Aviation medicine

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A deployed U.S. Navy flight surgeon performs a shipboard exam in the Persian Gulf in 2004. US Navy 040531-N-9630B-025 U.S. Navy Flight Surgeon, Lt. Cmdr. Scott Carlson of Downers Grove, Ill., performs and eye examination on Operation Specialist 1st Class Naron Williams of Jacksonville, Fla.jpg
A deployed U.S. Navy flight surgeon performs a shipboard exam in the Persian Gulf in 2004.

Aviation medicine, also called flight medicine or aerospace medicine, is a preventive or occupational medicine in which the patients/subjects are pilots, aircrews, or astronauts. [1] The specialty strives to treat or prevent conditions to which aircrews are particularly susceptible, applies medical knowledge to the human factors in aviation and is thus a critical component of aviation safety. [1] A military practitioner of aviation medicine may be called a flight surgeon and a civilian practitioner is an aviation medical examiner. [1] One of the biggest differences between the military and civilian flight doctors is the military flight surgeon's requirement to log flight hours. [2]

Contents

Overview

Broadly defined, this subdiscipline endeavors to discover and prevent various adverse physiological responses to hostile biologic and physical stresses encountered in the aerospace environment. [1] Problems range from life support measures for astronauts to recognizing an ear block in an infant traveling on an airliner with elevated cabin pressure altitude. Aeromedical certification of pilots, aircrew and patients is also part of aviation medicine. A final subdivision is the AeroMedical Transportation Specialty. These military and civilian specialists are concerned with protecting aircrew and patients who are transported by AirEvac aircraft (helicopters or fixed-wing airplanes).

Atmospheric physics potentially affect all air travelers regardless of the aircraft. [1] As humans ascend through the first 9100–12,300 m (30,000–40,000 ft), temperature decreases linearly at an average rate of 2 °C (3.6 °F) per 305 m (1000 ft). If sea-level temperature is 16 °C (60 °F), the outside air temperature is approximately −57 °C (−70 °F) at 10,700 m (35,000 ft). Pressure and humidity also decline, and aircrew are exposed to radiation, vibration and acceleration forces (the latter are also known as "g" forces). Aircraft life support systems such as oxygen, heat and pressurization are the first line of defense against most of the hostile aerospace environment. Higher performance aircraft provide more sophisticated life support equipment, such as "G-suits" to help the body resist the adverse effects of acceleration, along with pressure breathing apparatus, or ejection seats or other escape equipment.

Every factor contributing to a safe flight has a failure rate. The crew of an aircraft is no different. Aviation medicine aims to keep this rate in the humans involved equal to or below a specified risk level. This standard of risk is also applied to airframe, avionics and systems associated with flights.

AeroMedical examinations aim at screening for elevation in risk of sudden incapacitation, such as a tendency towards myocardial infarction (heart attacks), epilepsy or the presence of metabolic conditions diabetes, etc. which may lead to hazardous condition at altitude. [1] The goal of the AeroMedical Examination is to protect the life and health of pilots and passengers by making reasonable medical assurance that an individual is fit to fly. [1] Other screened conditions such as colour blindness can prevent a person from flying because of an inability to perform a function that is necessary. [1] [3] In this case to tell green from red. [4] These specialized medical exams consist of physical examinations performed by an Aviation Medical Examiner or a military Flight Surgeon, doctors trained to screen potential aircrew for identifiable medical conditions that could lead to problems while performing airborne duties. [1] [5] In addition, this unique population of aircrews is a high-risk group for several diseases and harmful conditions due to irregular work shifts with irregular sleeping and irregular meals (usually carbonated drinks and high energy snacks) and work-related stress. [1] [6] [7] [8] [9]

Topics in aviation medicine

Educational institutes

Medical boards & memember associations

See also

Related Research Articles

<span class="mw-page-title-main">Flight surgeon</span> Military occupation

A flight surgeon is a military medical officer practicing in the clinical field of aviation medicine. Although the term "flight surgery" is considered improper by purists, it may occasionally be encountered.

g-suit Flight suit which controls blood-flow during high acceleration

A g-suit, or anti-g suit, is a flight suit worn by aviators and astronauts who are subject to high levels of acceleration force (g). It is designed to prevent a black-out and g-LOC caused by the blood pooling in the lower part of the body when under acceleration, thus depriving the brain of blood. Black-out and g-LOC have caused a number of fatal aircraft accidents.

<span class="mw-page-title-main">Barotrauma</span> Injury caused by pressure

Barotrauma is physical damage to body tissues caused by a difference in pressure between a gas space inside, or contact with, the body and the surrounding gas or liquid. The initial damage is usually due to over-stretching the tissues in tension or shear, either directly by an expansion of the gas in the closed space or by pressure difference hydrostatically transmitted through the tissue. Tissue rupture may be complicated by the introduction of gas into the local tissue or circulation through the initial trauma site, which can cause blockage of circulation at distant sites or interfere with the normal function of an organ by its presence.

To assume a brace position or crash position is an instruction that can be given to prepare for a crash, such as on an aircraft; the instruction to "Brace for impact!" or "Brace! Brace!" is often given if the aircraft must make an emergency landing on land or water. There are many different ways to adopt the brace position, with many countries adopting their own version based on research performed by their own aviation authority or that of other countries. The most common in passenger airliners being the forward-facing seat version, in which the person bracing places their head against or as close as possible to the surface it is likely to strike, placing their feet firmly on the floor, and their hands either on their head or the seat in front.

Airsickness is a specific form of motion sickness which is induced by air travel and is considered a normal response in healthy individuals. Airsickness occurs when the central nervous system receives conflicting messages from the body affecting balance and equilibrium. Whereas commercial airline passengers may simply feel poorly, the effect of airsickness on military aircrew may lead to a decrement in performance and adversely affect the mission.

An Aviation Medical Examiner or Aero-medical Examiner (AME) is a physician designated by the national aviation authority and given the authority to perform flight physical examinations and issue aviation medical certificates. AMEs are practitioners of aviation medicine, although most are also qualified in other medical specialties.

<span class="mw-page-title-main">Aerosinusitis</span> Barotrauma of the sinuses

Aerosinusitis, also called barosinusitis, sinus squeeze or sinus barotrauma is a painful inflammation and sometimes bleeding of the membrane of the paranasal sinus cavities, normally the frontal sinus. It is caused by a difference in air pressures inside and outside the cavities.

<span class="mw-page-title-main">Hypobaric chamber</span> Chamber for simulating high altitude

A hypobaric chamber, or altitude chamber, is a chamber used during aerospace or high terrestrial altitude research or training to simulate the effects of high altitude on the human body, especially hypoxia and hypobaria. Some chambers also control for temperature and relative humidity.

<span class="mw-page-title-main">Aerospace Medical Association</span> Professional organization in aviation, space, hyperbaric and environmental medicine

The Aerospace Medical Association (AsMA) is the largest professional organization in the fields of aviation, space, and environmental medicine. The AsMA membership includes aerospace and hyperbaric medical specialists, scientists, flight nurses, physiologists, and researchers from all over the world.

<span class="mw-page-title-main">Barodontalgia</span> Tooth pain caused by ambient pressure change

Barodontalgia, commonly known as tooth squeeze, is a pain in a tooth caused by a change in ambient pressure. The pain usually ceases at ground level. Dental barotrauma is a condition in which such changes in barometric pressure changes cause damage to the dentition.

In aviation medicine, the 1% rule is a risk threshold that is applied to the medical fitness of pilots. The 1% rule states that a 1% per annum risk of medical incapacitation is the threshold between acceptable and unacceptable. In other words:

Applying this 1 percent rule would result in an airline pilot being denied a medical certificate if their risk of a medical incapacitation was determined as being greater than 1% during the year.

Fatigue is a major human factors issue in aviation safety. The Fatigue Avoidance Scheduling Tool (FAST) was developed by the United States Air Force in 2000–2001 to address the problem of aircrew fatigue in aircrew flight scheduling. FAST is a Windows program that allows scientists, planners and schedulers to quantify the effects of various work-rest schedules on human performance. It allows work and sleep data entry in graphic, symbolic (grid) and text formats. The graphic input-output display shows cognitive performance effectiveness as a function of time. An upper green area on the graph ends at the time for normal sleep, 90% effectiveness. The goal of the planner or scheduler is to keep performance effectiveness at or above 90% by manipulating the timing and lengths of work and rest periods. A work schedule is entered as red bands on the time line. Sleep periods are entered as blue bands across the time line, below the red bands.

<span class="mw-page-title-main">RAF Centre of Aviation Medicine</span> Military unit

The RAF Centre of Aviation Medicine is a medical organisation run by the Royal Air Force and based at RAF Henlow in Bedfordshire. It is the main organisation conducting aviation medicine research in the UK.

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<span class="mw-page-title-main">Air medical services</span> Use of air vehicles to transport patients

Air medical services are the use of aircraft, including both fixed-wing aircraft and helicopters to provide various kinds of medical care, especially prehospital, emergency and critical care to patients during aeromedical evacuation and rescue operations.

<span class="mw-page-title-main">Civil Aerospace Medical Institute</span>

Civil Aerospace Medical Institute (CAMI) is the medical certification, education, research, and occupational medicine wing of the Office of Aerospace Medicine (AAM) under the auspices of the Federal Aviation Administration Office of Aviation Safety. The Institute's primary goal is to enhance aviation safety.

<span class="mw-page-title-main">United States Air Force School of Aerospace Medicine</span>

The United States Air Force School of Aerospace Medicine (USAFSAM) is the United States Air Force (USAF) organization focused on education, research, and operational consultation in aerospace and operational medicine. USAFSAM was founded in 1918 to conduct research into the medical and physiologic domains related to human flight, and as a school for medical officers trained to support military aviation operations, later coined as flight surgeons. The school supported early military aviation from World War I through the evolution of aviation and into the modern era. USAFSAM conducted medical research and provided medical support for the initial US space operations beginning in 1947 through the establishment of NASA in 1958. After the creation of NASA, USAFSAM continued to actively support civilian and military manned space missions through clinical and physiologic research. USAFSAM is one of the oldest continually operating school for flight surgeons and other operational medical personnel of its kind in the world. USAFSAM is located in Dayton, Ohio at Wright-Patterson Air Force Base, and is part of the 711th Human Performance Wing and the Air Force Research Laboratory (AFRL).

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Jarnail Singh was a Singaporean physician who focused on aviation medicine. He was known for coordinating the aviation community's response to the severe acute respiratory syndrome (SARS) epidemic outbreak in 2003 and had led the International Civil Aviation Organization's anti-SARS projects for impacted states, studying the spread of communicable diseases via air travel. He also led health studies on pilot fatigue on ultra long-haul flights. He was the chairman of the Civil Aviation Authority of Singapore's Medical Board and the first Asian president of the International Academy of Aviation and Space Medicine.

<span class="mw-page-title-main">Julian Elvis Ward Jr.</span>

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References

  1. 1 2 3 4 5 6 7 8 9 10 Dehart, R. L.; J. R. Davis (2002). Fundamentals Of Aerospace Medicine: Translating Research Into Clinical Applications, 3rd Rev Ed. United States: Lippincott Williams And Wilkins. p. 720. ISBN   978-0-7817-2898-0.
  2. ↑ Jedick, Rocky (2 November 2014). "Why Flight Surgeons Fly". Go Flight Medicine. Retrieved 28 November 2014.
  3. ↑ Squire TJ, Rodriguez-Carmona M, Evans AD, Barbur JL (May 2005). "Color vision tests for aviation: comparison of the anomaloscope and three lantern types". Aviat Space Environ Med. 76 (5): 421–9. PMID   15892538. Archived from the original on 4 July 2008. Retrieved 2008-07-20.
  4. ↑ Birch J (September 1999). "Performance of red-green color deficient subjects on the Holmes-Wright lantern (Type A) in photopic viewing". Aviat Space Environ Med. 70 (9): 897–901. PMID   10503756.
  5. ↑ Baker DP, Krokos KJ (April 2007). "Development and validation of Aviation Causal Contributors for Error Reporting Systems (ACCERS)". Hum Factors. 49 (2): 185–99. doi:10.1518/001872007X312432. PMID   17447662. S2CID   5654753.
  6. ↑ Van Dongen HP, Caldwell JA, Caldwell JL (May 2006). "Investigating systematic individual differences in sleep-deprived performance on a high-fidelity flight simulator". Behav Res Methods. 38 (2): 333–43. doi: 10.3758/BF03192785 . PMID   16956110.
  7. ↑ Grósz A, Tóth E, Péter I (February 2007). "A 10-year follow-up of ischemic heart disease risk factors in military pilots". Mil Med. 172 (2): 214–9. doi: 10.7205/MILMED.172.2.214 . PMID   17357781.
  8. ↑ Buja A, Lange JH, Perissinotto E, et al. (November 2005). "Cancer incidence among male military and civil pilots and flight attendants: an analysis on published data". Toxicol Ind Health. 21 (10): 273–82. doi:10.1191/0748233705th238oa. PMID   16463960. S2CID   37427615 . Retrieved 2008-07-20.
  9. ↑ Lurie, O; Zadik, Y; Tarrasch, R; Raviv, G; Goldstein, L (February 2007). "Bruxism in Military Pilots and Non-Pilots: Tooth Wear and Psychological Stress". Aviat Space Environ Med. 78 (2): 137–9. PMID   17310886 . Retrieved 2008-07-16.

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