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Aeromedical Consultation Service critical to ‘Fly, Fight, Win’

Published: Friday, October 06, 2017 @ 10:58 AM


            Aeromedical Consultation Service Deputy Chief Dr. Daniel Van Syoc listens during one of four weekly case review sessions in order to determine whether or not a waiver should be recommended for an aviator’s disqualifying medical condition. The ACS reviews approximately 2,000 cases a year with an 88 percent determination of recommendation for waivers, keeping Air Force pilots safely flying. (U.S. Air Force photo/John Harrington)
Aeromedical Consultation Service Deputy Chief Dr. Daniel Van Syoc listens during one of four weekly case review sessions in order to determine whether or not a waiver should be recommended for an aviator’s disqualifying medical condition. The ACS reviews approximately 2,000 cases a year with an 88 percent determination of recommendation for waivers, keeping Air Force pilots safely flying. (U.S. Air Force photo/John Harrington)

Ever since humans took to flight, the unique physics and environmental conditions of soaring through the air have tested mankind to overcome challenges, both physical and mental. For U.S. Air Force pilots, aircrew and others, their journey to flight starts with being medically screened.

Every pilot in the Air Force who didn’t graduate from the U.S. Air Force Academy – rough 1,000 annually – has walked through the doors of the Aeromedical Consultation Service for flight evaluation, according to ACS Deputy Chief Dr. Daniel Van Syoc. The academy screens their own pilot candidates, 345 of them in 2016, according to an academy fact sheet.

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“Our motto is ‘Fly, Fight, Win.’ That’s what we do,” Van Syoc said. “Everybody who wears the uniform, even (Air Force civilians), are here to directly or indirectly support the flying mission. We play a very critical role in that.”

Currently, the Air Force has 12,600 pilots and 3,297 navigators, according to the Air Force Personnel Center. The strains of flying, medical conditions and even stress can find a pilot facing a disqualifying condition for flight duties. When it does, their case goes to what’s known as a waiver authority to determine if a waiver is possible for the condition; generally this is a major command. When the waiver authority is faced with a case for which they can’t make a determination based on the medical data, it goes to the highly skilled aeromedical experts at the ACS.

A staff of about 80 psychiatrists, neurologists, pulmonologists, cardiologists, general internal medicine doctors, ophthalmologists, psychologists and optometrists, assisted by skilled technicians, carefully review all aspects of a case to determine whether or not to recommend a medical waiver to the waiver authority, the ultimate say on whether a pilot will get to fly again.

“We’re very much a world-class aeromedical evaluation center,” Van Syoc said. “There isn’t really a comparable organization in the world to what we do, that has the ability to go to the lengths that we do in evaluating military aviators.”

To say the professionals at the ACS are at the top of their game may actually be a bit of an understatement.

“I have had the pleasure of working with people who are literally the world expert in what they do,” Van Syoc said.

Today, ACS sees some 2,000 waiver recommendation requests annually. ACS staff can make a waiver recommendation based solely on the case materials in roughly 1,400 of those cases, with the other 600 requiring individuals to be physically seen at the ACS at Wright-Patterson Air Force Base.

“We get sent some of the toughest cases from the field and our job is to make sure that the air crews are flying safely,” said Aeromedical Consultation Service Chief Col. Niraj Govil. “The question that we get is ‘Is this particular flyer safe to fly? If not, if he can’t fly the airframe that he was trained for, where can he go?’ Bottom line, we’re here for the safety of the air crew. What we try to do is return them (to flying status) as safely and as quickly as possible.”

In fact, about 88 percent of the cases ACS reviews ends with a recommendation for waiver to the waiving authority.

“We send the ACS dozens of cases every year: pilots, navigators, enlisted crew members and air traffic controllers,” said Jim J. Cahill, health systems specialist with the Office of the Pacific Air Forces Command Surgeon, who manages primary oversight of all requests for medical waivers on aviators and special-duty personnel from nine PACAF bases. “One of the most important functions they perform for us is to quantify risk. They answer the question, ‘How much risk is associated with allowing this crewmember to continue to fly?’ This is priceless information when the waiver authority is trying to determine if a waiver will be granted.”

To measure that risk, it takes time. Van Syoc says that in the commercial world, a person with a mental health issue might get an hour with a psychiatrist to determine the problem. At the ACS, individuals would meet with both a psychiatrist and psychologist for upwards of 20 hours, not including the time required to review the case materials and research the medical issue. It may seem like a lot of effort, but at a cost of $3 to $5 million to train a fighter pilot, depending on aircraft, Van Syoc says every second is worth it.

“We’ve invested several million dollars in every pilot just to get them to the point where they’re mission ready,” Van Syoc said. “So, if we’re going to invest that kind of money in them and we’re going to say ‘up’ or ‘down’ we want to have covered every aspect of the case and make a very well-informed recommendation to the waiver authority.”

Even with the level of detail the ACS provides, Van Syoc says that once a case comes to them, they can often make a waiver recommendation determination within one month, including for those individuals who need to travel to the ACS to be seen.

To speed up the timeline for waiver authorities to receive a recommendation, the ACS provides specific submission information through online waiver guides – guides they are currently reviewing to ensure they are as clear and specific as possible. As long as all information requested is submitted, the ACS can make a waiver recommendation as quickly as possible.

“Every branch of the ACS, internal medicine, ophthalmology and neuropsychology, provides us with a dedicated consultant we can reach out to any time for the advice we need to support our warfighters,” Cahill said. “The doctors are available pretty much 24/7, which comes in handy considering the challenges of communicating across multiple time zones.”

Cahill says it’s truly a team effort that makes the ACS successful.

“While the docs provide the professional consultation and advice, the case managers are the unsung heroes of the ACS,” Cahill said. “People like Tech. Sgt. Blackwell, Lisa Martin and Dena Green do all of the behind-the-scenes work. They perform the initial review of all cases to ensure everything they need is included, interface with the major command and, in many cases, the referring base, and manage the endless changes to scheduled appointments for our patients.”

While the humans serving as pilots and flight crew haven’t changed much since the ACS first began screening pilots and making waiver recommendations back in the early 1950s, the way they fly has.

“Probably the biggest mission change we’ve been involved with is in remotely piloted aircraft,” Van Syoc said. “A large number of those folks are trained pilots, although not all of them have gone through military pilot training, but that’s the future of the Air Force, the unmanned aircraft. So, we get quite involved in caring for them.”

Besides varying flight missions, changing technology like maneuverable jet nozzles in higher performance aircraft like the F-22 Raptor and F-35 Lightning can subject their pilots to new stressors, according to Govil.

“I think that’s going to broaden our job,” Govil said. “Because, a lot of times we’re waiting for those specific problems that come from the field. Many times, they ask for our advice when they first see problems coming up. What we’re trying to do right now is to enhance our research publishing capabilities, because right now we’re sitting on kind of a goldmine.”

That “goldmine” is the 58,000-some cases in the ACS database reaching back to the 1950s. While ACS staff can access the information located in the database, it’s not as efficient as it could be, according to Govil. Enabling that database to be easier to mine data from is critical to providing research-based recommendations in the future.

“To look at the natural history of a condition in a large group of people, that’s how we end up giving effective advice for policy changes, as far as waivers,” Van Syoc said.

Govil said he doesn’t have a timeline as to when a new form of the database could be ready, but feels confident that not only is it possible, but once done, could be quite significant.

“It looks like it’s going to be the largest data bank of aeromedical information in the world,” he said, which would again set the ACS as the premiere aeromedical evaluation center in the world.

“Behind every pilot, behind every mission, we have people here at ACS who are doing everything we can medically to get them flying,” Govil said. “We’re a critical piece of the ‘Fly, Fight, Win’ mission of the Air Force.”

The ACS is part of the U.S. Air Force School of Aerospace Medicine, the premiere institute for research, education and worldwide operational consultation in aerospace medicine, under the umbrella of the 711th Human Performance Wing, both headquartered at Wright-Patterson AFB.

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Rain continues into the morning; wet commute, reduced visibility expected

Published: Wednesday, February 21, 2018 @ 3:53 AM

Meteorologist Kirstie Zontini looks at the rain Wednesday and who could see some light freezing rain Thursday.

>> Record-breaking warmth this week 

QUICK-LOOK FORECAST

  • Rain returns this morning, chance storm
  • Rounds of rain continue into weekend
  • Flood threat lingers

>> 5-Day Forecast

DETAILED FORECAST

TODAY: Rain with the chance for a few thunderstorms will continue to move into the Miami Valley this morning. The commute will likely be wet so drivers should slow down and watch for pockets of heavy rain that could drop visibility. A very mild morning, but temperatures drop during the day behind the cold front to the upper 30s and low 40s by the end of the afternoon. Rounds of rain showers continue through the afternoon and evening hours, but won’t be as heavy. The roads will stay wet for the drive home and it could get cold enough at night for some freezing rain to develop. 

>> County-by-County Weather

THURSDAY: Temperatures, especially in the northern Miami Valey, should drop below 32 degrees. Scattered rain showers in the morning will mix with freezing rain in some spots, however, temperatures will quickly climb to above freezing, limiting any major impact. Road temperature may also stay warm enough to limit problems, but conditions could get slick briefly in some areas. The rest of the day will be dry in most cities as highs reach the upper 40s. 

FRIDAY: Another wave of energy will bring widespread showers back to the Miami Valley. It’ll be breezy with highs in the upper 50s. Rain may fall heavy in some spots, keeping the flood threat elevated for low lying cities, creeks, and streams. 

>> WHIO Doppler 7 Interactive Radar

SATURDAY: We’ll see scattered showers at times, especially in the afternoon. A breezy day with highs in the upper 50s. 

SUNDAY: Morning showers come to an end with it being windy and cooler at times as highs peak in the low 50s. These temperatures will drop quickly into the evening. 

WHIO Weather App

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Alabama police officer shot, killed; suspect dead

Published: Wednesday, February 21, 2018 @ 4:36 AM

Mobile Police Officer Justin Billa. (Photo credit: Mobile Police Department)
Mobile Police Department
Mobile Police Officer Justin Billa. (Photo credit: Mobile Police Department)(Mobile Police Department)

An Alabama police officer who was shot Tuesday night has died, authorities say.

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Dayton traffic from the WHIO Traffic Center

Published: Monday, February 19, 2018 @ 3:49 AM
Updated: Wednesday, February 21, 2018 @ 5:03 AM

2 lanes of I-75N closed after two-vehicle crash
2 lanes of I-75N closed after two-vehicle crash

Traffic issues can be reported by calling our newsroom at 937-259-2237 or tweeting @WHIOTraffic .

Traffic conditions are updated every six minutes on AM 1290 and News 95.7 FM.

Major Highway Incidents

  • No incidents to report

Surface Street Incidents 

  • At Limestone Street and Chesnut Avenue in Springfield, a serious single-vehicle crash was reported around 4:03 a.m. A traffic reconstruction team has been called to the scene.

>> RELATED: WHIO App-Winter

>> RELATED: Track the latest conditions in your neighborhood on our live WHIO Doppler 7 Interactive Radar

Ongoing Construction & Other Closures 

Live look at highways on our traffic cameras here.

Latest traffic conditions are also available on our traffic map. 

MONTGOMERY COUNTY

  • Keowee Street north of Stanley Avenue, bridge closed until 2019. The official detour is: Keowee Street to Stanley Avenue to I-75 to Wagner Ford Road and back to Dixie. More information is available here.
  • Stewart Street Ramp to US 35 East, RAMP CLOSURE March 28 - Sept 30, 2018. The official detour is: Stewart Street to Edwin C. Moses Boulevard to I-75 north to US 35 west to James H. McGee Blvd. to US 35 east.
  • I-75 north Ramp to US 35 west and east, Lane width restriction until Apr. 1, 2018. One lane will remain open on the ramp with a width of 11 feet.

SHELBY COUNTY

  • SR 47 between Fifth Avenue and Wilkinson Avenue, Lane closures Jan. 21 - Nov. 27. One lane will remain open in each direction at all times. 

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Driver extricated, highway reopens after crash on SB I-75 

Published: Wednesday, February 21, 2018 @ 1:37 AM
Updated: Wednesday, February 21, 2018 @ 4:42 AM

Crash on I-75 near Needmore Road exit

UPDATE @ 3:40 a.m: All lanes on southbound I-75 have reopened following a crash early Wednesday morning.

The driver was taken to Miami Valley Hospital by CareFlight, and is listed in stable condition.

>> Dayton traffic from the WHIO traffic center

UPDATE @ 3:03 a.m: After nearly two hours, the driver of a vehicle that went off the road on southbound I-75 has been extricated from the vehicle.

The interstate has been shut down for over an hour between Needmore Road and Wagner Ford Road.

The extrication of the driver took hours because a guard rail went into the door of the vehicle. 

Per initial reports, the individual will be transported by Careflight to Miami Valley Hospital.

We will continue to monitor when the highway reopens. 

UPDATE @ 2:09 a.m: One person is still trapped inside of their vehicle after it went off the road on southbound I-75 Wednesday morning, according to Ohio Highway State Patrol, Dayton Post. 

OTHER LOCAL NEWS: Coroner’s identify two men shot to death at Harrison Twp. auto dealership

Harrison Twp. emergency crews are working to extricate the driver from the vehicle in order to be transported to Miami Valley Hospital via Careflight. Though he is trapped, he appears in stable condition, according to officials.

The single-vehicle crash was reported around 1:20 a.m. and due to the entrapment, Careflight was requested to the scene, shutting the interstate down between Needmore Road and Wagner Ford Road exits.

I-75 has been shut down for about 45 minutes and officials believe it should reopen in the next 30 minutes once Careflight lifts off the ground. 

The cause of the crash is still under investigation. 

UPDATE @ 1:50 a.m: Soutbound I-75 between the Needmore Road and Wagner Ford Road exits is shut down after a crash occurred early Wednesday morning. 

INITIAL REPORT

Careflight has been requested to a crash with reports of entrapment on southbound I-75 near the Needmore Road exit early Wednesday morning.

The incident was dispatched around 1:20 a.m., per initial reports.

The Needmore Road exit ramp is currently closed and with Careflight on their way to the scene, this will likely shut the highway down.

We have a crew on the way to the scene and will update this story with more details. 

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