JASON CUTSFORTH
Polk City, Iowa

As a Soldier, I had the pleasure of attending some of the best schools the Army offered. These schools gave me the knowledge and experience required to become a successful and contributing member of the Army National Guard, in my civilian career as a firefighter/paramedic and with my family. One school, in particular, taught me the valuable lesson of knowing my personal limitations regarding high-altitude flight.

America’s “highest level” of flight training, the High-Altitude Army Aviation Training Site in Gypsum, Colorado, is among the best at humbling even the most experienced aviator. HAATS offers students a unique training environment designed to dramatically increase individual and crew situational awareness. However, increasing situational awareness encompasses much more than being aware of the environment, terrain and radio traffic. It includes the ability to understand how the aeromedical factors of being at high altitude affect your emotions, judgment and thought processes.

My first experience in a hypoxic environment occurred while I was attending the flight medic course at the School of Army Aviation Medicine (SAAM). During the course, students had the opportunity to train on the Army’s only hypobaric altitude chamber. The training required each student to demonstrate a thorough understanding of the effects of altitude on the human body and how to recognize hypoxia and utilize available oxygen systems.

If you haven’t had the opportunity to attend this training, do so. The experience of being hypoxic and not knowing it will leave a lasting impression on you. During my training, I found it fascinating how my motor skills, thought process and attitude could become so degraded. Concluding the training, I believed I had the skills required to recognize a hypoxic state if ever I should encounter it again.

Many years later, I attended the HAATS UH-60 course when my MEDEVAC unit was preparing for deployment to Afghanistan. At the time of the training, I was a pilot with less than 300 hours total time. When instructors were assigned, our crew had the pleasure of drawing Col. Joel Best, the state aviation officer/regimental commander of the Colorado Army National Guard and former commander of the HAATS course. As you can imagine, I was a bit intimidated but very glad to be instructed by someone with such vast knowledge and experience.

My second experience with hypoxic hypoxia occurred about midway through the course. It was a beautiful day in the Colorado Rockies — fresh snow, clear skies and a good 10- to 15-knot wind to help with training. As I climbed into the cockpit, I noticed I had a bit of a headache starting, so I did as all good Soldiers do to cure any aliment we encounter — drink water — and we were on our way. Soon into the flight, I could feel myself becoming less focused on flying and more on looking at the mountains and beautiful scenery not found in the lonely flats of the Midwest. I quickly regained my composure and drank more water.

Soon after, Col. Best demonstrated to me that our UH-60 Franken Hawk (an enhanced UH-60A) does actually hover at 14,000 feet out-of-ground effect. He then decided to train me on landing at one of the higher elevation ridges nearby. I found it incredibly difficult to maneuver the helicopter the way he was describing. Frustrated, I transferred the controls to have him demonstrate. When the demonstration was complete, I had the controls and tried again with no luck. Like most Type A, perfectionist pilots, I was getting frustrated with myself. My body language was changing, my headache was getting worse and the tone in my voice must have been growing more impatient.

My crew chief was trying to provide excellent aircrew coordination by asking if I felt OK. Later, he told me I had said, out of frustration, things I wouldn’t normally say. That was his cue to ask how I was feeling. Col. Best noticed right away that I was probably suffering from hypoxia, took the controls and descended from high altitude. Soon after, I began feeling much better and realized I felt like I had been in a fog. I did not realized I’d become hypoxic.

The lesson learned for me was that hypoxia can set in quickly, especially if you are not accustomed to flying at higher altitudes. Water intake is critical at higher altitudes. Drinking the same amount of water as when I’m at home at 1,000 feet is simply not enough. Also, aircrew coordination becomes crucial, and a constant verbal feedback from crewmembers may give warning signs of possible hypoxia.

The hypobaric chamber is busy. SAAM and the U.S. Army Aviation Research Laboratory at Fort Rucker, Alabama, are continuously training classes and conducting experiments to improve equipment and processes to support flight safety. However, all aviators in flight training should be required to experience being hypoxic in a controlled environment. By providing this training to new aviators and using a good risk management process, hypoxic situations that could contribute to accidents may be easier to recognize.