Aviat Space Envir Md
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Aviat Space Envir Md · Jun 1999
Case ReportsHyperbaric chamber-related decompression illness in a patient with asymptomatic pulmonary sarcoidosis.
An asymptomatic 46-yr-old male sustained an acute neurologic insult, appearing during the decompression phase of a 50-m dry hyperbaric chamber dive. The right hemisyndrome was most probably related to diving, since symptoms responded rapidly to the early commenced recompression therapy. ⋯ This case may illustrate a potential risk of decompression illness even during dry chamber dives in patients suffering from asymptomatic pleuro-parenchymal pulmonary disease. The value of chest X-ray in the medical assessment of fitness to dive is therefore emphasized.
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General aviation accounts for the majority of aviation crashes and casualties in the United States, and general aviation safety has not improved in the past decade. ⋯ The most important correlates of pilot fatality are variables likely related to increased impact forces. Better occupant protection equipment, such as air bag and crashworthy fuel system, are needed for general aviation aircraft.
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Aviat Space Envir Md · Apr 1999
Testing of the AVL OPTI 1 portable blood gas analyzer during inflight conditions.
The "AVL OPTI 1" (AVL Medical Instruments, Saint-Ouen l'Aumone, France), a completely automated portable blood gas analyzer, was chosen because of its accuracy under usual sea-level conditions and because of its new technology which broadens the possibilities for in-flight blood determinations: a) a single use cassette made of plexyglass containing the measurement chamber and the aligned sensors required for pO2, pcO2 and pH determination; b) calibration coefficients memorized in a bar code label fixed on the packing material; c) a quality control of each individual cassette prior to the measurement and at least once a day by two standard reference cassettes simulating high and low levels of pH, pcO2 and pO2; and d) a fully automatic introduction of the blood sample. The complete analytical cycle requires about 3 min with a sample volume of 80 microL of whole blood. After the measurement, the cassette containing blood sample is destroyed. ⋯ The pressure value given by the AVL OPTI 1 was controlled before the experiment began and during the different depression levels. Barometric pressure results showed: a) concordance of pressure values with those of ground instrumentation; b) stable response; and c) absence of hysteresis. We conclude that the performance of the AVL OPTI 1 is satisfactory during inflight conditions.
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Vibroacoustic disease (VAD) is an insidious environmental entity caused by occupational exposure to large pressure amplitude and low frequency (LPALF) noise (> or = 90 dB SPL, < or = 500 Hz). Significant disabilities may result, and issues of worker's compensation should be openly discussed and settled. Toward this goal, a rigorous review of all available information on this disease was undertaken in order to document the need to define industrial exposure standards, and to settle on the diagnostic procedures that will help distinguish the VAD from other, similar conditions. ⋯ These findings appear to be pathognomonic for the VAD, and the echocardiogram has been confirmed as a fundamental diagnostic tool. The degree of disability due to VAD can be determined from Portuguese national disability tables, which cover almost all of the VAD-induced disabilities. However, these tables do not specify LPALF noise as an occupational hazard, rendering them inapplicable to VAD patients. Also, suicide, a most serious psychiatric consequence, is not covered by these tables. Such situations highlight the absolute necessity to recognize LPALF noise as the cause of VAD, and as an industrial hazard.
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A retrospective study was performed of 10 yr of medical records to determine the type, severity, etiological factors and treatment of cold injury experienced by members of the British Antarctic Survey between 1986-95. ⋯ Cold injury is uncommon in Antarctica. Despite this, it warrants a continued high profile as under most circumstances it may be regarded as an entirely preventable occurrence.