physiological training in hypobaric chamber · • hypobaric chamber system separated from the...
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XX Congresso AI.M.A.S. – Firenze 4/7 settembre 2007
Physiological training in
Hypobaric Chamber
Lt. Col. Francesco Torchia, M.D.
Capo Gruppo Alta Quota ed Ambienti EstremiCentro Sperimentale Volo
Reparto di Medicina Aeronautica e Spaziale
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Guidonia1938 ca.
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Pratica di Mare 2007
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Altitude range: 0 - 100.000 ftMax theoretical altitude: 200.000 ftMax altitude for training: 45.000 ft
Main ch. 10 seats + 2
Secondary ch. 4+1
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Programmable logic computer- Fresh air flow rate up to 1000 m3/h- Temperature adj. range: 15-25 CO
- Humidity adj. range: 20-80%- 2 Fire suppression system (water + Inergen)-Oxygen % detector- System failure
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HyperbaricChamber
DCS treatment
Single seat + 1 assistant
50 mt max capacity
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Physiological trainingin hypobaric chamber
1)1) Hypoxia experience
2) Hypobarism experience
3) Cabin decompression
4) Oxygen equipment training (oxygen mask and regulator, positive pressure breathing)
5) Emergency procedure
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0 10 20 30 40 50 60 70
HypobaricHypobaric chamberchamber profileprofile typetype 22
Altitude (ft)
Time (min)
Sinus checkDenitrogen
Hypo experience
Night hypo ex.
Basic Course : all military pilots
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HypobaricHypobaric chamberchamber profileprofile typetype 2A2A
Altitude (ft)
Time (min)
Sinus checkDenitrogen
Hypo exp.Night hypo ex.
Initial Course : EFA and F16 pilots
PPB experience
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HypobaricHypobaric chamberchamber profileprofile typetype 11Flight personnelArmy Paratroopers “Col Moschin”Refresher course (every 5 ys)
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HypobaricHypobaric chamberchamber profileprofile typetype 33((RapidRapid decompressiondecompression))
< 3 S
2.500 ft/min.
Main chamber up to 33000
G.L.
Altitude (ft)
Sinus check
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First training exercise20 may 2003
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Physiological Training 2003 - 2007Aerospace Medicine Department
Data: Centro Sperimentale Volo
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2003 2004 2005 2006 1^sem.2007
25,000ft35,000ft43,000ftR.D.
97
240
217 220
111
Totale: 885
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Medical problems
• No DCS• 4 mild barotrauma- 1 frontal sinus (descending at 5.000ft)- 1 left middle ear (descending at 7.000ft)- 1 barodontalgia at 16.000ft- 1 abdominal pain at 32.000ft
• 1 hypoxia under PPB• 1 panic reaction wearing mask + helmet ….
(a doctor !!)
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Standard Operational Procedure
• PO-RMAS-028-REV01 jan 2004• “Hypobaric chamber” (system safety,
responsibility, personnel)• “Physiological training” (personnel, tasks)• “Experimental exercise”• Documents enclosed: personnel
qualification, emergency procedures, checklist, registrers, medical records
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Our Team
• Exercise above 18.000 ft:- 1 main operator- 1 qualified instructor every 5 students- 1 medical doctor- 1 qualified nurse - 2 hypobaric chamber technicians- 2 hyperbaric chamber technicians (Air Force
personnel qualified as Navy divers)*
(*) not required if the profile is below 18.000 ft
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Personnel qualification• Aerospace Physiologist non-USAF• Aerospace Medicine Primary for FS• Naval Flight Surgeon• AMST hypobaric ch. course• PHTLS/MIMMS
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Medical check: preflight- Blood exam (sickle cell disease screening)- Medical questionnaire + Flight physical check- Tympanic membrane impedance exam + ENT exam
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In-flight telemetricmonitoring system
ECG Respiratory rateHeart rateO2 arterial saturation
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Post flight- Medical and ENT check if needed- Otovent for delayed barotrauma prevention
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Scientific cooperation• Angelo D’Arrigo: - Flying over Everest- Flying over Aconcagua
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Scientific cooperation• Veronique Billat: “Alexia 8000” evaluation of
COSMED K4b2 portable metabolimeter
• Milano University: evaluation of an instrument tomeasure pulmonary impedance (in asthmaticpatients)
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Future research
• Modification of ocular pressure in hypobaric condition
• Arythmias and Hypoxia• Hyperbaric preoxygenation for DCS
prevention• Hypoxic stress inducing hormones profile
modification
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NATO STANAG nNATO STANAG n°° 31143114Aeromedical Training of flight Aeromedical Training of flight personnelpersonnel
SMA 324SMA 324--0101--0000Direttiva per lDirettiva per l’’addestramento addestramento aerofisiologicoaerofisiologicodel personale navigante e degli equipaggi fissi del personale navigante e degli equipaggi fissi
di volodi volo
Dalla ricerca all’addestramento aerofisiologico….
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Operational characteristics
- Altitude range: 0 - 100.000 ft- Max theoretical altitude: 200.000 ft- Max altitude for training: 45.000 ft- Climb rate range: 500 - 16.000 ft/min (max
10K’ with trainees)- Descend rate r.: 500 - 20.000 ft/min (max
11K’ with trainees)
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Operational characteristics- Main Chamber volume: 25.3 m3
- Secondary chamber volume: 12.4 m3
- Fresh air flow rate < 25.000 ft: 1000 m3/h- Fresh air flow rate > 25.000 ft: 400 m3/h- Temperature adj. range: bw 15 and 25 CO
- Humidity adj. range: bw 20 and 80%- 2 Fire suppression system (water + Inergen)- Oxygen % detector- Data trasmission via modem
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System modification
• Hypobaric chamber system separated from the hyperbaric chamber system
• O2 and compressed air in a separate building• Fukuda system• O2 sensor below the false floor• Modem• Audio system modification for inside instructors• CO2 sensor in hyperbaric chamber• Autorespiratore
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Problems
• Safety valve inside the chamber• Audio system monodirectional• Oxygen regulator