Aviat Space Envir Md
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Hypobaric hypoxia during commercial air travel has the potential to cause or worsen hypoxemia in individuals with pre-existing cardiopulmonary compromise. Knowledge of cabin altitude pressures aboard contemporary flights is essential to counseling patients accurately about flying safety. The objective of the study was to measure peak cabin altitudes during U.S. domestic commercial flights on a variety of aircraft. ⋯ Peak cabin altitude on commercial aircraft flights has risen over time. Cabin altitude is lower with flights of shorter distance. Physicians should take these factors into account when determining an individual's need for supplemental oxygen during commercial air travel.
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The goal of this study was to investigate the contribution of splanchnic volume redistribution and lower limb vasoconstriction in the maintenance of blood pressure during progressive central hypovolemia induced by graded lower body negative pressure (LBNP). It was hypothesized that splanchnic blood volume loss during LBNP would buffer decreases in thoracic blood volume. ⋯ Our results suggest that splanchnic blood volume redistribution--rather than leg vasoconstriction--plays an important role in blood pressure regulation during central hypovolemia.
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Aviat Space Envir Md · Nov 2012
Clothing buoyancy and underwater horizontal swim distance after exiting a submersed vehicle simulator.
Winter road workers, who drive heavy vehicles over ice-covered waterways, are at risk for ice failure, vehicle submersion, and subsequent drowning in frigid water. Although some jurisdictions require these workers to wear flotation clothing, there are concerns that, following an underwater exit in fast-moving water, increased clothing buoyancy may reduce ability to swim against the current to safely return to the ice opening. ⋯ Flotation clothing (either Jackets or Overalls) is recommended for vehicle travel on ice because they do not impede underwater exit from a vehicle and allow significant horizontal underwater swim distance. An inflatable vest is not recommended because inappropriate premature inflation could increase exit impedance and decreased underwater swim distance.
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Aviat Space Envir Md · Nov 2012
ReviewAcute neurological symptoms during hypobaric exposure: consider cerebral air embolism.
Cerebral arterial gas embolism (CAGE) is well known as a complication of invasive medical procedures and as a risk in diving and submarine escape. In the underwater environment, CAGE is caused by trapped air, which expands and leads to lung vessel rupture when ambient pressure decreases during ascent. Pressure decrease also occurs during hypobaric activities such as flying and, therefore, CAGE may theoretically be a risk in hypobaric exposure. ⋯ We recommend considering CAGE in all patients presenting with acute central neurological injury during or shortly after pressure decrease such as flying. A CT scan of head and chest should be performed in these patients. Treatment with hyperbaric oxygen therapy should be initiated as soon as possible in cases of proven or probable CAGE.
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Aviat Space Envir Md · Oct 2012
Education and experience of Army flight medics in Iraq and Afghanistan.
Adequate training levels and an appropriate amount of continuing education for Army flight medics (AFM) is a highly contested topic. We sought to obtain a cross-section of the education, experience, and time spent by flight medics on patient care before and in between deployments. We also sought the opinions of AFM regarding training, transport staffing, and medical oversight. ⋯ Results from this study seem to indicate AFM feel their training and patient contact is too limited prior to and in between deployments. These findings support a need for the reassessment of initial and ongoing training standards for AFM in order to best take care of our sick and wounded service members.