INTRODUCTION: Different types of remote expeditions often require an expedition crew to conduct medical emergency assessments without prior medical training. Modern technology offers new devices that support diagnosis with a simple guided user instructions interface. It is not yet clear how quickly medically untrained individuals can acquire the required skills with such a device. This study investigated the time and quality of obtained outcomes, as well as the mental workload when using a vital signs monitor and its guided procedure interface during a simulation of a medical emergency event.

METHODS: There were 50 individuals (25 medically inexperienced, 25 medically trained) who participated in this study. In a randomized order subjects measured electrocardiography, noninvasive blood pressure, pulse oximetry, and body temperature. The procedure was repeated after a 20-min break. Completion time, data validity, and mental workload were analyzed.

RESULTS: Average times to obtain stable and reliable signals of all recorded vital signs were significantly shorter for both groups during the second attempt and for medically experienced individuals in comparison to medically inexperienced individuals. The number of errors did not change between attempts for both groups. The mental workload was higher during the first attempt in both groups for most vital sign acquisitions.

DISCUSSION: Automated devices could be easily and quickly used by members of a given expedition, even if the crew lacks advanced medical training. With relatively little training provided by a built-in guidance system, medically untrained individuals can achieve a basic level of proficiency in reliably obtaining valid vital signs.

Huerta R, Kaduk SI, Fatai L, Rusch H, Weber T, Sammito S. A built-in guidance system to monitor vital signs in space and on Earth. Aerosp Med Hum Perform. 2024; 95(3):139–146.

INTRODUCTION: Aircraft cabins, susceptible to disease transmission, require effective strategies to minimize the spread of airborne diseases. This paper reviews the James Reason Swiss Cheese Theory in mitigating these risks, as implemented by the International Civil Aviation Organization during the COVID-19 pandemic. It also evaluates the use of airborne ultraviolet-C (UV-C) light as an additional protective measure.

METHODS: Our approach involved a thorough literature review by experts and a detailed risk-vs.-benefit analysis. The review covered existing research to understand the scientific foundation, while the analysis used established techniques to assess the impact of influenza and COVID-19 in terms of infections, deaths, and economic costs.

RESULTS: Integrating UV-C light in aircraft cabins, when applied with appropriate scientific understanding and engineering safeguards, has the potential to reduce in-flight disease transmission. This additional mitigation strategy can work synergistically with existing measures.

DISCUSSION: The research and risk-vs.-benefit analysis present strong evidence for the safety and effectiveness of continuous UV-C disinfection in aircraft cabins. It suggests that UV-C light, maintained below exposure limits, can be a valuable addition to existing measures against disease transmission during flights.

Belland K, Garcia D, DeJohn C, Allen GR, Mills WD, Glaudel SP. Safety and effectiveness assessment of ultraviolet-C disinfection in aircraft cabins. Aerosp Med Hum Perform. 2024; 95(3):147–157.

INTRODUCTION: Real-time cardiovascular imaging during hypergravity exposure has been historically limited by technological and physical challenges. Previous efforts at sonographic hypergravity imaging have used fixed ultrasound probes; the use of hand-held ultrasound, particularly performed by minimally trained laypersons, has been less explored. Here we will discuss handheld sonography to self-visualize carotid vascular and cardiac changes during hypergravity.

METHODS: Three subjects with variable ultrasound experience ranging from no familiarity to extensive clinical experience used handheld ultrasound at rest and under stepwise +G_z hypergravity exposures (maximum +3.5 G_z) to visualize carotid vascular changes. Subxiphoid cardiac ultrasound was obtained by the most experienced subject. Subjects had variable prior hypergravity experience; all were trained in anti-G straining techniques. Sonographically inexperienced subjects underwent a brief (< 5 min) familiarization with the ultrasound probe, user interface, and desirable viewing window immediately prior to centrifugation; real-time coaching was provided. Ultrasound images were correlated to self-reported symptoms and hemodynamic data.

RESULTS: Handheld ultrasound performed as desired; all subjects were successful at obtaining ultrasound images with adequate capture of windows of interest. Subxiphoid imaging efforts were limited by probe overheating and associated with variable quality of imaging due to probe displacement from straining techniques; the subject noted transient, mild discomfort and ecchymosis after imaging in the subxiphoid region.

DISCUSSION: Even individuals with minimal or no ultrasound experience successfully obtained usable images under centrifuge conditions. While there were some limitations, this technical demonstration provides initial validation of handheld sonography as an available tool for real-time cardiovascular imaging in a hypergravity environment.

Blue RS, Ong KM. Handheld sonographic cardiovascular imaging under hypergravity conditions. Aerosp Med Hum Perform. 2024; 95(3):158–164.

INTRODUCTION: Work-related stress is common in pilots, with broad implications, including the potential development of mental health symptoms and sometimes even psychiatric disease. This commentary argues for the use of narrative as a tool to promote preventive health behaviors in pilots and combat misinformation about aeromedical certification related to mental health.

Hoffman WR, McNeil M, Tvaryanas A. The untapped potential of narrative as a tool in aviation mental health and certification. Aerosp Med Hum Perform. 2024; 95(3):165–166.