Aviat Space Envir Md
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Aviat Space Envir Md · Apr 2009
Focused ultrasound: concept for automated transcutaneous control of hemorrhage in austere settings.
High intensity focused ultrasound (HIFU) is being developed for a range of clinical applications. Of particular interest to NASA and the military is the use of HIFU for traumatic injuries because HIFU has the unique ability to transcutaneously stop bleeding. Automation of this technology would make possible its use in remote, austere settings by personnel not specialized in medical ultrasound. Here a system to automatically detect and target bleeding is tested and reported. ⋯ An automated system to detect and target simulated bleeding has been built and tested. The system could be combined with existing algorithms to detect, target, and treat clinical bleeding.
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Aviat Space Envir Md · Apr 2009
Case ReportsAED use in a passenger during a long-haul flight: repeated defibrillation with a successful outcome.
Sudden cardiac arrest is one of the leading causes of death, and early defibrillation of ventricular fibrillation (VF) is the single most important intervention for improving survival. The automated external defibrillator (AED) and the concept of public access defibrillation provide a solution to shorten defibrillation delays. Commercial aircraft create a unique environment for the use of the AED since an emergency medical service system (EMS) response is not available. We review published studies on this subject and describe the case of a passenger who developed VF during an intercontinental flight and was successfully resuscitated despite recurrent episodes of VF. ⋯ There are three large studies reporting placing AEDs on commercial aircraft. No harm for co-passengers or malfunctions were reported. Survival rates have been higher than those obtained by well-performing EMS. According to previous studies, placing AEDs on commercial aircraft is also cost effective. The absence of a suitable diversion destination should not influence the rescuers' decision to attempt CPR on board.
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Aviat Space Envir Md · Feb 2009
Review Comparative StudyCivil aviation rules on crew flight time, flight duty, and rest: comparison of 10 ICAO member states.
Members of the International Civil Aviation Organization (ICAO) use various criteria to control flight crew scheduling and rest periods with the intention of reducing fatigue and thus improving airline safety. Comparison of these rules across nations may allow future harmonization of the criteria. ⋯ Although the 10 states in this study have common aims and premises for regulating crew duty, their regulations diverge with respect to details, using different tools in an effort to prevent the occurrence of excessive fatigue in aircrew members.
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Aviat Space Envir Md · Feb 2009
Resting and exercise response to altitude in patients with chronic obstructive pulmonary disease.
Exposure to altitude invariably involves some form of physical activity. There are limited data available to help predict the response to activity at altitude in patients with chronic obstructive pulmonary disease (COPD). The aim of the present study was to investigate the response to acute altitude exposure at rest and during exercise in patients with COPD. ⋯ Baseline arterial oxygen levels and K(CO) are key measures in predicting the hypoxemic response to acute altitude exposure in patients with COPD. The impairment in gas exchange associated with COPD is a significant mechanism causing altitude-related hypoxemia in this group.