aerospace medicine and transformation - aimas.it · 2007. 11. 13. · aerospace medicine and...
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Aerospace Medicine and TransformationAerospace Aerospace Medicine Medicine and Transformationand Transformation
Vision and RealityVision and Reality
BrigadierBrigadier General Dr. General Dr. RRöödigdigpresented by: Colonel Dr. Krausepresented by: Colonel Dr. Krause
XX Italian Aerospace Medicine Annual MeetingXX Italian Aerospace Medicine Annual MeetingFlorence, 4.Florence, 4.--77-- September 2007September 2007
NATO StrategyEssential Operational Capabilities
NATO StrategyNATO StrategyEssential Operational CapabilitiesEssential Operational Capabilities
•• MobilityMobility•• InteroperabilityInteroperability•• FlexibilityFlexibility•• SurvivabilitySurvivability•• SustainabilitySustainability•• Rapid Augmentation (module) Rapid Augmentation (module) •• Command & Control (C4ISR)Command & Control (C4ISR)•• Jointness and Jointness and MultinationalityMultinationality
Responsibility for the Health of NATO Forces rests personally with the Operational NATO- Commander
Doc.: MC 326/2 NATO Principles and Policies of Operational Medical Support
Pilot Skill EvolutionPilot Skill EvolutionPilot Skill EvolutionPi
lot
Pilo
tW
orkl
oad
Wor
kloa
d
Aircraft EvolutionAircraft Evolution
Information ProcessingInformation ProcessingRequirementRequirement
Basic AircraftBasic AircraftHandlingHandling
MajGen Robert J. ELDER Jr.
Seat ofSeat ofthe Pantsthe Pants
Decision AideDecision AideSystemsSystems
Ever Tightening OODA CyclesEver Tightening OODA Cycles"The OODA Point""The OODA Point"
• Key is to Observe and Orient with Sensors outside the Aircraft
• Make Targeting Decision
• Link Targeting Informationand Data to Aircraft
• Pilot Acts on Fused Data
BrigGen Robert J. ELDER Jr.
ActAct ObserveObserve
DecideDecide OrientOrient
Battle Space Risk Management
Full Spectrum Health Care
Human Performance Enhancement
Aerospace Medicine
Human to Weapon System
Interface
AEROSPACE MEDICINE AEROSPACE MEDICINE AEROSPACE MEDICINE
Screening, Selectionand Training
Quality Management Evidence Based Medicine
AirMedEvacSAR /CSAR
Interoperabilitymultinational,civil -military
Human SystemsIntegrations
Operational FlightMedicine
Clinical Flight MedicineConsulting and Standards
Prevention
AEROSPACE MEDICINE AEROSPACE MEDICINE AEROSPACE MEDICINE
Quality Management Evidence Based Medicine
AirMedEvacSAR /CSAR
Interoperabilitymultinational,civil -military
Human SystemsIntegrations
Operational FlightMedicine
Clinical Flight MedicineConsulting and Standards
Prevention
Screening, Selectionand Training
Screening, Selectionand Training
Human Consequences of Agile AircraftHuman Human ConsequencesConsequences of Agile of Agile AircraftAircraft
„„OperationalOperational agilityagility““ ((weaponsweapons and systems)and systems)
Airframe AgilityAirframe Agility::-- angle of angle of attackattack
-- nose pointingnose pointing, , multimulti -- axesaxes
-- offoff-- boresight missilesboresight missiles
-- HMD/HOTASHMD/HOTAS
-- sightsight systems (systems (offboard offboard / / onboardonboard))
-- manoeuverabilitymanoeuverability
-- fly by wirefly by wire
Human Consequences of Agile AircraftHuman Human ConsequencesConsequences of Agile of Agile AircraftAircraftTheThe human engineeringhuman engineering challengechallenge
Human Human FactorsFactors::-- neuromuscular consequencesneuromuscular consequences ((biomechanicalbiomechanical))
-- psychomotoric activitiespsychomotoric activities
-- situational awarenesssituational awareness
-- physiological stressesphysiological stresses
-- cognitive performance cognitive performance (man(man--computer symbiosiscomputer symbiosis))
NEW MEDICAL STANDARDS ?NEW MEDICAL STANDARDS ?
Surg. Gen. Dr. Rödig
neuromuscular consequences (biomechanical)neuromuscular consequencesneuromuscular consequences ((biomechanicalbiomechanical))
Stenosis Cervical CordStenosis Cervical CordGiant ArachnoidalGiant Arachnoidal--cystcyst
c - TEE c c -- TEE TEE
contrastcontrast -- enhanced transesophagealenhanced transesophagealechocardiographyechocardiography(c(c--TEE)
„„gold standardgold standard““TEE)
OpenOpen foramenforamen ovaleovale
PFO : PFO : 27,3%27,3% overall incidenceoverall incidence of of different different degreesdegreesRiskRisk: : paradoxical embolismparadoxical embolism
Pilot TrainingPilot Training
•• Basic Piloting Skills Still TaughtBasic Piloting Skills Still Taught–– Flying SkillsFlying Skills–– Decision MakingDecision Making–– Tactical NavigationTactical Navigation
•• Focus Will Change to:Focus Will Change to:–– Display ManipulationDisplay Manipulation–– Information ManagementInformation Management
•• Upgrade Trainer CockpitsUpgrade Trainer Cockpits
BrigGen Robert J. ELDER Jr.
The FourthThe Fourth--Generation ChallengeGeneration Challenge
Sustained 9Sustained 9--g g maneuverability maneuverability
with g onset rates of with g onset rates of
15 to 20 g per second15 to 20 g per second
Problem Areas of Conventional SystemsProblem Areas of Conventional Systems
•• TimeTime--delayed effect delayed effect
•• Voice communication impossible at > Voice communication impossible at > 6 g 6 g
•• Arm painArm pain
•• Substantial fatigue of the pilotsSubstantial fatigue of the pilots
•• System faults cannot be compensatedSystem faults cannot be compensated
•• Physiological longPhysiological long--term effects of term effects of pressure breathing?pressure breathing?
Upgrade Hochleistungszentrifuge in Königsbrück
g-Onset:5 g/s -> 10 g/sec
„Close(r) to Reality“
Upgrade Hochleistungszentrifuge in Königsbrück
Neue Gondel (Karbon-Faser)360°-Motion X/Y/Z-Achse in Active-Steering-Mode
Push-Pull-Phänomen Simulation
Upgrade Hochleistungszentrifuge in Königsbrück
Glas-Cockpit analog zu EF-2000
Screening, Selectionand Training
Quality Management Evidence Based Medicine
AirMedEvacSAR /CSAR
Interoperabilitymultinational,civil -military
Human SystemsIntegrations
Clinical Flight MedicineConsulting and Standards
Prevention
Operational FlightMedicine
Operational FlightMedicine
AEROSPACE MEDICINE AEROSPACE MEDICINE AEROSPACE MEDICINE
Performance Level DegradationPerformance Level DegradationPerformance Level Degradation
•• After 17 hours of sustained After 17 hours of sustained wakefulness, science has shown wakefulness, science has shown that crews will have the same that crews will have the same degraded performance as degraded performance as someone with a Blood Alcohol someone with a Blood Alcohol Concentration (BAC) of 0.05%Concentration (BAC) of 0.05%
•• After 24 hours of sustained After 24 hours of sustained wakefulness, performance wakefulness, performance degradation is similar to degradation is similar to someone who has a BAC level someone who has a BAC level of roughly 0.10% of roughly 0.10% ---- legally legally intoxicated in all statesintoxicated in all states
1Dawson, D. and Reid, K., "Fatigue, Alcohol and Performance Impairment." Nature, 388 (1997): 235.
Emergency Medicine Emergency Medicine Emergency Medicine
Emergency MedicineEmergency MedicineEmergency Medicine
AEROSPACE MEDICINE AEROSPACE MEDICINE AEROSPACE MEDICINE
Screening, Selectionand Training
Quality Management Evidence Based Medicine
AirMedEvacSAR /CSAR
Interoperabilitymultinational,civil -military
Human SystemsIntegrations
Operational FlightMedicine
Prevention
Clinical Flight MedicineConsulting and Standards
Clinical Flight MedicineConsulting and Standards
CT-Angiographie - 64 slicesCTCT--AngiographieAngiographie -- 64 64 slicesslices
VISUAL
VISUAL
HMD/Visors
Contact lenses Color vision
AIDS
AIDS
NVG / FLIR
AEROSPACE MEDICINE AEROSPACE MEDICINE AEROSPACE MEDICINE
Screening, Selectionand Training
Quality Management Evidence Based Medicine
AirMedEvacSAR /CSAR
Interoperabilitymultinational,civil -military
Human SystemsIntegrations
Operational FlightMedicine
Clinical Flight MedicineConsulting and Standards
PreventionPrevention
•• identifying the risks and threats to the health of soldiers identifying the risks and threats to the health of soldiers deployed in a specific theatre of operations fromdeployed in a specific theatre of operations from-- terrainterrain-- climateclimate-- endemic diseaseendemic disease-- special environmental & occupational hazardsspecial environmental & occupational hazards
•• identifying necessary preventive and controlling measures identifying necessary preventive and controlling measures and and advising commanders on their implementationadvising commanders on their implementation
Preventive MedicineMilitary
Preventive MedicinePreventive MedicineMilitaryMilitary
TACTICS
LEPLEP
AEROSPACE MEDICINE AEROSPACE MEDICINE AEROSPACE MEDICINE
Screening, Selectionand Training
AirMedEvacSAR /CSAR
Interoperabilitymultinational,civil -military
Human SystemsIntegrations
Operational FlightMedicine
Clinical Flight MedicineConsulting and Standards
PreventionQuality Management Evidence Based Medicine
Quality Management Evidence Based Medicine
PLAN
DOCHECK
ACT
AEROSPACE MEDICINE AEROSPACE MEDICINE AEROSPACE MEDICINE
Screening, Selectionand Training
Quality Management Evidence Based Medicine
Interoperabilitymultinational,civil -military
Human SystemsIntegrations
Operational FlightMedicine
Clinical Flight MedicineConsulting and Standards
Prevention
AirMedEvacSAR /CSARAirMedEvacSAR /CSAR
STRATAIRMEDEVACSTRATAIRMEDEVACSTRATAIRMEDEVACTransport deutscher Soldaten i. R. Busattentat Kabul Transport deutscher Soldaten i. R. Busattentat Kabul
07.06.07.06.--08.06.200508.06.2005
2626 PatientenPatienten
STRATAIRMEDEVACSTRATAIRMEDEVACSTRATAIRMEDEVACKatastrophenhilfe Seebeben SKatastrophenhilfe Seebeben Süüdostasiendostasien
28.12.2004 28.12.2004 -- 04.01.200504.01.2005
133133 PatientenPatienten
((1818 Intensiv) Intensiv)
AEROSPACE MEDICINE AEROSPACE MEDICINE AEROSPACE MEDICINE
Screening, Selectionand Training
Quality Management Evidence Based Medicine
AirMedEvacSAR /CSAR
Human SystemsIntegrations
Operational FlightMedicine
Clinical Flight MedicineConsulting and Standards
Prevention
Interoperabilitymultinational,civil -military
Interoperabilitymultinational,civil -military
Joint and AlliedJoint and AlliedJoint and Allied
E A G(European Air Group)
NATO INTEROPERABILITYNATO INTEROPERABILITYNATO INTEROPERABILITY
Interoperability is the golden standard ofInteroperability is the golden standard ofaeromedicalaeromedical support in multisupport in multi--national NATOnational NATOairair--operationsoperations
and thus requires the effect ofand thus requires the effect of
••A ready medical forceA ready medical force
•• And a medically ready forceAnd a medically ready force
Anytime......AnywhereAnytime......Anywhere
AEROSPACE MEDICINE AEROSPACE MEDICINE AEROSPACE MEDICINE
Screening, Selectionand Training
Quality Management Evidence Based Medicine
AirMedEvacSAR /CSAR
Interoperabilitymultinational,civil -military
Operational FlightMedicine
Clinical Flight MedicineConsulting and Standards
Prevention
Human SystemsIntegrations
Human SystemsIntegrations
•• Human Factors Engineering Human Factors Engineering (optimize design, SA)(optimize design, SA)
•• Safety and Occupational Health Safety and Occupational Health (sustainability)(sustainability)
•• Survivability Survivability (human protection)(human protection)
•• Personal and Environment Personal and Environment (fatigue, data management)(fatigue, data management)
Ultimate Goal:Ultimate Goal: Mission Success and safety through human Mission Success and safety through human performance enhancement and performance enhancement and sustainmentsustainment
HUMAN
SYSTEMS
INTEGRATION
HHUMANUMAN
SSYSTEMS YSTEMS
IINTEGRATIONNTEGRATION
Combat EdgeCombat EdgeOxygen MaskOxygen Mask
LPULPU--9/P9/PLife Life
PreserverPreserver
CWUCWU--27/P27/PFlight SuitFlight Suit
CSUCSU--13B/P13B/PAntiAnti--G SuitG Suit
HGUHGU--55/P55/P(HGU(HGU--55/P 55/P
L/W)L/W)HelmetHelmet
GS/FRPGS/FRP--2 Flyers 2 Flyers GlovesGloves
Torso HarnessTorso Harness
CRUCRU--94/P94/PIntegrated Integrated
Terminal Block Terminal Block ConnectorConnector
SRUSRU--21/P21/PSurvival VestSurvival Vest
CSUCSU--17/P17/PAntiAnti--G VestG Vest
FWUFWU--8P8PFlying BootsFlying Boots
LIFE SUPPORT EQUIPMENTLIFE SUPPORT EQUIPMENTLIFE SUPPORT EQUIPMENT
Combat EdgeCombat Edge
HUMAN PERFORMANCE SUSTAINMENTAND ENHANCEMENT
HUMAN PERFORMANCE SUSTAINMENTHUMAN PERFORMANCE SUSTAINMENTAND ENHANCEMENTAND ENHANCEMENT
•• Performance EnhancementPerformance Enhancement–– ““Day into NightDay into Night””: : NVGsNVGs–– HelmetHelmet--Mounted DevicesMounted Devices
•• Sustained OperationsSustained Operations–– Laser ThreatLaser Threat–– Fatigue ManagementFatigue Management
Visible Laser Protection
Absorbing Dyes Holograms(Photopolymer)
HU
D
Rugates(Dielectric)
HSI Future ChallengesHSI Future ChallengesHSI Future Challenges
•• Greater emphasis on human / Greater emphasis on human / system interface and data system interface and data management challengesmanagement challenges–– Automated cockpit systems Automated cockpit systems ––
data management nightmaresdata management nightmares–– Remotely Piloted Vehicles Remotely Piloted Vehicles ––
flying in controlled airspace and flying in controlled airspace and flying without tactile or sensory flying without tactile or sensory cuescues
Data Fusion vs. ConfusionData Fusion vs. Confusion
UAV ChallengeUAV Challengeautomation to empower not to replace aircrewautomation to empower not to replace aircrew
•• HumanHuman--machine interfacemachine interface•• Auto responses to sytem failuresAuto responses to sytem failures•• Objectives vary contantly (IRS, CAS)Objectives vary contantly (IRS, CAS)•• No machine to machine interfaceNo machine to machine interface•• No mission management automationNo mission management automation
Problems:Problems:
UK MODUK MOD
April 2005April 2005
Six-Years 32 Million Euro Contract for Human Factors Research• Physical Fitness• Mental Perfomance• Nutrition• Sleep• Selection and Training• Equipment Design and Adaption
To Get the Best out of People • Especially in the Network-Enabled Battlespace• Where Human and Equipment Assets have to Work
Together in Novel Ways
Taking Care of Human PerformanceTakingTaking CareCare of Human Performanceof Human Performance
AEROSPACE MEDICINEAEROSPACE MEDICINEAEROSPACE MEDICINE
Organizational Element of Flight Surgeon OrganizationalOrganizational Element ofElement of Flight Surgeon Flight Surgeon
Reliable Presence of the Flight Surgeonon the Home Base and in Missions
is a Prerequisite for Mission Accomplishment
Questions??Questions??