Bernard l'Ons^1
1NSWHP

Impact brain apnoea is defined by the cessation of breathing after traumatic brain injury, and is characterised by the patient appearing lifeless, pale, with no respiratory effort. It is distinct from airway obstruction that may occur during reduced levels of consciousness. 

The two immediate pathophysiological events that may occur following head injury are apnoea and massive sympathetic discharge . The apnoea leads to hypoxia and the sympathetic discharge leads to an increased cardiovascular demand for oxygen. This interplay results in cardiorespiritory collapse. 

 

IBA is thought to be exacerbated by alcohol. Lateral impact  to the head is reported to be an additional risk factor.

Kate Manderson¹, Cheryl Charlwood
¹Civil Aviation Safety Authority 
 
Aviation deaths are relatively rare in Australia, with our aviation system recognised as one of the safest in the world. This means that the quality and consistency of information from investigations of each of our few fatal aircraft is very important. Gathering medical information in the event of an aviation safety incident is a requirement of Australia's compliance with the Chicago Convention of the International Civil Aviation Organisation, and is fundamental to developing a full picture not just of individual accident factors, but the medical and human performance functions within our aviation safety system. For activities that are rarely performed, standardised clinical guidelines are important to ensure the future performance of that activity doesn't depend on each clinician performing that task re-constructing the task or remembering the previous event. With these issues in mind, CASA, in collaboration with the RAAF Institute of Aviation Medicine, has created a Clinical Practice Guideline for standardised approach to collection and analysis of the medical aspects of aircraft accidents in Australia. It is hoped that this guideline will support all agencies involved in investigating, analysing and learning from aircraft accidents in Australia to adopt a consistent approach to gathering this critical set of data. 

Hans H. de Boer^1,2, Judith Fronczek^1,2, Melanie Archer^1,2 

¹Victorian Institute of Forensic Medicine, Southbank, Victoria, Australia; ²Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia 

Forensic pathology aims to be an evidence-based specialty, and when in court, forensic pathologists are expected to provide opinions that are based on experience, expertise, and the best available medical and scientific knowledge. Such forensic pathology evidence is mostly well-accepted and uncontroversial. There are however deficiencies associated with the empirical underpinning of some forensic pathology opinions. First, there can be issues with the application of experience and published research to individual cases. Second, substantial impediments exist to conducting certain types of forensic pathology research, for instance due to an inability to ethically replicate casework conditions. Without clear guidance by robust scientific evidence, practitioners may be left to their own devices when addressing specific questions in court. This increases the risk of inaccurate, ‘eminence-based’ opinions, which may ultimately affect justice delivery. More generally, the above issues also hamper the development of forensic pathology academically. This presentation presents a possible way forward, by advocating for performing a systematic discipline-led analysis of the empirical foundations of specific forensic pathology opinions.