Page 204 - PJ MED OPS Handbook 8th Ed

17. Aerospace Accident and Injuries

As PJ first responders, it is very helpful to understand mechanism of injuries (MOI) and patterns of
associated injuries. An understanding of MOI helps to identify what injuries to look for and to antic-
ipate those that might be life threatening. This is especially important in circumstances when verbal
communication with the patient is limited, as in the back of any type of aircraft.

Pilot Ejection Injuries
1. Basic principles when treating ejection injury patients
a. Be prepared above all for penetrating trauma – the “golden hour” is when lives are saved.
b. Be prepared for airway injury, head trauma, and non-ambulatory pilots.
c. Pilots surviving aircraft ejection frequently sustain vertebral and extremity fractures. Proper
packaging of such patients may result in salvage of neurologic function in severe cases.
d. If such packaging requires any kind of risk to the Medic or pilot, abandon attempts at spinal
immobilization in favor of a prompt return to safety.
e. If there is injury by ground fire, rapid hemorrhage control will make the difference between
life and death.
2. Factors affecting pilot ejection injuries
a. Aircraft
i) speed
ii) altitude
iii) attitude
b. Pilot
i) Extraneous or poor fitting gear, harness, helmet
ii) Body position in ejection seat
c. All of the above are affected by the pilot’s level of consciousness
3. Causes of known combat ejection injuries
a. Body Part Flail 33%
b. Enemy inflicted 17%
c. Ejection seat G forces 14%
d. Struck object 13%
e. Parachute landing 11%
f. Fire 10%
g. Parachute opening shock 2%
h. Vertebral injury
4. Pre-ejection injuries – time from initial aircraft emergency until ejection is initiated
a. Fire
i) burns
ii) smoke inhalation
iii) blindness
iv) loss of consciousness
b. Explosion
i) wide range from lacerations to multiple extreme injuries
ii) shrapnel wounds
1) “Pilots sustaining shrapnel wounds from primary or secondary projectiles usually die.”

202 n Pararescue Medical Operations Handbook / 8th Edition