Fatigue management program keeps pilots awake, alert 

By Master Sgt. Scott Elliott
Air Force Print News

WASHINGTON -- Fatigue kills.

In the high-speed, high-stress environment of the combat aviator, it is a fact of life, and Air Force officials are doing what they can to ensure aircrew members are armed with the ability to fight an internal enemy that is potentially as deadly as a surface-to-air missile.

Fatigue was a contributing factor in 391 Air Force aircraft accidents from 1991 to 2002, Air Force safety officials said.

Those officials added that people who have been awake for 24 continuous hours react equivalently to someone with a blood alcohol content of .10, which is considered legally intoxicated in most states. A person who has been awake for 18 continuous hours has the equivalent BAC of .05.

That potential loss of motor skills is what prompted the Air Force to develop the fatigue-management program for aircrews who are tasked with extremely long missions.

According to Col. Tom Hyde, chief of "Checkmate," the Air Force chief of staff's directorate for air and space strategy development, the fatigue-management program is the pilot's set of tools to remain awake and alert during extremely long flights.

"The tools we have available are diet, exercise, sleep cycles and a medication program," Hyde said. "When you (use) all four in combination, it ends up being a reasonable and prudent approach in order to combat fatigue."

When a person is physically fit, Hyde said, the body is better able to handle stresses, including an interrupted sleep cycle, deployment and family separation.

Although most elements of the fatigue-management program are preflight, Hyde said there are some things crewmembers can do to stay alert even while strapped into their ejection seats. Those fatigue-fighting techniques include stretches, G-suit and oxygen system adjustments, and snacking.

The fatigue-management tool of last resort is a doctor-prescribed stimulant.

Only fighter and bomber crewmembers are authorized stimulants, Hyde said, because commanders have the option to augment tanker and airlift aircraft with additional pilots.

The "go pill," as it is commonly called, is a 5- or 10-milligram dose of Dexedrine. Dexedrine is the same medication routinely prescribed to treat attention deficit disorder. At the prescribed dosage, the stimulating effect of Dexedrine wears off after about four hours.

"The dosage is not too strong," Hyde said. "It's just designed to take the edge off."

Before pilots are authorized to use a "go pill" while flying, they must complete a prescribed testing protocol to determine how the medication will affect each pilot's body. The details are recorded in the pilot's medical records.

Before lengthy missions, and after consulting with their commanders and flight surgeons, pilots decide whether or not they want to take the pills with them on the mission. Then, it is up to the individual pilot as to whether or not to take the pill, Hyde said.

"When you walk out the door to fly (an) extended mission, do you have to take it with you? No," he said. "Is it advisable? Sure, but it's up to you whether or not to use it.

"It's (prescribed) under a doctor's care and with commander involvement," he said. "It's done with the full consent of the individual taking it."

Aircraft on bombing runs can approach a target at about 1,000 feet per second, Hyde said. In air-to-air engagements, aircraft can close in on each other at up to double that speed.

"When you get an idea of how fast things are moving through space, there is a lot that can happen as a result of a one- or two-second delay in making a decision," he said.

As a former squadron and group commander who has more than 3,300 flying hours, Hyde knows firsthand how fatigue can affect a pilot at those speeds.

"If you look at those instances where, after the fact, I said 'What was I thinking?' about 80 percent of the time it could be tied back to fatigue," he said.

"Fatigue's a killer out there," he said.