Aviat Space Envir Md
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In 1989, a Boeing 737-400 aircraft crashed at Kegworth, near Nottingham, England. The survivors suffered a large number of pelvic and lower limb injuries, and approximately one-third of the passengers died. Subsequent research has suggested that the "brace-for-impact" position that passengers are advised to adopt prior to a crash landing might be modified in order to reduce the incidence of such injuries. The aim of this research was to evaluate biomechanically such a modified crash brace position. ⋯ A modified brace position would involve passengers sitting with the upper torso inclined forward so that the passenger's head rested against the structure in front, if possible. The legs would be positioned with the feet resting on the floor in a position slightly behind the knee. The position differs from those previously recommended in that the feet are positioned behind the knee. This study suggests that such a position would reduce the potential for head and lower limb injury in some passengers, given that only a single seat type and single size of occupant have been evaluated. Standardization to such a position would improve passenger understanding and compliance. Such a recommendation should not obscure the fact that an occupant seated in a forward-facing aircraft seat, restrained only by a lap belt, is exposed to considerable forces during an impact accident. Such forces are capable of producing injuries in the femur, pelvis, and lumbar spine.
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Aviat Space Envir Md · Oct 1998
Pilots with missing fingers and/or foot components: contemporary certification.
When an applicant with amputations presents to the Aviation Medical Examiner (AME) for Federal Aviation Administration (FAA) medical certification several potential "gates" must be passed. The first gate is the AME's impression of the applicant's reaction and adaptation to the loss. ⋯ Others may need to progress through the second gate. A few applicants will be unable to transit the gates and will not become certified.
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Aviat Space Envir Md · Sep 1998
Randomized Controlled Trial Comparative Study Clinical TrialAcetazolamide plus low-dose dexamethasone is better than acetazolamide alone to ameliorate symptoms of acute mountain sickness.
In a double-blind study, we compared the efficacy of a combination of sustained-release acetazolamide and low-dose dexamethasone and acetazolamide alone for prophylaxis against acute mountain sickness (AMS) caused by rapid ascent to high altitude. Before ascent, 13 subjects were randomly assigned to receive a combination of one sustained-release acetazolamide capsule (500 mg) in the afternoon and 4 mg dexamethasone every 12 h, or a combination of the same dose of acetazolamide once daily and a placebo every 12 h. Days 1 and 2 were spent at 3698 m (La Paz, Bolivia), while days 3 and 4 were spent at 5334 m (Mount Chaclataya, Bolivia). Ascent was by 2 h motor vehicle ride. Heart rates, peripheral oxygen saturations and a modified score derived from the Environmental Symptom Questionnaire (modified-ESQ) were measured on each day. In addition, weighted averages of the cerebral (AMS-C) and respiratory (AMS-R) symptoms were calculated for days 3 and 4. ⋯ We conclude that this combination of sustained-release acetazolamide once daily and low-dose dexamethasone twice daily is more effective in ameliorating the symptoms of AMS than azetazolamide alone at the ascent that was studied.
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Exercise performance data of numerous altitude research studies and competitive sporting events of the last four decades are reviewed. ⋯ By assessing the performance of elite athletes, who are performing at an "all-out" effort in precisely timed events for which they are trained, it is determined that: a) the magnitude of submaximal exercise impairment is proportional to both the elevation and exercise duration at a given altitude; and b) submaximal exercise performance at altitude can improve with continued exposure without an increase in VO2max. Muscle strength, maximal muscle power, and anaerobic performance at altitude are not affected as long as muscle mass is maintained. In addition, performance is not impaired in athletic activities that have a minimal aerobic component and can be performed at high velocity (e.g., sprints).
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An experiment on the relationship between aeromedical color vision screening test performance and performance on color-dependent tasks of Air Traffic Control Specialists (ATCS) was replicated to expand the database supporting the job-related validity of 13 FAA-accepted screening tests. ⋯ The aeromedical screening tests were generally acceptable in terms of selecting individuals who did not make errors on ATCS color tests, but several tests had high false alarm rates. High job-related validity, in the vicinity of 0.90, was confirmed for several aeromedical color vision tests used for ATCS screening.