[Stages of development of flight medical expertise in Russia].

Flight medical expertise (FME) in military aviation is one of the most important areas of medical support of flight crews manning, maintaining of aircrew health and flight safety. The authors analyse the main stages of development of this area of medical practice. The priority in creation of FME system belongs to our country. Domestic scientists, prominent organizers of military medicine and a large group of aviation physicians developed organizational and methodological basis for studying different impacts of flight factors on the health of flight personnel, development of criteria for admission to flight operations, principles of organization of the examination, implementation of effective methods of disease diagnosis. At the present stage FME development is determined by the needs of medical, technical and psycho-physiological support of supersonic aircraft, the need to adjust to the requirements of aircrew health, advanced diagnostics of the functional state and the search for means to improve the stability of his body to flight factors. The main principles of the FME remains the complexity of the study of the human body in terms of its professional and individual approach to a medical examination, a thorough clinical, clinical and physiological and psychological examinations, regular medical supervision of the health of flight crews.

[Methodological basis for modern stage of medical examination of the state aviation air crew].

The main methodological framework to improve the system of medical examination of flight crews is the concept of occupational health. One of the important areas is the study of the epidemiology of professionally caused disadaptation functional disorders and subclinical disease in aircrew, their preclinical diagnosis and classification. Pointed to the need to improve organizational and practical principle of comprehensive and regular inspection of the body of the pilot, not only for diagnostic purposes, but also for the smooth conduct medical and rehabilitation measures. Proved the ways to achieve these goals.

[Medical outcomes of emergency ejections from Russian aircrafts in 2003-2010].

Outcomes of 36 accidents with 37 aircrafts (one mid-air collision) in the period of 2003-2010 have been analyzed. Of 71 ejected crew members 14 pilots died (19.7%), 26 pilots (36.6%) suffered injuries of varying severity and 31 pilots (43.7%) escaped noticeable injuries. The major causes of the deaths were late emergency escape and failure of the eject mechanism (EM). The majority of harmed pilots (n = 18, 69.2%) had slight injuries; one crew member (3.9%) was injured moderately and 7 pilots (26.9%), substantively. Most of the injuries occurred on parachute landing (40.3%). The main reasons for severe injury were parachute landing impact (69.2%) and EM failure (23.1%). Commonly injuries were caused to the head and neck (30.7%) and a bit less often to the lower and upper extremities (22.6 and 19.4% respectively). 14.5% of the injuries were brought to the body and 11.3%--to the back. Severe injuries included fractures of the spine (42.9%) and lower and upper extremities (42.9 and 14.2% respectively).