[Measure on medical care and rescue for the first Chinese astronaut during manned space flight]

OBJECTIVE

To discuss the experience of medical care and rescue for the first Chinese astronaut during manned space flight.

METHODS

Review the experiences of foreign nations in respect to accidental injuries of astronaut during manned space flight, the possible reasons were analyzed, and accordingly a reasonable and effective prophylactic measures and health care were formulated.

RESULTS

An effective mobile intensive care unit (ICU) was established on desert or prairie where the capsule would land, so as to ensure the safety of the first Chinese astronaut, and to provide intensive care as well as successful emergency treatment in case of accidental injuries.

CONCLUSION

Reasonable and effective prophylactic measures and health care appear to be an important aspect of the successful manned space flight.

Columbia: what went wrong?

The results of the Gehman board's exhaustive investigation of the Columbia accident (STS-107) will have far-reaching effects on the U.S. space program.

Lawmakers battle for reform on many fronts

In Washington, much of the attention of the nation's leaders is focused on the economy, on next year's election, and on the war's aftermath in Iraq. Polls show that a restive nation wants more jobs and fewer casualties in the war on terror. In the world of aerospace, few topics seem to be headline-grabbers lately, but the lawmakers are always working on air and space issues--some of them very familiar to Americans. The U.S. program for manned spaceflight remains controversial and a firm date for a return to flight elusive. The little-known air war in Colombia is receiving more attention than many in Washington would like. And the Air Force plan to lease air-refueling tankers continues to draw flak from the Hill.

Human Factors in Air Traffic Control: Problems at the Interfaces

The triangular ISIS model for describing the operation of human factors in complex sociotechnical organisations or systems is applied in this research to a large international air traffic control system. A large sample of senior Air Traffic Controllers were randomly assigned to small focus discussion groups, whose task was to identify problems occurring at the interfaces of the three major human factor components: individual, system impacts, and social. From these discussions, a number of significant interface problems, which could adversely affect the functioning of the Air Traffic Control System, emerged. The majority of these occurred at the Individual-System Impact and Individual-Social interfaces and involved a perceived need for further interface centered training.

Medical risk factors in fatal military aviation crashes: a case-control study

BACKGROUND

Periodic medical examinations are the daily work of the flight surgeon. Their immediate impact on flight safety, however, has not been evaluated. This case-control study was done to ascertain whether, among German military pilots, differences exist in the results of periodic medical examinations that were associated with a higher odds of being involved in a fatal aircraft mishap.

METHODS

Participants were 146 German military pilots who died in air crashes and 292 controls. Cases and controls were matched 1:2 by aeronautical confounders (age, type of aircraft aeronautical experience, and membership in the air force, army, or navy). Data source was the central register of the German Air Force Institute of Aviation Medicine; data were obtained from periodic medical examinations and included physical examination and laboratory data. Odds ratios were calculated by conditional logistic regression analysis.

RESULTS

Descriptive statistics showed no distinct difference between cases and controls in most of the parameters considered except for total serum bilirubin, but multiple conditional logistic regression showed no remarkably different odds for any of the parameters tested.

CONCLUSION

In aircrew who pass all the criteria for fitness to fly there are no important medical risk factors for fatal air crashes that can be detected by periodic medical examinations.

Paragliding accidents--the spine is at risk. A study from a Swiss Trauma Centre

In recent decades, paragliding-like other fashionable activities-has become a part of lifestyle and outdoor activities. The introduction of protective devices has helped to reduce the risk of severe injuries. However, it seems that the spine remains the paraglider's 'Achilles heel'. Better education, training, and the introduction of innovative back protectors are required to reduce the frequency and severity of paragliding injuries.

Effects of deliberate practice on crisis decision performance

This study examined the impact of deliberate practice on pilot decision making in once-in-a-career crisis decision scenarios. First we explored the impact of deliberate practice on pilot decision-making performance for crisis flying scenarios that had been practiced in their entirety. Then we looked at the impact of deliberate practice in which one aspect of the crisis scenario--the particular malfunction--was unpracticed. We analyzed pilot decision-making performance in response to 160 airborne mechanical malfunctions. We initially found that deliberate practice significantly improves decision-making performance for wholly practiced crises but does not improve decision-making performance when the specific malfunction has not been practiced. We then split decision making for each crisis into two phases: assessment and action selection. For wholly practiced crisis scenarios, additional deliberate practice positively impacts each decision-making phase. However, for part-practiced scenarios, deliberate practice appears to differentially affect phase of error. Specifically, pilots with more deliberate practice erred in action selection, whereas less-practiced pilots erred in assessment. Actual or potential applications of this research include training proscriptions for crisis decision making.

Weatherwise: evaluation of a cue-based training approach for the recognition of deteriorating weather conditions during flight

Inappropriate and ineffective weather-related decision making continues to account for a significant proportion of general aviation fatalities in the United States and elsewhere. This study details the evaluation of a computer-based training system that was developed to provide visual pilots with the skills necessary to recognize and respond to the cues associated with deteriorating weather conditions during flight. A total of 66 pilots were assigned to one of two groups, and the evaluation process was undertaken at both a self-report and performance level. At the self-report level, the results suggested that pilots were more likely to use the cues following exposure to the training program. From a performance perspective, there is evidence to suggest that cue-based training can improve the timeliness of weather-related decision making during visual flight rules flight. Actual or potential applications of this research include the development of computer-based training systems for fault diagnosis in complex industrial environments.

Error Prevention and Error Management in Medicine – Adopting Strategies from Other Professions

The report of the Institute of Medicine (IOM) 'To Err Is Human' received public interest. The simple term 'medical error' as it has been used in public so far does not describe the complex setting in medicine. The development of error management in industry (e.g. aviation) with an emphasis on human factors, communication, and systematic error is demonstrated in order to design similar approaches for medicine. Recommendations are based on the principles for designing safety systems in health care organisations published in the IOM report.

Routine electroencephalograms of pilots later killed in crashes: a case-control study

BACKGROUND

The value of the electroencephalogram (EEG) as a screening tool in aviation medicine is subject to debate. We evaluated the use of periodic repetition of the EEG--after an initial EEG screening-in healthy, fully-licensed pilots to identify risk factors for fatal air crashes.

METHODS

In a nested case-control study, we compared the EEG patterns of 33 pilots who died in military aviation accidents from 1990 to 2001 with the recordings of 66 controls. Cases and controls were matched for potentially confounding factors such as age, military membership, type of aircraft, and aeronautical experience.

RESULTS

Both groups presented normal EEGs. EEG findings in cases and controls did not differ; nonspecific EEG abnormalities did not occur more frequently in those pilots who crashed.

CONCLUSIONS

After an initial EEG screening, periodic repetition of the EEG is not a useful means to detect risk for fatal air crashes.

Collision in space

On June 25, 1997, the Russian supply spacecraft Progress 234 collided with the Mir space station, rupturing Mir's pressure hull, throwing it into an uncontrolled attitude drift, and nearly forcing evacuation of the station. Like many high-profile accidents, this collision was the consequence of a chain of events leading to the final piloting errors that were its immediate cause. The discussion in this article does not resolve the relative contributions of the actions and decisions in this chain. Neither does it suggest corrective measures, many of which are straightforward and have already been implemented by the National Aeronautics and Space Administration (NASA) and the Russian Space Agency. Rather, its purpose is to identify the human factors that played a pervasive role in the incident. Workplace stress, fatigue, and sleep deprivation were identified by NASA as contributory factors in the Mir-Progress collision (Culbertson, 1997; NASA, forthcoming), but other contributing factors, such as requiring crew to perform difficult tasks for which their training is not current, could potentially become important factors in future situations.

Injury prophylaxis in paragliding

OBJECTIVES

To show trends in paragliding injuries and derive recommendations for safety precautions for paraglider pilots on the basis of accident statistics, interviews, questionnaires, medical reports, and current stage of development of paragliding equipment.

METHODS

All paragliding accidents in Germany have to be reported. Information on 409 accidents was collected and analysed for the period 1997-1999.

RESULTS

There was a substantial decrease in reported accidents (166 in 1997; 127 in 1998; 116 in 1999). The number of accidents resulting in spinal injuries was 62 in 1997, 42 in 1998, and 38 in 1999. The most common cause of accident was deflation of the glider (32.5%), followed by oversteering (13.9%), collision with obstacles (12.0%), take off errors (10.3%), landing errors (13.7%), misjudgment of weather conditions (4.9%), unsatisfactory preflight checks (4.9%), mid-air collisions with other flyers (2.2%), accidents during winching (2.2%), and defective equipment (0.5%). Accidents predominantly occurred in mountain areas. Fewer than 100 flights had been logged for 40% of injured pilots. In a total of 39 accidents in which emergency parachutes were used, 10 pilots were seriously injured (26%) and an additional three were killed (8%).

CONCLUSIONS

Injuries in paragliding caused by unpredictable situations can be minimised by (a) using safer gliders in the beginner or intermediate category, (b) improving protection systems, such as padded back protection, and (c) improving pilot skills through performance and safety training.

Autogenic Feedback Training Exercise and pilot performance: enhanced functioning under search-and-rescue flying conditions

Studies have shown that autonomous mode behavior is one cause of aircraft fatalities due to pilot error. In such cases, the pilot is in a high state of psychological and physiological arousal and tends to focus on one problem, while ignoring more critical information. This study examined the effect of training in physiological self-recognition and regulation, as a means of improving crew cockpit performance. Seventeen pilots were assigned to the treatment and control groups matched for accumulated flight hours. The treatment group contained 4 pilots from HC-130 Hercules aircraft and 4 HH-65 Dolphin helicopter pilots; the control group contained 3 pilots of HC-130s and 6 helicopter pilots. During an initial flight, physiological data were recorded on each crewmember and an instructor pilot rated individual crew performance. Eight crewmembers were then taught to regulate their own physiological response levels using Autogenic-Feedback Training Exercise (AFTE). The remaining participants received no training. During a second flight, treatment participants showed significant improvement in performance (rated by the same instructor pilot as in pretests) while controls did not improve. The results indicate that AFTE management of high states of physiological arousal may improve pilot performance during emergency flying conditions.

Human factors analysis of accidents involving visual flight rules flight into adverse weather

BACKGROUND

General aviation (GA) accident statistics indicate that visual flight rules (VFR) flight into instrument meteorological conditions (IMC) is a major safety hazard. However, little research has been conducted to identify the factors that influence VFR pilots' decisions to risk flying into deteriorating weather. The purpose of the present study was to further examine the causes of GA accidents associated with VFR flight into IMC.

METHOD

A comprehensive review of GA accident reports maintained by the National Transportation Safety Board (NTSB) was conducted to identify accidents involving VFR flight into IMC between January 1990 and December 1997. These accidents were compared with other GA accidents that occurred during the same time period.

RESULTS

Analyses of these accidents revealed that VFR flight into IMC accidents were more likely to involve less-experienced pilots and to have passengers aboard the accident aircraft compared with the other GA accidents. In addition, most VFR flight into IMC accidents were considered by the NTSB to have involved intentional flight into adverse weather by the pilot.

DISCUSSION

These findings are interpreted in terms of their implications for the underlying causes of VFR flight into IMC, including situation assessment, risk perception, and social pressure. Intervention programs that address all of these factors are needed.