JOINT ORDER OF THE MINISTER OF TRANSPORT AND COMMUNICATIONS OF THE REPUBLIC OF KAZAKHSTAN AND I.O. MINISTER OF HEALTH OF THE REPUBLIC OF KAZAKHSTAN

of August 28, 2013 No. 666, of September 17, 2013 No. 532

About approval of Rules of medical examination in civil aviation of the Republic of Kazakhstan

According to Item 3 of article 54 of the Law of the Republic of Kazakhstan of July 15, 2010 "About use of airspace of the Republic of Kazakhstan and activities of aircraft" PRIKAZYVAYEM:

1. Approve the enclosed Rules of medical examination in civil aviation of the Republic of Kazakhstan.

2. To committee of civil aviation of the Ministry of Transport and Communications of planning of the Republic of Kazakhstan (Seydakhmetov B. K.) in the procedure established by the legislation to provide:

1) state registration of this order in the Ministry of Justice of the Republic of Kazakhstan;

2) after its state registration in the Ministry of Justice of the Republic of Kazakhstan, official publication in mass media, including on Internet resource of the Ministry of Transport and Communications of the Republic of Kazakhstan and placement it on the Internet portal of the state service;

3) submission to Legal department of the Ministry of Transport and Communications of the Republic of Kazakhstan of data on state registration and about the direction on publication in mass media within 5 working days after state registration of this order in the Ministry of Justice of the Republic of Kazakhstan.

3. Declare invalid the order of the Minister of Health of the Republic of Kazakhstan of April 9, 2012 No. 212 "About approval of Rules of medical examination in civil aviation of the Republic of Kazakhstan" (No. registered in the Register of State registration of regulatory legal acts of the Republic of Kazakhstan of May 2, 2013 8453).

4. To impose control of execution of this order on vice-Ministers of Transport and Communications of the Republic of Kazakhstan Bekturova A. G., health cares of the Republic of Kazakhstan of Bayzhunusov E. A.

5. This order becomes effective after ten calendar days after its first official publication.

Deputy. Minister of Health of the Republic of Kazakhstan

B. Tokezhanov

Minister of Transport and Communications of the Republic of Kazakhstan

A. Zhumagaliyev

Approved by the Joint order of the Minister of Transport and Communications of the Republic of Kazakhstan and the deputy. The Minister of Health of the Republic of Kazakhstan of August 28, 2013 No. 666, of September 17, 2013 No. 532

Rules of medical examination in civil aviation of the Republic of Kazakhstan

1. General provisions

1. These rules of medical examination in civil aviation of the Republic of Kazakhstan (further - Rules) are developed according to Item 3 of article 54 of the Law of the Republic of Kazakhstan of July 15, 2013. "About use of airspace of the Republic of Kazakhstan and activities of aircraft" also determine procedure for performing medical examination of aeronautical personnel according to requirements of the Convention on the International civil aviation signed in Chicago on December 7, 1944 (further - ICAO), the European aviation requirements and extend to all physical persons and legal entities, irrespective of pattern of ownership.

2. In these rules the following basic concepts are used:

1) the flight surgeon - the specialist having the higher medical education and preparation in the field of aviation medicine, providing professional health and reliability of work of persons on which efficiency of flight work and aviation safety depends;

2) flight-surgeon commission of experts (further - VLEK) - the expert body determining and predicting working ability of the person for accomplishment of flights on air vehicles and air traffic maintenance;

3) medical examination - inspection of physical person for the purpose of establishment or confirmation of the fact of availability or absence at it of disease, determination of the state of health, and also temporary disability, professional and other suitability;

4) the medical expert - the flight surgeon who is taking out the expert medical certificate on the specialty about the validity to work of aeronautical personnel according to his health;

5) management on aviation medicine - structural division of authorized body in the field of civil aviation which carries out control and supervision over the organization of survey of aeronautical personnel by flight-surgeon commissions of experts;

6) the medical certificate - the document confirming compliance of the owner of the certificate of aeronautical personnel to the specific requirements imposed to the validity for health reasons.

3. Medical examination includes:

1) annual medical examination in VLEK and/or the central flight-surgeon commission of experts (further - TsVLEK);

2) dynamic medical observation of aeronautical personnel during the intercommission period;

3) pre-flight (prereplaceable) medical examination.

4. Tasks of medical examination are:

1) validity determination for health reasons to flight work, housekeeping of air traffic (further - Department of Internal Affairs) and to training in aviation training center (further - AUTs);

2) identification of early forms of diseases, risk factors and functional variations in the state of health.

5. The following categories of persons are subject to medical examination:

1) persons arriving for study and students in AUTs on training of pilots, air traffic controllers of Department of Internal Affairs;

2) pilots, flight engineers (aircraft mechanics), navigators;

3) air traffic controllers;

4) flight attendants, operators;

5) private pilots (airplane or helicopter), pilots of extralight aircraft, flight radio operators.

6. The medical certificate to persons listed in Item 5 of these rules (further - aeronautical personnel), is issued in form according to appendix of 1 these rules which is integral part of the certificate of aeronautical personnel.

7. Types of medical certificates and terms of their action:

1) "The medical certificate of 1 class" of the student in AUTs is issued to persons belonging to the subitem 1) of Item 5 of these rules. The medical certificate is valid within 12 months from the date of its issue;

2) "The medical certificate of 1 class" of the pilot, flight engineer (aircraft mechanic), the navigator is issued to persons belonging to the subitem 2) of Item 5 of these rules. The medical certificate is valid within 12 months from the date of its issue;

3) the medical certificate 3 classes" the air traffic controller is issued to persons belonging to the subitem 3) of Item 5 of these rules ", (and for persons having only qualification marks of control office briefing and (or) dispatchers of planning, control and coordination of air traffic and (or) the shift supervisor of the Main center of planning of air traffic the medical certificate in the form No. 086/at "Medical professional advisory proceeding" approved by the order of the Minister of Health of the Republic of Kazakhstan of November 23, 2010 No. 907) is issued. The medical certificate is valid within 24 months from the date of issue;

4) the medical certificate 2 classes" the flight attendant, the operator is issued to persons belonging to the subitem 4) of Item 5 of these rules ". The medical certificate is valid within 24 months from the date of issue;

5) the medical certificate 2 classes" the private pilot (the airplane or the helicopter), the pilot of extralight aircraft, the flight radio operator is issued to persons belonging to the subitem 5) of Item 5 of these rules ". The medical certificate is valid within 24 months from the date of issue.

8. The medical certificate 2 classes", belonging to the subitem 5) of Item 5 of these rules is issued to the aeronautical personnel which received "The medical certificate of 1 class" ".

9. Effective periods of medical certificates are reduced to 6 months:

1) for owners of the certificate of the linear pilot of airline (the airplane, the helicopter), certificates of the pilot of commercial aviation (the airplane, the helicopter) and certificates of the pilot of polynomial crew (airplane) which are carrying out commercial air transportations and which performed 60 years;

2) for owners of certificates of the linear pilot of airline (the airplane, the helicopter) and certificates of the pilot of commercial aviation (the airplane, the helicopter, the airship), carrying out commercial flights on public conveyance by the airplanes managed by one pilot is more senior than 40 years.

10. Effective periods of medical certificates are reduced to 12 months to private pilots (the airplane or the helicopter), to pilots of extralight aircraft, air traffic controllers 50 years are more senior.

11. Effective periods of medical certificates are reduced on medical indications with indication of specific terms and reasons for change of effective period of the medical certificate which are reflected in the expert decision in the magazine of the VLEK (TsVLEK) protocols in form according to appendix of 2 these rules.

12. Are issued to the faces of aeronautical personnel relating medical certificates to the subitems 2), 3) and 4) Item 5 of these rules working under the contract abroad according to requirements of these rules.

13. The medical certificate is signed by the chairman of VLEK (TsVLEK) and certified by seal.

14. The following persons are part of TsVLEK: the chairman - the pathologist having occupational retraining on professional pathologies and the certificate of the specialist (pathologist), the medical expert on medical support of aviation safety (vice-chairman), therapist expert, doctor-neuropathologist-expert, doctor-surgeon-expert, ophthalmologist expert, otorhinolaryngologist expert, psychologist, medical sister secretary of the commission, nurses.

The following persons are part of VLEK: the chairman - the pathologist having occupational retraining on professional pathologies and the certificate of the specialist (pathologist), the therapist expert, the doctor-neuropathologist-expert, the doctor-surgeon-expert, the ophthalmologist expert, the otorhinolaryngologist expert, the psychologist, the medical sister secretary of the commission, nurses.

TsVLEK (VLEK) skilled doctors from among working in the aviamedical organization with the general length of service at least 5 years having qualification category on the main specialty and special preparation on aviation medicine according to requirements of ICAO are included.

TsVLEK is headed by the chairman who is the chief non-staff specialist on flight-surgeon's appraisal of civil aviation of the Republic of Kazakhstan.

Position assignment of the chairman of TsVLEK (VLEK) and dismissal affirms the order of the head of authorized body in the field of civil aviation.

The doctor who graduated the medical faculty having preparation majoring in and on aviation medicine, having occupational retraining on professional pathologies and the certificate of the specialist (pathologist), and also general medical working years of service at least 10 years including on aviation medicine at least 5 years is appointed to position of the chairman of TsVLEK (VLEK).

15. Placement, operation of rooms for performing medical examination is allowed in the presence sanitary and epidemiologic the conclusion issued according to the order of the acting minister of national economy of the Republic of Kazakhstan of February 24, 2015 to No. 127 "About approval of Sanitary regulations "Sanitary and epidemiologic requirements to health care facilities" (it is registered in the Register of state registration of regulatory legal acts for No. 10713 of April 14, 2015).

16. The aeronautical personnel without medical certificate of VLEK (TsVLEK) or with the expired effective period of the medical certificate is not allowed to accomplishment of service duties.

In case of force and impreventable majeure (the spontaneous phenomena, act of war) the validity of the medical certificate according to the decision of authorized body in the field of civil aviation is extended by the chairman of TsVLEK for the term of no more than one month.

17. The aeronautical personnel in case of the diseases arising during effective period of the medical certificate on recovery is allowed to accomplishment of flights by the flight surgeon.

2. Procedure for performing medical examination of aeronautical personnel

18. Medical examination of aeronautical personnel for the purpose of obtaining or renewal of the medical certificate carry out TsVLEK and VLEK operating in coordination with authorized body of the Republic of Kazakhstan in the field of civil aviation.

19. The direction of aeronautical personnel on medical examination in VLEK (TsVLEK) is performed by administration of civil aviation organization (further - GA).

20. The decision on extraordinary medical examination of aeronautical personnel made by the flight surgeon and/or the medical expert is approved with the chairman of VLEK (TsVLEK).

21. The aeronautical personnel going to work in GA from other departments undergoes medical examination in VLEK (TsVLEK) irrespective of availability at them of the conclusion about the validity for health reasons to work in other departments.

22. The aeronautical personnel in case of preliminary medical examination in case of revenues to study, work shows in VLEK (TsVLEK) the medical record of the ambulatory patient at the place of residence or the statement from it, statements from psychoneurological and narcological dispensaries in the forms approved by the order of the Minister of Health of the Republic of Kazakhstan of October 23, 2010 No. 907 "About approval of forms of primary medical documentation of the organizations of health care" (registered in the Register of state registration of regulatory legal acts at No. 6697), the assigned certificate or the military ID.

23. Medical examination is carried out to VLEK (TsVLEK) (carrying out laboratory, functional and tool researches, survey by specialists and pronouncement of the expert medical certificate) in 1-3 working days.

24. Faces of aeronautical personnel undergo medical examination on compliance of their health to requirements for health reasons imposed to aeronautical personnel (further - Requirements), according to appendix 3 to these rules and medical contraindications to work in the countries with hot climate and to air-chemical works according to appendix 4 to these rules.

25. In case of medical examination of aeronautical personnel physical examination in volume of inspection for the purpose of flight-surgeon's appraisal, according to appendix 5 to these rules is conducted.

26. Medical experts of VLEK (TsVLEK) write down data of physical examination, the diagnosis and recommendations about the profile in medical documentation. Accuracy of the data of physical examination is certified by the personal signature and personal seal with indication of surname of the medical expert of VLEK (TsVLEK).

27. Stationary (expanded) examination to aeronautical personnel for the purpose of flight-surgeon's appraisal till 10 working days is conducted:

1) in regional VLEK - to persons which reached 50 years with the diagnosis "Is healthy";

2) in TsVLEK - to the persons which reached 50 years, having diseases;

in 55 years - regardless of diagnosis availability;

since 60 years - annually;

on direct medical indications in case of negative dynamics in the state of health.

28. Results of stationary inspection are drawn up in the form of the statement from the clinical record which is stored in the medical book in form according to appendix 6 to these rules.

29. By results of medical examination of aeronautical personnel in VLEK (TsVLEK) the expert medical certificate is taken out:

1) it is suitable for work;

2) it is suitable for work with restrictions;

3) needs treatment (improvement) with the subsequent medical examination;

4) it is unusable to work.

29-1. VLEK/TsVLEK for health reasons set restriction in the medical certificate according to codes of the restrictions given in appendix 6-1 to these rules.

In cases when the decision on the validity is possible only in case of establishment of restriction, VLEK/TsVLEK estimate the state of health of the applicant and consults with flight operation specialists, air traffic control specialists or other specialists.

Restriction is set in case of incomplete compliance of the applicant to medical Requirements provided that this condition does not threaten aviation safety.

30. The medical certificate of VLEK (TsVLEK) is drawn up in form, according to appendix 1 to these rules.

33. In case of pronouncement of the medical certificate according to Requirements, providing individual assessment, the aeronautical personnel is recognized suitable for work, unusable to work or needing inspection, treatment (improvement) with the subsequent survey. At the same time specific psychophysiological features, expressiveness of disease, extent of compensation, reversibility of pathological process, possibility of progressing of disease in case of further work are considered, influence of disease on aviation safety, nature of attended operation.

33-1. Owners of certificates of aeronautical personnel address the chairman of VLEK/TsVLEK, in case of availability of the factors reducing the validity such as:

1) carrying out surgery or invasive procedure;

2) purpose of regular acceptance of any medicine;

3) receipt of considerable damage which involves inability to carry out professional obligations of the appropriate certificate;

4) emergence of serious disease which involves inability to carry out professional obligations of the appropriate certificate;

5) approach of pregnancy and childbirth;

6) hospitalization;

7) for the first time purpose of the adjusting lenses.

Owners of the medical certificate address the chairman of VLEK/TsVLEK, in case of any doubts concerning the state of health, in case of any disease causing inability to carry out obligations of aeronautical personnel within 21 calendar days.

34. In case of identification at faces of aeronautical personnel of the diseases interfering further work (training) according to Requirements, VLEK (TsVLEK) takes out the expert medical certificate about worthlessness. In case of disagreement with the expert medical certificate of VLEK the aeronautical personnel addresses to TsVLEK, in case of disagreement with the expert medical certificate of TsVLEK addresses to advisory council of authorized body in the field of civil aviation, in case of disagreement with the conclusion of advisory council appeals it judicially.

35. Aeronautical personnel in case of diseases or injuries with temporary disability with the adverse forecast for continuation of professional activity, go to VLEK (TsVLEK) irrespective of term of stay on the sick leave note. In this case temporary disability is not obstacle for medical examination and adoption of the medical certificate. The faces of aeronautical personnel recognized unusable to further work go to the out-patient and polyclinic organizations for the place of attachment for further dynamic observation and treatment.

36. The certificate of VLEK (TsVLEK) of medical examination in form according to appendix 7 to these rules is issued to the faces of aeronautical personnel recognized unusable to work to training in AUTs.

37. The validity to training on the pilot and to flight work provides the validity to educational and training parachute jumps.

38. Medical examination is carried out during effective period of the existing medical certificate, but no more than in 45 calendar days prior to date of the expiration of its effective period.

Effective period of the medical certificate begins with expiry date of the previous medical certificate, in case of preliminary medical examination - from the date of pronouncement of the expert medical certificate of VLEK (TsVLEK).

39. No. 731, 15.09.2015 No. 920 is excluded according to the joint Order of the Minister of health and social development of the Republic of Kazakhstan and the Minister of investments and development of the Republic of Kazakhstan of 18.09.2015

40. Upon termination of medical examination the flight surgeon within 30 calendar days draws up the final statement by results of medical examination in form according to appendix 8 to these rules.

The final act affirms the chairman of VLEK (TsVLEK), signed and goes to body of the state sanitary and epidemiological surveillance on transport, to management of flight division (airline).

The final statement is drawn up in four copies: for the flight surgeon, the chairman of VLEK (TsVLEK), body of the state sanitary and epidemiological surveillance on transport and the head of airlines (airline).

3. Dynamic medical observation of aeronautical personnel during the intercommission period

41. Dynamic medical observation of aeronautical personnel during the intercommission period is made by the flight surgeon, medical experts of VLEK (TsVLEK) and other specialists of the GA medical organizations.

42. In case of preliminary medical examination in case of revenues to study or work of faces of aeronautical personnel the medical record in form, according to appendix 9 to these rules is filled in.

The medical record (the scanned copy) after filling within 2 working days goes to Management on aviation medicine.

The management on aviation medicine within 3 working days considers the medical record on compliance to requirements of these rules. In case of detection of discrepancies temporarily before their elimination, it is suspended the medical certificate and the note and the offer go to the chairman of VLEK/TsVLEK.

43. In case of periodic medical examination of the pilots and persons studying in AUTs, the flight surgeon fills in the medical record and the medical book. In case of periodic medical examination of other aeronautical personnel the medical book is filled in.

44. Medical books are stored in office of the flight surgeon. Results of medical researches, consultations of medical experts of VLEK (TsVLEK) and all records are made in the medical book in chronological procedure. In medical documents reducing words, except the commonly accepted symbols, is not allowed.

45. Treatment-and-prophylactic, improving actions, medical researches and assignments to aeronautical personnel are performed according to recommendations of VLEK (TsVLEK).

46. Medical examination at the flight surgeon of faces of aeronautical personnel is performed every 6 months, before the next periodic medical examination in VLEK (TsVLEK), and also on medical indications. Availability or lack of claims when performing medical examination is fastened with the signature of inspected. After medical examination the flight surgeon certifies entries in the medical book the signature and personal seal with indication of surname.

To medical examination of the flight surgeon are in addition carried out:

1) electrocardiography (further - the ECG) at rest since 40 years in 6 months - to persons belonging to the subitem 2) of Item 5 of these rules;

2) general blood test and urine, microreaction, the ECG at rest and fluorography in 12 months - to persons belonging to subitems 3), 4), 5) of Item 5 of these rules;

3) in the absence of dynamic medical observation according to subitems 1 and 2 of this Item the next medical examination is carried out to the intercommission period in volume of stationary (expanded) inspection.

47. Except the medical actions specified in Items 45 and 46 of these rules, the flight surgeon performs medical examination of the aeronautical personnel which is observed according to columns 2, 3 (flight attendants), 4 (air traffic controllers) of table 1 to Requirements after recovery from disease (injury), aviation incidents, aviation incidents, after leave and business trip of 1 and more months.

48. Before medical examination the aeronautical personnel with own hand fills in the application form for medical examination according to appendix 10 to these rules.

49. When training persons of aeronautical personnel for VLEK (TsVLEK), in case of the direction on stationary (expanded) inspection, consultation the flight surgeon after survey draws up in the medical book epikriz (short record of results of dynamic medical observation of aeronautical personnel during the intercommission period).

50. In epikriza of osvidetelstvuyemy the following data are reflected:

1) availability or lack of claims, the postponed diseases, including the postponed diseases with temporary disability, group of dispensary observation;

2) flight loading, types of flights, prolongation of regulation of flight time, reeducation, premises to aviation incidents;

3) use of the next labor leaves, sanatorium treatment, regularity of the days off, debt on labor leaves;

4) data of pre-flight (prereplaceable) medical examinations, the discharge facts from work on first-aid post of air terminal (start), the discharge reason;

5) observation at other medical specialists and accomplishment of medical and improving actions and recommendations of VLEK (TsVLEK);

6) data of personal survey;

7) diagnosis;

8) conclusion of the flight surgeon about dynamics and the state of health and about efficiency of dispensary observation (improvement, deterioration, without changes) and recommendations about further work about main occupation.

51. Medical examination after aviation incidents and incidents is carried out in the direction of administration of airline right after incident (incident) by the health duty worker of first-aid post of air terminal (start) in the following amount: collection of the anamnesis, external examination, survey of mucous membranes, temperature measurement, arterial pressure, pulse. Expertize of alcoholic intoxication is carried out in the specialized medical organization having the corresponding license. The admission of crew to flights is performed by the flight surgeon.

52. By results of medical examinations by the flight surgeon or medical expert the following conclusions are accepted:

it is allowed to flights (to work on Department of Internal Affairs, the flight attendant);

needs provision of the extraordinary day off (the next labor leave);

needs carrying out consultation (treatment - out-patient, stationary, sanatorium);

is subject to preventive treatment (on an outpatient basis, in the conditions of hospital) - average term of treatment of 15 calendar days.

53. In the presence at osvidetelstvuyemy medical indications the flight surgeon represents to the chairman of VLEK (TsVLEK) reasons about extraordinary medical examination to VLEK (TsVLEK).

54. When training aeronautical personnel for the next medical examination in VLEK (TsVLEK) the flight surgeon performs personal inspection, draws up epikriz for the intercommission period, will organize not earlier than in 45 calendar days prior to survey carrying out laboratory, functional and tool researches according to amount according to appendix 5 to these rules.

54-1. In case of not appearance of aeronautical personnel on dynamic medical observation flight surgeons, medical experts of VLEK (TsVLEK) and other specialists of the GA medical organizations within 3 calendar days in writing notify Management on aviation medicine which temporarily suspends the medical certificate.

4. Pre-flight (prereplaceable) medical examination

55. The main objective of pre-flight (prereplaceable) medical examination is determination of the validity of crew members of AF for health reasons to flight execution, air traffic controllers - to work on Department of Internal Affairs.

56. Pre-flight (prereplaceable) medical examination:

1) at the airports and airfields (helidromes) with passenger traffic from 30 000 (thirty thousand) and more people a year it is carried out by the health duty worker (the doctor or the average health worker) of the medical center / health center / first-aid post of civil aviation organization who had special training in narcological dispensary (hospital);

2) at the airports and airfields (helidromes) with passenger traffic less than 30 000 (thirty thousand) people a year, and also in not classified airfields (helidromes) it is allowed to carry out by the health duty worker (the doctor or the average health worker) of health center/first-aid post of civil aviation organization or the medical organization for the contract with civil aviation organization. At the same time health workers have special preparation in narcological dispensary (hospital).

57. Pre-flight (prereplaceable) medical examination of crew members of AF is performed before flights, but not earlier than the 2nd hour prior to departure, in case of departure delay on 6 hours and more crew members of AF have medical examination repeatedly.

58. Pre-flight (prereplaceable) medical examination of crew members of AF performing several flights during on-duty time is carried out once before the first departure.

59. In case of accomplishment of especially important flights pre-flight (prereplaceable) medical examination of crew members of AF is performed in 2 hours prior to the planned departure time.

60. Standby crews have pre-flight (prereplaceable) medical examination before zastupleniye in reserve, and also before departure if from the moment of passing of survey there passed 6 hours and more.

60-1. Flight instructors, listeners and cadets of aviation training centers of civil aviation, pilots of general aviation, instructors of parachute service and parachutists are subject to pre-flight (prereplaceable) medical examination.

61. Pre-flight (prereplaceable) medical examination of instructors of parachute service (parachutists) who are carrying out several jumps during on-duty time is carried out once, but not earlier than in 1 hour before the first jump.

62. The flight operations directors, the senior air traffic controllers and air traffic controllers of Department of Internal Affairs included in structure of change are subject to pre-flight (prereplaceable) medical examination.

63. Change of air traffic controllers of Department of Internal Affairs has pre-flight (prereplaceable) medical examination before zastupleniye on watch, but not earlier than in 1 hour prior to change.

64. Before carrying out pre-flight (prereplaceable) inspection the health worker checks at crew members of AF and air traffic controllers of Department of Internal Affairs the certificate of the specialist and the medical certificate.

65. Faces of aeronautical personnel are not allowed to flight or to work on Department of Internal Affairs in case of establishment of disease signs at them, exhaustion, the fact of the use of medicines without assignment of the doctor, alcoholic beverages, violation of preflight (prereplaceable) rest and diet, the termination of effective period of the medical certificate.

66. Pre-flight (prereplaceable) medical examination is performed in the following amount: poll, external examination, survey of oral cavity and pharynx, pulse research, according to indications - measurement of arterial pressure, body temperature and test on alcohol in expiratory air.

67. In case of poll claims to the state of health, duration and quality of dream, condition of preflight (prereplaceable) rest, diet come to light, the behavior, the speech, mimicry, emotional condition, LOC ARM to flight execution (work on Department of Internal Affairs) are evaluated.

68. In the presence of claims to feeling sick, insufficient (defective) rest the crew member of AF is not allowed to flight (the air traffic controller - to work on Department of Internal Affairs) and goes to the flight surgeon.

69. External examination includes: exterior assessment, check of compliance of clothes of the crew member of AF to meteorological conditions on flight track; colourings and conditions of open integuments and visible mucous (pallor, hyperaemia, the increased perspiration, akrotsianoz, hypostases, yellowness of integuments and skler is noted); survey of almonds, mucous soft and hard palate, back head of throat, language; determination of reaction of pupils to light.

70. Pulse is determined palpatorno on beam artery (within 20 seconds with recalculation for 1 minute) in provision inspected sitting, at the same time its frequency, rhythm, filling and tension are evaluated.

71. In case of detection of tachycardia (pulse rate of 90 and more blows 1 minute) or bradycardia (less than 55 blows 1 minute) additional survey about health inspected is conducted, prior physical and emotional activities, rest within 5 minutes is provided and pulse rate (in case of tachycardia - body temperature is taken) is repeatedly counted.

72. Tachycardia, bradycardia and arrhythmia are the basis for discharge of the crew member of AF from flight (the air traffic controller - work on Department of Internal Affairs).

73. If pulse frequency deviation at the pilot or the air traffic controller is individual option of regulation, and it is established when conducting flight-surgeon's appraisal, the chairman of VLEK (TsVLEK) does mark about it in the medical certificate.

74. Measurement of arterial pressure is taken after five-minute rest, in sitting position on chair on the left hand by tonometer. Increase in AD is considered if it is registered in case of repeated measurement after the five-minute rest inspected.

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