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Aircraft Mishap Information*

PRE-MISHAP RESPONSIBLITIES

An aircraft mishap is a catastrophic event which is never planned for but one which requires prompt, precise actions on the part of all respondents.  The role of the medical department in the mishap scenario is key and if not conducted properly, can lead to unnecessary morbidity and mortality as well as cause a deterioration of evidence which might potentially lead to the discovery of the cause of the mishap.  If you are the Senior Medical Department Representative (SMDR) of a command that could be involved in the response to an aircraft mishap, it is of paramount importance you have contingencies clear in your mind, as well in the minds of all those who will participate in the response with you, of the role your medical department will play in the mishap response.   

The primary responsibility of all medical personnel at the time of a mishap is to preserve life and limb.  The details of mass casualty response are beyond the scope of this chapter and the SMDR is referred to the appropriate references. 

In preparation for a mishap response, an essential reference for your department files is OPNAVINST 3750.6 (or the most recent update) that spells out the details of pre-mishap planning, mishap response and mishap investigation. 

Sound pre-mishap planning and training are required to ensure a successful response.   Ensure you have the means of notifying local rescue, fire fighting, coroner and logistics support, whether military or civilian.  Meeting with the supervisors of responding agencies, as well as local hospitals, is essential.  When feasible, cooperative training evolutions should be conducted.

All personnel in the medical department must be fully prepared for the role they will play in the event of an aircraft mishap. It is key that all personnel understand that the command Public Affairs Officer (PAO) is the only command representative that may release information to the press. 

Medical personnel assigned to duties in the field with the investigating flight surgeon must be appraised of techniques of evidence gathering and of means of properly recording observations.  Ensure that all ordinance and ejection mechanisms are secured prior to personnel deploying into the mishap scene proper.  When searching wreckage, personnel must wear adequate personal protective equipment.  Be particularly mindful of the risk of blood borne pathogens that might contaminate the scene.  Adequate photographic capabilities are  required to document the relationship of remains, wreckage and surrounding landmarks.  Always include a clear plastic ruler with easily identifiable markings for close up photographs. 

Laboratory personnel must be aware of the blood samples that must be drawn on all survivors (see below).  The proper colored tubes in the proper numbers per survivor must be banded together with the blank forms necessary for processing.  Radiology personnel need to be prepared to conduct the full complement of required films based on the injuries sustained.  Full spinal radiographs are required on all personnel after ejections, bailouts and crashes, regardless of whether back injury is suspected.  Those sustaining fatal injuries must be radiographed wearing flight gear as well as without.                                       

In the event of a fatality, the SMDR can expect to work in close association with personnel from the Naval Safety Center and the Armed Forces Institute of Pathology (AFIP).  Your command must have the most current emergency telephone numbers for these agencies.

A mishap investigation kit must be assembled and properly maintained.  The purpose of this kit is to have the equipment available to safely and properly respond to and to record those elements leading up to and subsequent to the mishap.  Items can be personalized but should include certain essentials.  Such a kit might include;  

  • Personal Items

  • Insect repellant

  • Sunscreen

  • Sunglasses

  • Heavy work gloves

  • Flash camera (digital)

  • Tape measure

  • Ruler (clear plastic)

  • Pens, magic markers

  • Medical/recovery

  • Scissors, forceps, scalpel and blades

  • Audiocassette recorder

  • Surgical gloves

  • VHS video camera

  • Tissue collection kits

  • Body bags

Reference/Forms

  • OPNAVINST 3750.6

  • Aeromedical questionnaires

  • SF600’s

  • SF 523 – authorization for autopsy

 

POST MISHAP RESPONSIBILITIES

Care of survivors is the ultimate responsibility of medical personnel. Perform full physical exams on all survivors and immediately secure their medical and dental records as well as their flight gear.  Betadine and water are to be used for skin preparation prior to drawing labs.  DO NOT USE ALCOHOL RUBS ON THE SKIN.  Locally run laboratories include serum glucose, CBC, UA and SMA-12.  AFIP requires samples to measure serum ETOH levels, CO levels and drug screen. 

While in the field, the remains of the deceased should not be disturbed prior to completion of photographic documentation.  Body fluids should not be obtained from the deceased in the field.  Fluid collection on the deceased will be conducted during the autopsy.  Body parts and personal effects should be tagged and photographed where they are found.  Do not remove personal equipment from the body prior to radiographs being taken.

All information related to an aircraft mishap is privileged.  Medical personnel must ensure that all information obtained in the course of the performance of the medical mission is relayed to the Aircraft Mishap Board.  Such information would include that obtained in a standard post mishap aeromedical questionnaire which, besides the elements of a good demographic and medical history, also includes questions pertinent to the mishap flight from brief to termination.  To assist in the human factors analysis of the mishap, make every effort to establish a clear 72 hr. pre-mishap medical history    If fatalities result, other squadron personnel must be questioned immediately to establish an accurate 72 hr. pre-mishap history of the deceased.


This section was contributed by CAPT Mike McCarten, MC, USN (FS).

*Source: Operational Medicine 2001,  Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300 


 

 

 

Military Obstetrics & Gynecology

This information is provided by The Brookside Associates Medical Education Division.  The Brookside Associates, Ltd. is a private organization, not affiliated with any governmental agency. The opinions presented here are those of the author and do not necessarily represent the opinions of the Brookside Associates or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. All material presented here is unclassified.

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