633.qxp 5/2/2007 4:30 PM Page 1 President’s Page First, let me say that I am honored to serve as pres- ident of AsMA, and I hope I can justify the confidence placed in me. The friends I have made and the relation- ships I have developed within this association have en- riched my life immeasurably. I have had the opportu- nity to exchange ideas and work with colleagues worldwide. I know of no other organization with the spirit and international camaraderie that exists within our association. Those of you who attended business meeting in New Orleans know that we have ambitious plans for the coming year. Much effort was spent in hearing the voice of members in our survey and listening closely to the messages. I hope that 1 year from now we can look John D. Hastings, M.D. to some accomplishments that will demonstrate re- sponsiveness to member needs. Let me see if I can give in the important work our committees do for AsMA. a flavor of our future direction. Some survey responders perceived AsMA as a "U.S. Extensive discussions have taken place with the organization." I feel it is highly important to emphasize Fellows Group and its chair, George Anderson. Ideas and encourage our association's role as an international discussed included involvement by the Fellows Group entity. Our membership and our interests are global, and in current activities within AsMA, Fellow representa- we should strive to be a vehicle for worldwide fellow- tion on the Council, liaison between the Fellows Group ship and exchange. We are most happy to welcome the and the Associate Fellows Group, and critical review of European Society of Aerospace Medicine as an Affiliate the Fellowship selection process. George Anderson has organization and are looking forward to working with worked hard and long on these issues. The fabric of our colleagues across the sea. The aerospace sciences our organization can only be strengthened by integrat- have proven uniquely capable of transcending the sepa- ing the Fellows Group with its collective talent and rating influence of political, cultural, and geographical wisdom into association activities and asking their as- boundaries, and so it should be. sistance in developing future leadership. A frequent survey comment relates to a desire for Representation of both the Fellows Group and the greater presence of clinical material within AsMA. Associate Fellows Group was deemed an important Indeed, the most frequently downloaded journal article is step in recognizing the need for involvement of both "You're the Flight Surgeon." A significant proportion of groups in association governance and leadership. our members are involved in clinical aviation medicine. Inherent in most, if not all volunteer organizations, Clinical aviation medicine physicians are small in is what I will call "process problems." The Executive number, and many are involved in full-time activities Committee meets twice yearly, as does the Council. such as regulatory or administrative aspects of aviation Committees generally meet but once a year in conjunc- medicine or other endeavors. It is difficult to gather tion with the annual scientific meeting. We return good data for an evidence-based approach to regula- home from these meetings to busy jobs and personal tion, policy development, policy review in light of new lives, and well intentioned progress on committee developments and technology, regulatory change, and work becomes difficult. Meaningful dialogue leading to aeromedical disposition in individual cases. important decisions and conclusions is difficult to ac- I have formed a six member Clinical Aerospace complish by email. These "process problems" hamper Medicine Committee composed of one U.S. and five in- the development of resolutions, position papers, associ- ternational members. We met in New Orleans and ation letters, and other instruments by which AsMA ex- began discussions toward the goal of addressing the presses its views and positions. clinical needs within AsMA and determining future di- I have asked each committee chair to appoint a rection. I look forward to the work of this committee. deputy chair, as proposed by past president Melchor So, this is what we are about. In every decision Antuñano. I have also introduced an Action Item List for made in the coming year, we must ask if that decision Council, Executive Committee, and Committee use. The is in the best interest of the member. The best interest of list contains the action item, responsible entity or person, the member must be the association's guiding princi- projected completion date, and current status column. I pal. We will work for that, and I ask each constituent, suggest the list be used at each meeting following read- affiliate, and individual member to join in that effort. ing of the minutes. I hope these measures will be helpful Until next month… Aviation, Space, and Environmental Medicine • Vol. 78, No. 6, • June 2007 633 634-638.qxp 4/30/2007 12:26 PM Page 1 Medical News been very difficult, causing unacceptable de- sonnel. They look after the comfort of passen- Executive lays. We must be able to act expeditiously as gers and should be able to render first aid in Director’s the media, as well as government agencies, case of illness or accident. One line will take often impose short suspense times. no one but a trained nurse. All hostesses Column Consequently, our incoming president, Dr. should be trained nurses, and they will be Jack Hastings, plans to address the process much more efficient if they know something we use in determining our policy statements. about aviation medicine, such as air sickness, I'm hopeful that we will have this completed the effects of altitude, wind, cold, speed, dis- and implemented before the end of the year. turbances of equilibrium and have some expe- Obviously, the more efficient we are, the rience in flying before engaging on the first quicker we can act. And it is vital that we do flight as a hostess. Rayman act untrammeled by unnecessary roadblocks. "In the early part of this article the ques- I hope you agree with Teddy Roosevelt. tion was raised 'Are there in fact opportuni- ties for nurses in aviation?' It is believed the The Challenge of Policy (and question has already been answered in the Teddy Roosevelt) This Month in Aerospace affirmative" (5). In any moment of decision, the best thing you Medicine History-- Fifty Years Ago can do is the right thing, the next best thing is June 2007 Hyperventilation and aviation mishaps (USAF the wrong thing, and the worst thing you can do By Walter Dalitsch III, M.D., M.P.H. School of Aviation Medicine, Randolph AFB, TX): is nothing.--Teddy Roosevelt "Hypocapnia resulting from spontaneous or voluntary hyperventilation usually produces a Since 1992 your Association has published Seventy-five Years Ago deterioration of psychomotor performance. 71 position papers, resolutions, and policy The importance of nurses in aviation: "The Such a deterioration may become critical for letters that have been disseminated to inter- American Nurses Aviation Service Inc. is spon- the accomplishment of complex tasks. ested agencies worldwide. This averages out soring a comparatively new idea, namely the Hyperventilation, therefore, was suspected as to about five such policy documents per year. introduction of the trained nurse as a neces- a possible factor in modern aviation contribut- We can take great pride in this accomplish- sary part of aeronautics. ing to incidents or accidents otherwise unex- ment, particularly when you look at the "Flight surgeons' offices. There are at pre- plainable at the time. The only affirmative evi- breadth of the issues we have addressed. Our sent over 800 physicians engaged in examin- dence for such a suspicion seemed to exist in very first position paper prepared by Hank ing pilots for the Department of Commerce. occasional reports by jet pilots who had ob- Taylor was on Crew Resource Management, Some of these are doing a large amount of served 'high rates of breathing' while in flight. a revolutionary concept at the time (1992), work, some a moderate amount and some However, before hyperventilation could be that we fully supported and which, today, is only a little. Many of them have nurses in their classified as a major problem in aviation (like conventional practice. From there we went offices. A nurse can take visual fields with the hypoxia), it was necessary to demonstrate by on to a host of other issues including AEDs perimeter, do urinalyses, test visual acuity and some objective means the existence of true (automated external defibrillators), EMKs test depth perception, as well as assist with overventilation in flight. If overventilation (emergency medical kits), space life sciences, women applicants… does exist, the intensity and frequency of oc- alternative medicine, laser lights, etc. I rec- "Flight surgeons with air lines. Passenger currence possibly could clarify the importance ommend that you visit our website carrying air lines are gradually taking on flight of this problem… (www.asma.org) and click on Policy surgeons to supervise the physical welfare of "By laboratory experimentation it was Compendium where you will find all 71 doc- their pilots and other medical matters pertain- shown that progressive hypocapnia caused by uments, each one individually download- ing to the line. Here, again we have not only hyperventilation gradually impairs psychomo- able. As you go through these documents, the usual physical examinations for license but tor performance. Medical practitioners occa- you can see we have given support to mili- monthly checks of personnel. These checks sionally observe complete loss of conscious- tary aviation, civil aviation, and the space consist in certain eye and nervous system tests ness in patients very susceptible to the program over the years.