside visual cues
A

A keeping bus/occupied

AVMO (49 decks)

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