Table Of ContentErnsting’s Aviation Medicine
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Ernsting’s Aviation Medicine
Fourth edition
Air Commodore David J. Rainford
Civil Consultant in Renal Disease to the Royal Air Force,
Consultant Physician to the UK Civil Aviation Authority
and Consultant Adviser in Medicine to the Royal Air Force
of Oman
Group Captain David P. Gradwell
Royal Air Force Consultant Adviser in Aviation Medicine
and Reader in Aviation Physiology, Royal Air Force Centre
for Aviation Medicine, Royal Air Force Henlow, and Visiting
Senior Lecturer in Aviation Medicine, King’s College,
London
PART OF HACHETTE LIVRE UK
First published in Great Britain in 1978 by Tri-Med Books Ltd
Second edition 1988, paperback edition 1994, reprinted 1995
Third edition 1999 published by Butterworth-Heinemann, reprinted by
Arnold 2003
This fourth edition published in 2006 by
Hodder Arnold, an imprint of Hodder Education,
part of Hachette Livre UK, 338 Euston Road, London NW1 3BH
www.hoddereducation.com
©2006 Edward Arnold (Publishers) Ltd
All rights reserved. Apart from any use permitted under UK copyright law,
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Whilst the advice and information in this book are believed to be true
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ISBN 978 0 340 81319 5
2 3 4 5 6 7 8 9 10
Commissioning Editor: Joanna Koster
Project Editor: Heather Fyfe
Production Controller: Lindsay Smith
Cover Design: Sarah Rees
Typeset in 10 on 12pt Minion by Phoenix Photosetting, Chatham, Kent
Printed and bound in Great Britain by MPG Books, Bodmin, Cornwall
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Contents v
Contents
List of contributors ix–xi
Foreword xiii
Preface xv
The colour plate section appears between pages 416 and 417
PART I: AVIATION PHYSIOLOGY AND AIRCREW SYSTEMS
1 The Earth’s atmosphere 3–12
David P. Gradwell
2 Cardiovascular and respiratory physiology 13–40
John Ernsting, Jane Ward and Olga M. Rutherford
3 Hypoxia and hyperventilation 41–56
David P. Gradwell
4 Prevention of hypoxia 57–71
David P. Gradwell
5 Oxygen equipment and pressure clothing 73–107
David P. Gradwell
6 Principles of the pressure cabin and the effects of pressure change on body cavities containing gas 109–127
Alistair J.F. Macmillan
7 Subatmospheric decompression sickness 129–136
Alistair J.F. Macmillan
8 Effects of long-duration acceleration 137–158
Nicholas D.C. Green
9 Protection against long-duration acceleration 159–168
Nicholas D.C. Green
10 Short-duration acceleration 169–177
Matthew E. Lewis
11 Head injury and protection 179–188
Matthew E. Lewis
12 Human physiology and the thermal environment 189–212
Mike Tipton
13 Thermal stress and survival 213–229
Mike Tipton
14 Vibration 231–246
J.R. Rollin Stott
15 Anthropometry and aircrew equipment integration 247–256
Alistair J.F. Macmillan
vi Contents
16 Physiology of sleep and wakefulness, sleep disorders, and the effects on aircrew 257–272
J. Lynn Caldwell
17 Optics and vision 273–291
Paul Wright and Robert A.H. Scott
18 Spatial orientation in flight 293–306
Alan J. Benson
PART II: OPERATIONAL AVIATION MEDICINE
19 Selection and training 309–321
John W. Chappelow and Chris Elshaw
20 Crew resource management 323–335
Eric W. Farmer
21 Air traffic control: aeromedical aspects and human factors 337–347
Sheila Stork and Susan M. Baker
22 Error and accidents 349–357
John W. Chappelow
23 The flight deck and cockpit 359–372
Michael Bagshaw
24 Restraint systems and escape from aircraft 373–384
Alan E. Hepper
25 In-flight communication 385–394
Graham M. Rood and Susan H. James
26 Noise 395–415
Graham M. Rood and Susan H. James
27 Aircrew and cosmic radiation 417–431
Denis O’Sullivan and Dazhuang Zhou
28 Spatial disorientation in flight 433–458
Alan J. Benson and J.R. Rollin Stott
29 Motion sickness 459–475
Alan J. Benson and J.R. Rollin Stott
30 Passenger safety in transport aircraft 477–485
Helen Muir and Lauren J. Thomas
31 Patient transport by air-logistic considerations 487–506
Neil McGuire
32 Accident investigation 507–516
Ian R. Hill and S. Anthony Cullen
33 Aviation pathology and toxicology 517–533
S. Anthony Cullen and Ian R. Hill
34 Aircraft hygiene 533–538
Michael J. Kelly
35 Naval air operations 539–544
Adrian Baker and Mark Groom
PART III: CLINICAL AVIATION MEDICINE
36 International regulation of medical standards 547–566
Anthony D.B. Evans
Contents vii
37 Cardiovascular disease 567–604
Michael Joy
38 Hypertension 605–610
Anthony J. Batchelor
39 Respiratory disease 611–627
Gary Davies
40 Gastrointestinal disease 629–636
Trevor Laundy
41 Metabolic and endocrine disorders 637–646
Raymond V. Johnston
42 Renal disease 647–653
David J. Rainford
43 Haematology 655–664
Paul L.F. Giangrande
44 Malignant disease 665–681
Sally Evans
45 Neurological disease 683–693
Robert T.G. Merry
46 Ophthalmology 695–716
Robert A.H. Scott and Paul Wright
47 Otorhinolaryngology 717–725
Saliya Caldera and John Skipper
48 Aviation psychiatry 727–746
Geoffrey E. Reid
49 Orthopaedics 747–755
Ian D. Sargeant
50 Clinical management of decompression illness 757–766
Jane Risdall
51 Medication and aircrew 767–772
Anthony J. Batchelor
52 Aviator fatigue and relevant fatigue countermeasures 773–784
John A. Caldwell
53 The ageing pilot 785–790
John Cooke
54 Commercial passenger fitness to fly 791–799
Michael Bagshaw
55 International travel and disease 801–811
Andrew D. Green
56 Aeromedical evacuation: medical aspects 813–823
William J. Coker
57 Aeromedical transfer of the critically ill patient 825–833
Neil McGuire
Appendix 835–844
Index 845–864
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Contributors
Michael Bagshaw MB BCh MRCS LRCP FFOM DAvMed DFFP FRAeS John Cooke CB OBE MD FRCP FRCP(Ed) MFOM
Professor of Aviation Medicine, King’s College London, London, Air Vice-Marshal RAF (retired), Retired Senior Consultant to the
Army Honorary Civil Consultant in Aviation Medicine; Visiting Royal Air Force and Consultant Physician to the UK Civil Aviation
Professor, University of Cranfield, UK Authority
Adrian Baker MBChB MSc MFOM DAvMed MRAeS S. Anthony Cullen MD FRCPath FRAeS
Surgeon Commander, Royal Navy, Principal Medical Officer, Royal Air Commodore (retired), Lately Royal Air Force Consultant in
Naval Air Station Culdrose, Helston, UK Aviation Pathology, Royal Air Force Centre of Aviation Medicine,
Henlow, UK
Susan M. Baker BSc PhD
Head of Human Factors, Civil Aviation Authority, Aviation House,
Gary Davies MBBS MRCP(I)
Gatwick Airport South, UK
Squadron Leader, Specialist Registrar in Respiratory Disease —
Royal Air Force, Prestwood, UK
Anthony J. Batchelor CBE QHS BSc MBBS FRCP DAvMed FRCP FFOM
FRAeS
Air Commodore, Royal Air Force Consultant in Medicine and Chris Elshaw BSc
QinetiQ, Farnborough, UK
Whittingham Professor in Aviation Medicine, Royal Centre for
Defence Medicine, Birmingham, UK
John Ernsting CB OBE BSc MBBS PhD FRCP FFOM FRAeS
Alan J. Benson BSc MSc MB ChB FRAeS Air Vice-Marshal RAF (retired); Royal Air Force Honorary Civil
Visiting Consultant, Royal Air Force Centre of Aviation Medicine, Consultant in Aviation Medicine; and Visiting Professor in
RAF Henlow, UK Applied Physiology, King’s College London, London, UK
Saliya Caldera FRCS RAF Anthony D.B. Evans BSc MSc MB ChB DAvMed MFOM
Wing Commander, Consultant Otolaryngologist, Head and Neck Chief, Aviation Medicine Section, International Civil Aviation
Surgeon, ENT Department, The Royal Hospital Haslar, Gosport, UK Organization, Montreal, Canada
John A. Caldwell PhD Sally Evans MBBS DCH DRCOG DAvMed MFOM
Experimental Psychologist, Human Effectiveness Directorate, US
Chief Medical Officer, UK Civil Aviation Authority, Gatwick
Air Force Research Laboratory, Wright Patterson Air Force Base,
Airport South, UK
OH, USA
Eric W. Farmer BSc PhD AFBPsS
J. Lynn Caldwell PhD
Centre for Human Sciences, QinetiQ, Farnborough, UK
Diplomat, American Board of Sleep Medicine, US Air Force
Research Laboratory, Human Effectiveness Directorate, Dayton,
Paul L.F. Giangrande BSc MD FRCP FRCPath FRCPCH
OH, USA
Consultant Haematologist, Oxford Haemophilia Centre and
Thrombosis Unit, Oxford Radcliffe Hospitals, Oxford
John W. Chappelow BSc CPsychol AFBPsS
Centre for Human Sciences, QinetiQ, Farnborough, UK
David P. Gradwell BSc PhD MB ChB FRCP DAvMed FRAeS RAF
William J. Coker OBE QHP BSc MB ChB BA LLB FRCP DAvMed FRAeS Group Captain, Royal Air Force Consultant Adviser in Aviation
Air Commodore, Royal Air Force Consultant in Medicine and Medicine and Reader in Aviation Physiology, Royal Air Force
Officer Commanding the Royal Air Force Centre of Aviation Centre of Aviation Medicine, Royal Air Force Henlow, Visiting
Medicine, Royal Air Force Henlow, UK Senior Lecturer in Aviation Medicine, King’s College, London, UK
