Polytrauma in a Jet Pilot After Low-Altitude Ejection Without Parachute Deployment.

Abstract

Background: Ejection seats are designed to be a lifesaving device for aircrew in emergencies. Modern ejection seats are widely prevalent in fighter and bomber aircraft and are occasionally associated with acceleration injury from axial loading (Gz) during the catapult phase of ejection, limb flail injury due to windblast, or parachute landing fall, especially if the ejection is outside of the seat's performance envelope.

Case report: We present the first known case in the medical literature of a military pilot who survived a low-altitude, high-angulation (>90° of bank angle) ejection where the pilot's ejection seat parachute did not deploy due to contact with the ground before completion of the ejection sequence. The patient's initial exam upon arrival at a trauma center was significant for a Glasgow Coma Scale of 3T, with evidence of cranial and extremity trauma. The patient presented with respiratory acidosis and required upsizing of his endotracheal tube placed in the field. The patient's injury list included bilateral subdural and subarachnoid hemorrhages, a Hangman's fracture, spinal burst fractures, and extensive extremity fractures. After a prolonged hospital stay, the patient was discharged to rehabilitation. The patient made a functional and neurological recovery, including return to independent completion of his activities of daily living.

Discussion: This case provides evidence of favorable outcome after a low-altitude, high-angulation ejection without parachute deployment. This case details the medical and traumatic pathology medical personnel should expect from an ejection that occurs outside of the seat's performance envelope. Zivkovic MM, Inman BL, Figlewicz MR, Burchett JA, Nowadly CD. Polytrauma in a jet pilot after low-altitude ejection without parachute deployment. Aerosp Med Hum Perform. 2024; 95(11):862-866.