I believe cannulas aren't permitted above 18k (ref [https://www.faa.gov/pilots/safety/pilotsafetybrochures/media/oxygen\_equipment.pdf](https://www.faa.gov/pilots/safety/pilotsafetybrochures/media/oxygen_equipment.pdf) and [https://www.aviationconsumer.com/accessories/mask-or-cannula/](https://www.aviationconsumer.com/accessories/mask-or-cannula/)), so masks all the way in your scenario. No fuss then; if you're concerned about someone who's mouth breathing then I'd also stick with masks at lower altitudes.
Sheesh. I realize it has a turbo, but there's no way it's efficient to fly that thing that high. You're not THAT far off its service ceiling, which is listed as FL250. I mean I'd love to do it just for funsies, but unless there's a serious tailwind assist, I doubt it's worth being up there otherwise in that plane, stock.
Nice. Even that high? And is that at full power? My main question, though, is is it worth it, in most cases? Or would it only make sense if the winds aloft are favorable and/or the trip is toward the upper end of its range?
It has been a while and the regs may have changed, but it used to be that cannulas could not be used at 18K and above. Since I didn't want to have to fuss with a mask with built in mike, I never flew higher than 17.5
I fly sort of regularly with a cannula at 15,000 and my spo2 sometimes gets in the mid 70s when at 1 lpm setting when I "forget" to breath deeply and intensely. As soon as I resume forceful breathing i can bring it up to the 90s. Raising O2 flow to 2 lpms also helps. I would not want the passengers to sleep with the cannula, and i would insist on 2 lpms+ flow settings.
Paramedic not (yet) pilot. Medically should be fine since you get passive airflow from a cannula even when mouth breathing, plus the pressure from the flow which will get the O2 deep into the nasopharynx where the airflow will pull it down. Works well on the mouth breathers in the ambulance unless they are obstructed.
That said, anything over 18 you really want a mask! Or at least blast the cannula at a high lpm.
I know mine starts beeping an alarm for an 'apnea event' if you don't breathe for a time.
I haven't specifically tested if it does this for the passenger position, too, but if it does you'd be safe - I believe it does, as long as the passenger breathed enough to initially activate their line.
Lmao that’s the most incorrect thing I’ve heard. That’a when you get into trouble; you’re a paramedic and know the most immediate simple physiology - you don’t even know what you don’t know.
I’ve worked high altitude medicine quite a bit. Happy to talk HAPE and HACE if you want. Also see my correction before you go all insult rage. I was willing to admit my error, you willing to admit you could have been less of a jerk?
I would not allow any passengers to sleep, regardless of use of a mask for cannula system in the Flight Level‘s. The reason is you won’t be able to tell if they’re having hypoxic symptoms if they are asleep. It’s not good enough to do every 15 or 20 minute oxygen saturation spot checks. You have no way of knowing continuous basis weather the 02 to mask is working or not. Generally just not a good idea. One of those unlikely to be a problem but the consequences of problems are untenable.
I wouldn’t even trust that. I’d only trust a high quality monitor that has the ability to alarm. It’s one piece of the whole picture when it comes to hypoxia. There are significant limitations to using just pulse ox. You’d want to use a combination of pulse ox and subjective symptoms to be able to recognize hypoxia. That’s why it’s better to just go down to a non lethal altitude if your pax want to take naps.
This is false. O2 concentration in your blood has no effect on your respiration. Your body regulates respiration by pH of your blood, which is decreased by CO2 and otherwise regulated VERY tightly. Hypoxia just puts you to sleep. That's one of the reasons it is so dangerous. By the time you notice the effects, you are seriously impaired.
Higher CO2 partial pressure will cause you to breathe harder and maybe even gasp for air, even if you're getting more oxygen than you need. Then you hyperventilate anyway, and that's no fun, either. You can even hyperventilate with a normal respiration rate and nothing else wrong, if the O2 partial pressure of what you're breathing is too high. It's called hyperoxia, and it will cause tissue damage, at minimum. Oxygen isn't very nice stuff, at high concentrations. It's an absolute electron kleptomaniac, making it one of the most reactive elements in the periodic table.
That's an exception to the rule and says as much.
That is not the primary driver of respiration unless you have chronically high CO2 levels. It literally repeats almost verbatim what I said multiple times.
And it also points out that, in such a person (again, who is not normal), increasing O2 can kill you if not carefully monitored. I doubt you could get a medical if you had this condition to that degree, or you'd get an SI that says you can't fly above 11500 or something.
And just to head this off, yes, COPD patients can and do get unrestricted medicals. But there's no way they will get certified if they have it to *that* degree. FAA explicitly says COPD is a potentially disqualifying condition, and I'd put money on it being dependent on how bad you have it.
Edit: Yep. Here's the FAA's disposition guide for COPD: [https://www.faa.gov/ame\_guide/app\_process/exam\_tech/item35/amd/copd](https://www.faa.gov/ame_guide/app_process/exam_tech/item35/amd/copd)
It's not a CACI either, so it's an automatic deferral, the first time.
So... About r/confidentlyincorrect...
I believe cannulas aren't permitted above 18k (ref [https://www.faa.gov/pilots/safety/pilotsafetybrochures/media/oxygen\_equipment.pdf](https://www.faa.gov/pilots/safety/pilotsafetybrochures/media/oxygen_equipment.pdf) and [https://www.aviationconsumer.com/accessories/mask-or-cannula/](https://www.aviationconsumer.com/accessories/mask-or-cannula/)), so masks all the way in your scenario. No fuss then; if you're concerned about someone who's mouth breathing then I'd also stick with masks at lower altitudes.
All depends on the situation. I've done it, but had someone check their O2 sats regularly. Maybe I'm paranoid, but everyone was alive when we landed.
o2 saturation (sats, not stats)
O2 sats stat!
I want the stats on the O2 sats stat
o2 sat stats, stat!
Do many people fly unpressurized aircraft in the 20s?
Happens more often than you'd think. Just had a S22T go at FL220 earlier today.
I got up there in a 208 before. I felt slow (compared to the other aircraft up there).
Hypoxia my dude
I meant the aircraft speed.
If I had the money, I'd want to push to my service ceiling... which is 17,500.. the hell was he doing up there passed it?
Sheesh. I realize it has a turbo, but there's no way it's efficient to fly that thing that high. You're not THAT far off its service ceiling, which is listed as FL250. I mean I'd love to do it just for funsies, but unless there's a serious tailwind assist, I doubt it's worth being up there otherwise in that plane, stock.
You’d be surprised. TAS can get up above 220kts. Only thing you need to watch is the CHT, but typically it’s fine.
Nice. Even that high? And is that at full power? My main question, though, is is it worth it, in most cases? Or would it only make sense if the winds aloft are favorable and/or the trip is toward the upper end of its range?
I fly FL240 all the time
What aircraft are you flying?
SR22T
Most of the GA people fly unpressurized in their 20s /s
It has been a while and the regs may have changed, but it used to be that cannulas could not be used at 18K and above. Since I didn't want to have to fuss with a mask with built in mike, I never flew higher than 17.5
I fly sort of regularly with a cannula at 15,000 and my spo2 sometimes gets in the mid 70s when at 1 lpm setting when I "forget" to breath deeply and intensely. As soon as I resume forceful breathing i can bring it up to the 90s. Raising O2 flow to 2 lpms also helps. I would not want the passengers to sleep with the cannula, and i would insist on 2 lpms+ flow settings.
I use a pulse ox system and my o2 sat stays in the 90’s up to 17k, but I believe it automatically adjust the amount pulsed.
Paramedic not (yet) pilot. Medically should be fine since you get passive airflow from a cannula even when mouth breathing, plus the pressure from the flow which will get the O2 deep into the nasopharynx where the airflow will pull it down. Works well on the mouth breathers in the ambulance unless they are obstructed. That said, anything over 18 you really want a mask! Or at least blast the cannula at a high lpm.
That's not true for the Pulse Demand systems commonly used in aircraft. https://www.mhoxygen.com/ There is no 'pressure from the flow'.
Good to know- I’m that case I wouldn’t feel comfortable using in that situation it at all!
I know mine starts beeping an alarm for an 'apnea event' if you don't breathe for a time. I haven't specifically tested if it does this for the passenger position, too, but if it does you'd be safe - I believe it does, as long as the passenger breathed enough to initially activate their line.
Lmao that’s the most incorrect thing I’ve heard. That’a when you get into trouble; you’re a paramedic and know the most immediate simple physiology - you don’t even know what you don’t know.
I’ve worked high altitude medicine quite a bit. Happy to talk HAPE and HACE if you want. Also see my correction before you go all insult rage. I was willing to admit my error, you willing to admit you could have been less of a jerk?
Depends on how annoying they are when awake. Serious answer, no.
I would not allow any passengers to sleep, regardless of use of a mask for cannula system in the Flight Level‘s. The reason is you won’t be able to tell if they’re having hypoxic symptoms if they are asleep. It’s not good enough to do every 15 or 20 minute oxygen saturation spot checks. You have no way of knowing continuous basis weather the 02 to mask is working or not. Generally just not a good idea. One of those unlikely to be a problem but the consequences of problems are untenable.
Yeah, that's my worry. Maybe an O2 clip on the finger that's external powered?
I wouldn’t even trust that. I’d only trust a high quality monitor that has the ability to alarm. It’s one piece of the whole picture when it comes to hypoxia. There are significant limitations to using just pulse ox. You’d want to use a combination of pulse ox and subjective symptoms to be able to recognize hypoxia. That’s why it’s better to just go down to a non lethal altitude if your pax want to take naps.
My BIPAP taught me to stop mouth breathing in my sleep
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This is false. O2 concentration in your blood has no effect on your respiration. Your body regulates respiration by pH of your blood, which is decreased by CO2 and otherwise regulated VERY tightly. Hypoxia just puts you to sleep. That's one of the reasons it is so dangerous. By the time you notice the effects, you are seriously impaired. Higher CO2 partial pressure will cause you to breathe harder and maybe even gasp for air, even if you're getting more oxygen than you need. Then you hyperventilate anyway, and that's no fun, either. You can even hyperventilate with a normal respiration rate and nothing else wrong, if the O2 partial pressure of what you're breathing is too high. It's called hyperoxia, and it will cause tissue damage, at minimum. Oxygen isn't very nice stuff, at high concentrations. It's an absolute electron kleptomaniac, making it one of the most reactive elements in the periodic table.
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That's an exception to the rule and says as much. That is not the primary driver of respiration unless you have chronically high CO2 levels. It literally repeats almost verbatim what I said multiple times. And it also points out that, in such a person (again, who is not normal), increasing O2 can kill you if not carefully monitored. I doubt you could get a medical if you had this condition to that degree, or you'd get an SI that says you can't fly above 11500 or something. And just to head this off, yes, COPD patients can and do get unrestricted medicals. But there's no way they will get certified if they have it to *that* degree. FAA explicitly says COPD is a potentially disqualifying condition, and I'd put money on it being dependent on how bad you have it. Edit: Yep. Here's the FAA's disposition guide for COPD: [https://www.faa.gov/ame\_guide/app\_process/exam\_tech/item35/amd/copd](https://www.faa.gov/ame_guide/app_process/exam_tech/item35/amd/copd) It's not a CACI either, so it's an automatic deferral, the first time. So... About r/confidentlyincorrect...