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NASA Lunar Surface Innovation Initiative: Ensuring a Cohesive, Executable Strategy for Technology

Establishing a sustainable human presence on the Moon allows NASA to develop and test new approaches, technologies, and systems that will enable us to function in other, more challenging environments. The Lunar Surface Innovation Initiative (LSII) was established in 2019 and has evolved into a key agency asset to spur technology development and provide risk reduction for lunar surface system development and flight demonstrations. LSII coordinates activities implemented through a combination of in-house activities, competitive programs, and public-private partnerships to create transformative technologies needed for lunar surface exploration. This paper will outline the LSII model used to develop a technology pipeline that will retire the primary technology hurdles in six capability areas. In-situ resource utilization technologies for collecting, processing, storing, and using material found or manufactured on the Moon. Surface power technologies that provide the capability for sustainable, continuous power throughout the day and night for lunar missions. Dust mitigation strategies that diminish lunar dust hazards on lunar surface systems such as cameras, solar panels, space suits, habitats, and instrumentation. Extreme environments technologies that enable systems to operate throughout the full range of lunar surface conditions, including lunar noon (up to 150 at the equator), night (down to - 180 at the equator), multiple day/night cycles, and in permanently shadowed regions (down to -250). Extreme access technologies that enable humans or robotic systems to access, navigate, and explore previously inaccessible lunar surface or subsurface areas. Excavation and construction technologies that will allow affordable, autonomous manufacturing or construction. We outline key results, including milestones and achievements related to the capability areas and outcomes from partnerships with the commercial sector. A key tenet of the LSII is the Lunar Surface Innovation Consortium (LSIC), a collaboration across industry, academia, and government to successfully develop the transformative capabilities for lunar surface exploration. LSIC provides a forum for NASA to communicate technological requirements, needs, and opportunities and for the community to share existing capabilities and identify critical gaps with NASA. By working side by side with commercial enterprises and our international partners, NASA is able to combine the knowledge and expertise needed to explore the lunar surface and make technical advances that will feed technological and economic growth. Since its inception, LSII has engaged over 600 organizations across the United States and 46 countries to shape the technologies and systems needed to explore the lunar surface and stimulate a lunar surface economy.

Lunar↗

NASA Lunar Surface Innovation Initiative: Ensuring a Cohesive, Executable Strategy for Technology Development

Establishing a sustainable human presence on the Moon allows NASA to develop and test new approaches, technologies, and systems that will enable us to function in other, more challenging environments. The Lunar Surface Innovation Initiative (LSII) was established in 2019 and has evolved into a key agency asset to spur technology development and provide risk reduction for lunar surface system development and flight demonstrations. LSII coordinates activities implemented through a combination of in-house activities, competitive programs, and public-private partnerships to create transformative technologies needed for lunar surface exploration. This paper will outline the LSII model used to develop a technology pipeline that will retire the primary technology hurdles in six capability areas. In-situ resource utilization technologies for collecting, processing, storing, and using material found or manufactured on the Moon. Surface power technologies that provide the capability for sustainable, continuous power throughout the day and night for lunar missions. Dust mitigation strategies that diminish lunar dust hazards on lunar surface systems such as cameras, solar panels, space suits, habitats, and instrumentation. Extreme environments technologies that enable systems to operate throughout the full range of lunar surface conditions, including lunar noon (up to 150 at the equator), night (down to - 180 at the equator), multiple day/night cycles, and in permanently shadowed regions (down to -250). Extreme access technologies that enable humans or robotic systems to access, navigate, and explore previously inaccessible lunar surface or subsurface areas. Excavation and construction technologies that will allow affordable, autonomous manufacturing or construction. We outline key results, including milestones and achievements related to the capability areas and outcomes from partnerships with the commercial sector. A key tenet of the LSII is the Lunar Surface Innovation Consortium (LSIC), a collaboration across industry, academia, and government to successfully develop the transformative capabilities for lunar surface exploration. LSIC provides a forum for NASA to communicate technological requirements, needs, and opportunities and for the community to share existing capabilities and identify critical gaps with NASA. By working side by side with commercial enterprises and our international partners, NASA is able to combine the knowledge and expertise needed to explore the lunar surface and make technical advances that will feed technological and economic growth. Since its inception, LSII has engaged over 600 organizations across the United States and 46 countries to shape the technologies and systems needed to explore the lunar surface and stimulate a lunar surface economy.

lunar, lunar surface, technology development, ISRU↗

Human Health Countermeasures (HHC) Element Management Plan: Human Research Program

NASA s Human Research Program (HRP) is an applied research and technology program within the Human Exploration and Operations Mission Directorate (HEOMD) that addresses human health and performance risk mitigation strategies in support of exploration missions. The HRP research and technology development is focused on the highest priority risks to crew health and safety with the goal of ensuring mission success and maintaining long-term crew health. Crew health and performance standards, defined by the NASA Chief Health and Medical Officer (CHMO), set the acceptable risk level for exploration missions. The HRP conducts research to inform these standards as well as provide deliverables, such as countermeasures, that ensure standards can be met to maximize human performance and mission success. The Human Health Countermeasures (HHC) Element was formed as part of the HRP to develop a scientifically-based, integrated approach to understanding and mitigating the health risks associated with human spaceflight. These health risks have been organized into four research portfolios that group similar or related risks. A fifth portfolio exists for managing technology developments and infrastructure projects. The HHC Element portfolios consist of: a) Vision and Cardiovascular; b) Exercise and Performance; c) Multisystem; d) Bone; and e) Technology and Infrastructure. The HHC identifies gaps associated with the health risks and plans human physiology research that will result in knowledge required to more fully understand risks and will result in validated countermeasures to mitigate risks.

Norsk, Peter↗

Space Radiation and the Challenges Towards Effective Shielding Solutions

The hazards of space radiation and their effective mitigation strategies continue to pose special science and technology challenges to NASA. It is widely accepted now that shielding space vehicles and structures will have to rely on new and innovative materials since aluminum, like all high Z materials, are poor shields against the particulate and highly ionizing nature of space radiation. Shielding solutions, motivated and constrained by power and mass limitations, couple this realization with "multifunctionality," both in design concept as well as in material function and composition. Materials endowed with effective shielding properties as well as with some degree of multi‐functionality may be the kernel of the so‐called "radiation‐smart" structures and designs. This talk will present some of the challenges and potential mitigation ideas towards the realization of such structures and designs.

Barghouty, Abdulnasser↗

Risk as a Driver for Innovation

The Space Life Sciences directorate (SLSD) and Human Research Program (HRP) at NASA Johnson Space Center has implemented a system for managing human systems risks. These risks are defined as the health and performance risks posed to crew during and after spaceflight. Identification and evaluation of these risks has led to the identification of gaps in knowledge about the risks as well as gaps in technology needed to mitigate them. Traditional routes of closing technology gaps have, in some cases, proven to be too slow when a solution was required quickly. Therefore, certain gaps were used to drive the development of "challenges" for the scientific community. Partnering with open innovation service providers such as InnoCentive and Yet2.com, SLSD and HRP have decreased the amount of time from identification of a need to the evaluation of a solution. Although not all proposed solutions will result in a risk mitigation strategy or tool, the process has allowed faster evaluation of proposed solutions providing the researcher the ability to move to another possible solution if the first does not sufficiently address the problem. Moreover, this process engages the community outside of NASA and broadens the population from which to draw solutions. In the traditional grant funding structure, only those in the specific field will apply for the grant. However, using open innovation, solutions can come from individuals in many different fields. This can expand the general view of a field (way of thinking within a field) and the application of solutions form new fields while providing a pathway for the acquisition of novel solutions or refinements of current mitigations. Identification of the human systems risks has helped drive the development and evaluation of innovative solutions as well as engaging a broader scientific audience in working with NASA.

Davis, Jeff↗

Method and Apparatus for the Quantification of Particulate Adhesion Forces on Various Substrates

Mitigation strategies for lunar dust adhesion have typically been limited to qualitative analysis. This technical memorandum describes the generation and operation of an adhesion testing device capable of quantitative assessment of adhesion forces between particulates and substrates. An aerosolization technique is described to coat a surface with a monolayer of particulates. Agitation of this surface, via sonication, causes particles to dislodge and be gravitationally fed into an optical particle counter. Experimentally determined adhesion force values are compared to forces calculated from van der Waals interactions and are used to calculate the work of adhesion using Johnson-Kendall-Roberts (JKR) theory. Preliminary results indicate that a reduction in surface energy and available surface area, through topographical modification, improve mitigation of particulate adhesion.

Wohl, Christopher J.↗

Dust-Tolerant Intelligent Electrical Connection System

Faults in wiring systems are a serious concern for the aerospace and aeronautic (commercial, military, and civilian) industries. Circuit failures and vehicle accidents have occurred and have been attributed to faulty wiring created by open and/or short circuits. Often, such circuit failures occur due to vibration during vehicle launch or operation. Therefore, developing non-intrusive fault-tolerant techniques is necessary to detect circuit faults and automatically route signals through alternate recovery paths while the vehicle or lunar surface systems equipment is in operation. Electrical connector concepts combining dust mitigation strategies and cable diagnostic technologies have significant application for lunar and Martian surface systems, as well as for dusty terrestrial applications. The dust-tolerant intelligent electrical connection system has several novel concepts and unique features. It combines intelligent cable diagnostics (health monitoring) and automatic circuit routing capabilities into a dust-tolerant electrical umbilical. It retrofits a clamshell protective dust cover to an existing connector for reduced gravity operation, and features a universal connector housing with three styles of dust protection: inverted cap, rotating cap, and clamshell. It uses a self-healing membrane as a dust barrier for electrical connectors where required, while also combining lotus leaf technology for applications where a dust-resistant coating providing low surface tension is needed to mitigate Van der Waals forces, thereby disallowing dust particle adhesion to connector surfaces. It also permits using a ruggedized iris mechanism with an embedded electrodynamic dust shield as a dust barrier for electrical connectors where required.

Lewis, Mark↗

Compact Lightweight Aerial Sensor System (CLASSy)

In the wake of increasingly intense wildfires, innovative solutions are imperative to enhance wildfire mitigation strategies. Current technological integrations have hit a communicative limit. Between limited flight time, computational expenses as well as financial expenses, there is a hole in the market for an effective, low-tech, and disposable solution. The Compact Lightweight Aerial Sensor System (CLASSy) is designed to revolutionize active disaster operations through comprehensive decision support. CLASSy consists of a lightweight launch mechanism and a flight body equipped with a sensor package and parachute. The assembly integrates sensor networks with data analytics to provide real-time, high-resolution information to incident commanders, directly facilitating decision-making and resource allocation. Infrared imagery and temperature differentials are processed and analyzed throughout flight, offering valuable insights into fire behavior, hotspot detection, and fire spread trajectories. CLASSy is intended to meet a variety of natural disaster mitigation needs through its variable launch height and disposability. CLASSy’s goal is to assist wildfire fighting without taking up any human or material resources. As a result, CLASSy is as lightweight as possible, easily expendable, inexpensive to manufacture, and only requires one operator for effective use. CLASSy’s integrated sensor suite, real-time analytics, and closed loop active communications empower firefighting teams to proactively address wildfire challenges. As the frequency of wildfires continues to rise, technological innovations like CLASSy are crucial to effective wildfire management systems.

Kyleigh Anderson↗

Plume Impingement to the Lunar Surface: A Challenging Problem for DSMC

The President's Vision for Space Exploration calls for the return of human exploration of the Moon. The plans are ambitious and call for the creation of a lunar outpost. Lunar Landers will therefore be required to land near predeployed hardware, and the dust storm created by the Lunar Lander's plume impingement to the lunar surface presents a hazard. Knowledge of the number density, size distribution, and velocity of the grains in the dust cloud entrained into the flow is needing to develop mitigation strategies. An initial step to acquire such knowledge is simulating the associated plume impingement flow field. The following paper presents results from a loosely coupled continuum flow solver/Direct Simulation Monte Carlo (DSMC) technique for simulating the plume impingement of the Apollo Lunar module on the lunar surface. These cases were chosen for initial study to allow for comparison with available Apollo video. The relatively high engine thrust and the desire to simulate interesting cases near touchdown result in flow that is nearly entirely continuum. The DSMC region of the flow field was simulated using NASA's DSMC Analysis Code (DAC) and must begin upstream of the impingement shock for the loosely coupled technique to succeed. It was therefore impossible to achieve mean free path resolution with a reasonable number of molecules (say 100 million) as is shown. In order to mitigate accuracy and performance issues when using such large cells, advanced techniques such as collision limiting and nearest neighbor collisions were employed. The final paper will assess the benefits and shortcomings of such techniques. In addition, the effects of plume orientation, plume altitude, and lunar topography, such as craters, on the flow field, the surface pressure distribution, and the surface shear stress distribution are presented.

Lumpkin, Forrest↗

Ares I-X Roll Control System Development

Project Managers often face challenging technical, schedule and budget issues. This presentation will explore how the Ares I-X Roll Control System Integrated Product Team (IPT) mitigated challenges such as concurrent engineering requirements and environments and evolving program processes, while successfully managing an aggressive project schedule and tight budget. IPT challenges also included communications and negotiations among inter- and intra-government agencies, including the US Air Force, NASA/MSFC Propulsion Engineering, LaRC, GRC, KSC, WSTF, and the Constellation Program. In order to successfully meet these challenges it was essential that the IPT define those items that most affected the schedule critical path, define early mitigation strategies to reduce technical, schedule, and budget risks, and maintain the end-product focus of an "unmanned test flight" context for the flight hardware. The makeup of the IPT and how it would function were also important considerations. The IPT consisted of NASA/MSFC (project management, engineering, and safety/quality) and contractors (Teledyne Brown Engineering and Pratt and Whitney Rocketdyne, who supplied heritage hardware experience). The early decision to have a small focused IPT working "badgelessly" across functional lines to eliminate functional stove-piping allowed for many more tasks to be done by fewer people. It also enhanced a sense of ownership of the products, while still being able to revert back to traditional roles in order to provide the required technical independence in design reviews and verification closures. This presentation will highlight several prominent issues and discuss how they were mitigated and the resulting Lessons Learned that might benefit other projects.

Unger, Ronald J.↗

The New Face of Data Accessibility

Management of medical and research data at NASA's Johnson Space Center has been addressed with two separate, independent systems: the Lifetime Surveillance of Astronaut Health (formerly, The Longitudinal Study of Astronaut Health) (LSAH) and the Life Sciences Data Archive (LSDA). Project management for these has been autonomous with little or no cross-over of goals, objectives or strategy. The result has been limited debate and discussion regarding how contents from one repository might impact or guide the direction of the other. It is decidedly more efficient to use existing data and information than to re-generate them. Ensuring that both clinical and research data / information are accessible for review is a central concept to the decision to unify these repositories. In the past, research data from flight and ground analogs has been held in the LSDA and medical data held in the Electronic Medical Record or in console flight surgeon logs and records. There was little cross-pollination between medical and research findings and, as a result, applicable research was not being fully incorporated into clinical, in-flight practice. Conversely, findings by the console surgeon were not being picked up by the research community. The desired life cycle for risk mitigation was not being fully realized. The goal of unifying these repositories and processes is to provide a closely knit approach to handling medical and research data, which will not only engender discussion and debate but will also ensure that both categories of data and information are used to enhance the use of medical and research data to reduce risk and promote the understanding of space physiology, countermeasures and other mitigation strategies

Fitts, Mary A.↗

Predicting the Likelihood of Human-Elephant Conflict and Assessing Patterns in Elephant Movements Over Varying Habitat Conditions in the Kavango-Zambezi Area

In the Kavango-Zambezi area of southern Africa, three million people live within areas frequently traveled by free-ranging elephants. As the region continues to develop rapidly, urban and agricultural settlements further encroach upon the land that these elephants use. As elephants come into more frequent contact with urban and agricultural areas, human populations face financial loss through crop damage and the potential for injury from direct conflict with elephants. Elephant populations are also at risk of injuries from conflict as well as illness related to the consumption of waste. In order to implement human-elephant conflict mitigation strategies, local conservation groups need to be informed on best practices for coexistence. This project aided The Ecoexist Project and Connected Conservation in understanding the ecological factors that drive elephant movement into human settlements and provided Earth observation data to support conflict management in the future. The team used Landsat 5 Thematic Mapper (TM), Landsat 8 Operational Land Imager (OLI) data to create land use land cover maps and calculate vegetation indices, and used TerraClimate data to analyze drought conditions. These classified maps allowed us to display a time series of human settlement from 1990 to the present and were made explorable alongside other environmental variables in an updated Google Earth Engine (GEE) tool. This project also provided heat maps that show the risk of human-elephant conflict based on historical data of HEC locations. This analysis will provide support for conservation experts in determining best practices for future mitigation and prevention of human-elephant conflict.

Ariel Calle↗

Prediction of Calcium Oxalate Stone Risk with Interventions

Introduction Mitigations intended to reduce bone mineral loss in-flight also influence the level of renal stone risk to astronauts. Extending a recent study completed by our group [1], we investigate the likely influence of combined fluid intake and Ca excretion mitigation strategies. Methods A computational biochemistry model representing CaOx crystal precipitation, growth, and agglomeration [2] is combined with a probabilistic analysis to predict the in-flight CaOx renal stone incidence risk ratio (IRR) relative to pre-flight values using 1517 astronaut 24-hour urine chemistries. The output of this simulation is used to assess the combined impact of controlling fluid intake and Ca excretion on maintaining IRR < 1.2 for > 95% of the population, a threshold determined from initial analysis of the model output compared to referent populations [1]. Results and Conclusions Figure 1 illustrates the simulated in-flight astronaut population (n=40000) with CaOx IRR > 1.2. The red lines indicate the known clinical risk boundary of each factor, and the white box is considered the area of high combined clinical risk. The simulation and identified risk threshold conform well to the expected clinical risk boundaries. The results, assuming insensible water losses equal or exceed 0.7 L/day, imply mitigations achieve risks similar to pre-flight levels when either Ca < 150 mg/day or fluid volume intake > 3.2 L/day individually, or combined Ca < 200 and fluid volume intake > 2.5 L/day. We continue to investigate similar compounded effects and look to apprise engineering trades by informing relative risk changes during mission design. References [1] D. A. Goodenow-Messman, S. A. Gokoglu, M. Kassemi, and J. Myers, Jerry G., “Characterization of Astronaut CaOx Renal Stone Incidence Rates to Quantify In-flight and Post-flight Relative Risk,” npj Microgravity, in review, 2021. [2] M. Kassemi and D. Thompson, “Prediction of renal crystalline size distributions in space using a PBE analytic model. 1. Effect of microgravity-induced biochemical alterations,” Am. J. Physiol. Physiol., vol. 311, no. 3, pp. F520–F530, Sep. 2016, doi: 10.1152/ajprenal.00401.2015.

Debra A Goodenow↗

Analysis of Surface Charging for a Candidate Solar Sail Mission Using Nascap-2k

The characterization of the electromagnetic interaction for a solar sail in the solar wind environment and identification of viable charging mitigation strategies are critical solar sail mission design task. Spacecraft charging has important implications both for science applications and for lifetime and reliability issues of sail propulsion systems. To that end, surface charging calculations of a candidate 150-meter-class solar sail spacecraft for the 0.5 AU solar polar and 1.0 AU L1 solar wind environments are performed. A model of the spacecraft with candidate materials having appropriate electrical properties is constructed using Object Toolkit. The spacecraft charging analysis is performed using Nascap-2k, the NASA/AFRL sponsored spacecraft charging analysis tool. Nominal and atypical solar wind environments appropriate for the 0.5 AU and 1.0 AU missions are used to establish current collection of solar wind ions and electrons. Finally, a geostationary orbit environment case is included to demonstrate a bounding example of extreme (negative) charging of a solar sail spacecraft. Results from the charging analyses demonstrate that minimal differential potentials (and resulting threat of electrostatic discharge) occur when the spacecraft is constructed entirely of conducting materials, as anticipated from standard guidelines for mitigation of spacecraft charging issues. Examples with dielectric materials exposed to the space environment exhibit differential potentials ranging from a few volts to extreme potentials in the kilovolt range.

Parker, Linda Neergaard↗

Analysis of Surface Charging for a Candidate Solar Sail Mission Using NASCAP-2K

The characterization of the electromagnetic interaction for a solar sail in the solar wind environment and identification of viable charging mitigation strategies are critical solar sail mission design tasks. Spacecraft charging has important implications both for science applications and for lifetime and reliability issues of sail propulsion systems. To that end, surface charging calculations of a candidate 150-meter-class solar sail spacecraft for the 0.5 AU solar polar and 1.9 AU LI solar wind environments are performed. A model of the spacecraft with candidate materials having appropriate electrical properties is constructed using Object Toolkit. The spacecraft charging analysis is performed using Nascap-2k. the NASA/AFRL sponsored spacecraft charging analysis tool. Nominal and atypical solar wind environments appropriate for the 0.5 AU and 1.0 AU missions are used to establish current collection of solar wind ions and electrons. Finally, a geostationary orbit environment case is included to demonstrate a bounding example of extreme (negative) charging of a solar sail spacecraft. Results from the charging analyses demonstrate that minimal differential potentials (and resulting threat of electrostatic discharge) occur when the spacecraft is constructed entirely of conducting materials, as anticipated from standard guidelines for mitigation of spacecraft charging issues. Examples with dielectric materials exposed to the space environment exhibit differential potentials ranging from a few volts to extreme potentials in the kilovolt range.

Parker, Linda Neergaard↗

Percutaneous aspiration of fluid for management of peritonitis in space

BACKGROUND: As a medical emergency that can affect even well-screened, healthy individuals, peritonitis developing during a long-duration space exploration mission may dictate deviation from traditional clinical practice due to the absence of otherwise indicated surgical capabilities. Medical management can treat many intra-abdominal processes, but treatment failures are inevitable. In these circumstances, percutaneous aspiration under sonographic guidance could provide a "rescue" strategy. Hypothesis: Sonographically guided percutaneous aspiration of intra-peritoneal fluid can be performed in microgravity. METHODS: Investigations were conducted in the microgravity environment of NASA's KC-135 research aircraft (0 G). The subjects were anesthetized female Yorkshire pigs weighing 50 kg. The procedures were rehearsed in a terrestrial animal lab (1 G). Colored saline (500 mL) was introduced through an intra-peritoneal catheter during flight. A high-definition ultrasound system (HDI-5000, ATL, Bothell, WA) was used to guide a 16-gauge needle into the peritoneal cavity to aspirate fluid. RESULTS: Intra-peritoneal fluid collections were easily identified, distinct from surrounding viscera, and on occasion became more obvious during weightless conditions. Subjectively, with adequate restraint of the subject and operators, the procedure was no more demanding than during the 1-G rehearsals. CONCLUSIONS: Sonographically guided percutaneous aspiration of intra-peritoneal fluid collections is feasible in weightlessness. Treatment of intra-abdominal inflammatory conditions in spaceflight might rely on pharmacological options, backed by sonographically guided percutaneous aspiration for the "rescue" of treatment failures. While this risk mitigation strategy cannot guarantee success, it may be the most practical option given severe resource limitations.

Non-NASA Center↗

Estimating the Need for Medical Intervention due to Sleep Disruption on the International Space Station

During ISS and shuttle missions, difficulties with sleep affect more than half of all US crews. Mitigation strategies to help astronauts cope with the challenges of disrupted sleep patterns can negatively impact both mission planning and vehicle design. The methods for addressing known detrimental impacts for some mission scenarios may have a substantial impact on vehicle specific consumable mass or volume or on the mission timeline. As part of the Integrated Medical Model (IMM) task, NASA Glenn Research Center is leading the development of a Monte Carlo based forecasting tool designed to determine the consumables required to address risks related to sleep disruption. The model currently focuses on the International Space Station and uses an algorithm that assembles representative mission schedules and feeds this into a well validated model that predicts relative levels of performance, and need for sleep (SAFTE Model, IBR Inc). Correlation of the resulting output to self-diagnosed needs for hypnotics, stimulants, and other pharmaceutical countermeasures, allows prediction of pharmaceutical use and the uncertainty of the specified prediction. This paper outlines a conceptual model for determining a rate of pharmaceutical utilization that can be used in the IMM model for comparison and optimization of mitigation methods with respect to all other significant medical needs and interventions.

Myers, Jerry G.↗

Autonomous Medical Care for Exploration Class Space Missions

The US-based health care system of the International Space Station (ISS) contains several subsystems, the Health Maintenance System, Environmental Health System and the Countermeasure System. These systems are designed to provide primary, secondary and tertiary medical prevention strategies. The medical system deployed in Low Earth Orbit (LEO) for the ISS is designed to enable a "stabilize and transport" concept of operations. In this paradigm, an ill or injured crewmember would be rapidly evacuated to a definitive medical care facility (DMCF) on Earth, rather than being treated for a protracted period on orbit. The medical requirements of the short (7 day) and long duration (up to 6 months) exploration class missions to the Moon are similar to LEO class missions with the additional 4 to 5 days needed to transport an ill or injured crewmember to a DCMF on Earth. Mars exploration class missions are quite different in that they will significantly delay or prevent the return of an ill or injured crewmember to a DMCF. In addition the limited mass, power and volume afforded to medical care will prevent the mission designers from manifesting the entire capability of terrestrial care. NASA has identified five Levels of Care as part of its approach to medical support of future missions including the Constellation program. In order to implement an effective medical risk mitigation strategy for exploration class missions, modifications to the current suite of space medical systems may be needed, including new Crew Medical Officer training methods, treatment guidelines, diagnostic and therapeutic resources, and improved medical informatics.

Hamilton, Douglas↗