Aviat Space Envir Md
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Aviat Space Envir Md · Jul 2012
ReviewDifferences in cardio-ventilatory responses to hypobaric and normobaric hypoxia: a review.
The presence of differences in physiological response to a lowered inspired Po2 mediated by hypobaric hypoxia (HH) or normobaric hypoxia (NH) is controversial. This review examines the brief, acute, and subacute respiratory, cardiovascular, and subjective symptom response to intermediate and severe hypoxic exposure in NH and HH. ⋯ Explanations for the discrepancy between the two modalities include differences in ventilatory patterns, alveolar gas disequilibrium, and dissimilar acute hypoxic ventilatory responses. Awareness and consideration of these key differences between NH and HH is essential to their proper application to kinesiology, altitude, and aviation medicine.
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Aviat Space Envir Md · Jul 2012
Pulmonary artery pressure increases during commercial air travel in healthy passengers.
It is not known whether the mild hypoxia experienced by passengers during commercial air travel triggers hypoxic pulmonary vasoconstriction and increases pulmonary artery pressure in flight. Insidious pulmonary hypertensive responses could endanger susceptible passengers who have cardiopulmonary disease or increased hypoxic pulmonary vascular sensitivity. Understanding these effects may improve pre-flight assessment of fitness-to-fly and reduce in-flight morbidity and mortality. ⋯ Pulmonary artery pressure increases during commercial air travel in healthy passengers, raising the possibility that hypoxic pulmonary hypertension could develop in susceptible individuals. A hypoxia altitude simulation test with simultaneous echocardiography ('HAST-echo') may be beneficial in assessing fitness to fly in vulnerable patients.
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Aviat Space Envir Md · Apr 2012
Critical care aeromedical evacuation staff in Batang Airport after the Yushu earthquake at high altitude.
Aeromedical evacuation (AE), which is not well-developed in many less-developed countries, becomes increasingly important in preserving function and saving lives during disasters. Our primary goal was to describe and analyze the age, specialty, the relevant training or operational experience, attitude toward professional training, and main difficulties during aeromedical evacuation in critical care AE staff after the 2010 Yushu earthquake in China. ⋯ The results of the study supported the urgent requirement for building a professional critical care AE unit with well-equipped medical staff and facilities, and for founding a formal critical care training program in AE.
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Aviat Space Envir Md · Apr 2012
Crew resource management: using aviation techniques to improve operating room safety.
Since the publication of the Institute of Medicine report estimating nearly 100,000 deaths per year from medical errors, hospitals and physicians have a renewed focus upon error reduction. We implemented a surgical crew resource management (CRM) program for all operating room (OR) personnel. ⋯ CRM training and implementation had an impact on reducing the incidence of wrong site surgery and retained foreign bodies in our operating rooms. However, constant reinforcement and refresher training is necessary for sustained results. Though no one technique can prevent all errors, CRM can effect culture change, producing a safer environment.
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This study examined the hypothesis that women exhibit smaller vasoconstrictor responses in the calf during graded lower body negative pressure (LBNP). ⋯ The greater slopes in oxygenated Hb at given blood pooling and at each negative pressure in male subjects led us to conclude that men had greater vasoconstrictor responses in the calf during graded LBNP.