Ref Page 100 Cosgrove 8th Edition

To reduce the risk, pilots should consult a doctor on any side effects which may result from particular medication.

• The Danger: Many over-the-counter and prescription drugs cause drowsiness, slowed reaction times, or blurred vision, all of which are highly dangerous when flying.

• Why the others fail: Simply buying a drug from a chemist doesn’t guarantee it is flight-safe (many standard cold remedies cause severe drowsiness). Similarly, “not taking any medication” is unrealistic, as managing a known, approved chronic condition safely with the right medication under medical supervision is often perfectly acceptable.

Consulting an aviation medical examiner (AME) or a doctor ensures the medication is fully vetted for aviation safety before you enter the cockpit.

Ref Page 104 Cosgrove 8th Edition

When you experience stress, fear, or a sudden shock, your body releases adrenaline as part of the “fight or flight” response. This hormone triggers a rapid increase in your heart rate and breathing rate to pump more oxygen to your muscles.

However, if this surge of oxygen isn’t physically needed—such as when sitting in a cockpit or facing a sudden scare—the rapid, shallow breathing can quickly turn into hyperventilation. This causes your body to blow off too much carbon dioxide, leading to symptoms like lightheadedness, tingling in the fingers, confusion, and anxiety, which can further mimic or worsen the feelings of stress.

The best procedure for pilots to look out involves a systematic, focused scanning technique, not just casual glances, using short, 10-degree eye movements to observe distant points for at least one second to allow for focus, covering areas horizontally and vertically, and adjusting for blind spots (like wings) by leaning or maneuvering to maximize visual awareness and detect traffic

AOPA LINK

Page 103 Cosgrove 8th Edition

Ref Page 97 Cosgrove 8th Edition

Alcohol accelerates and worsens the effects of hypoxia (oxygen deprivation).

It does this through a combination of physiological effects:

• Slowing Brain Function: Alcohol is a central nervous system depressant. Hypoxia also slows down brain activity. When you combine them, your cognitive performance, reaction times, and judgment degrade much faster than they would from oxygen loss alone.

• Disrupting Oxygen Uptake: Alcohol changes how your cells use oxygen. It causes histotoxic hypoxia, meaning your brain cells become less capable of actually absorbing and utilizing the oxygen that is available in your bloodstream.

• Masking Symptoms: Because alcohol impairs judgment and can cause a false sense of well-being or euphoria, a person is much less likely to notice the early warning signs of hypoxia (like dizziness, tingling, or tunnel vision) until it is too late.

In environments where oxygen levels drop—such as high altitudes or unpressurized cabins—even small amounts of alcohol drastically lower your physiological tolerance to the altitude, making hypoxia set in much faster and at a lower elevation than normal.

See NHS Link

Vertigo is the false sensation that you or your surroundings are spinning, tilting, or moving when everything is actually completely still. It is typically caused by a temporary glitch in the inner ear’s balance system or, less commonly, a problem in the brain’s nerve pathways. Unlike general lightheadedness, true vertigo creates an unsettling, dizzy illusion of motion that can often trigger nausea, vomiting, and a loss of balance.

If you suspect frostbite in your fingers, you must act carefully to avoid permanent tissue damage.

• Use Body Heat: Tuck your fingers into your armpits or have a companion hold them with their warm hands.

• Warm Water Soak: Submerge the fingers in warm—not hot—water. The ideal temperature is between 37°C and 40°C (about the temperature of a comfortable baby bath).

• Duration: Keep them in the water for about 30 minutes or until the skin feels soft and sensation returns.

• Expect Pain: Re-warming is often very painful and can cause a stinging or burning sensation. You can take Ibuprofen or Paracetamol to help with the pain

NHS Link

Ref Page 105 Cosgrove 8th Edition

If a student pilot feels that an instructor has made an incorrect assessment of a situation, they should wait until a safe, low-workload phase of flight (or, ideally, the post-flight debrief) to calmly and openly discuss it. During flight, safety and the chain of command are paramount; unless the instructor’s action poses an immediate, catastrophic threat to the safety of the aircraft, the student should follow the instructor’s guidance to maintain situational control. Once on the ground, the student should ask clarifying questions using a non-confrontational, “threat and error management” approach to understand the instructor’s perspective, which often resolves misunderstandings or reveals a valuable learning point for both parties.

you should always ask for confirmation from ATC if you have any doubt.

In aviation, whenever you receive an instruction that involves a complete reversal of the active runway (from 02 to 20), or if the phrasing feels ambiguous, it is standard radio phraseology and good airmanship to clarify. You can simply transmit: “[Your Callsign], confirm joining runway 20?” It is always better to double-check on the ground or in the air than to risk a head-on conflict with traffic using the opposite runway.

No, it does not usually preclude you from flying.

Treatment for high blood pressure (hypertension) is very common among pilots. As long as your blood pressure is well-controlled and the medication you are taking is “approved,” you can usually maintain your medical certificate.

CAA Document LINK

See page 99 of Brian Cosgrove (8th Edition)

Ref Page 100 Cosgrove 8th

As a general rule, it takes about 1 hour for the body to process and clear 1 unit of alcohol from the bloodstream.

However, because the human body metabolizes alcohol at a fixed rate (roughly 7g to 8g per hour), the actual time can vary depending on a few key factors:

• Liver Efficiency: The liver does about 95% of the work, and its metabolic rate is constant regardless of how much water you drink or if you drink coffee.

• Size and Gender: Your weight, muscle-to-fat ratio, and metabolism influence how high your blood alcohol concentration (BAC) gets in the first place, which can affect the total clearance time.

• Food: Eating beforehand slows down the absorption of alcohol into the blood, but it does not speed up how fast your liver breaks it down once it is in your system.

Ref Page 98 Cosgrove 8th Edition

To equalize pressure between the outer ear and the middle ear during descents, it’s best to perform the Valsalva maneuver.

To do this, pinch your nostrils shut, close your mouth, and gently blow air as if you were exhaling through your nose. This forces air up through the Eustachian tubes and into the middle ear cavity, equalizing the pressure against the higher atmospheric pressure of the descent.

Other effective methods include:

• Yawning or swallowing frequently, which naturally opens the Eustachian tubes.

• Chewing gum or moving your jaw side-to-side.

Note: Avoid flying with a heavy cold or sinus congestion, as the swollen tissues can block the Eustachian tubes completely, making equalization impossible and causing severe barotrauma.

The lack of oxygen reaching the body’s tissues is known as Hypoxia.

In aviation, this is particularly dangerous because it can happen gradually without the pilot noticing.

Common Symptoms

• Confusion or poor judgement.

• Euphoria (feeling “high” or overly happy despite being in danger).

• Cyanosis (a blue tint to the lips or fingernails).

• Reduced vision, especially at night.

Page 122 of the SKYway Code LINK

The Human Performance Curve

In aviation psychology, performance is measured against stress (arousal) using an inverted U-curve.

• Too Low (Under-arousal): When stress is exceptionally low, the brain enters a state of complacency, boredom, or lethargy. Without a baseline level of stimulation, your mind naturally wanders, vigilance drops, and you genuinely cannot maintain concentration on routine tasks.

• The Sweet Spot (Optimum Stress): You actually need a moderate amount of stress/arousal to be at your peak. This optimum level is what keeps you alert, sharp, and able to absorb new information readily.

Therefore, a pilot with a low stress level isn’t in their peak learning state—they are disengaged and prone to missing critical cues because their concentration lapses.

Ref Page 98 Cosgrove 8th Edition

To avoid painful or dangerous results from pressure changes, you should never scuba dive while congested (with a cold or allergies) or fly too soon after a dive. Diving with blocked sinuses prevents your ears from equalizing, which can cause severe pain or eardrum damage called barotrauma. Furthermore, flying in an airplane too soon after a dive is dangerous because the drop in cabin pressure can cause residual nitrogen gas in your blood to expand into painful bubbles, leading to decompression sickness (“the bends”).

In the UK, the number of units in a pint of beer depends on its strength, known as ABV (Alcohol by Volume).

As a general rule, an “average” pint contains about 2 to 3 units

NHS LINK