title: Mask-on hypoxia training for tactical jet aviators: evaluation of an alternate instructional paradigm.
abstract: BACKGROUND
  Hypoxia familiarization instruction has been an integral part of military aviation training for more than 60 yr. Traditionally, aircrew learn hypoxia recognition while being exposed to hypobaric conditions in a low-pressure chamber (LPC). A training device has been developed that induces hypoxia using mixed gas delivered through an aviator's oxygen mask. The reduced oxygen breathing device (ROBD) simulates the diminished oxygen present at altitude by mixing breathing air and nitrogen under normobaric conditions. The purpose of this paper is to describe an alternate hypoxia training paradigm that combines the ROBD with tactical flight simulators and to present results from student surveys.
  
  
  METHODS
  Dynamic hypoxia instruction was provided inside F/A-18 tactical flight simulators using a second generation ROBD (ROBD-2). There were 121 naval aviators who were individually exposed to a simulated altitude of 7620 m (25,000 ft) while performing complex flight duties. Subsequent to ROBD training, all students completed a 19-question, anonymous survey that asked them to rate the quality of the instruction.
  
  
  RESULTS
  Of the 121 students trained with the ROBD-2 in combination with a flight simulator, 114 (94.2%) were able to recognize their hypoxia symptoms and recover the aircraft, 117 (96.7%) rated ROBD training as more realistic, and 110 (90.9%) as more effective than traditional LPC training.
  
  
  CONCLUSIONS
  Student feedback from this instructional evaluation indicates that using an ROBD in combination with actual flight duties is a safe, effective, and preferred means of training experienced tactical jet aviators to recognize and recover from hypoxia.
authors.affiliation: Naval Survival Training Institute, Naval Operational Medicine Institute, 55 Radford Blvd., Suite 211, Naval Air Station Pensacola, Pensacola, FL 32508-1091, USA. tony_artino@yahoo.com
authors.forename: Anthony R
authors.initials: AR
authors.lastname: Artino
authors.forename: Richard V
authors.initials: RV
authors.lastname: Folga
authors.forename: Brian D
authors.initials: BD
authors.lastname: Swan
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D000337:Aerospace Medicine; D001273:Atmosphere Exposure Chambers; D003479:Curriculum; D004521:Educational Measurement; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis* / Q000628:therapy*; D008397:Masks; D008889:Military Personnel; D014481:United States