NATO STANDARD

AAMedP-1.3

FUNCTIONAL REQUIREMENTS OF
AIRCRAFT OXYGEN EQUIPMENT AND
PRESSURE SUITS
Edition A Version 1
JANUARY 2017

NORTH ATLANTIC TREATY ORGANIZATION

ALLIED AEROMEDICAL PUBLICATION

Published by the
NATO STANDARDIZATION OFFICE (NSO)
© NATO/OTAN
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RESERVED FOR NATIONAL LETTER OF PROMULGATION

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RECORD OF RESERVATIONS

CHAPTER RECORD OF RESERVATION BY NATIONS

Note: The reservations listed on this page include only those that were recorded at time
of promulgation and may not be complete. Refer to the NATO Standardization Document
Database for the complete list of existing reservations.

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RECORD OF SPECIFIC RESERVATIONS

[nation] [detail of reservation]
BGR The standard will not be implemented for aircraft Su-25 and
helicopters AS 532 AL "Cougar", "Bell-206, Mi-17 and Mi-24".
FRA While the merits of lowering the threshold for supplemental oxygen
supply to 10,000 feet cabin altitude (paragraph 1.3.2) is recognized,
it is currently impossible for the French Navy and Air Forces to
implement this point. This would imply revising doctrines and
frameworks of the use of unpressurized aircrafts as well as
providing aircrafts with oxygen systems, which is not feasible at
present.
NLD The NLD reserves the right not to implement paragraphs 1.3, 2.2 to
2.6, 2.9, 2.10, 2.14 and 2.15 of AAMedP-1.3.
Rationale:
For passenger transport the MAA-NLD follows EASA and FAA
regulations concerning supplemental oxygen where possible. For
other missions the MAA-NLD sees no need to change current
aircraft systems or operations. For future applications, including
modifications to current systems, the use of AAMedP-1.3 shall be
considered.
Furthermore the NLD SOP differs from the STANAG on two points:
Paragraph 1.2 Unpressurized Aircraft:
a: below 13,000 ft: max 30 mins
b. Not applicable
Paragraph 2.5: Diluent Gas: Above 25,000 ft regulator not
automatically switch to 100% oxygen.
SVK The Slovak Republic reserves the right to apply this STANAG only
to aircraft and equipment procured in the future.

Note: The reservations listed on this page include only those that were recorded at time
of promulgation and may not be complete. Refer to the NATO Standardization Document
Database for the complete list of existing reservations.

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TABLE OF CONTENTS
CHAPTER 1 HYPOXIA PROTECTION ............................................................... 1-1
1.1 INTRODUCTION ....................................................................................... 1-1
1.2 UNPRESSURIZED AIRCRAFT ................................................................. 1-1
1.3 PRESSURIZED AIRCRAFT ...................................................................... 1-1
1.3.1 Cabin Altitude Less than 10,000 ft (in Normal Flight Conditions) ....... 1-1
1.3.2 Cabin Altitude Greater than 10,000 ft (in Normal Flight Conditions)... 1-2
CHAPTER 2 MINIMUM FUNCTIONAL REQUIREMENTS .................................. 2-1
2.1 OXYGEN SOURCES ................................................................................ 2-1
2.1.1 Aircraft Oxygen Sources .................................................................... 2-1
2.1.2 Ejection Oxygen Source ..................................................................... 2-1
2.2 OXYGEN CHARACTERISTICS AND REQUIREMENTS .......................... 2-1
2.3 LEVEL OF ACCEPTABLE HYPOXIA........................................................ 2-2
2.4 CONCENTRATION OF OXYGEN IN THE INSPIRED GAS FOLLOWING
DECOMPRESSION OF THE CABIN ........................................................ 2-2
2.5 DILUENT GAS .......................................................................................... 2-3
2.5.1 Minimum Dilution Requirements ........................................................ 2-3
2.5.2 Closure of the Dilution Orifice by the User ......................................... 2-3
2.5.3 CBRN Protection ................................................................................ 2-3
2.6 RESPIRATORY DEMAND ........................................................................ 2-3
2.7 SAFETY PRESSURE ................................................................................ 2-4
2.8 MASK CAVITY PRESSURE AT ALTITUDES LOWER THAN OR EQUAL
TO 38,000 FT (11,600 M) .......................................................................... 2-4
2.9 POSITIVE PRESSURE BREATHING FOR ALTITUDE (PBA) .................. 2-5
2.10 MASK CAVITY POSITIVE PRESSURE BETWEEN 38,000 FT (11,600 M)
AND 50,000 FT (15,240 M) IN THE ABSENCE OF COUNTER PRESSURE
EQUIPMENT ............................................................................................. 2-5
2.11 OPERATION OF THE ALTITUDE POSITIVE PRESSURE PRESS-TO-
TEST FUNCTION IN THE ABSENCE OF COUNTER PRESSURE
EQUIPMENT ............................................................................................. 2-6
2.12 ALLOWABLE INCREASES OF MASK CAVITY PRESSURE ................... 2-6
2.13 OSCILLATORY ACTIVITY ........................................................................ 2-6
2.14 ALARMS ................................................................................................... 2-6
2.15 COUNTER PRESSURE SUITS ................................................................ 2-6
2.15.1 Definitions .......................................................................................... 2-6
2.15.2 Scope of use ...................................................................................... 2-7
2.15.3 Mode of Operation ............................................................................. 2-7
2.15.4 Breathable Gas Supply ...................................................................... 2-8
2.15.5 Compatibility....................................................................................... 2-8
ANNEX A DEFINITIONS .................................................................................... A-1
ANNEX B ACRONYMS ...................................................................................... B-1

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CHAPTER 1 HYPOXIA PROTECTION

1.1 INTRODUCTION

It shall be the responsibility of each nation to ensure that its aircraft are fitted with
appropriate oxygen equipment capable of affording the aircrew adequate protection
against hypoxia throughout the operational envelope of the aircraft.

1.2 UNPRESSURIZED AIRCRAFT

If flight altitude exceeds 10,000 ft (3,048 m), unpressurized aircraft must be provided
with an oxygen system with the capability of maintaining physiological protection for all
aircrew members. While the maximum recommended altitude for unpressurized
aircraft without oxygen is 10,000 ft (3,048 m), it is recognised that at times aircraft
without oxygen systems may exceed this altitude limitation due to operational
imperatives. This activity creates a risk to flight safety and should only be undertaken
exceptionally and with due regard to aeromedical advice limiting altitudes and
exposure times of excursions as follows:

a. Below 14,000 ft (4,267 m): max 30 mins.

b. Below altitudes of 12,500 ft (3,810 m): max one hour.

1.3 PRESSURIZED AIRCRAFT

1.3.1 Cabin Altitude Less than 10,000 ft (in Normal Flight Conditions)

All pressurized aircraft must be fitted with an oxygen system capable of providing
physiological protection for all personnel in the event of decompression under the
following conditions:

a. Personnel Flying Aircraft. If the aircraft flight altitude exceeds 25,000

ft (7,620m)1, pilots require an oronasal mask of a type that can be
positioned, fixed, sealed and made operational with one hand in less than
5 seconds. The oxygen system shall be compatible with other aircrew
protection devices worn by the crewmember and its donning/doffing shall
not delay or prevent performance tasks assigned to the aircrew member.
If the aircraft flight altitude exceeds 40,000 ft (12,200 m), at least one
pilot must don and use his oronasal mask routinely as reactive delay to

1 Corresponding to the upper limit at which a ‘constant flow system’ can provide protection.

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mask application and oxygen delivery would result in significant transient

impairment.

b. Operational Personnel. The oxygen supply system shall be

positionable and made operational in a time compatible with personnel
safety. The system shall be compatible with the other aircrew protection
devices worn by the crewmember and shall not delay or prevent
performance tasks assigned to him.

c. Transported Personnel. An oxygen supply system shall be provided if

the aircraft altitude exceeds 25,000 ft (7,620 m) or if it cannot be
guaranteed, regardless of flight altitude, that the aircraft can descend to
an altitude not exceeding 10,000 ft (3,048 m) in less than 4 minutes after
accidental cabin decompression.

1.3.2 Cabin Altitude Greater than 10,000 ft (in Normal Flight Conditions)

All personnel must have an oxygen supply system available for inflight use.

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CHAPTER 2 MINIMUM FUNCTIONAL REQUIREMENTS

2.1 OXYGEN SOURCES

2.1.1 Aircraft Oxygen Sources

Aircraft oxygen sources may be described as either ‘primary oxygen systems’, or as

‘backup oxygen systems’. Oxygen for these systems may be from a pure oxygen
source produced by a reserve of liquid, gaseous or chemical oxygen, or from a
Molecular Sieve Oxygen Generating System (MSOGS), a form of On Board Oxygen
Generating System (OBOGS).2

2.1.2 Ejection Oxygen Source

The aircraft ejection system shall be fitted with an emergency oxygen system where
ejection occurs >25,000 ft (7,620 m). This system will be activated automatically as the
crewmember is disconnected from the aircraft.

2.2 OXYGEN CHARACTERISTICS AND REQUIREMENTS

1. Sources of pure oxygen shall guarantee a supply of gas containing at least

99.5% oxygen. However, oxygen provided from MSOGS is derived from engine ‘bleed
air’ and is at the most 94% (the remainder being mostly argon).3

2. The minimum concentration of oxygen within mixed inspired gas (containing a

partial pressure of water vapor of 47mmHg (63 kPa)) in pressurized cabins shall be
sufficient to:

a. Maintain an alveolar oxygen tension of at least 100 mmHg.

b. Prevent the alveolar oxygen tension from falling below 30 mmHg on rapid
cabin decompression when at least 94% oxygen is delivered to the mask
immediately after decompression.

These criteria are designed to assure the quality of breathing gas delivered to aircrew
during normal flight operations and are applicable to all types of OBOGS.

2An MSOGS cannot, by design, deliver pure oxygen.

3The variation in MSOGS concentration output being explained by efficiency changes with altitude,
being most efficient at higher altitudes.

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2.3 LEVEL OF ACCEPTABLE HYPOXIA

Oxygen concentration and pressure breathing for altitude (PBA) for a typical fighter
aircraft with a ceiling of 50,000 feet and a standard 5 psi (34.5 kPa or 259 mmHg) cabin
pressurization schedule shall conform to Figure 1. The step in the minimum oxygen
concentration curve is referred to as the "Ernsting notch" and it ensures 30 mm Hg
alveolar oxygen tension is maintained after a rapid decompression. BOS is the Back-
up Oxygen Supply providing 100% gaseous emergency oxygen and which is normally
part of the ejection seat assembly in order to provide oxygen following ejection at high
altitudes. Consideration should also be given to automatic BOS supply where cabin
altitudes exceed 25,000 ft or where OBOGS failure occurs.

Figure 1: Recommended Minimum and Maximum Oxygen Concentrations for an

OBOGS on a Military Aircraft with a Maximum Aircraft Altitude of 50,000 ft (15,240 m)

2.4 CONCENTRATION OF OXYGEN IN THE INSPIRED GAS FOLLOWING

DECOMPRESSION OF THE CABIN

1. On decompression of the cabin (time of decompression between 0.1 s and 90 s)

and the cabin altitude exceeding 30,000 feet, the concentration of oxygen in the gas
delivered to the mask cavity must rise to above 94% when no more than 0.7 liters
(ATPD) of gas has been inspired. The concentration of oxygen in the inspired gas
shall be at least 94% for as long as the cabin altitude exceeds 30,000 feet. Automatic

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BOS activation is recommended above 25,000 ft given increased likelihood of spurious

warnings from OBOGS control at these altitudes.

2. In order to reduce the incidence of acceleration atelectasis and/or delayed otitic

barotrauma, the concentration of oxygen in the inspired gas shall not exceed 60% at
cabin altitudes between 0 and 15,000 feet, or 75% at a cabin altitude of 20,000 feet.

2.5 DILUENT GAS

Above 25,000 ft cabin pressure, 100% oxygen must be supplied, however, below this
level, the oxygen equipment shall be able to supply the user with a diluted mixture of
gas where major acceptable gases in the breathing mixture supplied to the aircrew are
nitrogen, argon or a mixture of the two, in addition to oxygen. The concentration of
argon shall not exceed 5% by volume of the total gas mixture.

2.5.1 Minimum Dilution Requirements

Oxygen delivery shall be sufficient to maintain a mean alveolar pressure of oxygen of

at least 13.3 kPa (100 mmHg) up to a cabin altitude of 30,000 ft (9,150 m). Above this
altitude, the mean alveolar pressure of oxygen may transiently fall below 13.3 kPa
(100 mm Hg) but shall be at least 8 kPa (60 mm Hg) for all personnel flying aircraft,
operational and transported personnel and 7 kPa (53 mm Hg) for passengers. In such
circumstances, the aircraft must descend to 18,000 ft (5,486 m) if oxygen is available
and to 10,000 ft (3,048 m) if oxygen supply is limited.

2.5.2 Closure of the Dilution Orifice by the User

Independently of the requirement specified in paragraph 2.5.1. above, the oxygen

system must allow all aircrew personnel to close the dilution orifice and to select 100%
of the gas provided by the breathable gas source or additional source when OBOGS
is used as the primary source.

2.5.3 CBRN Protection

Protection against the risk of CBRN contamination of inhaled gas is the subject of a
special agreement.

2.6 RESPIRATORY DEMAND

The operation of the oxygen system shall meet the requirements of this specification
at pulmonary ventilations between 5 and 100L/min (ATPD) and peak inspiratory and
expiratory flow of up to 3.3 L/s, with maximum rates of change of 10 L/s2 at peak flows
of 1.5 L/s and 20 L/s2 at peak flows of 3.3 L/s.

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2.7 SAFETY PRESSURE

When pressure demand oxygen regulators are used, they shall deliver a positive safety
pressure sufficient for preventing the admixture of inboard leaks during the respiratory
cycle. Safety pressure shall be selectable by the crewmember at any altitude. When
the inspiratory flows do not exceed 1.4 L/s, the safety pressure delivered to the
crewmember must be sufficient to maintain a positive pressure in the oronasal mask
cavity.

2.8 MASK CAVITY PRESSURE AT ALTITUDES LOWER THAN OR EQUAL TO

38,000 FT (11,600 M)

The minimum pressure, maximum pressure and total pressure variation (swing) in the
mask cavity, during a ventilation cycle at altitudes lower than or equal to 38,000 ft
(11,600 m) shall not exceed the values given in Tables I and II below. The altitude of
38000ft is utilized to provide a margin of safety over the required figure of 39,000ft for
protection against hypoxia.

Flow Mask Cavity Pressure kPa (inch H2O gauge)

(L/s)
Lower Limit Upper Limit Max Permissible
Swing
0.5 -0.38 (-1.5) +0.38 (+1.5) 0.50 (2.0)
1.5 -0.55 (-2.2) +0.65 (+2.6) 0.85 (3.4)
2.5 -1.12 (-4.5) +1.00 (+4.0) 1.75 (7.0)
3.3 -1.90 (-7.6) +1.50 (+6.0) 3.00 (12.0)

Table 1: Without Safety Pressure

Peak Inspiratory and Expiratory Flow Limits and Mask Cavity Pressures at altitudes
between 0 and 38,000 ft (11,600 m)

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Flow Mask Cavity Pressure kPa (inch H2O gauge)

(L/s)
Lower Limit Upper Limit Max Permissible
Swing
0.5 +0.02 (+0.1) +0.75 (+3.0) 0.50 ( 2.0)
1.5 -0.20 (-0.8) +0.95 (+3.8) 0.85 ( 3.4)
2.5 -0.90 (-3.6) +1.25 (+5.0) 1.75 ( 7.0)
3.3 -1.75 (-7.0) +1.65 (+6.6) 3.00 (12.0)

Table 2: With Safety Pressure

Peak Inspiratory and Expiratory Flow Limits and Mask Cavity Pressures at altitudes
between 0 and 38,000 ft (11,600 m)

2.9 POSITIVE PRESSURE BREATHING FOR ALTITUDE (PBA)

Above 38,000 ft (11,582 m) cabin altitude, the breathable gas shall be supplied at a
sufficient positive pressure in order to mitigate the level of hypoxia to an acceptable
level to maintain consciousness and permit emergency descent actions by the pilot.
When the breathable gas is supplied by a pure oxygen source, altitude positive
pressure shall begin at a cabin altitude of 38,000 ft (11,582 m). When the breathable
gas is supplied by a MSOGS, altitude positive pressure shall begin at a lower cabin
altitude than the aforementioned value so that an equivalent mean alveolar pressure
of oxygen may be guaranteed. The altitude safety pressure should be 0.5 kPa (2 in
water gauge) at cabin altitudes greater than 30,000 ft (9,144 m).

2.10 MASK CAVITY POSITIVE PRESSURE BETWEEN 38,000 FT (11,600 M)

AND 50,000 FT (15,240 M) IN THE ABSENCE OF COUNTER PRESSURE
EQUIPMENT

1. Above 38,000 ft (11,580 m) and in the absence of counter pressure equipment,

the mask cavity pressure is to increase linearly with fall of environmental pressure up
to 50,000 ft (11,580 and 15,240 m). The mean mask cavity pressure (averaged over
the ventilatory cycle) is to lie within the limits +0.1 to +1.0 kPa (0.4 to 4.0 inch water
gauge) at 40,000 ft (12,200 m) and 4.0 to 4.5 kPa (16 to 18 inch water gauge) at 50,000
ft (15,240 m). At altitudes between 38,000 ft and 50,000 ft the total change of mask
cavity pressure during a ventilator cycle is not to exceed 0.5 kPa (2.0 inch water gauge)
with peak ventilator flow of 0.5 L.sec-1 and 1.0 kPa (4.0 inch water gauge) at peak
ventilator flow of 1.8 L.sec-1.

2. These values are applicable only where breathing gas supplied exceeds 94%
oxygen purity. If a crewmember receives oxygen through a molecular sieve oxygen
concentrating system, it must be capable of maintaining a mean alveolar pressure

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appropriate to the level required to maintain protection at the cabin altitude without the
use of counter pressure equipment.

2.11 OPERATION OF THE ALTITUDE POSITIVE PRESSURE PRESS-TO-TEST

FUNCTION IN THE ABSENCE OF COUNTER PRESSURE EQUIPMENT

Operation of the altitude positive pressure press-to-test function shall raise the mask
cavity pressure to between 3.5 kPa (14.0 in water gauge) and 4.5 kPa (18.0 in water
gauge). The total change of pressure during the respiratory cycle shall not exceed
0.75 kPa (3.0 in water gauge) when the peak inspiratory and expiratory flows are 0.5
L/sec.

2.12 ALLOWABLE INCREASES OF MASK CAVITY PRESSURE

When the crewmember must continually wear the oxygen mask, the rise of mask cavity
pressure induced by realistic head movements or throughout the maximum rate of
climb of an aircraft shall not exceed 0.25 kPa (1.0 in water gauge). The rise of mask
cavity pressure produced by either the oxygen regulator failing in the open position, or
rapid or explosive decompression, up to an altitude of 50,000 ft (15,240 m), shall not
exceed 5.5 kPa (22.1 in water gauge).

2.13 OSCILLATORY ACTIVITY

There shall be minimal oscillatory activity when the oxygen system is used by the
crewmember. The double amplitude of any oscillation of pressure in the mask cavity
which lasts 0.25 s or longer shall not exceed 0.06 kPa (0.24 in water gauge).

2.14 ALARMS

Aircrew oxygen equipment shall be fitted with a device to warn the crewmember when
a component of his oxygen system is defective or inoperative and BOS activation / use
must be shown visually.

2.15 COUNTER PRESSURE SUITS

2.15.1 Definitions

1. Pressure suits are categorized:

a. Full Pressure Suit. A full body garment that pneumatically pressurizes

the whole of the body surface, to include the head.

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b. Partial Pressure Suit. A pressure garment which mechanically

pressurizes only part of the body surface, eg chest or lower body counter-
pressure.

2.15.2 Scope of use

1. The use of pressure suits at altitudes exceeding:

a. 45,000 ft (13,720 m): partial suit strongly recommended.

b. 50,000 ft (15,240 m): partial suit mandatory.

c. 60,000 ft (18,288 m): full suit recommended.

d. Prolonged exposure: full suit recommended.

2.15.3 Mode of Operation

1. Partial pressure and full pressure suits should conform to the following modes
of operation:

a. Respiratory counter-pressure. To balance onset of PBA, an

automatically pressurized respiratory (chest) counter pressure garment
must be used above 50,000 ft (15,240 m) or if PBA pressure is greater
than 4 kPa gauge (30 mmHg). Respiratory counter pressure provided by
the garment should be no less than 0.86 times the breathing pressure.
This difference isolates the garment from safety pressure and allows
inflation only during periods of PBA or PBG.

b. Lower body counter-pressure. Automatically pressurized lower limb

and abdominal counter-pressure should be used when PBA pressure is
greater than 4 kPa gauge (30 mmHg) or with prolonged PBA. This
function can be provided by an anti-G garment or similar suit which
applies lower body counter-pressure : breathing gas pressure at a ratio
of between 1:1 and 1.5:1.

c. Full body counter-pressure. If a full pressure suit is used, it should

maintain the pressure altitude inside the suit at 38,000 ft (11,600 m) or
lower. This provision is for emergency use only; requirements for
prolonged pressure suit use are outside the scope of this agreement.

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2.15.4 Breathable Gas Supply

Under all operational conditions, the main and/or emergency gaseous supplies to a
pressure suit must ensure that the pressure and breathing gas composition delivered
to the aircrew are sufficient to meet the provision of paragraphs 2.3 and 2.9.

2.15.5 Compatibility

1. The use of counter pressure garments must not adversely affect operational
performance and shall not compromise:

a. Vision.

b. Hearing.

c. Speech.

d. Mobility (including the ability to check the 6 o’clock position).

e. Thermal comfort.

f. Emergency egress.

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ANNEX A DEFINITIONS

The following definitions shall be employed when implementing the provisions of this
document:

Ambient Temperature Volume of gas expressed as dry gas at the prevailing

and Pressure Dry atmospheric pressure and temperature. The ambient
Gas (ATPD) pressure is the absolute pressure of the gas within the
cavity of the mask and the temperature is constant at 15°C.
In this document, all the volumes and gas flows are
expressed in ATPD conditions.

Operational Crewmembers not in primary control of the aircraft.

Personnel

Personnel Flying Crewmembers in primary control of the aircraft.

Aircraft

Transported All personnel on board an aircraft, but having no role for

Personnel the performance or the safety of the aircraft itself.

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ANNEX B ACRONYMS

ATPD Ambient Temperature and Pressure Dry Gas

MSOGS Molecular Sieve Oxygen Generating System

OBOGS On Board Oxygen Generating System

PBA Positive Pressure Breathing for Altitude

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