Aviat Space Envir Md
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Aviat Space Envir Md · Dec 1989
Response capability during civil air carrier inflight medical emergencies.
Expanded civil aircraft medical emergency kits have been mandated on U. S. carriers since August 1986. Airlines provided the Federal Aviation Agency reports on medical kit usage and outcomes of the associated medical emergencies; 1,016 inflight medical events during the period August 1, 1986, through July 31, 1987, were available for review. ⋯ A minimum of 89 of the total cases resulted in flight diversions. The sphygmomanometer (739 cases) and stethoscope (734 cases) were the most frequently used kit items; oropharyngeal airways were utilized in 14 cases. Since standardized reporting formats are not required, evaluation of response capability remains incomplete.
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Aviat Space Envir Md · Oct 1989
Helicopter wire strike accident and high voltage electrocution: a case report.
Helicopter wire-strike accidents usually involve high-voltage lines or telephone wires where the resulting impact is low velocity with minimal loss of occupiable space. Death and injury in these mishaps is often due to blunt force trauma to the head. In a recent wire strike accident investigated by the Division of Aerospace Pathology at The Armed Forces Institute of Pathology, the circumstances suggest that death of both aviators was due to high-voltage electrocution. Evidence surrounding the case and high-voltage electrocution are discussed.
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Aviat Space Envir Md · Oct 1989
Touching the cornea enhances pharmacologic dilation of the pupil, mainly in the dark iris.
Adequate pupillary dilation is often difficult to achieve in darkly pigmented persons when using standard dilating drops. To quantify the degree to which mild corneal disruption could enhance this dilation, we touched the cornea of one eye and then placed dilating drops in both eyes of darkly pigmented and lightly pigmented subjects. ⋯ The mean difference in pupil diameter between the touched and the control eye at 30 min was six-fold greater in darkly pigmented, compared to lightly pigmented, subjects. Touching the cornea by the method described herein appears to be a safe, useful technique for routinely enhancing pharmacologic dilation of the pupil in persons who have dark irises.
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Aviat Space Envir Md · Jan 1989
Clinical Trial Controlled Clinical TrialHeat exchange through cutaneous vasodilation after atropine treatment in a cool environment.
This report summarizes a tightly controlled laboratory study in which the thermoregulatory effects of an intramuscular injection of atropine sulfate (2 mg) were compared with a placebo injection of sterile saline during exposure to a cool environment. Four subjects were tested during seated cycle exercise at a moderate exercise intensity (55% Vo2 peak) at an ambient temperature of 22 degrees C (37% relative humidity; ambient water vapor pressure 1.0 kPa). Esophageal temperature (Tes), mean weighted skin temperature (Tsk), and forearm sweating rate (ms) were continuously measured during 30 min of rest and 35 min of exercise. ⋯ By 25 min of exercise. FBF was 98% (p less than 0.05) greater after atropine treatment. These results show that the peripheral modification of cutaneous blood flow which occurs in atropine-treated subjects is sufficient to markedly alter heat exchange in a cool environment.
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This study reviews the outcome of 17 hypothermic patients air evacuated by a civilian helicopter transport service. Age (33 +/- 23), type and duration of exposure, and rewarm methods were examined for each patient. Temperature (T), heart rate (HR), blood pressure (BP), respiratory rate (RR), Glasgow coma score (GCS), trauma score (TS), CRAMS score (CS), and cardiac rhythm in the pre-hospital setting and in the emergency department (ED) were compared to outcome. ⋯ All patients were effectively rewarmed without incident. All patient disabilities and the single fatality were not directly related to hypothermia. There were no long-term adverse consequences of helicopter transport in these hypothermic patients.