SEC: UNCLASSIFIED:-Flight Physiology

[Bevan.Nylund@defence.gov.au]

Allan.

As you are aware, humans adapt to altitude when they are physiologically
well. The knowledge of these adaptations and mechanisms is the cornerstone
of altitude physiology. When there is physiological disruption by disease
or injury, then the adaptation mechanisms may not be viable.

How I do my assessments is:

For all patients.

      Look at the major systems involved in the adaptation process, which
is primarily the cardiovascular and respiratory systems. If they are
functioning, and have some physiological reserve, then there will not be a
problem. Often disease in one may be compensated if the other is normal.
Cardiorespiratory disease together often requires some intervention.
The second quick check is for trapped gases, which is another common
problem area. Can the patient Valsalva or Toynbe, and is there a
possibility of a gut obstruction. These two checks can take as little as 30
seconds if the patient obviously has no problems, and if they do no more
than 10 minutes.

Regardless of the primary presenting complaint, I always do these checks.
It is not always the presenting complaint that brings you unstuck during
flight.

Problem specific:

      Look at the presenting complaint or injury. How will ascent to
altitude in an aircraft affect the body in relation to the presenting
problem. I.e. gut problems will relate to trapped gases. Cardiac - altitude
hypoxia, respiratory altitude hypoxia and / or trapped gases. Recent
surgery or bleeding, vibration and turbulence. It becomes quite easy after
a while.

Once you identify a problem area, i.e a particular adaptation to the
altitude environment is impaired or absent, then you can formulate a plan
to get around the problem. - oxygen supplementation, cabin altitude
restriction, modified flight plan etc etc.


I hope this helps.

Regards

Bevan Nylund
Senior Nursing Officer
Army Aviation Centre
Oakey, Australia



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