PubMed · 9450708
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V Vlassov. 1998-01-28. Pulmonary function in space.. https://doi.org/10.1001/jama.279.4.275
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PURPOSE: This study was an effort to identify the botanical preparations of potential risk to the aviator and aviation safety, and to ascertain whether aviators are using dietary supplements despite extensive educational efforts discouraging over-the-counter medication use. Herbal preparations may be used by nearly 20% of the adult population. Although the aviator population may be presumed to use them as well, the actual degree of use among aviators is unknown. Use of such substances as health promotion or therapeutic agents may provide health benefits, but may also carry risk. Military and civilian aviators are not currently required to disclose such use, nor are examiners obligated to inquire or counsel aviators about them. This paper examines the trends in post-mortem toxicological samples suggesting botanical preparation use, and develops a rational method for determining suitability for use by the aviator. METHOD: The toxicological test results from 3177 mishap pilots performed at the Civil Aeromedical Institute from 1989-1997 were examined for the presence of substances suggesting botanical preparation use. The prevalence of positive test results for ephedrine among mishap pilots was compared with the prevalence of tests positive for chemically and biologically similar non-botanical substances among mishap pilots. A review of existing literature was also performed to identify substances posing possible risk to the aviator health or aviation safety. RESULTS: Ephedrine was found to be the only substance routinely screened on toxicological specimens that was suitable for association with botanical substance utilization. The percent of specimens positive for ephedrine increased three- to four-fold while the percent of specimens positive for similar non-botanical substances decreased overall. The literature revealed sufficient evidence that a number of open market botanical agents are capable of causing incapacitation by cardiovascular or neuropsychiatric mechanisms, yet are legally permitted for use by aviators. CONCLUSION: Aviators are using botanical products with increasing frequency, and many of those substances may pose significant risk of incapacitation, altered sensorium, or adverse health effects. The flight surgeon must be diligent in eliciting a history of use and assisting aviators to minimize personal risk and risks to flight safety. A rational approach to assessing risk is presented.
BACKGROUND: Current methods available to assess a passenger's life threatening medical condition during in-flight emergencies are inadequate. Critical communication channels between the airplane and ground control rely only on voice communication via a two-way radio. The purpose of this study was to test the efficacy of cellular telephone technology via the Internet as a cost-effective way to obtain the "linking" pathway from an aircraft to a ground medical facility by conducting a simulated on line triage. METHODS: On July 31, 1997, we transmitted vital signs from a Boeing 757, flying from Chicago to Los Angeles, simultaneously to: The Saddle Back Memorial, in Laguna Hills, CA; Hospital Santojanni in Buenos Aires, Argentina; and the Medical Department of American Airlines in Dallas/Fort Worth, TX. Three lead EKG, heart rate, BP, arterial oxygen saturation, end tidal CO2, respiratory rate body temperature and real time video images were collected from a passenger and transmitted to each facility from the aircraft via the Internet. Access to the Internet was gained via the cellular phone aboard the aircraft. RESULTS: A total of 20 different simulated scenarios of an medical emergency condition were successfully transmitted, simultaneously, to all health care facilities. All data was received without any corruption with an average delay time of 1 s. CONCLUSIONS: Close monitoring of the patient can lead to a better understanding and assessment of a medical condition, improve in-flight patient care, accelerate the decision making process by making an early diagnosis, and correct a life-threatening condition before the patient arrives at the destination.
El Al was one of the first international airlines to introduce a medical kit (MK) on board its passenger aircraft. Based on our own experience and considering the recent regulations of the European Joint Aviation Authority (JAA), the items are updated. The design of the kit is arranged so that all the medications with a short "kit life" are placed in a compartmented tray and can be removed in toto and replaced by a new tray. The equipment and medications in the MK are listed on the form which the physician on board is required to complete, checking the items used and filing a report. The contents of the MK will evidently be upgraded once ECG monitoring, transmission facilities and automatic external defibrillators (AED) are put on board.