Aviat Space Envir Md
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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.
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Aviat Space Envir Md · Sep 1992
Anesthesia crisis resource management training: teaching anesthesiologists to handle critical incidents.
The authors have developed a course in Anesthesia Crisis Resource Management (ACRM) analogous to courses in Crew (Cock-pit) Resource Management (CRM) conducted in commercial and military aviation. Anesthesiologists do not typically receive formal training in crisis management although they are called upon to manage life-threatening crises at a moment's notice. Two model demonstration courses in ACRM were conducted using a realistic anesthesia simulation system to test the feasibility and acceptance of this kind of training. ⋯ Scores on written tests of knowledge about anesthesia crisis management showed a significant improvement following the first course (residents) but not the second course (experienced anesthesiologists). Although the ultimate utility of this training for anesthesiologists cannot easily be determined, the course appeared to be a useful method for addressing important issues of anesthesiologist performance which have previously been dealt with haphazardly. The authors believe that ACRM training should become a regular part of the initial and continuing education of anesthesiologists.
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Aviat Space Envir Md · Aug 1992
Comparative StudyTreatment of acute diarrhea with norfloxacin during Desert Storm deployment.
A retrospective study on the treatment of diarrhea in a U. S. Air Force Wing deployed to Egypt during Operation Desert Storm was conducted. ⋯ The group treated with norfloxacin was noted to become asymptomatic in one-fourth the time of the group treated conservatively. This was highly significant, statistically, and in practice. It is recommended that diarrhea be treated aggressively during deployments to third world countries.
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During the 22-year period from 1 January 1969 to 31 December 1990, there were 205 reported cases of loss of cabin pressure in US Naval aircraft; 21 were crew-initiated and 184 were deemed accidental. The ambient altitudes varied from 10,000 ft (3048 m) to 40,000 ft. (12192 m). The most common reason for crew-initiated decompression was to clear smoke and fumes from the cockpit/cabin (95%). ⋯ Three aviators lost their lives following ejection and seven aircraft were lost. While the incidence of loss of cabin pressure in Naval aircraft appears low, it none-the-less presents a definite risk to the aircrew. Lectures on the loss of cabin/cockpit pressurization should continue during indoctrination and refresher physiology training.