Aeromedical Mishap
Investigation
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
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
surgeons 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 Surgeons 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 Surgeons Pocket Reference to Aircraft Mishap
Investigation, 4th Ed, 1995
-
The Naval Flight Surgeons Handbook, 2nd Ed, 1998, The
Society of U.S. Naval Flight Surgeons
-
The Naval Flight Surgeons Manual 3rd Ed, 1991, NAMI
Revised by CAPT Charles O. Barker, MC, USN, MED-23, Bureau of
Medicine and Surgery, Washington, D.C. (1999).
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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
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