aerospace medicine and transformation - aimas.it · 2007. 11. 13. · aerospace medicine and...

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

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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??