Faa Class I Ekg

[Soundbarviolatr]

Anyone have intel on FAA procedures if a 1st degree AV block is picked up by the EKG machine during a 1st Class Physical Exam? All else is normal. Will the Airman be grounded until further investigation by feds and cardiologist clears him/her?

Please respond only if you have actual knowledge of similar cases, NOT guesses or the basis of the condition of a 1st degree AV block. Thanks!

[Flyin'Dutch']

From the FAA website (http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&sid=b0859a44f58f555dbdc7660c19c131c6&rgn=div8&view=text&node=14:2.0.1.1.5.2.1.6&idno=14)

[Soundbarviolatr]

Thanks Dutch..I was aware about the general guidelines covered inthe FARs. What I was more concerned about was the actions of the FAA if a 1st stage AV block is discovered during the ECG. This "condition" is not regarded to a significant nature with medical personnel,1:1000 individuals register this on ECGs and if not accompanied by any other abnormal readings would be considered OK. However, knowing the Feds, I know they will make an issue of it -- I just want to know how much of an issue and how long the Airman would be grounded if at all. Sooooo, I think what I would like to ask is if anyone has ever run into this scenario and what the FAA and AME actions thereafter (ie, grounding, firther tests, cardiologists, length of grounding, etc.) Pls PM me if you you do not wish to disclose on the board. Thanks!!

[Flyin'Dutch']

AME actions

I'd have to ask them to be sure but suspect a first degree AV block would be a non-problem.

Frank Voeten
FAA AME

[Flyin'Dutch']

Asked and the reply is that an asymptomatic AV block is indeed not a problem.

Frank Voeten
FAA AME

[rhovsquared]

lots of athletic individuals or individuals with a slim build have this 'condition' also called 'Mobitz I' where the pr interval is greater than 240 milliseconds very very rarely cause for concern;)



Happy Chandelles:}
rhov:)

[Soundbarviolatr]

Thanks fellas. If its ok with you Dutch I will have the individual contact Frank for more info. Thanks again!

[rhovsquared]

I was wrong in my above post:O what I said is absolutely correct for Mobitz I there are no degrees in mobitz I [treatment is atropine for symptomatic folks]
Mobitz II first degree is NO change in pr interval but skipped ventricular beat i.e normal = PQRS first degree= P...PQRS, second degree P......PQRS and so on to complete heart block treatment for SYMPTOMATIC folks is transvenous or transdermal pacing. You should have Holter monitoring done and a definite consult with a cardiologist, for this condition unfortunately MAYBE serious


Happy Chandelles:}
rhov:)

[Flyin'Dutch']

Thanks fellas. If its ok with you Dutch I will have the individual contact Frank for more info. Thanks again!

That's fine. Feel free to send a PM/email

Rhov, in what line of medicine do you practise?

[rhovsquared]

Well Flyin'Dutch that's a long explaination...The truest answer I give now is that I'm very proficient in Internal medicine and I do see have seen, many many many sick people and have been at this for 18 or 19 years[I'm 27 years old.
but i'm not am MD but I AM A PHYSICIAN, the two are not mutually exclusive and yes I have done cadaveric disections:ok: If someone needs treatment or referal I have a family pracice physican who trust me enough I send her patiens along with eight or nine pages of my findings from history and physical, I'm not afraid of a penis, a vagina or a rectum:} I don't charge [A meal is good from those who can cook;) ] though and they DO know I don't have a licence and I'm very aware of assault and battery

I'll PM you soon as practical, so that I can explain more...If you wanna really know how such a thing could really be:eek:



Rule Books Are Paper...:}
rhov:)

[rhovsquared]

SORRYSoundbarviolatr, I was right the first time, but I looked it up and my reference got it wrong Gomella's clinician's pocket reference, causing me to second guess myself, you are fine with first degree block, both mobitz I and II are SECOND DEGREE blocks and mobitz II is much more serious, this statement come from a very comprehensive source Naccarelli's Clinical Cardiovasular Therapeutics vol.2: Cardiac Arrythmias a Practical Approach I hope I didn't cause alarm. 1st degree AV block is really nothing to worry about unless symptomatic

I really feel I should have known better!!!:O



To The Ramp On Point-Niner:E
rhov:)

[Flyin'Dutch']

I really feel I should have known better!!!

Rhov,

I have not been at this game very long so happy to take an experienced hand's viewpoint into consideration.

Found that most patients find it more helpful to have answers pitched at their level of understanding and the consequences that conditions may have for their well-being and flying.

Is it your experience that they prefer verbatim quotes from big medical tomes on different subjects than their queries?

:}

[rhovsquared]

Flyin' Dutch...I do try to temper my tone with people but I believe they should also have their disorders explained...If I didn't want them to understand they wouldn't understand, but I do like to check my facts sometimes especially when I'm wrong and I feel he deserved an expalination as to why.
I don't read too much Harrison's these days, because right now I am busy teaching my[private] USMLE review class for foreign medical graduates:\ :\ :\ , so If I get to much into the Glycogen storage diseases for to long well stop me...Also that's how I really talk :\ I have some social problems:}


Safe Flying for All:}
rhov:)

[Hawk]

Hello rhov. From now on, you are to cease offering "clinical" opinion on medical conditions in this forum.

For any other comments you are to reference your sources. This will enable other posters to check and do further research for themselves. If you do not know how to do this please check the link below.

Any posts by you, not complying with this request will be deleted.

Members who read this forum are reminded of the following statement on the PPRuNe homepage:

"News and debate about medical and health issues as they relate to aircrews and aviation. Any information gleaned from this forum MUST be backed up by consulting your state-registered health professional or AME".

Thank you
Mods.
http://www.lib.flinders.edu.au/info/branch/medical/harvard.pdf

[rhovsquared]

Hawk, references...No problem, but tell me name a doctor who doesn't make mistakes ever
sometimes it's possible to get you're mobitz I and II or wenckebach cycle mixed up with first degree AV block...just as it is possible to confuse osteogenesis inperfecta with chondrodysplasia puntacta:} ...including [rarely]a reference:
'clinical' should stay in quotes till I actually kill someone the mark of a 'real clinician':E ...but point well taken I will be more careful as a chemist and biochemist and biologist I should know about references:=

And this stuff is peoples livlihood...i too am a pilot:\



Rule Books Are Paper they Will Not Cushion A Sudden Meeting Of Metal And Stone:}
rhov:)

[rhovsquared]

Also, the other posts I've made are NOT MY OPINION THEY ARE FROM EXTREMELY AUTHORATATIVE SOURCES...clinician's pocket reference...current medical diagnosis and treatment....Harrison's principles of internal medicine:\ :\ :\ ...cecil's textbook of medicine...100 chest X-rays....100 pearls of clinical diagnostic radiology....clinical cardiovascular therapeutics vols. 1-3...secrets of surgery...current emergency medical diagnosis and treatment................................................... .......................................:} though those sources can be opinionated themselves:\
Medicine is an ART!!!!


Happy Contrails:}
rhov

[Evileyes]

Yes, and legal medical practitioners have malpractice insurance. Somehow it seems doubtful that an "artist" such as yourself carries any. ;)


"Physicians and physician assistants who practice or hold out to practice or engage in any physician-patient relationship in New York must be licensed and currently registered in New York. If a patient receives professional advice or treatment, even gratuitously, there is prima facie evidence that a physician-patient relationship exists."

"The misdemeanor charge of practicing without license can result in up to a year in jail; the felony charge, larceny, carries larger fines and a longer sentence."

"Any person who practices, offers to practice or holds himself or herself out to practice as a physician without being licensed must, in addition to other remedies provided for under the law, pay a civil penalty not to exceed $5,000 for each offense."

Rather than being an "expert" (although untrained and unlicensed) physician/chemist/biologist/biochemist/aeronautical engineer perhaps you should have read law?