Flight Medicine

[erdocdd]

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Anyone know of any good texts about the physiology, treatments of patients on fixed wing aircraft or such?

 

[willow18]

Would it be much different than regular care? Commercial, fixed-wing aircraft are usualy pressurized to about 6-8000 feet in altitude, which is somewhat higher than Denver. I doubt physiology, other than a mild drop in PaO2 easily fixed with a nasal cannula, changes that much otherwise. Limitations are obviously the equipment you have on-board.

 

[erdocdd]

30,000 flight

 

[willow18]

30,000 flight

As in the aircraft will be pressurized to 30,000 feet, or you'll be flying at 30,000? Doesn't matter what altitude you're flying at; cabin pressure determines changes in physiology.

Edit: okay, what you're looking for is essentially a transport/critical care transport textbook for physicians; other than this book on amazon whose author has a million abbreviations after her name (RN PhD CEN CCRN CFRN CTRN FAEN - wtf?) and whose book seems to be written for medics and such, I couldn't find anything after a cursory search. The reason is probably because actual medicine is the same at 30,000 feet or whatever (as long as cabin pressure...as above); a textbook on management/directing a medical transport wing might be useful for you though.

 

[diphenyl]

Jane Doe CNA LPN RN PHD CEN CRNA ROTFL LMAO WTF

 

[Stitch]

Jane Doe CNA LPN RN PHD CEN CRNA ROTFL LMAO WTF

I've never understood the nursing obsession with including EVERY possible degree after their name.

 

[southerndoc]

I've never understood the nursing obsession with including EVERY possible degree after their name.

They can get a little carried away when they list ACLS, etc. However, CEN is definitely a certification they should list. It's no different than ACEP fellows listing FACEP.

 

[Jlaw]

As in the aircraft will be pressurized to 30,000 feet, or you'll be flying at 30,000?

hahaha if the aircraft is pressured to 30k feet then medicine won't matter because you and the patient will both be unconcious within a minute and dead shortly thereafter!

 

[J-Rad]

http://www.amazon.com/Fundamentals-Aerospace-Medicine-Roy-DeHart/dp/0781728983
Alternatively see if you can get your hands on the flight surgeon handbook from the AF which is likely to be more abbreviated (you used to be able to buy a copy on CD from the museum gift shop on Brooks City Base in SA, so it's not secret material or anything).
Here's a link to the Navy's version of the same:
http://www.operationalmedicine.org/TextbookFiles/FlightSurgeonsManual.pdf

hahaha if the aircraft is pressured to 30k feet then medicine won't matter because you and the patient will both be unconcious within a minute and dead shortly thereafter!

HALO jumpers can jump from this elevation, so, obviously, flight at this altitude does happen (with supplemental O2 delivery). And the physiology is relevant. That's why in the Air Force there is an entire career field of "aerospace physiologists".

 

[Apollyon]

HALO jumpers can jump from this elevation, so, obviously, flight at this altitude does happen (with supplemental O2 delivery). And the physiology is relevant. That's why in the Air Force there is an entire career field of "aerospace physiologists".

"Supplemental O2 delivery" is the key. If the HALO jumper does NOT have on supplemental O2, yep, there it is - unconscious in a minute, and dead soon after. At angels 30, there is still enough atmosphere to prevent almost all of the nasty things that occur in space (like decompression). Jlaw is right - look at Payne Stewart.

 

[J-Rad]

"...Jlaw is right...

Maybe just arguing semantics but:
"hahaha if the aircraft is pressured to 30k feet then medicine won't matter..."

At 30,000 feet I couldn't imagine the medicine (or the physiology) mattering more 😉

 

[Apollyon]

Maybe just arguing semantics but:
"hahaha if the aircraft is pressured to 30k feet then medicine won't matter..."

At 30,000 feet I couldn't imagine the medicine (or the physiology) mattering more 😉

For about 30 seconds, then it's Margaritaville!

 

[willow18]

The OP is asking about Transport Medicine, not aerospace medicine.

Anyway, since we're talking about it, here's a scary, scary example of what altitude hypoxia does to you. These pilots were extremely lucky. Notice the contrast in mental status and speech signs between the same pilots at the beginning when they're around 30k then when they descend...amazing stuff! And kudos to the controllers who realized it. This should be mandatory for all controller trainees to listen to.

[YOUTUBE]http://www.youtube.com/watch?v=_IqWal_EmBg[/YOUTUBE]

 

[Stitch]

Maybe just arguing semantics but:
"hahaha if the aircraft is pressured to 30k feet then medicine won't matter..."

At 30,000 feet I couldn't imagine the medicine (or the physiology) mattering more 😉

Mt Everest is just over 29,000 feet, and there are a number of climbers who have made the summit without oxygen. Ed Visteurs has done it 9 times or so. 😱 Of course, he spends a LOT of time at elevation. I wonder what his Hgb is? High altitude physio is awesome.

 

[J-Rad]

In between 1st and 2nd year MS I went to a course on Brooks trying to convince us all to become flight surgeons. One of the things we did was go into an altitude chamber to demonstrate the effects of high altitude hypoxia. It was interesting.

And while the OP wasn't about aerospace medicine per se, aerospace med is going to deal with air transport issues, so it seemed relevant.

 

[theman1990]

Altitude chambers are fun!! Reveals everyones TRUE inner self....lol

And willow18, EXCELLENT video you posted up! Hypoxia is a killer!