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(1% rule)

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Aviation medicine
(Safety---------------------factor-------------------------Risk)

Flight
safety

Flight
safety
risk

2/7...
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1%rule is a example for risk management process
(Retrospective)
-Bad consequence in medicine :Mortality-Morbidity
-Bad con...
History
This "1 percent rule" began in the late 1980s and early 1990s
in a series of British and then European aviation ca...
Risk
management
process

1-Identify hazard&
2-Assess hazard:
Epidemiological study

-On average 1person
mortality in 10000...
Risk
management
process

3-Control of hazard

A-If100 year flight

B-10000 hour in one year

Risk rate:1/1000000
1000
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Risk
management
process

3-Control of hazard

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C-Incapacitation becomes
critical only during landing
or take-off,...
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Risk
management D-A simulator study indicated that
subsequent to pilot incapacitation at a
process
critical part of the fl...
DxCxBXA=Risk Threshold
D=1/100(sudden incapacitation risk)
C=1/10(Critical period)
B=1/10000(one hour per one year)
A=1/10...
Applying the one per cent rule
The acceptable maximum incapacitation rate of one per
cent per annum outlined above has bec...
Risk
management
process

5-Suprevie&
Evaluate

1-Evidence-Based Medicine
2-Aeromedical Decision-Making
3- Medical Incapaci...
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Systematic Review
Definition
A document often written by a panel that provides a comprehensive review of all relevant
stud...
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Ref:
1-Ernsting's Aviation Medicine-2006
2-Manual of Civil Aviation Medicine-2012

3-Joint Aviation Authorities -2009
4-In...
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One percent rule

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One percent rule

  1. 1. 2/7/2013 gasabeh.com gasabeh47@gmail.com 1
  2. 2. 2/7/2013 gasabeh.com gasabeh47@gmail.com 2
  3. 3. (1% rule) 2/7/2013 gasabeh.com gasabeh47@gmail.com 3
  4. 4. Aviation medicine (Safety---------------------factor-------------------------Risk) Flight safety Flight safety risk 2/7/2013 gasabeh.com gasabeh47@gmail.com 4
  5. 5. 2/7/2013 gasabeh.com gasabeh47@gmail.com 5
  6. 6. 2/7/2013 gasabeh.com gasabeh47@gmail.com 6
  7. 7. 2/7/2013 gasabeh.com gasabeh47@gmail.com 7
  8. 8. 2/7/2013 gasabeh.com gasabeh47@gmail.com 8
  9. 9. 2/7/2013 gasabeh.com gasabeh47@gmail.com 9
  10. 10. 2/7/2013 gasabeh.com gasabeh47@gmail.com 10
  11. 11. 2/7/2013 gasabeh.com gasabeh47@gmail.com 11
  12. 12. 1%rule is a example for risk management process (Retrospective) -Bad consequence in medicine :Mortality-Morbidity -Bad consequence in Aviation :Accident-Incident -Bad consequence in Aviation medicine : Pilot sudden medical incapacitation 2/7/2013 gasabeh.com gasabeh47@gmail.com 12
  13. 13. History This "1 percent rule" began in the late 1980s and early 1990s in a series of British and then European aviation cardiology workshops. The application of this "1 percent rule" has subsequently spread beyond the domain of aviation cardiology to all potential causes of medical incapacitation. 2/7/2013 gasabeh.com gasabeh47@gmail.com 13
  14. 14. Risk management process 1-Identify hazard& 2-Assess hazard: Epidemiological study -On average 1person mortality in 100000 population in one year or 10000 hours= 1/1000000000 (Risk Threshold) 2/7/2013 gasabeh.com gasabeh47@gmail.com 14
  15. 15. Risk management process 3-Control of hazard A-If100 year flight B-10000 hour in one year Risk rate:1/1000000 1000 2/7/2013 gasabeh.com gasabeh47@gmail.com 15
  16. 16. Risk management process 3-Control of hazard 2/7/2013 C-Incapacitation becomes critical only during landing or take-off, approximately 10% of an average one hour flight.(1/10) gasabeh.com gasabeh47@gmail.com 16
  17. 17. 2/7/2013 gasabeh.com gasabeh47@gmail.com 17
  18. 18. Risk management D-A simulator study indicated that subsequent to pilot incapacitation at a process critical part of the flight (takeoff and initial climb, approach and Landing the second pilot would take over successfully on 399 3-Control of occasions out of 400 such events hazard& (Chapman 1984). Taking this into account, 4- Implement it was assumed that a trained pilot should control be able to take over safely on 99 occasions out of 100 (Bennett 1988). 1/100 or (1%rule) Acceptable risk in two-pilot operations 2/7/2013 gasabeh.com gasabeh47@gmail.com 18
  19. 19. DxCxBXA=Risk Threshold D=1/100(sudden incapacitation risk) C=1/10(Critical period) B=1/10000(one hour per one year) A=1/100(one year per one century) 1/100x1/10x1/10000x1/100=Risk Threshold 1/1000000000 2/7/2013 gasabeh.com gasabeh47@gmail.com 19
  20. 20. Applying the one per cent rule The acceptable maximum incapacitation rate of one per cent per annum outlined above has become known as the “1% rule”. . This is widely regarded as an acceptable risk level and was adopted by the European Joint Aviation Authorities as the basis of aeromedical risk assessment. 2/7/2013 gasabeh.com gasabeh47@gmail.com 20
  21. 21. Risk management process 5-Suprevie& Evaluate 1-Evidence-Based Medicine 2-Aeromedical Decision-Making 3- Medical Incapacitation Risk of Airline Pilots(Renal colic/Seizure/Pneumothorax) 4-Flight Safety(Medical-Environmental-Aircraft)in ICAO annexes-FAR(FAA)-JAR(JAA)-IATA 5-Flight Time(long haul:multizones/multisegments) 6-Aircraft automated/simulated 7-Number of pilots 8-Waivers 9-Controversy RISK LIMITS:1%, 2%, or 5% 2/7/2013 gasabeh.com gasabeh47@gmail.com 21
  22. 22. 2/7/2013 gasabeh.com gasabeh47@gmail.com 22
  23. 23. Systematic Review Definition A document often written by a panel that provides a comprehensive review of all relevant studies on a particular clinical or health-related topic/question. The systematic review is created after reviewing and combining all the information from both published and unpublished studies (focusing on clinical trials of similar treatments) and then summarizing the findings. Advantages Exhaustive review of the current literature and other sources (unpublished studies, ongoing research) Less costly to review prior studies than to create a new study Less time required than conducting a new study Results can be generalized and extrapolated into the general population more broadly than individual studies More reliable and accurate than individual studies Considered an evidence-based resource Disadvantages Very time-consuming May not be easy to combine studies 2/7/2013 gasabeh.com gasabeh47@gmail.com 23
  24. 24. 2/7/2013 gasabeh.com gasabeh47@gmail.com 24
  25. 25. 2/7/2013 gasabeh.com gasabeh47@gmail.com 25
  26. 26. 2/7/2013 gasabeh.com gasabeh47@gmail.com 26
  27. 27. 2/7/2013 gasabeh.com gasabeh47@gmail.com 27
  28. 28. Ref: 1-Ernsting's Aviation Medicine-2006 2-Manual of Civil Aviation Medicine-2012 3-Joint Aviation Authorities -2009 4-Internet sources 5-Stuart J. Mitchell and Anthony D. Evans.Flight Safety and Medical Incapacitation Risk of Airline Pilots. Aviation, Space, and Environmental Medicine • Vol. 75, No. 3 • March 2004 6-Dougal B. Watson. Aeromedical Decision-Making: An Evidence-Based Risk Management Paradigm. Aviation, Space, and Environmental Medicine • Vol. 76, No. 1 • January 2005 2/7/2013 gasabeh.com gasabeh47@gmail.com 28
  29. 29. 2/7/2013 gasabeh.com gasabeh47@gmail.com 29

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