Aerospace medicine and human performance
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Aerosp Med Hum Perform · Aug 2017
Case ReportsSustained Accelerated Idioventricular Rhythm in a Centrifuge-Simulated Suborbital Spaceflight.
Hypergravitational exposures during human centrifugation are known to provoke dysrhythmias, including sinus dysrhythmias/tachycardias, premature atrial/ventricular contractions, and even atrial fibrillations or flutter patterns. However, events are generally short-lived and resolve rapidly after cessation of acceleration. This case report describes a prolonged ectopic ventricular rhythm in response to high G exposure. ⋯ While prolonged, the dysrhythmia was asymptomatic and self-limited. AIVR is likely a physiological response to acceleration and can be managed conservatively. Vigilance is needed to ensure that AIVR is correctly distinguished from other, malignant rhythms to avoid inappropriate treatment and negative operational impacts.Suresh R, Blue RS, Mathers C, Castleberry TL, Vanderploeg JM. Sustained accelerated idioventricular rhythm in a centrifuge-simulated suborbital spaceflight. Aerosp Med Hum Perform. 2017; 88(8):789-793.
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Aerosp Med Hum Perform · Aug 2017
Observational StudyExperiences with Regional Anesthesia for Analgesia During Prolonged Aeromedical Evacuation.
There is much debate regarding the appropriate analgesic management of patients undergoing medical evacuation following combat trauma. Our primary objective was to review the utility of regional anesthetic techniques in patients undergoing aeromedical evacuation following surgical limb amputation as treatment for combat trauma. ⋯ Our analysis demonstrates the feasibility and effectiveness of applying regional anesthetic techniques for pain management to our combat wounded trauma patients throughout multiple stages of aeromedical evacuation. Benefits include the potential for less sedation and less opioid consumption while potentially foregoing the requirement for intubation during transport.Carness JM, Wilson MA, Lenart MJ, Smith DE, Dukes SF. Experiences with regional anesthesia for analgesia during prolonged aeromedical evacuation. Aerosp Med Hum Perform. 2017; 88(8):768-772.
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Aerosp Med Hum Perform · Jul 2017
The Effects of Training on Anxiety and Task Performance in Simulated Suborbital Spaceflight.
In commercial spaceflight, anxiety could become mission-impacting, causing negative experiences or endangering the flight itself. We studied layperson response to four varied-length training programs (ranging from 1 h-2 d of preparation) prior to centrifuge simulation of launch and re-entry acceleration profiles expected during suborbital spaceflight. We examined subject task execution, evaluating performance in high-stress conditions. We sought to identify any trends in demographics, hemodynamics, or similar factors in subjects with the highest anxiety or poorest tolerance of the experience. ⋯ Training programs appear best when high fidelity and sequential exposures may improve tolerance of physical/psychological flight stressors. The studied variables did not predict anxiety-related responses to these centrifuge profiles.Blue RS, Bonato F, Seaton K, Bubka A, Vardiman JL, Mathers C, Castleberry TL, Vanderploeg JM. The effects of training on anxiety and task performance in simulated suborbital spaceflight. Aerosp Med Hum Perform. 2017; 88(7):641-650.
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Aerosp Med Hum Perform · Jun 2017
Sunlight Exposure, Work Hours, Caffeine Consumption, and Sleep Duration in the Naval Environment.
Sailors in the U.S. Navy are habitual shiftworkers, often experiencing circadian misalignment due to their irregular work/rest schedules. This study assessed the effect of sunlight exposure, work hours, and caffeinated beverage consumption on the daily sleep duration of crewmembers of a U.S. Navy ship during a 2-wk underway period. ⋯ Exposure to sunlight, work hours, and consumption of caffeinated beverages are important factors when planning watchstanding schedules at sea. Even though further research is needed, our results suggest that even brief exposure to sunlight may contribute to circadian misalignment that negatively affects sleep in the operational environment. Educating crewmembers about sleep hygiene, especially the important roles played by sunlight and caffeine, could potentially improve the sleep and fatigue levels of this population of maritime shiftworkers.Shattuck NL, Matsangas P. Sunlight exposure, work hours, caffeine consumption, and sleep duration in the naval environment. Aerosp Med Hum Perform. 2017; 88(6):579-585.
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Aerosp Med Hum Perform · May 2017
ReviewTransferring Aviation Practices into Clinical Medicine for the Promotion of High Reliability.
Aviation is a classic example of a high reliability organization (HRO)-an organization in which catastrophic events are expected to occur without control measures. As health care systems transition toward high reliability, aviation practices are increasingly transferred for clinical implementation. ⋯ The adoption of aviation practices into clinical medicine facilitates an evolution toward high reliability. Evidence for the efficacy of the checklist and crew resource-management training is robust. Transference of aviation accident investigation practices is preliminary. A standardized, independent investigation process could facilitate the development of a safety culture commensurate with that achieved in the aviation industry.Powell-Dunford N, McPherson MK, Pina JS, Gaydos SJ. Transferring aviation practices into clinical medicine for the promotion of high reliability. Aerosp Med Hum Perform. 2017; 88(5):487-491.