Aerospace Medicine - Role and Management

Introduction

Aerospace medicine is a field that focuses on the health and safety of the crew members and passengers of air and space vehicles. The focus is on research, clinical care, and operational support to improve the performance and operation of air and space vehicles. Travelers in space vehicles are a subset of people who live and work in isolated, remote, and extremely enclosed environments. These work conditions could cause psychological and physical stress. Therefore, the practitioners of aerospace medicine strive to achieve a safe and optimal occupational setting, along with countermeasures to deal with the hazards.

What Is Aerospace Medicine?

Aerospace medicine is a field that determines and maintains the health, performance, and safety of the people undergoing air and space travel. The space and aviation environments provide many challenges for the people embarking on their exploration, including radiation exposure, microgravity, emergency ejection injuries, G-forces, and low-oxygen environments. Unfortunately, primary care and surgical specialties do not address these issues. Therefore, aerospace medicine is needed to manage the healthcare of civilian and military aviators and space explorers. The physicians trained in aerospace medicine study in-depth, explore extreme environments and are trained in the appropriate medical management of the aviators and space explorers, thus ensuring safe skies.

Why Is Aerospace Medicine Necessary?

Several medical problems are encountered by people traveling in the air and beyond the atmosphere. Aerospace medicine includes aviation medicine and space medicine to promote the safety of travelers in and beyond the atmosphere. The various issues faced by aviators and space travelers include:

1. Stress due to aerospace flight.

2. Decompression illness (pain in and around joints).

3. Extreme temperature.

4. Low atmospheric pressure.

5. Radiation.

6. Noise.

7. Vibrations.

8. Oxygen deprivation.

9. Strong forces of acceleration and deceleration.

10. Motion sickness.

11. Pilot fatigue.

12. Discomfort from hunger or sleep deprivation.

13. Psychological disturbances caused by isolation and confinement.

What Are the Diverse Work Areas of Aerospace Medicine Physicians?

Aerospace medicine finds its home with clinics and agencies concerning the safety and medical issues related to aviation and space travel. Thus, aerospace medicine doctors trained in the field are found worldwide. They do not practice in traditional hospital settings. Instead, they work with the military, regulatory agencies, commercial airline companies, space agencies, and independent clinics (for medical flight certifications and in academia.

What Is the Role of an Aerospace Medicine Physician?

The role of aerospace medicine physicians is quite diverse and varies depending on their place of work. For example, they can be involved in establishing certification protocols for aviators who have challenging medical issues and in providing medical ground support to those in spaceflight experiencing illness or effects of microgravity. On the other hand, suppose they are employed in the military (active duty and reserves). In that case, their operational role ranges from providing medical support to flight squadrons and their families to evaluating the medical facilities in the military. The civilian aerospace medicine doctors work with the following:

1. Commercial airline medical offices.

2. Private practice offices are concerned with aviator medical certification and review officer privileges.

3. Aviation regulatory agencies.

4. General aviator education and academia.

5. Accident investigation research.

6. Space centers (for spaceflight crew medical support and related research).

What Are the Key Roles of Aviation Medicine Physicians?

Physicians trained in aerospace medicine are called flight surgeons. The key roles of aerospace medicine physicians include:

1. Establish and apply medical standards for the selection and certification of flight personnel and pilots.

2. To ensure that the air travelers, pilots, and flight personnel have no medical conditions impairing their performance.

3. Planning and guiding flight-crew training in first aid.

4. Planning and guiding flight-crew training to prevent injuries and illness in passengers.

5. Training paramedical staff in aerial transportation of patients.

6. Application of preventive medicine principles to prevent disease spread by air travel.

7. To conduct medical evaluations of astronauts post-flight.

8. To identify the adverse effects of traveling to space on the human body.

9. To monitor the astronauts during space flight (their physiological response to space and travel).

10. To advise the astronauts on how to manage the medical problems that occur in flight.

11. They are involved in developing emergency systems, vehicles, and protective equipment for space travel.

What Are Inflight Medical Emergencies, and How Are They Managed?

In-flight medical emergencies are health emergencies that can occur during air travel with limited medical resources. The emergencies occur within an airplane cabin, with different atmospheric pressure, low oxygen, and humidity. The aerospace medicine physicians are involved in ensuring the safety of patients. The emergency kits include the following:

1. An automated external defibrillator (to manage cardiac emergencies).

2. Basic assessment equipment.

3. Equipment and tools to control hemorrhage (bleeding).

4. Intravenous line tool kit.

5. Emergency medications to treat common health emergencies and basic conditions.

The most common medical emergencies include:

1. Syncope (fainting) and near-syncope.

2. Gastrointestinal problems.

3. Respiratory emergencies.

4. Heart-related emergencies.

Diversion of aircraft and landing at a different airport can occur in case of major health emergencies during flight. Healthcare professionals in aerospace medicine manage these emergencies in-flight as a part of the team (involving the flight crew), and ground-based physicians guide the necessary interventions.

How to Prevent Medical Emergencies That Occur During Air Travel?

Preventing medical emergencies is the most effective way to address them in flight. These include:

1. Air travelers should keep themselves hydrated during travel. They should also eat the scheduled meals and snacks during extended travel. These prevent the risk of fainting (syncope).

2. Physicians must educate patients with chronic medical conditions on possible medical emergencies during travel and guide them to prevent such emergencies.

3. A person with uncontrolled diabetes must carry glucometers, medications, and glucose supplements during air travel.

4. A person with a high risk of symptomatic hypoxia must carry a portable oxygen concentrator during the flight.

5. Parents in flight with their kids must carry pediatric medications, especially if their child has an underlying health condition.

6. Healthcare professionals must consult with flight and medical transport experts for special circumstances.

Conclusion

The space and aviation environments provide many challenges for people traveling in and above the atmosphere. Aerospace medicine is a specialized field of medicine training physicians to ensure the safety and health of aviators and space travelers. In addition, the aerospace medicine physicians work with the military, regulatory agencies, commercial airline companies, space agencies, and independent clinics for medical flight certifications and in academia to ensure safe and healthy air travel.