Aeromedical Mishap Investigation

Background

Other Duties

References

Immediate Post-mishap Duties

Survivor blood drawing

Background

As the physician aboard an air-capable ship you will deploy with an assigned air detachment, but without a flight surgeon. While deployed, if you are confronted by an aircraft mishap on your ship, you must be prepared to treat casualties and assist in gathering information for the flight surgeon appointed to the team investigating the aircraft mishap.

Immediate Post-mishap Duties

  • Care of survivors is the first priority.

  • Draw appropriate labs: (See (4) serum blood drawing.)

  • Do physical exams. The services have agreed that the first FS (GMO in this case) on a mishap scene, or the one to whom mishap victims are brought, shall immediately perform examinations and laboratory procedures required by the flight surgeon’s service.

  • Perform radiological studies as clinically indicated. After all ejections and mishaps resulting in personnel with suspected back injuries, full spinal x-rays are required.

  • Document aircraft-deceased relationships at the mishap site before the remains are moved. Use of photography or sketching the site and relationships are very helpful during mishap investigation board deliberations.

  • Obtain taped statements and interviews from each member of the aircrew (and possibly air traffic controllers or plane captains, etc., as appropriate) recounting the mishap from brief to rescue.

  • Begin interviewing witnesses.

  • Distribute and explain the 72-hour history forms.

  • Impound the medical and dental records.

  • Impound flight equipment.

  • Issue Grounding Notices (NAVMED 6410/1; the " Down Chit").

Other Duties

  • Ascertain injuries and determine the injury codes for the Mishap Investigation Report and Flight Surgeon’s report, known officially as the Aeromedical Analysis (AA).

  • Coordinate with the Armed Forces Institute of Pathology (AFIP) at (202) 782-2100 or DSN 662-2100 for the autopsy.

  • With deceased personnel, obtain full body x-rays in and out of flight equipment with emphasis on hands, feet, head, and neck (AP and lateral). Order special views whenever indicated.

  • Submit lab specimens to AFIP as appropriate.

  • Collect the 72-hour history forms for use in the Aeromedical Analysis.

  • Maintain close followup with those involved to monitor any changes in their medical condition and to obtain further elaboration on the mishap events.

  • Be sensitive to the psychological trauma a mishap may inflict on all, including those participating in remains recovery; counsel or refer, as appropriate.

  • Participate fully in the AMB investigation until the flight surgeon arrives.

  • Initiate completion of the Aeromedical Analysis.

  • For assistance as needed, contact or message the Commands:

Naval Safety Center Aeromedical division: (757) 444-3520

COMNAVAIRPAC: (619) 545-1148

COMNAVAIRLANT force medical: (757) 444-7028/29

Survivor blood drawing

In all Class A and B mishaps, and when deemed necessary in Class C mishaps, collect blood and urine of survivors.

AFIP requests that the following specimens be collected:

  • Serum: 14 to 20 ml (no preservatives, red top) blood: 14-20 ml (Sodium fluoride, gray top) 14 to 20 ml (EDTA, lavender top).

  • Urine: 70 ml is optimum (no preservatives).

However, as a practical guide, as soon as possible after a mishap collect the following laboratory samples from each of the aircrew (as well as anyone else who may have been a factor in the mishap). Prepare the skin with betadine or soap and water. Do not use alcohol swabs

2 – 3 red tops

2 gray tops

2 lavender tops

100 ml of urine

 

Sample analysis

Locally run

AFIP run

Held frozen > 90 days

serum glucose

ETOH level

Drug screen

CBC

CO level

UA (rout. & micro) (SMA-18)

Drug screen

1 gray top

1 gray top

1 lavender top

1 lavender top

Urine + (1 red top) (serum)

1 red top (serum)+ 70 ml urine

1 red top (serum)+ 10 ml urine

References

  • The Naval Flight Surgeon’s Pocket Reference to Aircraft Mishap Investigation, 4th Ed, 1995

  • The Naval Flight Surgeon’s Handbook, 2nd Ed, 1998, The Society of U.S. Naval Flight Surgeons

  • The Naval Flight Surgeon’s Manual 3rd Ed, 1991, NAMI

Revised by CAPT Charles O. Barker, MC, USN, MED-23, Bureau of Medicine and Surgery, Washington, D.C. (1999).

Preface  ·  Administrative Section  ·  Clinical Section

The General Medical Officer Manual , NAVMEDPUB 5134, January 1, 2000
Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300

This web version of The General Medical Officer Manual, NAVMEDPUB 5134 is provided by The Brookside Associates Medical Education Division.  It contains original contents from the official US Navy version, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy 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 Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense. All material in this version is unclassified. This formatting © 2006 Medical Education Division, Brookside Associates, Ltd. All rights reserved.

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