Aviat Space Envir Md
-
In recent years, there have been increasing complaints from cockpit crew, cabin crew, and passengers that the cabin air quality of commercial aircraft is deficient. A myriad of complaints including headache, fatigue, fever, and respiratory difficulties among many others have been registered, particularly by flight attendants on long-haul routes. ⋯ This paper will review some aspects relevant to cabin air quality such as volatile organic compounds (VOCs), carbon dioxide (CO2), carbon monoxide (CO), ozone (O3), particulates, and microorganisms, as well as the cabin ventilation system, to discern possible causes and effects of illness contracted inflight. The paper will conclude with recommendations on how the issue of cabin air quality may be resolved.
-
Aviat Space Envir Md · Feb 2002
Review Case ReportsPulmonary barotrauma-induced cerebral arterial gas embolism with spontaneous recovery: commentary on the rationale for therapeutic compression.
Pulmonary barotrauma-induced cerebral arterial gas embolism (CAGE) continues to complicate compressed gas diving activities. Inadequate lung ventilation secondary to inadvertent breath holding or rapid buoyant ascent can quickly generate a critical state of lung over-pressure. Pulmonary over-pressurization may also occur as a consequence of acute and chronic pulmonary pathologies. ⋯ Prediction of who will relapse is not possible, and any such relapse is of ominous prognostic significance. It is advisable, therefore, that CAGE patients who undergo spontaneous recovery be promptly recompressed while breathing oxygen. Therapeutic compression will serve to antagonize leukocyte-mediated ischemia-reperfusion injury; limit potential re-embolization of brain blood flow, secondary to further leakage from the original pulmonary lesion or recirculation of gas from the initial occlusive event; protect against embolic injury to other organs; aid in the resolution of component cerebral edema; reduce the likelihood of late brain infarction reported in patients who have undergone spontaneous clinical recovery; and prophylax against decompression sickness in high gas loading dives that precede accelerated ascents and omitted stage decompression.
-
Aviat Space Envir Md · Jul 2001
ReviewU.S. Army MEDEVAC in the new millennium: a medical perspective.
The U. S. ⋯ These proposed changes are discussed in detail, from the perspective of current emergency medicine and aviation medicine standards of practice. If instituted, these changes would facilitate the emergence of a true air medical transport capability comparable with the civilian community standard.
-
Aviat Space Envir Md · Jul 2000
ReviewCold stress, near drowning and accidental hypothermia: a review.
This paper reviews literature on the topic of cold stress, near-drowning and hypothermia, written mainly since the last review of this type in this journal. The main effects of cold stress, especially in cold water immersion, include the "cold shock" response, local cooling causing decrements in physical and mental performance, and ultimately core cooling as hypothermia occurs. The section on cold-water submersion (near-drowning) includes discussion regarding the various mechanisms for brain and body cooling during submersion. ⋯ The section on the post-cooling period includes the post-rescue collapse and subsequent rewarming strategies used in the field, during emergency transport or in medical facilities. Recent research on topics such as inhalation warming, body-to-body warming, radio wave therapy, warm water immersion, exercise, body cavity lavage, and cardiopulmonary bypass is reviewed. Information on new methods of warming, including arteriovenous anastomoses (AVA) warming (by application of heat- with or without negative pressure application-to distal extremities in an effort to increase AVA blood flow), forced-air warming, and peripheral vascular extracorporeal warming, are discussed.
-
Aviat Space Envir Md · Aug 1999
ReviewThe non-invasive assessment of stroke volume and cardiac output by impedance cardiography: a review.
Impedance cardiography (IC) is an inexpensive, reliable and noninvasive technique for determining stroke volume (SV) and cardiac output (CO). It relies on the measurement of phasic changes in transthoracic electrical resistivity, related to ejection of blood into the ascending aorta with each heart beat. Because of its non-invasive nature, IC is becoming increasingly used in clinical settings, as well as in many areas of physiological research. ⋯ The question of accuracy of IC in terms of absolute values of SV and CO remains to be determined. The methodological limitations, accuracy, reliability and reproducibility of IC are examined, as are some of the methods developed to improve these aspects of the technique. The application and utility of IC in aerospace medicine research is also addressed.