On the unexpected consequences of publication by a novice author.

In the early 1960s, the author became increasingly aware of spatial disorientation as a potential cause of aircraft accidents in the USAF. Using minimal resources, he was able to document this problem and in 1969 as a first-time author published a journal article under the title "Spatial disorientation as a factor in accidents in an operational command." His work was recently used by the USAF in evaluating the need for installation in fighter aircraft of automated equipment to prevent controlled flight into terrain. He received a letter of thanks from the office of the U.S. Secretary of Defense 40 yr after his paper was published. He concludes that even front-line aeromedical personnel can make a worthwhile contribution to the literature.

Development of a state medical surge plan, Part II: Components of a medical surge plan.

In 2003, the Utah State Department of Health received funding from the Health Resources and Services Administration to develop a medical surge plan to increase the number of available hospital beds in the state by 1250 beds, including 125 beds for burn or critical trauma patients. A prior article discussed the planning procedures and process. This article describes the major components of the plan, including analysis of threats, direction and control, activation and system response; communications; and critical issues.

Development of a state medical surge plan, part I: the procedures, process, and lessons learned or confirmed.

In 2003, the Utah Department of Health received funding from the Health Resources and Services Administration to develop a medical surge plan. The plan was designed to increase the number of available hospital beds in the state by 1250 beds, including 125 beds for patients with burns or trauma patients. Interested parties were contacted and a coordinating group composed of Utah Department of Health and University of Utah Health Sciences Center representatives was formed, who were responsible for developing the plan. This article is Part I of a 2-part series that discusses the planning process and identification of a group of stakeholders who served as a planning task force, and concludes with a summary of lessons learned or confirmed during the planning process. Part II will discuss the content of the medical surge plan.

High-risk head and neck movements at high G and interventions to reduce associated neck injury.

BACKGROUND: Neck injuries are a significant concern for aviators of high performance aircraft. A recent comprehensive technical report on cervical spinal injury associated with exposure to sustained acceleration, from NATO's Research and Technology Organization, recommended delineating the neck muscles used by aviators in this flying environment and developing improved neck muscle strengthening programs in an attempt to reduce such injuries. METHODS: A review of current literature was conducted in the fields of biomechanics, ergonomics, orthopedics, neurology, neurosurgery, rehabilitative medicine, and aerospace medicine. An objective description is provided of the muscles involved in specific head and neck movements, and those movements that are associated with a greater risk of injury during high-G sorties. The intensity and duration of force exposures common to high performance aircraft sorties, the effects of seat-back angle on these exposures, and the types and mechanisms of neck injury reported in this environment are also described. RESULTS: Primary, secondary, and tertiary preventive interventions are introduced with the goal of providing unit-level flight surgeons an approach to reducing neck injury and promoting prompt, safe return to flying of aviators with identified neck injury. A central component of these interventions is a "specific" and "intensive" neck muscle training regimen, as described in the medical literature. CONCLUSION: Increased axial compressive force and unique biomechanics combine to make neck injury likely in high performance aviators. The application of some proposed intervention strategies may reduce the occurrence of these injuries.