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Symposium
2002 Tours
Davis Hyberbaric Laboratory
The
role of the U.S. Air Force School of Aerospace Medicine (USAFSAM)
Davis Hyperbaric Laboratory at Brooks Air Force Base, Texas, has
expanded tremendously since 1974 when its primary purpose was
to treat aviators suffering from decompression sickness. The laboratory
is now internationally recognized as a leading authority in patient
treatment, facility requirements, safety standards and research
using hyperbaric oxygen (HBO). HBO is used to treat medical disorders
such as chronic nonhealing wounds, carbon monoxide poisoning,
osteo-radionecrosis, gas gangrene and air gas embolism.
The Hyperbaric Medicine Division serves as the lead agency for
all Department of Defense clinical hyperbaric facilities, and
as the center establishing policy for all U.S. Air Force clinical
and operational (field) hyperbaric facilities.
Each year approximately 250 patients are evaluated and treated
and more than 3,000 treatments are prescribed at USAFSAM, Department
of Force Enhancement, Hyperbaric Medicine Division (FEH). To date,
more than 5,000 patients have been treated. There are two multiplace
chambers and one monoplace chamber. A 12-place chamber is typically
used for the majority of patient care. The four-place "Panama"
chamber (probably the oldest operating hyperbaric chamber in the
world, dating back to 1903-1904) is available for patient overflow
and customizing of treatment protocols. There is also a Sechrist
monoplace chamber, which can be utilized to help meet scheduling
requirements. Most patients are referred from three tertiary care
hospitals: Audie Murphy VA Hospital (San Antonio), Wilford Hall
Medical Center (Lackland Air Force Base, Texas) and Brooke Army
Medical Center (Fort Sam Houston, Texas).
This large patient population forms the foundation for the Air
Force Physician Fellowship in Clinical Hyperbaric Medicine. This
is a broad-based, intensive, study of hyperbaric and hypobaric
physiology, wound physiology, diving medicine, and clinical hyperbaric
medicine. The duration of study is one year, and up to four fellows
can be accepted, two Air Force and two from other U.S. or allied
military organizations. Prospective Fellows are expected to be
board eligible/certified in a primary care or surgical specialty.
In addition, each Air Force Fellow must be a flight surgeon having
completed the Air Force Aerospace Medicine Primary Course or its
equivalent. Responsibilities during the Fellowship include patient
care, formal lectures, conference presentations, research, Air
Force Hyperbaric Newsletter articles, a structured reading program,
and multiple outside courses and rotations designed to enhance
and supplement their training experience. The final product of
this Fellowship is a physician who is among the finest trained
operational hyperbaric medicine specialists in the country.
Clinical Hyperbaric Medicine is a rapidly growing medical specialty.
The basis for wound care and hyperbaric oxygen therapy are grounded
in sound physiology. The primary payoff is reduced overall healing
time for many debilitating wounds. This translates directly into
reduced hospitalization times and associated medical costs for
the DoD. Research is consistently unearthing hidden mechanisms
that were unpredictable or unexpected (i.e., reperfusion injury
mitigation). Research and patient care experiences at Brooks AFB
were instrumental in the revival of hyperbaric medicine. Today,
our facility remains at the forefront of clinical hyperbaric medicine.
The present training curriculums are well structured, intense
and innovative. Whether for the technician, nurse, or physician,
there is no better-recognized program than that found at USAFSAM's
Davis Hyperbaric Laboratory.
Centrifuge
When
Brooks Air Force Base began pilot training in World War I, the
gravitational effects (G forces) on the human body caused by aircraft
dive pullouts and sharp turns were not a major concern to aviation
researchers even though pilots were reporting degradation of vision
and ³fainting in the air² (loss of consciousness) when performing
high speed maneuvers. As the Air Force's aircraft inventory grew
more sophisticated and faster, reports of acceleration (G) problems
increased in number becoming a more important operational problem
for fighter planes. It was apparent that these G effects could
cause accidents with possible loss of aircraft and aircrew. A
test vehicle was needed to study these problems in a controlled
and safe environment. In 1938, the first such vehicle (a centrifuge
for human use) was built at Wright Field (now Wright-Patterson
Air Force Base, Ohio).
In 1964, the U.S. Air Force School of Aerospace Medicine, now
a unit of the 311th Human Systems Wing, installed a large centrifuge
at Brooks to study such higher G effects on humans and to develop
life support equipment to help protect aircrews from these effects.
Research support equipment was installed to include pulmonary,
blood gas and cardiovascular monitoring facilities, and data and
video equipment to help record human physiologic response to high-sustained
G forces. The centrifuge is now operated by the Air Force Research
Laboratory, Biodynamics and Protection Division, Flight Motion
Effects Branch.
The primary missions of this AFRL centrifuge are to provide:
A test vehicle for developing and assessing the effectiveness
of experimental aircrew G-protection equipment and methods.
A means for indoctrination and training of aeromedical specialists
and other aerospace personnel in the use of these protective techniques.
Initially, the centrifuge could accomplish acceleration onset
rates up to 1.5 G per second, which was adequate to simulate the
performance of most aircraft of that time. In 1971, a USAFSAM
centrifuge human G tolerance record of 9 Gs for 45 seconds was
established using the G-protective equipment and straining techniques
developed at USAFSAM. At that time, high performance aircraft
such as the F-15 and F-16 were in design and the achievement of
this new high-G record helped to prove that pilots could effectively
fly these new aircraft.
As studies in acceleration physiology continued, it was learned
that the rate of G onset, as well as G level, was a very important
factor in the effect of G on humans. It was obvious that the original
centrifuge could not simulate the G onset rates of the newer high
performance aircraft. In September 1984, the Brooks Air Force
Base centrifuge was modified to boost the G-onset rate from 1.5
G per second to 6 G per second and to update the control system
and physiological monitoring equipment.
Scientists of the Flight Motion Effects Branch (AFRL/HEPM) have
developed new protective equipment such as pressure breathing
systems, an advanced anti-G suit and valve, physical conditioning
programs to increase G tolerance and advanced straining techniques
that pilots of the new high performance aircraft needed to survive
and perform in the new high-G environment. This centrifuge has
also been used to train thousands of aeromedical specialists in
the proper use of this equipment and techniques.
The AFRL centrifuge has proven to be a valuable tool to the Air
Force and is continuously used by researchers to investigate present
and future areas of acceleration effects and protection not even
conceivable to the early aviation cadets who flew out of Brooks
Field during World War I.
Following are facts about the centrifuge:
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Horsepower:
1,000 Hp (four 250-horsepower electric motors)
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Number
of operators:
3 for direct training contact
2 additional supervisor/support personnel = 5 total personnel
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Duties
of these personnel:
1 - Flight Surgeon as medical monitor
1 - Aerospace Physiologist or Principal Investigator
1 - Operator
1 - Central observer
1 - Data specialist/Recorder
For
More Information...
For
more information about the symposium, contact Janie D. Fields,
Executive Director at 512.657.7405 or e-mail
, Director of Education.
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A
copy of the proceedings from the 2000 Symposium is now available!
Please visit Scientific
Proceedings to learn more. (11
CME's are available including 1 hour of ethics for reviewing the
home study course)
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