RTO MP-062 / HFM-050 - FTP Directory Listing - Nato

More documents

Recommendations

Info

T-8 improvements regarding operational procedures, equipment, diagnosis and treatment. Cooperation in future research and development between alliance nations and close contact with other relevant nations is strongly recommended. Research funding has become increasingly scarce in this area in most countries. Accordingly, international co-operation at project level and sharing of data is mandatory for optimal use of dwindling resources. Correct breathing gas composition is crucial in both diving and aviation, i.e. routine alliance operations. Besides optimal oxygen content, the choice of inert gas component is decisive in many dive operations. This part should probably also be looked at more closely in aviation, especially pertinent to Eustachian tube function. Maybe heliox could reduce the risk of alternobaric vertigo. Co-operation and exchange of research data at project report level within the alliance is recommended. It takes a long time to wait for new knowledge to be published in international professional journals. Hyperbaric oxygen therapy is well established within the alliance for the treatment of pressure related illnesses. Time is now overdue to make this modality available also for combat injuries. Limbs and lives may be saved by early and correct use HBO as an adjunct in the treatment of battlefield injuries at sea and on land. Development in this field should be followed closely, encouraged and supported. Work regarding follow up of possible long-term health damage in divers is in progress in Norway, and is planned in the UK. The alliance should pay attention to, and possibly support these efforts. Recommendations NATO/RTO/HFM should form a group with special interest in baromedicine. They should meet annually and keep the alliance updated on progress with operational relevance in this field. On the said group’s recommendation, HFM should stage broad meetings like the present one. NATO should encourage and support research and development of operational medical issues in hypo- and hyperbaric conditions.
Present and Future Compromises in Altitude Protection in Combat Aircraft John Ernsting Human Physiology and Aerospace Medicine GKT School of Biomedical Sciences King’s College London Guy’s Campus London SE1 1UL, United Kingdom Summary KN1-1 The crews of high performance combat aircraft operating at high altitude are protected against the effects of exposure to high altitude by two methods viz pressurisation of the cabin and raising the concentration of oxygen in the gas delivered by the oxygen system to the respiratory tract. The historical development of the current compromises between cabin pressurisation and increasing the concentration of oxygen in the inspired gas is reviewed. The physiological requirements with respect to the prevention of hypoxia, decompression sickness, and otitic and sinus barotrauma are considered. The criteria for avoiding lung damage and hypoxia on rapid decompression are discussed. The changes required to the present specification for the cabin pressurisation schedule of high altitude fighter aircraft associated with the increase in the operational ceiling above 50,000 feet and the agility of future fighter aircraft are considered. It is proposed that the maximum cabin pressure differential should be increased at altitudes above 40,000- 45,000 feet to 6.0-6.7 Lb in -2 . The relative simple fixed cabin pressurisation control systems currently employed should be replaced by variable differential pressure control, so that the optimum compromise can be made depending upon the nature and duration of the sortie. Introduction A fundamental consideration in the design of a combat aircraft is the provision of protection to the crew against the effects of the low environmental pressure of altitude. This protection should prevent hypoxia, decompression sickness, and minimise the incidence of otitic and sinus barotrauma during routine flight and in emergency situations. It should allow the crew to perform efficiently throughout the flight envelope of the aircraft and minimise the effects on the crew and the aircraft of a malfunction or failure of any components of the protective systems. Two methods are employed, usually together, to provide altitude protection to the crews of combat aircraft flying at altitude. These are supplemental oxygen to raise the partial pressure of oxygen in the inspired gas and pressurisation of the cabin to increase the absolute pressure to which the crew are exposed. The extent to which each of these methods is employed depends upon physiological, engineering and operational considerations. The physiological requirements relate to hypoxia, decompression sickness, otitic and sinus barotrauma and the effects of failure of the pressure cabin. The engineering requirements are concerned principally with the mass of the aircraft, the reliability and life of the pressure cabin and the reduction of the risk of losing the aircraft and its crew in the event of a failure of the pressure cabin due to enemy action. Operational considerations which influence the way in which altitude protection is provided include the role of the aircraft and hence the other protective and aircrew performance enhancing systems with which the altitude protection has to be integrated. The manner in which altitude protection is provided in modern fighter aircraft represents a series of compromises between the physiological, engineering and operational requirements. The current compromises have developed over the last sixty years or so. An understanding of how these compromises have developed is of value in considering the compromises that should be made in future combat aircraft. This paper therefore commences with a historical overview of the development of altitude protection. The basis of the way in which altitude protection is provided in present high performance combat aircraft is then considered. Finally proposals are made as to how altitude protection should be affected in future combat aircraft. Historical Overview Whilst the effect of the lowered partial pressure of oxygen in producing hypoxia at altitude was well recognised by the third quarter of the 19 th century, the syndrome of decompression sickness at altitude, in spite of J S Haldane’s Paper presented at the RTO HFM Symposium on “Operational Medical Issues in Hypo- and Hyperbaric Conditions”, held in Toronto, Canada, 16-19 October 2000, and published in RTO MP-062.
Page 1 and 2: RTO-MP-062 NORTH ATLANTIC TREATY OR
Page 3 and 4: NORTH ATLANTIC TREATY ORGANIZATION
Page 5 and 6: Operational Medical Issues in Hypo-
Page 7 and 8: Contents Executive Summary iii Synt
Page 9 and 10: Respiratory Changes and Consequence
Page 11 and 12: Introduction Technical Evaluation R
Page 13 and 14: In addition to cabin pressurisation
Page 15 and 16: critical. The so-called technical d
Page 17: levator veli palatini, like when sw
Page 21 and 22: KN1-3 (RGE) as the safety criterion
Page 23 and 24: Pulmonary Barotrauma KN1-5 Free ven
Page 25 and 26: KN1-7 Future fighter aircraft may w
Page 27 and 28: KN1-9 Figure 1 Cabin Pressurisation
Page 29 and 30: KN1-11 Figure 3 The relationships b
Page 31 and 32: +\SHUEDULF 2[\JHQ $ 6FLHQWLILF 8SGD
Page 33 and 34: KN2-3 recovers spontaneously withou
Page 35 and 36: KN2-5 Hg or less. The attendant hyp
Page 37 and 38: KN2-7 8 Tompach PC, Lew D, Stoll JL
Page 39 and 40: USAF Experience with Hyperbaric The
Page 41 and 42: Exposure Results and Discussion The
Page 43 and 44: Symptomotology Symptom presentation
Page 45 and 46: Air Force Altitude DCS Treatment Al
Page 47 and 48: References 1. Atlas of Injuries in
Page 49 and 50: Headache and Decompression Sickness
Page 51 and 52: Numerous studies have been done to
Page 53 and 54: 8. Madeline LA and Elster AD. Sutur
Page 55 and 56: Figure 2. Sutural Movement with Spi
Page 57 and 58: Patent Foramen Ovale as a Risk Fact
Page 59 and 60: 90 minutes prior to the start of th
Page 61 and 62: The Relevance of Patent Foramen Ova
Page 63 and 64: In a human population, Glen et al (
Page 65 and 66: Studies evaluating PFO detection me
Page 67 and 68: References 1. O’Rahilly, R., Mull
Page 69 and 70:
55. Giroud, M., Tatou, E., Steinmet
Page 71 and 72:
Introduction Altitude DCS Susceptib
Page 73 and 74:
Cumulative DCS Incidence, % 100 90
Page 75 and 76:
Pharmacological Correction of the H
Page 77 and 78:
metabolic regulation remedies [A.S.
Page 79 and 80:
asis of these indicators there were
Page 81 and 82:
liquidation of energetic debt in mu
Page 83 and 84:
Analysis of correlation structures
Page 85 and 86:
Interesting data on bemithylum pres
Page 87 and 88:
to high altitude hypoxia and allows
Page 89 and 90:
35. Shanazarov, A.S., Ryskulova, G.
Page 91 and 92:
Prognozing of the Resistance to Hyp
Page 93 and 94:
autonomic cardiac control whereas i
Page 95 and 96:
METHOD Subjects 21 male military pi
Page 97 and 98:
mean R-R interval (X), STV, LTV (ms
Page 99 and 100:
• Significant negative correlatio
Page 101 and 102:
DISCUSSION Hypoxic Tolerance Our re
Page 103 and 104:
8. Casa M., Casa H., Pages T., Rama
Page 105 and 106:
66. Sheffield P., Heimbach R. Respi
Page 107 and 108:
Abstract Alternobaric Vertigo: Inci
Page 109 and 110:
12. Nagai H. et al. Effect of incre
Page 111 and 112:
Neuropsychometric Test in Royal Net
Page 113 and 114:
Table 4 Results of neuropsychometri
Page 115 and 116:
Summary: Spanish Navy Up to Date Da
Page 117 and 118:
Hypobaric Training for Royal Air Fo
Page 119 and 120:
c. Fast jet high level. Climb to 18
Page 121 and 122:
Introduction Hypobaric Training Iss
Page 123 and 124:
To be able to tolerate breathing pr
Page 125 and 126:
during the change in ambient pressu
Page 127 and 128:
Designing Efficient and Effective,
Page 129 and 130:
The Type II profile involves positi
Page 131 and 132:
Pressurized, Cabin below 10,000 ft
Page 133 and 134:
than 10 minutes at a hypoxia level
Page 135 and 136:
Military Personnel Selection and Di
Page 137 and 138:
expressed by them, are closely inte
Page 139 and 140:
of shortage of blood circulation fu
Page 141 and 142:
The results of the conducted resear
Page 143 and 144:
15-9
Page 145 and 146:
15-11
Page 147 and 148:
In norm there is A > B, and the reg
Page 149 and 150:
Burger, M., 1921, Uber der klinisch
Page 151 and 152:
In: Sbornik nauchno-prakticheskih r
Page 153 and 154:
Templeton, A.W., 1965, Renal Aortog
Page 155 and 156:
Some Psycho-Physiological and Cogni
Page 157 and 158:
Testing in hypobaric chamber condit
Page 159 and 160:
supply immediately recovered. Subje
Page 161 and 162:
The Role of PWC in Declaring a Dive
Page 163 and 164:
Out of 1200 ergometric examinations
Page 165 and 166:
Application of Hypo and Hyperbaric
Page 167 and 168:
evaluation of mountain-climber's hy
Page 169 and 170:
Figure 2 % oxyhemoglobin saturation
Page 171 and 172:
The Effects of Normobaric Hypoxia i
Page 173 and 174:
Memory Scanning Task: Cadets with p
Page 175 and 176:
The statistical analysis of the beh
Page 177 and 178:
ACKNOWLEDGMENTS The authors wish to
Page 179 and 180:
Severe Decompression Illness Follow
Page 181 and 182:
In this set of studies, observation
Page 183 and 184:
pulmonary oedema, a diuretic may be
Page 185 and 186:
Decompression Sickness Research: Ne
Page 187 and 188:
Figure 3. Pigs treated with methano
Page 189 and 190:
Abstract Using “Technical Diving
Page 191 and 192:
ecreational diving training agencie
Page 193 and 194:
After the intermediate or “deco
Page 195 and 196:
include paresthesia, headache, dizz
Page 197 and 198:
practice. Some dives were conducted
Page 199 and 200:
Abstract Into the Theater of Operat
Page 201 and 202:
Procedures: The FCT evaluation init
Page 203 and 204:
The matrix of tests conducted, some
Page 205 and 206:
6. Kennedy, T. Concept of Operation
Page 207 and 208:
The Relevance of Hyperbaric Oxygen
Page 209 and 210:
In reperfusion injury, HBO diminish
Page 211 and 212:
HBO has long been known to favorabl
Page 213 and 214:
3-Nitrotyrosine Predicts Healing in
Page 215 and 216:
corresponded respectively to the si
Page 217 and 218:
that in these diabetic subjects, ne
Page 219 and 220:
Summary Role of a Clinical Hyperbar
Page 221 and 222:
Benefits to the Defence Secondary C
Page 223 and 224:
The study has been deferred due to
Page 225 and 226:
ABSTRACT Incidence of Decompression
Page 227 and 228:
Table 1: Number of Diving Incidents
Page 229 and 230:
Introduction Evaluation of Treatmen
Page 231 and 232:
Table 6A (CF TT6A, initial recompre
Page 233 and 234:
INTRODUCTION Modelling and Validati
Page 235 and 236:
moved to the treatment chamber. Fiv
Page 237 and 238:
Figure 3 The predicted gas in bubbl
Page 239 and 240:
Table 5 shows the same information
Page 241 and 242:
CONCLUSIONS Although it would have
Page 243 and 244:
Respiratory Changes and Consequence
Page 245 and 246:
Table 2 Inspired-expired oxygen dif
Page 247 and 248:
Figure 2 Respiratory patterns, expe
Page 249 and 250:
Apnoea is characteristic of herniat
Page 251 and 252:
Effect of Exercise on Bubble Activi
Page 253 and 254:
The KISS is an index derived from i
Page 255 and 256:
DISCUSSION: In all group comparison
Page 257 and 258:
Thermography - A Method for the Eva
Page 259 and 260:
level atmospheric pressure O2 parti
Page 261 and 262:
lower extremities cephalic extremit
Page 263 and 264:
1-st group - flying crews We divide
Page 265 and 266:
ABSTRACT Altitude Decompression Sic
Page 267 and 268:
Table 1. Results of validation Prof
Page 269 and 270:
Summary Altitude Decompression Illn
Page 271 and 272:
17 oxygen demand regulator with a p
Page 273 and 274:
During these altitude exposures a n
Page 275 and 276:
Subject Number Subject Number Subje
Page 277 and 278:
that this discrepancy in the incide
Page 279 and 280:
Extrapolation of the data presented
Page 281 and 282:
MITCHELL SJ & LEE VM. (2000) A surv
Page 283 and 284:
Expression of Neuronal and Inducibl
Page 285 and 286:
Experimental procedures Groups of 1
Page 287 and 288:
immunoreactive Purkinje cells were
Page 289 and 290:
Western blotting Cerebral cortical
Page 291 and 292:
certain proteins as substrates for
Page 293 and 294:
Griffiths, T., Evans, M.C. and Meld
Page 295 and 296:
Simon, R.P., Griffiths, T., Evans,
Page 297 and 298:
RESUME Intérêt du caisson d’alt
Page 299 and 300:
3. TYMPANOMETRIE La tympanométrie
Page 301 and 302:
quelconque douleur. Dans ce cas, il
Page 303 and 304:
Altitude DCS Research in Support of
Page 305 and 306:
Altitude, feet X 1000 30 25 20 15 1
Page 307 and 308:
2. POST-LANDING EXERCISE AND RISK O
Page 309 and 310:
addition to observed or reported DC
Page 311 and 312:
% DCS 100 80 60 40 20 0 25,000 30,0
Page 313 and 314:
Modeling Approach for Oxygen Exchan
Page 315 and 316:
The first equation states that the
Page 317 and 318:
may cause the remaining discrepanci
Page 319 and 320:
0 0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 F
Page 321 and 322:
Sa (%) Pa (mmHg) 100 80 60 40 V’E
Page 323 and 324:
Sa (%) Pa (mmHg) V’E (L/min) 100
Page 325 and 326:
Changes of Ventilator Generated Vol
Page 327 and 328:
Emergency descent : Oxylog 2000 : C
Page 329 and 330:
&DELQ $OWLWXGH IHHW Table 6 &DELQ D
Page 331 and 332:
The Effect of Increased Full Covera
Page 333 and 334:
assembly incorporating FCAGTs infla
Page 335 and 336:
Following garment fitting, subjects
Page 337 and 338:
Mean CBV (cm/s) 70 60 50 40 30 20 1
Page 339 and 340:
Alveolar Carbon Dioxide Tension Alv
Page 341 and 342:
Phase 2 All experimental exposures
Page 343 and 344:
Diffusion coefficient for carbon mo
Page 345 and 346:
Mean arterial pressure (mmHg) 140 1
Page 347 and 348:
In previous studies (Ernsting, 1966
Page 349 and 350:
Determination of the Most Effective
Page 351 and 352:
Decompression Sickness, Extravehicu
Page 353 and 354:
As a corollary, what about the alle
Page 355 and 356:
Introduction Optimizing Denitrogena
Page 357 and 358:
Cumulative % DCS 100 90 80 70 60 50
Page 359 and 360:
Benefit of Acclimatization to Moder
Page 361 and 362:
. Following completion of the quest
Page 363 and 364:
Discussion This study demonstrated
Page 365 and 366:
12. White, D.P., K. Gleeson, C.K. P
Page 367 and 368:
Introduction: Physiological and Cli
Page 369 and 370:
The steepness of hypoxia-induced de
Page 371 and 372:
RESUME Évaluation d’équipements
Page 373 and 374:
2.1. Règlement TSO-C99 Le règleme
Page 375 and 376:
autre personne s’assure que, sans
Page 377 and 378:
Il est équipé de l’équipement
Page 379 and 380:
REPORT DOCUMENTATION PAGE 1. Recipi
Page 381 and 382:
NORTH ATLANTIC TREATY ORGANIZATION
show all

RTO MP-062 / HFM-050 - FTP Directory Listing - Nato

Create successful ePaper yourself

Delete template?

Save as template?