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Technology-enhanced Learning - Activity Plan
Name: Sandra Pilote
Grade / Course: Patient Care and the Flight Environment: Hypoxia
 Aeromedical Evacuation Nursing, On-Job-Training Program (OJTP) for Health
Care Providers;
 Individually paced, can be blended course or face-to-face.
Length of Activity: 90 minutes
Lesson Summary:
Students will review the basics principles of aviation environment: composition of the
atmosphere, different layers of the atmosphere and their associated characteristics, gas
laws and their practical significance. Students will become familiar with hypoxia and
how to manage hypoxic patient in-flight.
Lesson Objective:
To provide students with the opportunity to discuss the hypoxic effect of flight on
patients and to become familiar with the management of hypoxia in the aviation
environment.
Resources/Technology – Teacher
Computer or Laptop, internet (high-speed);
Dwan military account and Sharepoint platform: access to discussion forum and online
library;
Email capability
Online Resources
 Aviation Medecine - Division Surgeon website (available via military dwan only)
 1 Canadian Air Division Surgeon App – available for android and iphone
 http://guides.erau.edu/aerospace-medicine
 https://www.omicsonline.org/blog/2015/08/10/18083-Aviation-medicine.html
 https://thoughtsonmilitaryhistory.wordpress.com/tag/aviation-medicine/
Resources/Technology – Students
Computer Lab or Student Laptop setting, internet (high-speed);
Dwan military account and Access to Sharepoint for Learning Materials/online library,
discussion forum and quiz.
Email capability
Online Resources
 http://www.space.com/17683-earth-atmosphere.html
 https://www.oercommons.org/courses/earth-s-atmosphere-composition-andstructure
 http://aviationknowledge.wikidot.com/aviation:gas-laws-human-factors
 https://opentextbc.ca/clinicalskills/chapter/5-3-causes-of-hypoxemia-2/
 https://opentextbc.ca/clinicalskills/chapter/5-5-management-of-hypoxemia/
 http://aviationknowledge.wikidot.com/aviation:hypoxia
 YouTube (2015) The effects of hypoxia at high altitude.
https://www.youtube.com/watch?v=XcvkjfG4A_M
 YouTube (2016). Aeromedical Factors: This video describes many of the
aeromedical factors that pilots should consider before taking off. These include:

hypoxia, hyperventilation, middle ear and sinus problems, spatial disorientation,
motion sickness, carbon monoxide poisoning, stress and fatigue, and dehydration.
We also cover the effects of alcohol, drugs, and over-the-counter medications, as
well as the effects of excess nitrogen during scuba dives upon a pilot or passenger
in flight. www.erau.edu https://www.youtube.com/watch?v=xK44nFczul0
1 Canadian Air Division Surgeon App – available for android and iphone
Intended Curriculum Learning Outcomes
 Students will describe the composition of the atmosphere, explain the layers and
their associated characteristics;
 Students will discuss the reduction of atmospheric pressure during ascent into the
atmosphere;
 Students will define the gas laws, and discuss the practical significance of each;
 Students will define hypoxia and list signs and symptoms;
 Students will identify factors associated with hypoxia;
 Students will identify the four types of hypoxia and give examples of each;
 Students wil describe the four stages of hypoxia;
 Students will explain the hypoxic effect of flight on patients;
 Students will identify measures to minimize the effects of hypoxia and describe
the management of the patient hypoxic condition;
 Students will define hyperventilation and discuss the two most common causes on
the aviation environment; and
 Students will differentiate between hypoxia and hyperventilation.
Instructional Activities
Teacher and students. Teacher will introduce course material/use of sharepoint and
answer potential questions (15 minutes) in the conference room (if group) and/or in office
(if individual).
Students will self-review course material/theory and videos available via sharepoint (75
minutes).
Students will participate to guided discussion/comments and quiz online via sharepoint or
hard copy (no time limit).
Learner Assessment
 Students will engage in self-directed learning.  Students will engage with teacher and other learners (comments/guided
discussion).
 Students will recognize hypoxia and appropriate explain measures to manage
related patient hypoxic condition (comments/guided discussion).
 Students will successfully complete the quiz (80% required).
Topics for comments/guided discussion (via sharepoint or face-to-face) to include but not
limited to:
 Explain hypoxia;
 Explain hyperventilation;
 Explain the main difference between hypoxia and hyperventilation;
 Management of patient with hypoxia (different medical conditions, cardio,
pregnant, respiratory, burn, etc.)
Quiz Questions (onlive via sharepoint or hard copy):
1. Dalton’s Law apllies mainly to:
a. Pressure
b. Volume
c. Temperature
d. Mass
2. The largest percentage of the dry atmospheric composition is:
a. Oxygen
b. Carbon dioxide
c. Nitrogen
d. Hydrogen
3. The avaerage time of useful consciousness for depressurization at 25 000 feet is:
a. 30-60 secondes
b. 90 secondes
c. 3-5 minutes
d. 30 minutes
4. List the four stages of hypoxia: indifferent, compensatory, disturbance, critical.
5. List 10 signs and symptoms of hypoxia:
a. Objective Signs: confusion, tachycardia, tachypnea, seizurs, stupor,
dyspnea, hypertension, bradycardia, arrhytmias, restlessness, slouching,
uncousciousness, hypotension (lateÙ), cyanosis (late), euphoria,
belligerence.
b. Subjective Signs: confusion, headache, insomnia, changing judment or
personality, dizziness, blurred vision, tunnel vision, hot and cold flashes,
tingling, numbness, nausea, euphoria, anger.
6. Hypoxic hypoxia is associated with all of the following conditions except:
a. Drowning
b. Airway obstruction
c. Pulmonary edema
d. Venous pooling
7. List patient care interventions to monitor and/or manage hypoxia (Possible
answers as following):
a. Oxygen supplement (bring adequate amount of oxygen, monitor and titrate
saturation, humidify oxygen)
b. Reduce cabin altitude to minimize the hypoxia associated with flight.
c. Identify patie4nts at risk
d. Treat types of hypoxia:
i. Hypemic: correct problem (ex. Methemoglobinemia)
ii. Anemia: transfusion
iii. Shock: volume and/or inotropes
iv. Histotoxic: antedote/hyperbaric treatment
v. Hypoxic: treat cause, provide oxygen
8. Identify the types of hypoxia in the following patients:
a. 32 year old patient with smoke inhalation and thermal respiratory burns
(A- hypoxic, hypemic, histotoxic)
b. Intoxicated 25 year old patient with massive chest trauma, hypovolemic
shock, and fractured femur. (A – hypemic, hypoxic, histotoxic, stagnant)
9. List patient care interventions to manage hyperventilation (Possible answers as
following):
a. Administer oxygen
b. Consider positive pressure breathing
c. Reassurance, briefing
d. Check equipment and consider descending to reduce altitude/degree of
hypoxia