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Moynihan, Shannan

Publications and source records attributed to Moynihan, Shannan.

Suited Ground Vacuum Chamber Testing Decompression Sickness Tiger Team Report

Suited vacuum chamber testing is critical to flight crew training, sustaining engineering, and development engineering. Most suited vacuum chamber testing at NASA’s Johnson Space Center (JSC) involves crewmembers or human test subjects working at a hypobaric pressure of 4.3 psia, which requires that an oxygen prebreathe be performed prior to decompression to reduce the risk of decompression sickness (DCS). Since 1986, NASA’s policy has been to require a 4-hour resting prebreathe for hypobaric chamber exposures of 4.2 psia lasting greater than 30 minutes. There have been no reports of Type II (i.e., serious, potentially life-threatening) DCS at NASA while using this prebreathe protocol. Several chamber runs, believed to be approximately 5% of all runs, are believed to have been terminated due to Type I DCS symptoms that were performance impairing; however, detailed records of DCS symptoms during suited vacuum chamber runs are not available. The adequacy of the 4-hour prebreathe protocol, as well as the processes by which prebreathe protocols and policies are established, became the subject of significant discussion in April 2018 when medical planning was initiated for chamber runs that were scheduled to occur later in 2018 that would last 8 hours or more with high metabolic rates.

Abercromby, Andrew F. J.↗

Evidence Based Medicine in Space Flight: Evaluation of Inflight Vision Data for Operational Decision-Making

Due to recently identified vision changes associated with space flight, JSC Space and Clinical Operations (SCO) implemented broad mission‐related vision testing starting in 2009. Optical Coherence Tomography (OCT), 3 Tesla Brain and Orbit MRIs, Optical Biometry were implemented terrestrially for clinical monitoring. While no inflight vision testing was in place, already available onorbit technology was leveraged to facilitate in‐flight clinical monitoring, including visual acuity, Amsler grid, tonometry, and ultrasonography. In 2013, on‐orbit testing capabilities were expanded to include contrast sensitivity testing and OCT. As these additional testing capabilities have been added, resource prioritization, particularly crew time, is under evaluation.

Van Baalen, Mary↗

Visual Impairment/lntracranial Pressure Risk Clinical Care Data Tools

Prior to 2010, several ISS crewmembers returned from spaceflight with changes to their vision, ranging from a mild hyperopic shift to frank disc edema. As a result, NASA expanded clinical vision testing to include more comprehensive medical imaging, including Optical Coherence Tomography and 3 Tesla Brain and Orbit MRIs. The Space and Clinical Operations (SCO) Division developed a clinical practice guideline that classified individuals based on their symptoms and diagnoses to facilitate clinical care. For the purposes of clinical surveillance, this classification was applied retrospectively to all crewmembers who had sufficient testing for classification. This classification is also a tool that has been leveraged for researchers to identify potential risk factors. In March 2014, driven in part by a more comprehensive understanding of the imaging data and increased imaging capability on orbit, the SCO Division revised their clinical care guidance to outline in‐flight care and increase post‐flight follow up. The new clinical guidance does not include a classification scheme

Van Baalen, Mary↗