Aviation medicine PDF
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Ernsting’s Aviation Medicine This page intentionally left blank Ernsting’s Aviation Medicine Fourth edition Air Commodore David J. Rainford Civil Consultant in Renal Disease to the Royal Air Force, Consultant Physician to the UK Civil Aviation Authority and Consultant Adviser in Medicine to the Royal Air Force of Oman Group Captain David P. Gradwell Royal Air Force Consultant Adviser in Aviation Medicine and Reader in Aviation Physiology, Royal Air Force Centre for Aviation Medicine, Royal Air Force Henlow, and Visiting Senior Lecturer in Aviation Medicine, King’s College, London PART OF HACHETTE LIVRE UK First published in Great Britain in 1978 by Tri-Med Books Ltd Second edition 1988, paperback edition 1994, reprinted 1995 Third edition 1999 published by Butterworth-Heinemann, reprinted by Arnold 2003 This fourth edition published in 2006 by Hodder Arnold, an imprint of Hodder Education, part of Hachette Livre UK, 338 Euston Road, London NW1 3BH www.hoddereducation.com ©2006 Edward Arnold (Publishers) Ltd All rights reserved. Apart from any use permitted under UK copyright law, this publication may only be reproduced, stored or transmitted, in any form, or by any means with prior permission in writing of the publishers or in the case of reprographic production in accordance with the terms of licences issued by the Copyright Licensing Agency. In the United Kingdom such licences are issued by the Copyright Licensing Agency: Saffron House, 6–10 Kirby Street, London EC1N 8TS. Hachette’s policy is to use papers that are natural, renewable and recyclable products and made from wood grown in sustainable forests. The logging and manufacturing processes are expected to conform to the environmental regulations of the country of origin. Whilst the advice and information in this book are believed to be true and accurate at the date of going to press, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. In particular, (but without limiting the generality of the preceding disclaimer) every effort has been made to check drug dosages; however it is still possible that errors have been missed. Furthermore, dosage schedules are constantly being revised and new side-effects recognized. For these reasons the reader is strongly urged to consult the drug companies’ printed instructions before administering any of the drugs recommended in this book. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data A catalog record for this book is available from the Library of Congress ISBN 978 0 340 81319 5 2 3 4 5 6 7 8 9 10 Commissioning Editor: Joanna Koster Project Editor: Heather Fyfe Production Controller: Lindsay Smith Cover Design: Sarah Rees Typeset in 10 on 12pt Minion by Phoenix Photosetting, Chatham, Kent Printed and bound in Great Britain by MPG Books, Bodmin, Cornwall Text printed on FSC accredited material What do you think about this book? Or any other Hodder Arnold title? Please visit our website at www.hoddereducation.com Contents v Contents List of contributors ix–xi Foreword xiii Preface xv The colour plate section appears between pages 416 and 417 PART I: AVIATION PHYSIOLOGY AND AIRCREW SYSTEMS 1 The Earth’s atmosphere 3–12 David P. Gradwell 2 Cardiovascular and respiratory physiology 13–40 John Ernsting, Jane Ward and Olga M. Rutherford 3 Hypoxia and hyperventilation 41–56 David P. Gradwell 4 Prevention of hypoxia 57–71 David P. Gradwell 5 Oxygen equipment and pressure clothing 73–107 David P. Gradwell 6 Principles of the pressure cabin and the effects of pressure change on body cavities containing gas 109–127 Alistair J.F. Macmillan 7 Subatmospheric decompression sickness 129–136 Alistair J.F. Macmillan 8 Effects of long-duration acceleration 137–158 Nicholas D.C. Green 9 Protection against long-duration acceleration 159–168 Nicholas D.C. Green 10 Short-duration acceleration 169–177 Matthew E. Lewis 11 Head injury and protection 179–188 Matthew E. Lewis 12 Human physiology and the thermal environment 189–212 Mike Tipton 13 Thermal stress and survival 213–229 Mike Tipton 14 Vibration 231–246 J.R. Rollin Stott 15 Anthropometry and aircrew equipment integration 247–256 Alistair J.F. Macmillan vi Contents 16 Physiology of sleep and wakefulness, sleep disorders, and the effects on aircrew 257–272 J. Lynn Caldwell 17 Optics and vision 273–291 Paul Wright and Robert A.H. Scott 18 Spatial orientation in flight 293–306 Alan J. Benson PART II: OPERATIONAL AVIATION MEDICINE 19 Selection and training 309–321 John W. Chappelow and Chris Elshaw 20 Crew resource management 323–335 Eric W. Farmer 21 Air traffic control: aeromedical aspects and human factors 337–347 Sheila Stork and Susan M. Baker 22 Error and accidents 349–357 John W. Chappelow 23 The flight deck and cockpit 359–372 Michael Bagshaw 24 Restraint systems and escape from aircraft 373–384 Alan E. Hepper 25 In-flight communication 385–394 Graham M. Rood and Susan H. James 26 Noise 395–415 Graham M. Rood and Susan H. James 27 Aircrew and cosmic radiation 417–431 Denis O’Sullivan and Dazhuang Zhou 28 Spatial disorientation in flight 433–458 Alan J. Benson and J.R. Rollin Stott 29 Motion sickness 459–475 Alan J. Benson and J.R. Rollin Stott 30 Passenger safety in transport aircraft 477–485 Helen Muir and Lauren J. Thomas 31 Patient transport by air-logistic considerations 487–506 Neil McGuire 32 Accident investigation 507–516 Ian R. Hill and S. Anthony Cullen 33 Aviation pathology and toxicology 517–533 S. Anthony Cullen and Ian R. Hill 34 Aircraft hygiene 533–538 Michael J. Kelly 35 Naval air operations 539–544 Adrian Baker and Mark Groom PART III: CLINICAL AVIATION MEDICINE 36 International regulation of medical standards 547–566 Anthony D.B. Evans Contents vii 37 Cardiovascular disease 567–604 Michael Joy 38 Hypertension 605–610 Anthony J. Batchelor 39 Respiratory disease 611–627 Gary Davies 40 Gastrointestinal disease 629–636 Trevor Laundy 41 Metabolic and endocrine disorders 637–646 Raymond V. Johnston 42 Renal disease 647–653 David J. Rainford 43 Haematology 655–664 Paul L.F. Giangrande 44 Malignant disease 665–681 Sally Evans 45 Neurological disease 683–693 Robert T.G. Merry 46 Ophthalmology 695–716 Robert A.H. Scott and Paul Wright 47 Otorhinolaryngology 717–725 Saliya Caldera and John Skipper 48 Aviation psychiatry 727–746 Geoffrey E. Reid 49 Orthopaedics 747–755 Ian D. Sargeant 50 Clinical management of decompression illness 757–766 Jane Risdall 51 Medication and aircrew 767–772 Anthony J. Batchelor 52 Aviator fatigue and relevant fatigue countermeasures 773–784 John A. Caldwell 53 The ageing pilot 785–790 John Cooke 54 Commercial passenger fitness to fly 791–799 Michael Bagshaw 55 International travel and disease 801–811 Andrew D. Green 56 Aeromedical evacuation: medical aspects 813–823 William J. Coker 57 Aeromedical transfer of the critically ill patient 825–833 Neil McGuire Appendix 835–844 Index 845–864 This page intentionally left blank Contributors Michael Bagshaw MB BCh MRCS LRCP FFOM DAvMed DFFP FRAeS John Cooke CB OBE MD FRCP FRCP(Ed) MFOM Professor of Aviation Medicine, King’s College London, London, Air Vice-Marshal RAF (retired), Retired Senior Consultant to the Army Honorary Civil Consultant in Aviation Medicine; Visiting Royal Air Force and Consultant Physician to the UK Civil Aviation Professor, University of Cranfield, UK Authority Adrian Baker MBChB MSc MFOM DAvMed MRAeS S. Anthony Cullen MD FRCPath FRAeS Surgeon Commander, Royal Navy, Principal Medical Officer, Royal Air Commodore (retired), Lately Royal Air Force Consultant in Naval Air Station Culdrose, Helston, UK Aviation Pathology, Royal Air Force Centre of Aviation Medicine, Henlow, UK Susan M. Baker BSc PhD Head of Human Factors, Civil Aviation Authority, Aviation House, Gary Davies MBBS MRCP(I) Gatwick Airport South, UK Squadron Leader, Specialist Registrar in Respiratory Disease — Royal Air Force, Prestwood, UK Anthony J. Batchelor CBE QHS BSc MBBS FRCP DAvMed FRCP FFOM FRAeS Air Commodore, Royal Air Force Consultant in Medicine and Chris Elshaw BSc QinetiQ, Farnborough, UK Whittingham Professor in Aviation Medicine, Royal Centre for Defence Medicine, Birmingham, UK John Ernsting CB OBE BSc MBBS PhD FRCP FFOM FRAeS Alan J. Benson BSc MSc MB ChB FRAeS Air Vice-Marshal RAF (retired); Royal Air Force Honorary Civil Visiting Consultant, Royal Air Force Centre of Aviation Medicine, Consultant in Aviation Medicine; and Visiting Professor in RAF Henlow, UK Applied Physiology, King’s College London, London, UK Saliya Caldera FRCS RAF Anthony D.B. Evans BSc MSc MB ChB DAvMed MFOM Wing Commander, Consultant Otolaryngologist, Head and Neck Chief, Aviation Medicine Section, International Civil Aviation Surgeon, ENT Department, The Royal Hospital Haslar, Gosport, UK Organization, Montreal, Canada John A. Caldwell PhD Sally Evans MBBS DCH DRCOG DAvMed MFOM Experimental Psychologist, Human Effectiveness Directorate, US Chief Medical Officer, UK Civil Aviation Authority, Gatwick Air Force Research Laboratory, Wright Patterson Air Force Base, Airport South, UK OH, USA Eric W. Farmer BSc PhD AFBPsS J. Lynn Caldwell PhD Centre for Human Sciences, QinetiQ, Farnborough, UK Diplomat, American Board of Sleep Medicine, US Air Force Research Laboratory, Human Effectiveness Directorate, Dayton, Paul L.F. Giangrande BSc MD FRCP FRCPath FRCPCH OH, USA Consultant Haematologist, Oxford Haemophilia Centre and Thrombosis Unit, Oxford Radcliffe Hospitals, Oxford John W. Chappelow BSc CPsychol AFBPsS Centre for Human Sciences, QinetiQ, Farnborough, UK David P. Gradwell BSc PhD MB ChB FRCP DAvMed FRAeS RAF William J. Coker OBE QHP BSc MB ChB BA LLB FRCP DAvMed FRAeS Group Captain, Royal Air Force Consultant Adviser in Aviation Air Commodore, Royal Air Force Consultant in Medicine and Medicine and Reader in Aviation Physiology, Royal Air Force Officer Commanding the Royal Air Force Centre of Aviation Centre of Aviation Medicine, Royal Air Force Henlow, Visiting Medicine, Royal Air Force Henlow, UK Senior Lecturer in Aviation Medicine, King’s College, London, UK
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