For want of a flight surgeon....

In 1863, Captain John Randolph Bryan conducted the Confederate States Army's first military reconnaissance balloon flights. On his second flight, he survived a class "A" aviation mishap. This article discusses the probable contributing mishap factors stemming from the lack of an effective aviation medicine program with appropriate flight surgeon input and participation. Physical standards, flying duty medical examinations, the Acceptability Rating for Military Aeronautics (ARMA), crew rest regulations, unit safety programs, physiological training, aviation life support equipment (ALSE), night vision training, survival training, and aircraft accident investigation are explored.

Important AMSUS anniversaries.

The article discusses important upcoming anniversaries of the historical development of the modern day Association of Military Surgeons of the United States (AMSUS) and its medical journal Military Medicine. It does this through chronicling the successive, antecedent military medical and dental associations and their journals which amalgamated to form AMSUS. It follows the development of the Association and the journal from the oldest constituent society.

General Armstrong's monuments.

During his term as surgeon general, Maj. Gen. Harry G. Armstrong was interested in the French monument commemorating the balloon flight of John Jeffries, the first American aviator, and Jean Pierre Blanchard. Maj. Gen. Armstrong proposed to visit the monument, located in a French forest, and have it renovated with appropriate multi-national ceremonies. The monument is at the landing site of the first flight across the English Channel. The authors discovered the former and current condition of the monument in Guines, France and compare that monument, of interest to Maj. Gen. Armstrong, to a new monument named for him, the newly enlarged U.S.A.F. Armstrong Laboratory.

Compatibility of the aviation night vision imaging systems and the aging aviator.

With the advent of the night vision goggle (NVG) mission requirements in the United States Army, the reserve components began training with the second generation (AN/PVS-5 & AN/PVS-5A) systems. These systems prohibit the wear of spectacles by the aviator. Certain modifications on some systems allowed for spectacle wear. However, there still exists a 5-h day filter training minimum in which the full NVG with facemask and cushion must be worn without spectacles. The NVG system corrects up to +2.00 diopters of hyperopia and up to -6.00 diopters of myopia, but only +/- 1.00 diopter of astigmatism. A survey of the reserve component (USAR and NG) aviators in the Southwest was conducted to establish the relative incompatibility of the NVG system among an aviator population older than the active component aviators. All medical record custodians received questionnaires and the flight surgeon followed up replies by telephone or on-site visits. We screened a total of 127 aviator records. The aviator's average age was 39.5 years; 65.3% had 20/20 vision and were emmetropes. Of those that wore spectacles, 82.4% had hyperopia or myopia correctable by the built-in optical adjustments contained in the NVG. The other 17.6%, who had vision that exceeded the correction factors built into the NVG, consisted of astigmats with greater than 2.00 diopters of cylinder. Nearly 20% of the aviators who wore corrective lenses exceeded the corrective limits of the goggles that they used. Further, pilots had no specific prescreening instruction. With the development of more sophisticated aviation optics. Three options exist: modify visual standards, allow contact lens wear, or design future systems to be compatible with spectacles.

U.S. Army anthropometric standards for rotary-wing aviators in the light observation helicopter.

U.S. Army anthropometric standards for rotary-wing aviators were examined to determine if the standards allowed an adequate fit of the aviator to the cockpit of the OH-58A "Kiowa" light observation helicopter, which now comprises the overwhelming majority of light helicopters in the active army and reserve forces. Thirty rated aviators with heights less than or equal to 70 in. were examined, and standard anthropometric measurements were made. Army regulations require these measurements on all initial-entry aviation students with heights less than or equal to 68 in. The aviators were then placed in a representative OH-58A cockpit to determine their ability to reach all control surfaces and panel switches. Several aviators greater than 68 in. tall and, therefore, not subject to anthropometric testing upon entry into army aviation, could not perform all cockpit tasks without cockpit changes beyond the limited adjustments in the OH-58A. Several had developed aid devices, especially pads to support forearm-to-thigh "spot welds" to ensure right arm stability on the cyclic control. The same problem was seen with some aviators less than 68 in. in height, who had been anthropometrically evaluated. The present standards do not adequately address functional ability in the OH-58A cockpit, which is the least adjustable cockpit in the combat inventory. Design modifications to accommodate these factors exist and should be used to retrofit existing aircraft and to design future aircrafts.

Injury pattern analysis of helicopter wire strike accidents (-Gz load).

Injury patterns in rotary wing aircraft wire strike accidents were reviewed to determine mechanisms of injury. It was found that U.S. Army Safety Center data showed that between 1 January 1974 and 31 August 1981 there were 167 wire strikes involving Army helicopters which resulted in 60 injuries and 34 fatalities at a cost of $12,809,100. Updated data on all military rotary wing aircraft accidents investigated between 1978 and 1982 were screened by the Division of Aerospace Pathology to determine the mechanisms of injury to flight deck personnel. From 13 December 1978 to 23 June 1982, three types of rotary wing aircraft were in eight fatal accidents. These mishaps accounted for 28 casualties: 14 fatalities and 14 injuries. Aviators comprised 64.4% of the fatalities. Injury pattern analysis showed 100% had major head and neck injuries with 66% having basilar skull fractures. Two-thirds had associated mandibular fractures or evidence of impact forces transmitted through the mandible to the skull. The same number had wedge-shaped chin lacerations from impact with the cyclic control stick. We postulate transmission of lethal impact forces primarily in the +Gz direction through the mandible to the skull. This suggests either improper use and/or failure of the seat and restraint systems.