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Federal Aviation Administration CAMA Certification Updates · Federal Aviation Administration AME...
Transcript of Federal Aviation Administration CAMA Certification Updates · Federal Aviation Administration AME...
Federal AviationAdministration
CAMACertification
Updates
NAME: Warren S. Silberman
Division: Aerospace Medical Education
Sept 2016
Federal AviationAdministration
AME Updates: Sept. 8, 2016
Structure Changes to Guide• 3 columns (was 4)• Moved the “class” to top of page• Look for “Updated” dates• USE THE DISPO TABLES---to help a/m
collect the info we will ask for
Updates---how to find changesLast Wed of the month: AME guide “archives section” with links
– AMCS banner
– www.faa.gov/go/ame
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Structure Changes -- AME aids• Disposition table updates• CACIs• Status Reports• AME Checklist• Certification Aids• Airman Questionnaires• Pharmaceutical sections
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Disposition tables• Start here• Many conditions can now be cleared by the
AME at this step• Need block 60 notes
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Has it been updated?• Old version • New version
Disposition table changes
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CACIs---4/9/2013• Allows AME to issue from the office without
calling the FAA.• Start with the Disposition Table first• If CACI is needed--Follow the worksheet• If NOT CACI qualified—most likely will AASI
or SI
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CACIs• AME can issue if the
worksheet criteria aremet
• Worksheets Do NOTneed to be submitted toFAA
• Current conditions:
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If NOT CACI qualified• See what info to submit• Middle column• Possible AASI or SI
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CACI vs Special IssuanceCACI Special issuance
Where to find info to submit Dispo table first, then CACI Dispo table
Initial presentation AME can issue if conditions aremet
AME must defer
Follow up AME can issue if conditions aremet
AME can issue follow up withvalid Authorization Letter
Reports are due 1st and 2nd—annually3rd class—at each exam (2 or 5years)
Per Authorization letter (mostare annual)
If not qualified May be special issuance Defer for FAA decision
Reports submitted to FAA No—keep in your records Yes
Time limited cert NO Yes
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CACI-- Pearls• See if CACI is even needed (dispo tables)• Review the required documents• Block 60 notes
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CACI block 60• Previously:
– “Airman meets certification criteria forhypothyroidism”
• NOW– CACI qualified hypothyroidism
• Working on a CACI button (IT $$)• If no block 60 notes—it is an AME error
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Status Reports• Must be signed and dated• Can take the place of clinic notes• Must be submitted to FAA
• Current:– Diabetes– Gender Dysphoria
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AME Checklist• Must be signed and dated• Does NOT take the place of
clinic notes– Allows AME to issue a follow up
if criteria met
• Must be submitted to FAA
• Current:– SSRI recert– HIMS recert
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Certification Aids• Designed to treating
providers• Does NOT need to be
submitted• Must be submitted to FAA
• Current:– SSRI recert– HIMS recert
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Airman Questionnaires• Designed to collect history
from the airman• Must be submitted to FAA• Only used for specific
conditions
• Current:– Seizure history
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Pharmaceutical section
• Designed to identify medsallowed/not allowed/waittime
• Only used for specificconditions
– Do Not Issue –Do Not Fly list– Pharmaceuticals table
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Pharmaceuticals• Pharmaceutical table
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Federal AviationAdministration
AME Updates: Sept. 8, 2016
Changes since 3/2015– Seizure history sheet added– SSRI and HIMS standardization– Remove ATCs (x color vision)– Student Pilot combined cert
remove 4/1/16– Mitral valve repair– Gender Dysphoria– Chronic Kidney Disease– HTN medication section expanded,
CACI updated, 7 days, new AASI,FAQ
– Kidney stones---big changes,CACI, AASI
– Renal cancer CACI
– PC and TC have CACI worksheets– ED/BPH meds– Bladder cancer CACI– HIV prophylaxis meds– Hypothyroid 1 year TSH is ok– Diabetes. IDDM—3rd class send to
AMCD/RFS. 1st/2nd class decisionreview at HQ, DM form, metformin14 days
– CACI wording changes
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SSRI Program Changes• Initial
– 6 months on meds (was 12) to consider for initial Authorization– AME must defer– Worked at HQ
• Recerts– Can be issued by HIMS AMEs in some cases– Must now see face to face every 6 months– Checklist
SSRI and HIMS—AME pearls• Current auth letter is ok to use• Will get new auth letter saying 6 months
• AME phone calls/complaints---HQ• AME questions—send to AAM-220• SEE HANDOUT (checklist and cert aid)
SSRI• www.faa.gov/go/ssri
HIMS• www.faa.gov/go/HIMS-DA
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Federal AviationAdministration
AME Updates: Sept. 8, 2016
Student Pilot changes 4/1/16• Removal of the COMBINED student pilot
certificate and medical certificate
• AMEs—continue to perform AME medicalexams.
• Student need a medial prior to solo
Student Pilot – AME pearls• 1) MFT needed---AME should defer• 2) Restrictions eliminated
• Valid for MFT only• VSPPO—valid for student pilot purposes only• Not valid until (mm/dd/yy) age 16
• 3) Language requirement—FSDO• 4) Transmit all w/in 14 days
Student Pilot – where AMEs arehaving trouble• Think they cannot do the medical if they are
a student• Places to go for help• www.faa.gov.go/ame
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Federal AviationAdministration
AME Updates: Sept. 8, 2016
Mitral Valve Repair
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Mitral Valve Repair• Followed indefinitely• Previously all Special Issuance• Now 5 or more years out—possible CACI
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Mitral Valve Repair
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Mitral Valve Repair -- CACI
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Mitral Valve—not CACI qualified• Mitral Valve REPLACEMENT• Any other valve• Any other additional valve• Any of the Co-morbid conditions
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Mitral Vale Repair–AME Pearls• If 5 or more years out---- New CACI
– see if CACI qualified– What’s NOT a CACI
• Other valves• Other cardiac conditions• Co-morbid conditions
– Echo results—use the CACI worksheet• If not—may qualify for AASI (annual c/s and
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Federal AviationAdministration
AME Updates: Sept. 8, 2016
Gender Dysphoria
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Gender Dysphoria
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Gender Dysphoria• The AME may ISSUE (no further information is needed), if the
airman:• Was evaluated for or diagnosed with Gender Dysphoria and
has never undergone treatment (counseling or support groupfor GD does not require information);
• Has no history of other mental health diagnoses or treatment;and
• Is otherwise qualified
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Gender Dysphoria
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Gender Dysphoria—Status Report
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Gender Dysphoria–AME Pearls• 5 or more years stable on meds—AME may be able
to issue• Change in status may reset 5 year clock
• Use the AME Gender Dysphoria Status Report• If airman has shaded answers---send in addition
info
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Federal AviationAdministration
AME Updates: Sept. 8, 2016
Chronic Kidney Disease
Chronic Kidney Disease
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Chronic Kidney Disease
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Chronic Kidney Disease
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CKD – AME Pearls• New CACI• New AASI
– New info in the guide– eGFR – if other testing was done, have the airman
submit
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Federal AviationAdministration
AME Updates: Sept. 8, 2016
Hypertension
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Hypertension (HTN)
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Hypertension (HTN)
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Hypertension (HTN)---- FAQs
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Hypertension (HTN)—Pharmaceutical Section
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HTN—if airman does not meet 155/95
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HTN- AME Pearls• CACI is based on # of component meds
– Lisinopril/HCTZ is 2
– 7 days no fly when starting meds– (was 14 day no fly)
– New AASI if 4 or more meds
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Federal AviationAdministration
AME Updates: Sept. 8, 2016
Kidney Stones
Kidney Stone(s)
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Kidney Stone(s)(Nephrolithiasis, Renal Calculi)
Or Renal ColicAll Classes
Updated 9/30/15 4/27/16
DISEASE/CONDITION
EVALUATION DATA DISPOSITION
A. Most recentevent/diagnosis 5 ormore years ago
No symptoms or current problems. Renal functionhas returned to normal. No ongoing treatment orsurveillance needed.
ISSUESummarize this history inBlock 60.
B. Less than 5 years agowith no complications*
Single stone that haspassed
If a single stone passed or is in the bladder withno further problems and imaging (such as a KUB)verifies no retained stones:
ISSUESummarize this history inBlock 60.
Kidney Stones--retainedC. Less than 5 years ago with no
complications*
Retained, asymptomaticstone(s)
Follow CACI worksheet.
Use this for retained, asymptomatic or incidental stone(s).
Follow the CACI RetainedKidney Stone worksheet
Note in block 60.
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D.
Kidney Stones--retained
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Kidney Stones – AME Pearls• 5 or more years ago---AME may issue• If retained stones
– No complications– Possible CACI– If complications---possible AASI– Size and number no longer requirement. Urologist
needs to state if treatment is needed.
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Kidney Stones—when NOT CACI
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Federal AviationAdministration
AME Updates: Sept. 8, 2016
Renal Cancer
CACI
Federal AviationAdministration
AME Updates: Sept. 8, 2016
Prostate Conditions & Cancer
Prostate Meds
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Prostate Cancer -- CACI
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Federal AviationAdministration
AME Updates: Sept. 8, 2016
Testicular Cancer
Bladder Cancer
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HIV prophylaxis
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Hypothyroid• TSH within the last year for CACI• (was 90 days)
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Federal AviationAdministration
AME Updates: Sept. 8, 2016
Diabetes• Up to 3 meds allowed
Diabetes -- DM Status Report
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Diabetes -- DM Status Report
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Diabetes – Metformin 14 days
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Diabetes—Acceptable Combo Meds
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Diabetes• B-blockers and insulin• B-blockers and sulfonylurea• ALLOWED
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Diabetes---IDDM• 3rd class---as before• 3rd class who wants to upgrade---ok to issue
3rd class if qualified and a/m wants in themeantime (per auth letter) while HQ workson the upgrade
• 1st/2nd – worked at HQ
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OSA 3/19/15
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Skin Cancer updates
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Liver transplant
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Federal AviationAdministration
AME Updates: Sept. 8, 2016
Summary• Condition Changes• Updates
– Dispo tables– CACI– New AASIs– AME & treating physician tools
• What’s next
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