Use common sense with supplemental oxygen

I receive a plethora of rabid emails and letters regarding my position on the use of supplemental oxygen for pilots. To my mind, at least, the federal regulation regarding its use is too lax.

In regard to supplemental oxygen in a non-pressurized aircraft, 14 CFR 91.211 states in part that:

(a) General. No person may operate a civil aircraft of U.S. registry—

(1) At cabin pressure altitudes above 12,500 feet (MSL) up to and including 14,000 feet (MSL) unless the required minimum flight crew is provided with and uses supplemental oxygen for that part of the flight at those altitudes that is of more than 30 minutes duration;

(2) At cabin pressure altitudes above 14,000 feet (MSL) unless the required minimum flight crew is provided with and uses supplemental oxygen during the entire flight time at those altitudes; and

(3) At cabin pressure altitudes above 15,000 feet (MSL) unless each occupant of the aircraft is provided with supplemental oxygen.

I cannot conceive that someone bright enough to fly an airplane would question that oxygen is necessary to sustain life. When you stop breathing you stop living, right? People who have diseases of the lungs, heart, circulatory system, or blood may have problems picking up enough oxygen from the air and delivering it to tissues throughout the body. This leads to an increased incidence of heart attacks, strokes, kidney failure, toes and feet becoming gangrenous, and other nasty sequelae. Chronic shortage of oxygen to the brain may lead to dementia and early death. And in the acute phase?  In how many movies does one see the hero trapped in an airtight room, gasping for breath and becoming unconscious? Yes, shortage of oxygen impairs one’s ability to think clearly and act efficiently.

As you ascend in an aircraft, the number of oxygen molecules you inspire diminishes with each breath; the air truly is “thinner” up there. Failure to use supplemental oxygen exposes you—and your passengers—to risks from reduced mental functioning to, perhaps, chronic damage to your body. Is hypoxia a factor in aviation accidents? That question is rather difficult to answer definitively because it is impossible to ascertain from post-crash human remains whether the person was hypoxic at the time of impact. But, common sense tells us it is not beyond the realm of possibility. One thing is for sure—using oxygen will prevent the post-flight headache and reduce fatigue.

Now let’s consider the downsides—the substrate of the angry communiqués I receive: “Oxygen is expensive.” Sorry; no, it is not compared to the fuel we burn or our aircraft maintenance costs. “The equipment to use it is expensive.” Wrong again! “It is not widely available.” Nope. “I am fine without it.” Well, to answer that one, let me float one other nugget by you: You can apply a pulse oximeter to your finger during flight to measure blood oxygenation. The baseline oxygen level of a fit person is 98 percent to 100 percent at rest on the ground. Some pilots tell me that they are quite happy flying with a pulse ox reading of about 90 percent. Do you know what happens if you go to your local ER with a reading of 90 percent? They put you on oxygen pronto! My practice? I wear oxygen at 5,000 feet and above during the day and don it at night prior to takeoff. I may not be the brightest bulb in the chandelier, but I know how airplanes fly and common sense demands I look after my body and breathe deeply. I suggest you do the same.

Jonathan Sackier
Dr. Jonathan Sackier is an expert in aviation medical concerns and helps members with their needs through AOPA Pilot Protection Services.
Topics: Pilot Protection Services, AOPA Products and Services

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