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PubMed2002

Simulated parachute descent in the cold: thermal responses and manual performance.

BACKGROUND: Ejection from a fighter aircraft can expose the pilot to extreme cold and windy conditions. Knowledge of the effects of such conditions on thermal responses and performance of the pilot is scarce. HYPOTHESIS: It is expected that the temperature of bare skin and fingers may decrease to the level where health and/or performance are hampered. METHODS: Seven fighter pilots performed a simulated parachute descent (SPD) at ambient temperature (Ta) of -35 degrees C and wind velocity of 10 m x s(-1). The 8-min SPD was followed by a 60-min cold exposure (CE) at Ta of -20 degrees C. Flight garments with or without immersion suit were used. During SPD the subjects performed basic survival tasks. Rectal and skin temperatures were measured and manual performance was tested. RESULTS: Thermal responses did not significantly differ between the clothing ensembles. Mean skin temperature was 28 degrees C and 27 degrees C at the end of SPD and CE, respectively. The cheek temperature was 9 degrees C (range 3.2-13.8 degrees C) at the end of SPD. Finger skin temperature was 7 degrees C and 9 degrees C at the end of SPD and CE, respectively. The subjects could perform the defined tasks during SPD while manual performance was slightly impaired during CE. CONCLUSIONS: Subjects could tolerate the 8-min SPD and the following CE in the studied conditions without a loss of vital performance in basic survival actions. However, the risk of frostbite on the uncovered skin area as well as numbness of the fingers may jeopardize pilots' health and performance during parachuting.

Adaptation, Physiological↗
PubMed2004

[Parachute mitral valve coexisting with complex congenital heart defect. Successful multistage surgical treatment].

Type parachute valve is a very rare bicuspid valve congenital anomaly. When signs of dysfunction are noted the valve has to be replaced with an artificial one. The case describes a 7-year old girl suffering from complex congenital heart defect: coarctation of the aorta followed by hypoplastic aortic arch, ventricular septal defect and parachute mitral valve. In the neonatal period the girl had been operated on by the subclavian floppy aortoplasty method due to coarctation of the aorta. At the age of 2, another surgical correction was performed: ventricular sept defect closure simultaneously with mitral valvuloplasty. In infancy she failed to thrive, also signs of heart failure had been observed which resulted from increasing mitral valve stenosis and III grade mitral insufficiency. These findings in with artificial valve replacement (type Sorin O 23 mm). Procedure has been performed by the left atrium. Post operational period was uneventful. Proper function of the implanted valve has been observed with no perivalvular leakage and left atrium diameter has been normalized.

Child↗
PubMed1991

[Evaluating parachute-drop stress by measuring blood lipids].

An attempt to evaluate parachute-drop related stress by determining the blood lipid profile (cholesterol, LDL, HDL, apo-A, apo-B, and triglycerides) is reported. Measurements were made on starting the parachute course, just before the first jump, and just after the third jump. On these 3 occasions 38 combat troops answered psychological questionnaires and 30 of them gave blood samples. While there were significant fluctuations in level of all blood lipids and their apoproteins, they could not be correlated selectively with presumed levels of stress. The well-known difficulties in field studies in controlling crucial factors such as the exact timing of the measurements and food intake (specific diet or fasting) make questionable the use of biochemical markers in measuring stress under the conditions of our study. It is possible that the high rate of refusal to give blood samples biased the findings.

Apolipoproteins A↗
PubMedDate not supplied

[Osteoarticular lesions from parachuting].

Based on personal experience gained in a parachuting centre (Pescara Aero-club) from 1975 up to 1988, the authors report their evaluation on chronic and acute osteoarticular lesions. The review of the cases was not based on the incidence of the lesions nor on their characteristics, normally found in common traumatology, but it was related to the dynamics of the trauma during the landing and to painful syndromes following a prolonged parachuting activity.

Athletic Injuries↗
PubMed1990

[Mitral valve replacement in 12-month-old infant with parachute mitral valve associated with ventricular and coronary sinus septal defect].

A 12-month-old infant, weighting 6.7 kg, underwent mitral valve replacement with a 17 mm Björk-Shiley prosthetic valve for parachute mitral valve, and patch closure of the associated ventricular and coronary sinus septal defects. Progressive pulmonary artery hypertension and heart failure required surgical intervention. The diagnosis of parachute mitral valve and associated lesions was established by echocardiogram and angiogram. Postoperative recovery was uneventful and he is doing well 3 years after the operation. To our knowledge this is the first successful case to be reported in the literature with such combination of the congenital anomalies.

Age Factors↗
PubMedDate not supplied

Anomalies associated with the parachute mitral valve: a pathologic analysis of 52 cases.

Fifty-two specimens of heart with parachute mitral valve were reviewed. An associated anomaly was present in all but two patients. In these two patients parachute mitral valve was an isolated anomaly. The associated anomalies were divided into those which form part of the developmental complex described by Shone and associates and other anomalies designated as major anomalies. Normally related great vessels were present in 35 cases, double outlet right ventricle in eight cases, complete transposition in four cases, corrected transposition and single ventricle in two cases each and straddling tricuspid valve in one case. The most common associated anomaly was an interventricular communication occurring in 37 cases. Less common anomalies were an atrial septal defect (18 cases), patent ductus arteriosus (21 cases), complete atrioventricular canal (five cases), right-sided obstructive anomalies (13 cases) and left-sided obstructive anomalies other than those as part of the Shone syndrome (11 cases).

Double Outlet Right Ventricle↗
PubMed1995

The psycho-physiological response to parachuting among novice and experienced parachutists.

Elevated heart rate and increased anxiety are two indicators of stress. This study investigated the heart rate and anxiety response to parachuting among seven novice and six experienced parachutists. Heart rate was measured from the moment of boarding the aircraft until landing. Anxiety was measured prior to boarding the aircraft. Heart rate was significantly higher among the novice compared to the experienced parachutists, especially during takeoff (125 +/- 11 vs. 95 +/- 17 beats.min-1, respectively), and upon exit or free fall (184 +/- 12 vs. 164 +/- 17 beats.min-1, respectively). However, due to the difference in ages between the groups, when expressed relative to maximal heart rate, there was no difference in the heart rate response between groups (e.g., exit/free fall: 93.0 +/- 5.5% vs. 88.4 +/- 7.8% for novice and experienced, respectively). No statistical differences were observed in the anxiety scores between groups, although the novice parachutists scored somewhat higher (16.0 +/- 3.7 vs. 12.5 +/- 5.7, respectively). A significant correlation (r = 0.72) was observed between heart rate upon landing and the state anxiety scores. These results demonstrate a high psycho-physiological stress response to parachuting among both novice and experienced parachutists. It is likely that novice parachutists are stressed to a higher degree and may therefore be more prone to performance-related injury (e.g., upon landing). However, since both groups reached a similar percentage of their maximal heart rate, they may be at a similar risk of cardiac injury.

Adult↗
PubMed1996

Parachuting injuries among Army Rangers: a prospective survey of an elite airborne battalion.

Injuries are common in sports and military parachuting. This paper presents results of a prospective survey of parachuting injuries in an airborne Ranger battalion. The Ranger regiment is the U.S Army's most elite airborne infantry, prepared for worldwide deployment without advanced notice. Average unit size was 556 Rangers for the 18 months of follow-up. Other variables examined were type of landing area and time of day. During the follow-up period, all injuries occurring in the battalion were documented, as were all airborne operations. During the survey period, 65 airborne operations were conducted (7,948 static-line and free-fall jumps), which caused 163 injuries to Rangers. Fifty-five percent of the operations and jumps were made at night, and 63, 23, and 14% of operations were onto fields, airports, and unimproved airplane landing strips, respectively. All operations were performed in a tactical environment with equipment. The "static-line" injury rate was 2.2%. The types of injuries were similar to those found in previous reports. Dirt landing strips (4.7% injured) and airports (2.3%) appeared to be more hazardous landing areas than fields (1.6%) and water (0%), and more injuries occurred during night operations (2.7%) than during the day (1.4%). Two and one-half times as many severe injuries occurred at night versus day. This type of information is important for combat airborne operations.

Adolescent↗
PubMed1996

Parachuting injuries: a medical analysis of an airborne operation.

The purpose of this paper is to discuss parachuting variables as they affect support and planning. The authors retrospectively analyzed an operation in which a Ranger battalion parachuted onto an airfield drop zone. Leaders weighed Rangers to estimate the soldiers' load. The advance team failed to adequately coordinate administrative medical assistance on the drop zone. Forty-one Rangers were injured and evacuated from the drop zone (8.6% of the jumpers). Variables in such operations include drop zone selection, equipment weight, drop altitude, wind speed, the wind-flight angle, drop height, and jumper density over the drop zone. Solutions include cargo drops and leaders' repeated emphasis on minimizing the soldiers' loads in accordance with mission accomplishment.

Aviation↗
PubMed1997

Neck injury after repeated flexions due to parachuting.

A 37-yr-old, previously healthy officer developed a severe pain in the right shoulder and parethesia in the right I-III fingers during a high-altitude low-opening parachute jump. The pain started after a sudden neck flexion while he was checking the developing canopy, well before landing. Electroneuromyography revealed damage to the right C7 nerve root. Cervical radiography showed severe spondylosis and discus degeneration in the CV-VII region; magnetic resonance image demonstrated posterior disk protrusions in this area. Military aviators flying high-performance aircraft often have similar problems in the cervical spine; they have been attributed to effects of high + Gz forces in association with twisted head positions. Parachutists appear to face similar risks. Selection of the optimal head position during the parachute opening and use of light helmets should be emphasized.

Adult↗
PubMed1976

Parachute mitral valve: echocardiographic findings resembling idiopathic hypertrophic subaortic stenosis.

The echocardiographic features recorded in a patient with a congenital anomaly, single papillary muscle (parachute mitral valve), were identical with those seen in patients with idiopathic hypertrophic subaortic stenosis (IHSS). Asymmetric septal hypertrophy, mitral valve systolic anterior movement, aortic valve vibration, and midsystolic reclosure were all demonstrated. This congenital anomaly, should, therefore, be considered in any young patient before making the diagnosis of IHSS from the echocardiogram.

Cardiomyopathy, Hypertrophic↗
PubMed1979

New parachute cuff and positive end-expiratory pressure to minimize tracheal injury and prevent aspiration.

A new parachute cuff has been tested in combination with a positive end-expiratory pressure (PEEP) on mongrel dogs. During positive-pressure ventilation the intracuff and intratracheal pressures showed synchronous, identical pressure variations, and therefore theoretically with this type of cuff the pressure against the tracheal wall would be minimal. The cuff provided a seal against gas leakage from the lungs throughout the entire test period, i.e., for up to 7 h. To avoid aspiration of mouth contents during the passive exhalation phase, different amounts of PEEP were tested. A PEEP of 4.0--8.0 cm H2O always produced a seal against a column of fluid in the mouth exerting a hydrostatic pressure of 5.4--8.8 cm H2O against the cuff. This seal was maintained during the whole test period. No difference in sealing capacity was found when the cuff was used with a normal respiratory frequency (20/min) and with high-frequency positive-pressure ventilation (60/min). When the PEEP is eliminated, e.g., when the respirator is disconnected for suction of the endotracheal tube, the sealing effect will be abolished. As the cuff extends up into the larynx there will be no pooling of fluid above the cuff. The risk of aspiration can therefore be diminished by suction of oral cavity before disconnecting the respirator. With the use of the pneumatic valve principle together with high-frequency positive-pressure ventilation, an open respirator system can produce a continuous PEEP, thereby preventing aspiration even during suctioning of the tracheal tube.

Animals↗
PubMed1986

Single papillary muscle of the left ventricle associated with persistent common atrioventricular canal: variant of parachute mitral valve.

Six cases of single papillary muscle of the left ventricle in persistent common atrioventricular canal (AVC) are described. Except for one case with double outlet right ventricle and AVC, in the other five cases AVC occurred with normally related great vessels. Down's syndrome was present in two cases. The mitral valvular condition in AVC is not the classic parachute mitral valve since the separation between the common anterior and the common posterior leaflet leaves a space (cleft) oriented toward the ventricular septum. This mitral valve in AVC may or may not be obstructive. The common anterior leaflet fixed to the ventricular septum may result in obstruction. Clinically, single left ventricular papillary muscle should be suspected if the AVC is associated with coarctation of the aorta or tubular hypoplasia of the aortic arch. This type of mitral valve in AVC may also be associated with double outlet right ventricle. Preoperative recognition of the single papillary muscle by echocardiogram or left ventriculogram will prevent postoperative mitral obstruction following closure of the mitral cleft.

Aortic Coarctation↗
PubMed1989

Parachuting injuries during training descents.

An analysis of the injuries sustained during a series of 51,828 military training parachute descents and which were treated at the John Radcliffe Hospital is presented. The significant casualty rate was 0.22 in every 100 descents. There were 4 deaths, 5 multiple injuries and 104 single fractures, dislocations or head injuries. The injury rate is lower than that reported for training descents made by sports parachutists, despite more difficult conditions. Serious injuries and deaths were often the consequence of interactions between two jumpers.

Accidents, Aviation↗
PubMed2000

Unbalanced atrioventricular septal defect with parachute valve.

A 5-month-old male patient presented with right-dominant unbalanced atrioventricular septal defect and left-sided parachute valve, and underwent successful biventricular repair. Because of the presence of a small left ventricle, left atrium, and a single left papillary muscle, an additional orifice was created in the left-sided atrioventricular valve with artificial partitioning of the right-sided atrioventricular valve. There was no evidence of mitral stenosis or regurgitation on follow-up echocardiography.

Follow-Up Studies↗