# Actions for patient going into shock



## brochocinco (May 26, 2010)

I'm touching up on my material and reading through the Brady book...This book has so many inconsistencies and errors, it's frustrating. Maybe someone can help clarify..

For steps to Emergency Medical Care, it says
"If the patient has injuries to the pelvis, lower extremities, head, chest, *abdomen*, neck or spine, or if the shock may be due to cardiac compromise, keep the patient supine; *do not elevate the feet*"

Now in the chapter review's case study follow-up, you respond to a teenager thats been stabbed in the LUQ..."Although the external bleeding was profuse, you know that because the wound site is the *abdomen*, the patient is most likely bleeding internally as well as suffering from shock. *You elevate the patients feet approximately 8-12 inches*..."

Can someone tell me what I am supposed do in that situation?


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## Giddi (May 26, 2010)

Trendelenburg maybe?


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## jjesusfreak01 (May 26, 2010)

I'll agree I have found an alarming number of errors and inaccuracies in the Brady EMT-B book (you can tell when it starts to contradict itself).

Since basics usually can't use full body anti-shock suits, this does pose an interesting problem. I think the question is, "Will putting the patient in the Trendelenburg position aggravate the abdominal injury?"

It appears that the book is placing the emphasis on preventing shock rather than worrying about aggravating the abdominal wound. That would seem to be the right course of action, since shock is going to be the thing that kills them in the end.


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## Smash (May 27, 2010)

Trendelenburg position was used to allow better view of the abdominal contents during surgery. It is of no use in preventing or treating hypovalemic shock. Nor are PASG/MAST suits.  Leave them flat, control bleeding as best you can, control pain, avoid cyclic crystalloid resuscitation, drive fast to top tier trauma center.


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## CAOX3 (May 27, 2010)

Smash said:


> Trendelenburg position was used to allow better view of the abdominal contents during surgery. It is of no use in preventing or treating hypovalemic shock. Nor are PASG/MAST suits.  Leave them flat, control bleeding as best you can, control pain, avoid cyclic crystalloid resuscitation, drive fast to top tier trauma center.



What he said.

Trendelenburg is useless in EMS.

We havent had MAST trousers on a truck since we had the EOA/EGTA.


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## lightsandsirens5 (May 27, 2010)

CAOX3 said:


> What he said.
> 
> Trendelenburg is useless in EMS.
> 
> We havent had MAST trousers on a truck since we had the EOA/EGTA.


 
We have 'em! They are a PAIN to put on, but they worked in the case I have used them. I think the key is proper use. I do agree with you on Trendellenburg (or however the h**l you spell it) though. 

My insturtor used to say "The best way to control traumatic hypovolemic shock is surgery. Since you cant do that on an ambulance, you tell me what you should do. If you can't figure it out, it is: Stop dinging around on scene or in the rig and GET THE PATIENT TO A TRAUMA CENTER AS SOON AS POSSIBLE. Yesterday if you can."

But standard proceedures at my service? Control bleeding before moving on to any other steps. (Well DUH!) Trendeleburg position (However useless it may be. Our hospital likes it.......) IV fluid resuscetation (or IO if indicated) PASG (_maybe, like once in a blue moon),_ and a Diesel and Wheelen combo special.


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## CAOX3 (May 27, 2010)

If I remeber correctly PASG were removed because there was no scientific data on hand to prove they were effective.

I havent seen a pair in a long time.


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## Smash (May 27, 2010)

CAOX3 said:


> If I remeber correctly PASG were removed because there was no scientific data on hand to prove they were effective.
> 
> I havent seen a pair in a long time.



We ditched ours some time in the late 1980s.


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## lightsandsirens5 (May 27, 2010)

CAOX3 said:


> If I remeber correctly PASG were removed because there was no scientific data on hand to prove they were effective.


 
Really, I am going to have to look innto that. I assumed that some of it was based on the g-suit concept. Pilot goes into high G situation essentially causing hypovolemic shock in his upper body, but g-suit inflates and blood is forced back up into his upper body since the legs are no longer able to hold as much blood.


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## Smash (May 27, 2010)

lightsandsirens5 said:


> Really, I am going to have to look innto that. I assumed that some of it was based on the g-suit concept. Pilot goes into high G situation essentially causing hypovolemic shock in his upper body, but g-suit inflates and blood is forced back up into his upper body since the legs are no longer able to hold as much blood.



It's a nice idea, but like so many ideas in medicine, particularly prehospital medicine, the reality doesn't match the theory.  It's like fluid resus for penetrating trauma. Back in the day we saw that circulating volume had been lost, resulting in poor perfusion, so we restored circulating volume with crystalloids (and colloids) to improve perfusion. And we certainly improved some numbers. Patients got to hospital with superb blood pressure and we all felt good. All of us except the patients who died horribly as a result of our nice idea.  

From the Cochrane plain English summary: _ About one third of injury deaths are due to shock from blood loss. Preventing shock in people with uncontrolled bleeding is therefore vital. Treatment aims to maintain blood pressure, so that tissue damage is minimised. Medical anti-shock trousers (MAST) are believed to increase blood pressure and blood flow to the heart and brain, helping to stabilise the person until they receive further treatment. The review of trials found no evidence that MAST application decreases deaths, with some suggestion that it may even do harm. More research is needed.
_


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## Veneficus (May 27, 2010)

brochocinco said:


> I'm touching up on my material and reading through the Brady book...This book has so many inconsistencies and errors, it's frustrating. Maybe someone can help clarify..
> 
> For steps to Emergency Medical Care, it says
> "If the patient has injuries to the pelvis, lower extremities, head, chest, *abdomen*, neck or spine, or if the shock may be due to cardiac compromise, keep the patient supine; *do not elevate the feet*"
> ...



Forget elevating the feet. It is not going to help.

These type of inconsistencies are relatively normal when you have a textbook written by multiple authors.


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## EMSLaw (May 27, 2010)

Veneficus said:


> Forget elevating the feet. It is not going to help.
> 
> These type of inconsistencies are relatively normal when you have a textbook written by multiple authors.



I think the textbook answer for EMT-B is still that the treatment for hypovolemic shock includes high flow O2, keeping the patient warm, and placing the patient in the modified Trandelenberg position (feet raised).  

Of course, since the textbook also tells us that we should be backboarding almost every trauma patient, I'm not entirely sure how we accomplish this.  We need to carry a phone book to prop the foot end of the board up, I guess.

This is what happens when two useless EMS interventions collide!


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## Veneficus (May 27, 2010)

EMSLaw said:


> I think the textbook answer for EMT-B is still that the treatment for hypovolemic shock includes high flow O2, keeping the patient warm, and placing the patient in the modified Trandelenberg position (feet raised).
> 
> Of course, since the textbook also tells us that we should be backboarding almost every trauma patient, I'm not entirely sure how we accomplish this.  We need to carry a phone book to prop the foot end of the board up, I guess.
> 
> This is what happens when two useless EMS interventions collide!



in the 10th edition book i have it says to elevate the feet, but I will call my NR friend and see if it is still tested there for basic.


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## dudemanguy (May 27, 2010)

I've heard of PASG pants working when transfering a patient with a AAA. You put the pants on and in the event the patient starts crashing you inflate them to buy some time en route. I talked to a paramedic who told me about this situation being the only time he's ever seen a patient have a AAA rupture and still live.

I did see a pair and practiced applying them in my Basic class, although we were told we werent likely to see them.


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## EMSLaw (May 27, 2010)

The plural anecdote is not data.  The fact that someone, somewhere used MAST pants and they seemed to work provides no evidence of their clinical efficacy.  

EMS as a whole is far to dependent on anecdotal "evidence" for why we do what we do.


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## JPINFV (May 27, 2010)

EMSLaw said:


> I think the textbook answer for EMT-B is still that the treatment for hypovolemic shock includes high flow O2, keeping the patient warm, and placing the patient in the modified Trandelenberg position (feet raised).
> 
> Of course, since the textbook also tells us that we should be backboarding almost every trauma patient, I'm not entirely sure how we accomplish this.  We need to carry a phone book to prop the foot end of the board up, I guess.
> 
> This is what happens when two useless EMS interventions collide!



For a backboarded patient you can go full on trendelenburg by raising the feet end of the gurney, thus tilting the entire backboard and body.

Of course this doesn't change the fact that I still haven't seen a single study that supports trendelenburg as an intervention for shock.


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## LondonMedic (May 27, 2010)

EMSLaw said:


> EMS as a whole is far to dependent on anecdotal "evidence" for why we do what we do.


The problem of course is that it's very hard to do any form of ethical RCT in emergency cases.


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## Veneficus (May 27, 2010)

*the great MAST debate*

Here are a few links for your perusal.


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1875765/

http://www.annemergmed.com/article/S0196-0644(81)80158-8/abstract

Which of course have links to other links.

I have heard of the research about MAST helping with aortic bleeds, but it was years ago and I honestly dismissed it when I read it as extremely impractical in EMS. (Read I have no idea where to find a copy anymore)

From what I understood, if memory serves me, was that inflating the abd. compartment could basically "cross clamp" the aorta if the bleed was low enough. I also recall something about the BP having to be <50 systolic but I am not sure what exactly it pertained to.

Unfortunately, most of the MAST studies are done by people who have a position for or against them. I see the middle road. MAST definitively does not do what it was supposed to do in theory. It may have some occasional uses which it will benefit a patient by a different mechanism.

But consider... How often are these events? I have read that applying MAST in patients not requiring, results in an average of +1.7 ICU days. That means they do harm if not used properly. So we cannot simply advocate to use these on every patient or under broad painted protocols. 

How are EMS providers going to recognize when MAST will be useful? Does the environment (rural, wildernes, military) play an important factor? If you are using MAST in desperation, while you may make it to the hospital alive, how many people are going to leave the hospital?

Let's say you do successfully crossclamp an aorta by inflating them, once at the hospital, now what? The patient is going to have to be opened up to fix it. Forget about acidosis, how is the abd. going to be accessed for surgical correction?

I have had the honor of speaking with what could be described as the leading "pro" and "anti" surgeons about MAST. I find the Anti argument more compelling in this case.

I think that since there will be no definitive studies on this. (ethcally it might not be possible) It will come down to the judgement of medical directors and protocol.


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## MonkeySquasher (May 27, 2010)

Veneficus said:


> Let's say you do successfully crossclamp an aorta by inflating them, once at the hospital, now what? The patient is going to have to be opened up to fix it. Forget about acidosis, how is the abd. going to be accessed for surgical correction?



Not to mention when you get them to the hospital, you have to in-service the ER staff and surgeons on them.  Otherwise, ER staff who don't know what they are will either:

A)  Attempt to cut off the pressurized pants.  Which I hear is a bad idea.

or

B.)  Depressurize the pants to get them off, and you'll watch your patient's BP go from 90/palp to 40/crap and they die.


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## Veneficus (May 27, 2010)

MonkeySquasher said:


> Not to mention when you get them to the hospital, you have to in-service the ER staff and surgeons on them.  Otherwise, ER staff who don't know what they are will either:
> 
> A)  Attempt to cut off the pressurized pants.  Which I hear is a bad idea.
> 
> ...



Actually, surgeons are educated on them. Most just don't have any respect for MAST. I suspect that most EMs are educated on them too.

I live for the day i get to cut a set off of a patient. Even better if it is in a trauma bay in front of the person who put them on. Then they will go tell all of their EMS buddies how stupid I am.


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## EMTinNEPA (May 28, 2010)

I have had anecdotal success with the Trendelenburg position, and while that does not prove that it is effective, is does not improve it either.  I know we're supposed to be practicing evidence-based medicine, but I haven't seen anything suggesting that it causes harm, and if there's even a chance it may help keep my patient alive for a bit longer while I haul @$$ to the hospital, I'm going to do it.  It's one of the few tools I have at my disposal, effective or not.


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## Smash (May 28, 2010)

EMTinNEPA said:


> I have had anecdotal success with the Trendelenburg position, and while that does not prove that it is effective, is does not improve it either.  I know we're supposed to be practicing evidence-based medicine, but I haven't seen anything suggesting that it causes harm, and if there's even a chance it may help keep my patient alive for a bit longer while I haul @$$ to the hospital, I'm going to do it.  It's one of the few tools I have at my disposal, effective or not.



You could dance an Irish Jig in the corner as well.  No evidence that it helps, but it's probably not harmful, so that is one more tool at your disposal, effective or not.  Who knows, it may even make you patient laugh, and we know that laughter is the best medicine.

Bridges and Jarquin-Valdivia do a reasonable review in AJCC, there is a good plain summary at BestBETS and numerous papers that can be perused to show the complete lack of any evidence for the use of trendelenburg positioning.


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## MrBrown (May 28, 2010)

What to do? ... it depends what type of shock 

We no longer teach raising the legs, but it is taught to the lay first aider.  

Large volumes of crystalloid are no longer infused in *uncontrolled* hypovalemia e.g. triple A or penetrating trauma.  For controlled hypovolaemia I have seen blood pressure cuffs wrapped around bags and two to three litres given.

M*A*S*H pants were thrown out here about 10 years ago, I know we still had them in 1998.


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## EMTinNEPA (May 28, 2010)

Smash said:


> You could dance an Irish Jig in the corner as well.  No evidence that it helps, but it's probably not harmful, so that is one more tool at your disposal, effective or not.  Who knows, it may even make you patient laugh, and we know that laughter is the best medicine.
> 
> Bridges and Jarquin-Valdivia do a reasonable review in AJCC, there is a good plain summary at BestBETS and numerous papers that can be perused to show the complete lack of any evidence for the use of trendelenburg positioning.



An Irish Jig in the corner is still better than nothing, which is exactly what I can do for hypovolemic shock.  Every other treatment we used to use has been shown to be ineffective or harmful... Aggressive fluid therapy?  Nice pretty blood pressure, too bad crystalloids don't carry oxygen.  MAST suit?  Looks cool, but doesn't work, and good job wasting the time to put it on.  Trendelenburg?  Maybe not effective, but it takes what, half a second to perform?  Supplemental oxygen?  Great!  Too bad he has no hemoglobin in his blood syst- er, saline system now, to carry it.  Until they give us whole blood, packed RBCs, of FFP, there's not gonna be anything especially effective we can do about hypovolemic shock other than a rapid diesel infusion WFO, so we should at least do the things that we haven't shown to be harmful yet, instead of nothing at all just because it's ineffective.


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## JPINFV (May 28, 2010)

EMTinNEPA said:


> I know we're supposed to be practicing evidence-based medicine, but I haven't seen anything suggesting that it causes harm,




Off the top of my head, increased ICP and increased incidences of difficulty breathing.


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## EMTinNEPA (May 28, 2010)

JPINFV said:


> Off the top of my head, increased ICP and increased incidences of difficulty breathing.



Ok.  Do you have a source?


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## mycrofft (May 28, 2010)

*Just lay down in Trendellenburg and experience it.*

Some of us lose our airway if you do that.

A coworker in 1978 was a volunteer to wear the trousers for a class. They just opened the stopcocks to let him out. He said later it was as close to an orgasm, or dying, as he ever wanted to experience in front of an audience.

Combat aviators wearing their suit also do a conrolled Valsalva and are in very good shape, albeint occasionally a little hung over. Not bled out, shot or dissecting.


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## Akulahawk (May 28, 2010)

mycrofft said:


> Some of us lose our airway if you do that.
> 
> A coworker in 1978 was a volunteer to wear the trousers for a class. They just opened the stopcocks to let him out. He said later it was as close to an orgasm, or dying, as he ever wanted to experience in front of an audience.
> 
> *Combat aviators wearing their suit also do a conrolled Valsalva and are in very good shape, albeint occasionally a little hung over. Not bled out, shot or dissecting*.


Those anti-G suits provide at MOST about 1-1.5 G's above what the Pilot can achieve without one. They train to perform essentially a massive valsalva maneuver, and is one BIG reason why they do strength training over cardio alone. A lot of people can handle 6 G's without too much effort. Older fighters were limited to about 7.5 G's because of that. Once it was figured out what helps the aviators fight G-LOC, training was adapted and now it's commonplace for aviators to achieve 9-10 G's without G-LOC with assistance of the suit. There have even been improvements in the suits and other life-support systems. The most visually apparent of those is the Oxygen Mask.


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## LucidResq (May 28, 2010)

Ha. Accidentally researched spinal immobilization and increased ICP / respiratory problems. Will update with info on TRENDELENBURG'S and aforementioned physiological effects.


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## Akulahawk (May 28, 2010)

For the OP:
Your patient who is stabbed in the LUQ, the MAST won't help. MAST suits normally don't extend much beyond the lower quadrants of the abdomen. The suit just won't tamponade the wound. Treatment should include: IV (with blood tubing) at a KVO rate, with boluses to maintain SBP at about 90 mmHg or just enough to maintain a detectable radial pulse. Oxygen. Diesel. Get the patient to a surgeon. Your time on scene? As close to zero as you can make it. Scoop and run. Make the patient naked and search for additional wounds. It's just not that complicated.


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## LucidResq (May 28, 2010)

It was surprisingly hard to dig up literature on the use of Trendelenburg's in emergency or prehospital medicine. Here's a start... 



> Use of the Trendelenburg position in the treatment of shock has been common practice on the assumption that it can divert blood into the central circulation and improve the systemic hemodynamics. The literature on the hemodynamic effects of the effectiveness of use of the Trendelenburg position in treating hypovolemic shock is small and does not reveal beneficial or sustained changes in systolic blood pressure, preload, afterload, or cardiac output.



Bridges, N. and Jarquin-Valdivia, A. A. 2005. Use of the Trendelenburg position as the resuscitation position: to t or not to t? American Journal of Critical Care : an official publication, American Association of Critical-Care Nurses 14:364-368.


I'll post more as I find it.


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## Smash (May 28, 2010)

Reuter DA, Felbinger TW, Moerstedt, Kilger E, Lamm P, Goetz AE Trendelenburg Positioning After Cardiac Surgery: Effects on Intrathoracic Blood Volume Index and Cardiac Performance Eur J Anaesthesiol 2003;20:17-20.

Transient and non-significant rise in BP and MAP with trendelenburg followed by significant deterioration in cardiac index when returned to supine position.  There is also the potential for respiratory distress and decreased tidal volume, agitation from the uncomfortable position making the patient harder to manage, increased ICP from venous congestion.

We all want to be seen to be doing something for out patients, but sometimes there really isn't anything to do.  Stop the bleeding that you can, stop the pain that you can, keep them warm and drive to hospital.


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## JPINFV (May 28, 2010)

Well... errr... I see my job here is done.


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## LucidResq (May 28, 2010)

JPINFV said:


> Well... errr... I see my job here is done.



I see that DO training is getting to you... already letting your underlings do your dirty work eh?


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## JPINFV (May 28, 2010)

LucidResq said:


> I see that DO training is getting to you... already letting your underlings do your dirty work eh?



Leading by inspiration! ::cackles::


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## usafmedic45 (May 28, 2010)

> blood is forced back up into his upper body since the legs are no longer able to hold as much blood.



You have it backwards.  The "anti-G suit" (can't remember the technical term for it) is designed, not to push blood back up, but to limit the amount of blood being forced into the capitance vessels of the legs in the first place.  



> Combat aviators wearing their suit also do a conrolled Valsalva and are in very good shape, albeint occasionally a little hung over.



Actually fighter pilots (at least modern ones) are not nearly as frequently hung over or "Tom Cruise style mavericks" as we are led to believe.  Those who are find themselves kicked out of training programs or 'flying a desk' very quickly.



> Those anti-G suits provide at MOST about 1-1.5 G's above what the Pilot can achieve without one.


 
Quick point.  It's G, not "Gs".  8 G, 10 G, etc.  Just a friendly reminder from your local injury epidemiologist in training. 

It adds that little bump in tolerance mostly because it limits the amount of blood squeezed into the legs and abdomen by the Valsalva.  



> They train to perform essentially a massive valsalva maneuver, and is one BIG reason why they do strength training over cardio alone.



Well, that and the fact that your arm weighs about 200 lbs at 8 G. 



> Older fighters were limited to about 7.5 G's because of that.



The wings or horizontal stabilizers will come off most propeller-driven warbirds somewhere around 8 G.  That's another major reason (the major reason) for it.


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## Akulahawk (May 29, 2010)

Anti-G Garment.

That's the name for the suit. There's a "few" different designs in use. One type requires essentially CPAP or BiPAP to overcome counter pressure put on by a chest piece. That system is called COMBAT EDGE. 

Oh, and I was referring to more modern aircraft designs from the late '60's and newer. The F-16 is a great design... capable of much more stress that pilots can handle. The F-14 can handle greater stress than 7.5 G, same with the F-15. Wonder why they limited max G loads on the F-14 and 15 to about 7.5 G...

The older WW2 warbirds can turn inside modern jets at lower G loads. Why? They fly slower...


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## usafmedic45 (May 29, 2010)

> The F-16 is a great design... capable of much more stress that pilots can handle.



It's a great design....right up until it develops electrical or engine problems.  Then it turns into what one of my friends (a LTC who flew them and who was the pilot when I got my incentive ride in one) eloquently described as "the world's most expensive lawndart".  



> Wonder why they limited max G loads on the F-14 and 15 to about 7.5 G...



According to a friend of mine (retired F-14 crew chief) it was over concerns about how the wing and tail structures would handle repeated high G loading and unloading.  This is one of the reasons why the F-15s had safety stand down days a couple of years back after several broke apart in mid-air due to metal fatigue of structural members.  There was a question of whether the failure was due to "overload fatigue" (to quote a friend who was on the investigation board for the incidents in question) or simply due to the standard wear and tear all aircraft encounter. 



> The older WW2 warbirds can turn inside modern jets at lower G loads. Why? They fly slower...



Right, and they have a much prettier sound to them as well.  



> That's the name for the suit. There's a "few" different designs in use. One type requires essentially CPAP or BiPAP to overcome counter pressure put on by a chest piece. That system is called COMBAT EDGE.



Were you aircrew life support or something?


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## Akulahawk (May 29, 2010)

usaf: Not even close... you could say that I developed a nearly unhealthy knowledge of (primarily) USN flight gear at a very young age. When your Dad flies combat aircraft for a living, you kind of get _real_ curious what keeps him alive and how the aircraft and is' systems work... Plus I read pretty much whatever I could get my hands on. 

The G limitations were mostly in place prior to many of those crashes. 

The original engine was an OK design. At least they didn't use the TF-30 in it... those had some sensitivity to airflow inlet disturbances. The F110 engine was a better design. FCS problems will be a problem for any FBW aircraft... There aren't any direct connections to the flight control surfaces and in an aircraft with relaxed static stability or even negative static stability, controlled flight is basically impossible without the computers. 

Any very modern aircraft will turn into a lawn dart if the computers die and no longer can control the flight control surfaces... at which point the pilot can only hope to reach the ejection handles...

Oh, and I got one detail slightly incorrect about COMBAT EDGE. The O2 mask increases pressure in the thoracic cavity during higher G loads and the chest piece provides counter pressure to prevent barotrauma.


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## usafmedic45 (May 29, 2010)

> The G limitations were mostly in place prior to many of those crashes.



Correct.  I didn't not mean to imply that those particular crashes were the reason for the regulations.  For example, there was a F-89 (?; the Scorpion) that broke up during an airshow in the 1950s due to structural failure after an excessively high G performance the previous day.  I don't believe they ever definitively linked that to the crash, but that was one source of the regulations (they are "written in blood" as the saying goes) according to some sources including a friend of mine who was a civilian researcher and temporarily found himself persona non grata for suggesting it was improper for the miltary to be investigating its own crashes. 



> Any very modern aircraft will turn into a lawn dart if the computers die and no longer can control the flight control surfaces... at which point the pilot can only hope to reach the ejection handles...



Pretty much, but the regularity of F-16 crashes is what earned it that nickname.  The other moniker it is saddled with is the "disposable jet".


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## Hal9000 (May 29, 2010)

usafmedic45 said:


> Pretty much, but the regularity of F-16 crashes is what earned it that nickname.  The other moniker it is saddled with is the "disposable jet".



I live right by an F-16 base, and one took off and then lost power on the crosswind, I believe.  He had live munitions, which he immediately ditched in order to make it back to the runway.  One exploded, and the other destroyed a structure and was buried underneath the ground.  They detonated it later.  It was pretty neat, and a lot nicer than having the jet plow into buildings, like the F/A-18 down by SAN.

Good discussion on G performance of both humans and airplanes.


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## mycrofft (May 29, 2010)

*Wonder why "shock trousers" don't work then?*

Probably because more things happen in shock than just degraded haemodynamic circulation. 

PS: OK plane buffs, whose unofficial motto was "19 G's in 0.7 seconds"?


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## usafmedic45 (May 29, 2010)

> PS: OK plane buffs, whose unofficial motto was "19 G's in 0.7 seconds"?



John Paul Stapp.  :lol:  Seriously...no clue, but I'm assuming it was the pilots of something rocket powered, perhaps the X-15.


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## mycrofft (May 29, 2010)

*Martin-Baker ejection seats*


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## Akulahawk (May 29, 2010)

Perhaps Scott Crossfield?

Ejection seat guys also might just make the grade...


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## usafmedic45 (May 29, 2010)

> Perhaps Scott Crossfield?



Judging by the state his remains were in after his last flight, I think he experienced a lot more than that in his last moment on earth.


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## Akulahawk (May 29, 2010)

Scott Crossfield was sitting in X-15-3 during the engine test of the XLR-99 motor... when it blew up. The cockpit and front half of the fuselage was shoved forward about 20 feet or so...

Here's a video of the event, and the man himself.
http://www.youtube.com/watch?v=WXpEPZ6ZZIs


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## usafmedic45 (May 29, 2010)

Akulahawk said:


> Scott Crossfield was sitting in X-15-3 during the engine test of the XLR-99 motor... when it blew up. The cockpit and front half of the fuselage was shoved forward about 20 feet or so...
> 
> Here's a video of the event, and the man himself.
> http://www.youtube.com/watch?v=WXpEPZ6ZZIs


One brave SOB....and someone I had the pleasure of having coffee with and receiving a ride home from (in a car) at the ripe old age of 12.


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## mycrofft (May 29, 2010)

*Martin Baker ejecton seats....0 to 9 G's in 0.7 seconds,*

Hello, former 57150 Fire Protection Specialist/Rescueman..B)

THe photo seems to be a test of a seat on a U-2?


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## usafmedic45 (May 29, 2010)

Not even close.  I believe that's an old USN F-3 Demon.


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## MonkeySquasher (May 30, 2010)

Akulahawk said:


> Scott Crossfield was sitting in X-15-3 during the engine test of the XLR-99 motor... when it blew up. The cockpit and front half of the fuselage was shoved forward about 20 feet or so...
> 
> Here's a video of the event, and the man himself.
> http://www.youtube.com/watch?v=WXpEPZ6ZZIs



0:00-1:06   -  B)


1:07-1:08   -  :blink:


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## Akulahawk (May 30, 2010)

The amazing part about that explosion is that there were no major injuries that day... Scott himself wasn't injured and a rescueman got some minor burns to his hands. The back half of the X-15... well that was in bits.


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## mycrofft (May 30, 2010)

*USAF was right, photo ID'ed as F3.*

AS a rescueman, your job is *safely* approach and gain access, safety the seats (no seats this time), and unarse the craft with the occupants. I never saw an egress plan for the X-15 (it was out of the USAF T.O. 00105E-9 before I was on board), but I don't think you'de be cutting in with an axe.


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## usafmedic45 (May 30, 2010)

> I never saw an egress plan for the X-15



I think "Get baggie.  Gather tissue fragments from across the dry lake bed." pretty much summed it up.


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## mycrofft (May 31, 2010)

*Probably square 1/2 inch drive on port fuselage below canopy.*

Pretty standard except the space shuttle, which was 3/4 and you had to break the thermal tile to get to it.

Boy is this thread jacked. Sorry!


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