Immediate Post-mishap Duties

• Care of survivors is the first priority.

• Draw appropriate labs: (See (4) serum blood drawing.)

• Do physical exams. The services have agreed that the first FS (GMO in this case) on a mishap scene, or the one to whom mishap victims are brought, shall immediately perform examinations and laboratory procedures required by the flight surgeon’s service.

• Perform radiological studies as clinically indicated. After all ejections and mishaps resulting in personnel with suspected back injuries, full spinal x-rays are required.

• Document aircraft-deceased relationships at the mishap site before the remains are moved. Use of photography or sketching the site and relationships are very helpful during mishap investigation board deliberations.

• Obtain taped statements and interviews from each member of the aircrew (and possibly air traffic controllers or plane captains, etc., as appropriate) recounting the mishap from brief to rescue.

• Begin interviewing witnesses.

• Distribute and explain the 72-hour history forms.

• Impound the medical and dental records.

• Impound flight equipment.

• Issue Grounding Notices (NAVMED 6410/1; the " Down Chit").

Other Duties

• Ascertain injuries and determine the injury codes for the Mishap Investigation Report and Flight Surgeon’s report, known officially as the Aeromedical Analysis (AA).

• Coordinate with the Armed Forces Institute of Pathology (AFIP) at (202) 782-2100 or DSN 662-2100 for the autopsy.

• With deceased personnel, obtain full body x-rays in and out of flight equipment with emphasis on hands, feet, head, and neck (AP and lateral). Order special views whenever indicated.

• Submit lab specimens to AFIP as appropriate.

• Collect the 72-hour history forms for use in the Aeromedical Analysis.

• Maintain close followup with those involved to monitor any changes in their medical condition and to obtain further elaboration on the mishap events.

• Be sensitive to the psychological trauma a mishap may inflict on all, including those participating in remains recovery; counsel or refer, as appropriate.

• Participate fully in the AMB investigation until the flight surgeon arrives.

• Initiate completion of the Aeromedical Analysis.

• For assistance as needed, contact or message the Commands:

Naval Safety Center Aeromedical division: (757) 444-3520

COMNAVAIRPAC: (619) 545-1148

COMNAVAIRLANT force medical: (757) 444-7028/29

In all Class A and B mishaps, and when deemed necessary in Class C mishaps, collect blood and urine of survivors.

AFIP requests that the following specimens be collected:

• Serum: 14 to 20 ml (no preservatives, red top) blood: 14-20 ml (Sodium fluoride, gray top) 14 to 20 ml (EDTA, lavender top).

• Urine: 70 ml is optimum (no preservatives).

However, as a practical guide, as soon as possible after a mishap collect the following laboratory samples from each of the aircrew (as well as anyone else who may have been a factor in the mishap). Prepare the skin with betadine or soap and water. Do not use alcohol swabs

• The Naval Flight Surgeon’s Pocket Reference to Aircraft Mishap Investigation, 4^th Ed, 1995

• The Naval Flight Surgeon’s Handbook, 2^nd Ed, 1998, The Society of U.S. Naval Flight Surgeons

• The Naval Flight Surgeon’s Manual 3rd Ed, 1991, NAMI