Aviat Space Envir Md
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Aviat Space Envir Md · Feb 1993
The effects of brace position on injuries sustained in the M1 Boeing 737/400 disaster, January 1989. NLDB Study Group.
Of the initial 87 survivors of the East Midlands Boeing 737/400 aircraft, 77 sustained head and facial trauma during the crash, 45 of whom were rendered unconscious. There were 21 who received injuries to the back of their head, including 5 of the 6 severely head-injured adults. Those passengers who adopted the fully flexed "brace" position for crash-landing achieved significant protection against head injury, concussion, and injuries from behind irrespective of local aircraft structural damage. ⋯ W. Structures, Ltd.) using the predicted crash pulse of the accident has validated these clinical findings and allows theoretical biomechanical modeling for the design of occupant protection systems in the future. Although the major role of structural failure should not be forgotten, bracing maximizes the chance of uninjured survival in the current generation of aircraft and should be demonstrated and practiced as a pre-flight routine.
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Diazepam is known to decrease organophosphate nerve agent-induced convulsions, neuropathology, and lethality in rhesus monkeys. We report that, when added to the previously fielded treatment regimen (pyridostigmine, atropine, and pralidoxime chloride), diazepam significantly protects the performance of rhesus monkeys trained in an equilibrium task, the Primate Equilibrium Platform (PEP), against deficits induced by the nerve-agent soman. If administered soon enough to minimize the occurrence of convulsions, diazepam should increase the probability of mission accomplishment and eventual complete recovery from nerve agent poisoning. Diazepam was fielded by the United States military services during Operations Desert Shield and Storm for the treatment of possible organophosphate toxicity.
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Aviat Space Envir Md · Dec 1992
Randomized Controlled Trial Comparative Study Clinical TrialLimited heat transfer between thermal compartments during rewarming in vasoconstricted patients.
Thermoregulatory vasoconstriction may serve to separate and limit heat transfer between peripheral and central thermal compartments, in effect providing a thermal buffer for central temperature. We hypothesized that thermoregulatory vasoconstriction would limit heat transfer to the central compartment in patients warmed cutaneously. Hypothermic patients (central temperatures < 35 degrees C) recovering from surgery were randomly assigned to receive forced-air warming (n = 6) or warmed cotton blankets (n = 6). ⋯ Despite a significantly greater increase in mean skin-surface temperature with forced-air warming, central temperature in the two groups did not significantly differ. All patients vasoconstricted and there was no difference in oxygen consumption between groups. These data confirm that thermoregulatory vasoconstriction limits heat transfer from peripheral to central thermal compartments and impedes skin surface warming of the body core.
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Aviat Space Envir Md · Dec 1992
Comparative StudyComparison of four noninvasive rewarming methods for mild hypothermia.
Four noninvasive rewarming techniques for mildly hypothermic subjects were compared. Seven subjects were cooled in a water bath of 15 degrees C for 2 h to an average esophageal temperature (Tes) of 36 degrees C. Thereafter, the subjects were rewarmed by immersion of the body in a water bath of 42 degrees C (Method 1), the body but not the extremities in water of 42 degrees C (Method 2), only the extremities in water of 42 degrees C (Method 3), or spontaneous rewarming in blankets (Method 4). ⋯ The afterdrop and rewarming rate were 0.38 degrees C and 0.8 degrees C/h, respectively. Method 4 had the lowest rewarming rate (0.2 degrees C/h), and an afterdrop (0.14 degrees C) which was not significantly lower than that of Method 1 or 2. Therefore, Method 1 is recommended for rewarming mild hypothermic subjects because of its high rewarming rate and small afterdrop.
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Aviat Space Envir Md · Nov 1992
Case ReportsHyperbaric oxygen treatment for carbon monoxide poisoning in pregnancy: a case report.
Carbon monoxide (CO) poisoning is one of the most common forms of poisoning in the United States. When CO poisoning occurs in the pregnant patient, it is extremely toxic to the mother and fetus in terms of central nervous system disorders and delayed central nervous system sequelae. Controversy exists in treating the pregnant patient with hyperbaric oxygen (HBO) because of the unknown effects of high partial pressures of oxygen on the fetus. ⋯ Third, HBO may reduce lipid peroxidation which may be responsible for neurological deterioration and delayed central nervous system sequelae. Fourth, decreased CO influence through HBO may reduce changes in the myocardium as a result of CO poisoning, if cardiovascular disease is already present. A case study of successful HBO therapy used during pregnancy is presented and effects of CO on the fetus are discussed.