In this St Emlyn’s podcast, Ian Beardsell and Simon Carley speak with RAF GP Phil Lucas from the Royal Air Force Centre of Aerospace Medicine at the BASICS conference in Leicestershire. They explore what really happens when a pilot pulls the ejection handle, and what this means for pre-hospital and Emergency Department teams who may be the first to see an ejectee.

Phil explains:

• Why the aviation environment is so hostile to humans and how aerospace medicine supports aircrew

• How modern ejection seats work – from canopy jettison and rocket firing to parachute deployment and landing

• The decision making required to eject in a matter of seconds, and how pilots are trained to be “mentally ready”

• Typical injury patterns after ejection, how technology has reduced spinal compression injuries, and where the remaining risks lie

• Practical considerations for ED and pre-hospital teams when a pilot presents after ejection, including spinal precautions and safe removal of flight equipment

• The psychological impact of surviving a crash or ejection, how support needs can change over months, and what helps people return to flying

• Aviation medicine as a career path, including the role of the RAF Centre of Aerospace Medicine, the diploma in aviation medicine, and how this can sit alongside general practice or emergency care

This conversation draws strong parallels between aviation and emergency medicine: human factors, training under pressure, using simulation and mental rehearsal, and the importance of honest, individualised psychological support after critical incidents.