Early Enteral Nutrition in Aeromedically Evacuated Critically Ill/Injured Patients With a Resultant Validation Algorithm for the Theater Validating Flight Surgeon.

Introduction: Early enteral feeding in critically ill/injured patients promotes gut integrity and immunocompetence and reduces infections and intensive care unit/hospital stays. Aeromedical evacuation (AE) often takes place concurrently. As a result, AE and early enteral feeding should be inseparable.

Decompression Sickness Risk Assessment and Awareness in General Aviation.

Decompression sickness (DCS) can occur during unpressurized flight to altitudes >18,000 ft (FL180; 5486 m). To our knowledge, this has not been studied in general aviation (GA). This knowledge gap may have public health and safety implications because the most popular models of GA aircraft by sales volume are capable of flying >FL180.

Clinical Impact of Cabin Altitude Restriction Following Aeromedical Evacuation.

Combat medical care relies on aeromedical evacuation (AE). Vital to AE is the validating flight surgeon (VFS) who warrants a patient is "fit to fly." To do this, the VFS considers clinical characteristics and inflight physiological stressors, often prescribing specific interventions such as a cabin altitude restriction (CAR).

Patient-Centric Side Effect Risk Assessment for Medications Used During Aeromedical Evacuations.

Background: The U.S. Air Force performs more than 6000 aeromedical transport flights annually, both internationally and domestically.

A Retrospective Cohort Analysis of Battle Injury Versus Disease, Non-Battle Injury-Two Validating Flight Surgeons' Experience.

Today, military combat medical care is the best it has ever been. Regulated U.S.

Complication Rates in Altitude Restricted Patients Following Aeromedical Evacuation.

Introduction: Military aeromedical evacuation, especially that associated with the present Middle East conflict, is seeing increasing research. This ecological study initiates research into the validating flight surgeon by looking at cabin altitude restriction (CAR), arguably the validating flight surgeon's prescription with the highest patient-mission impact, and its association with postflight complications.

Methods: CAR rates from January 2006 through February 2008 were determined from the U.

Aeromedical decision making--it may be time for a paradigm change.

Recent events in the U-2 and F-22 fleets have challenged aeromedical experts, highlighting the need for better in-flight aircrew physiologic and cognitive monitoring capability. Existing aerospace medicine risk assessment tools, while necessary, are no longer sufficient to affect positive safety changes given the evolving nature of the aerospace environment. Cognition and its sub-elements are now primary measures for the "Fit to Fly" decision.

Altitude decompression sickness incidence among U-2 pilots: 1994-2010.

Introduction: The U-2 aircraft exposes its pilots to cabin pressures equivalent to 29,500 ft (8992 m) during flight, placing them at risk for decompression sickness (DCS). Historical data documenting DCS in the U-2 pilot community is lacking. This study assesses how rates and types of DCS have changed temporally in the U-2 flight program.

Pressurized flight immediately after splenic infarction in two patients with the sickle cell trait.

Splenic infarction in individuals harboring the sickle cell trait can occur in the setting of exposure to low oxygen tension at high altitudes. While this is a concern in unpressurized aircraft flight, it has not been well documented in pressurized flight. What has not been addressed is whether this relative safety of pressurized flight extends to the postinfarction period and whether or not pressurized flight in the immediate post-infarction period, especially air evacuation, would change the patient's outcome.

Decompression sickness rates for chamber personnel: case series from one facility.

During 2004, a case series of decompression sickness (DCS) meeting the definition of epidemic DCS was observed in the Shaw AFB Physiological Training Program. There were 10 cases of chamber-induced altitude DCS observed. Internal and external investigations focused on time, place, person, and environment.

Frostbite in a mountain climber treated with hyperbaric oxygen: case report.

We describe a case of frostbite to all fingers of a mountain climber, treated with hyperbaric oxygen (HBO). All fingers eventually healed to full function, with only some cosmetic deformity to the tip of the most severely affected finger. Because few cases of frostbite treated with HBO have been reported, we hope that such case reports will stimulate future research in this area.

The ex vivo pig eye as a replacement model for laser safety testing.

The purpose of this study was to evaluate the viability of ex vivo pig eyes as a replacement model for in vivo testing in the establishment of laser eye safety standards. Previous studies of pulsed energy absorption at 3.8 microm were performed using rhesus monkey cornea at pulse durations two orders of magnitude shorter than the 8-micros pulses used in the current study.

Headache and altitude decompression sickness: joint pain or neurological pain?

Introduction: Exposure to reduced ambient pressure may result in decompression sickness (DCS). Headache is among the DCS symptoms encountered and is usually regarded as neurological DCS, which is traditionally classified as serious DCS. Since cranial sutures may be considered joints, it is possible that some headaches are actually joint pain and when associated with decompression sickness need not be neurological DCS.

Epidemic decompression sickness: case report, literature review, and clinical commentary.

Background: Decompression sickness (DCS) is a syndrome of symptoms caused by bubbles of inert gas. These bubbles are produced by a significant ambient pressure drop. Although cases are usually solitary there have been several episodes of DCS clusters.

USAF treatment table 8: treatment for altitude decompression sickness.

Introduction: Altitude decompression sickness (DCS) has been treated with hyperbaric therapy since 1941. Treatment has essentially followed the diving DCS paradigm. Expanding space operations and higher flying, more remotely placed military aircraft have stimulated a re-examination of this paradigm.