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NASA NTRSDate not supplied

Pilot Study of Medications Exposed to Vacuum

Background Few studies have been conducted regarding the effects of vacuum on medications and their packaging. While relevant on the International Space Station, understanding these effects becomes even more critical as future NASA missions venture farther away from Earth. Vehicles supporting the Artemis missions will have dedicated, vehicle-specific medical kits as well as crew medical accessory kits. Although most of the kits will be stored in a pressurized, climate-controlled volume, there are specific scenarios in which they may become exposed to vacuum. These include the vehicle being brought to vacuum to enable clearance of atmospheric contaminants, and on Human Landing System (HLS), in the airlock (in which kits may be stored) during extravehicular activities. Overview The Exploration Medical Integrated Product Team (XMIPT) in collaboration with the Department of Defense is conducting a pilot study to assess the effects of vacuum on the medications and their packaging to be used in exploration missions. Phase A of this study will focus on manufacturer’s package integrity and Phase B on identifying chemical changes through active pharmaceutical ingredient (API) testing of the medications at 0, 4.5 and 9 months post exposure. Two exposure durations, 1 hour and 8 hours were selected to represent the expected time at vacuum for an Orion contaminated atmosphere vent/repress and the time at vacuum for a lunar surface EVA. The medications for this study were identified based on those currently being considered for future Artemis missions and represent the types of pharmaceuticals and formulations that are likely to comprise an exploration formulary. Discussion The results from this pilot study will aid in decision making related to the development of medical kits, medication packaging and stowage for long duration lunar and Mars missions, and inform the direction of future medication in vacuum studies.

Vacuum↗
NASA NTRSDate not supplied

Clinical Decision Support For Exploration Space Flight: Software Augmentation To Enhance Progressively Earth-Independent Medical Operations

This panel identifies the challenges of supporting medical events in deep space using integrated systems software to augment existing capabilities during increasingly Earth-independent missions where an asynchronous communication environment becomes routine. An interdisciplinary team of software designers, physicians, human factors engineers, and computational modelers applied their respective expertise to develop a roadmap for supporting the crew making medical decisions in more autonomous fashion with time-delayed ground support. The first presentation describes predictive modeling implemented to assist medical system design and address risk reduction using robust clinical decision support software. The second presentation details how operational and environmental challenges guide assumptions and, in turn, by what means requirements for medical decision-making in deep space are derived. The third presentation describes and defines the skills and capabilities an exploration spaceflight medical officer will need to perform effectively during extended-duration spaceflight missions. The fourth presentation covers the potential models and function of the software element for supporting clinical decisions. The final presentation covers how these elements may work together with ground support to provide comprehensive care despite deep space travel's extreme challenges and limitations.

Dana Levin↗
NASA NTRS1975

International Conference on Remote Emergency Medical Services

An emergency medical system is characterized. Applications of NASA technology in biomedical telecommunication and bioinstrumentation are explored. The training and effectiveness of paramedics, technicians, nurses, and physicians are evaluated as applied to emergency situations and the operations of trauma centers. Civilian and military aeromedical evacuation is discussed.

Source record↗
NASA NTRS1992

Critical issues for space life sciences

Human exploration of space requires the interaction of three general systems: environmental health and life support systems, countermeasure systems, and medical care systems. These systems address atmospheric pressure, uncertainties associated with space radiation, the potential for exposure to toxic materials in the closed environment, spacecraft habitability, human physiology, and microgrvaity. While these interdependent systems serve the same overall goal -- the protection of the human crewmember from the hostile space environment -- each has specific essential roles. Individually and in combination the three systems should be responsive to a strategy of risk reduction, so that the scientific possibilities of exploration missions may be maximized.

Nicogossian, Arnauld E.↗
NASA NTRS2025

Limitations and Feasibility of Mini X-Ray Devices in Space Environments

LIMITATIONS AND FEASIBILITY OF MINI X-RAY DEVICES IN SPACE ENVIRONMENTS As space exploration advances toward long-duration missions, reliable medical diagnostic tools become increasingly critical. The miniature x-ray (XR) technology demonstrations by the Exploration Medical Capability (ExMC) and the Exploration Medical Integrated Product Team (XMIPT) aim to assess the feasibility and utility of miniature XR devices in spaceflight. This abstract explores the limitations of current miniature XR systems, the challenges of training crew members, the potential role of clinical decision support systems (CDSS), and the feasibility of ground-based image interpretation. We also propose the integration of miniature XR into other ExMC efforts aimed at identifying the capabilities and resources needed for future exploration class missions. One of the primary challenges with miniature XR devices is the ability to achieve specific anatomical views, particularly in the confined and weightless conditions of a spacecraft. Operators may struggle to acquire diagnostic-quality images when space is limited for proper patient positioning and the volume of the imaging device. Since space radiation and detector limitations may further impact image quality, the flexibility of the operating procedures of these devices will be critical for their success in space applications. CHALLENGES IN TRAINING CREW TO OPERATE IMAGING DEVICES Training in the skills necessary to acquire diagnostic-quality scans may be a barrier for non-clinician crewmembers. The curriculum developed for crew medical officers (CMOs) will require simplification and adaptation to fit into the highly truncated pre-flight training period. Therefore, hands-on familiarization and simulation, both pre-flight and just-in-time training during missions, will be crucial to ensuring the crew can operate the devices in real-life situations. The ability to adjust acquisition parameters must be simplified or made automatic through exam selections on equipment user interfaces, and subject and operator positioning should be assisted with laser guidance and pictorial guides. POTENTIAL FOR CDSS OR ARTIFICIAL INTELLIGENCE (AI)-ASSISTED CDSS CDSS and AI-assisted CDSS offer significant promise in assisting crew members with limited medical training. These systems could provide real-time feedback on image quality and interpretation, helping to mitigate the risks of human error during space missions. Integrating procedural guidance tools, such as virtual and augmented reality, will support crewmembers in accurately positioning patients and obtaining high-quality images. However, the success of such systems will depend on the development of robust training datasets, integration with spaceflight-rated hardware, and the medical decision-making capabilities of operators. FEASIBILITY OF GROUND INTERPRETATION AND DATA TRANSMISSION Reliance on ground-based interpretation may prove difficult for acute care during exploration class-missions due to delays in transmission with increasing distance from Earth or complete communication blackout periods. In such instances where immediate interpretation for clinical intervention is required, crew must be able to interpret the images independently or utilize AI-based assistance to do so. File sizes for XR exams can also be large if numerous images are acquired and bandwidth constraints may limit data transmissions for both radiography and ultrasound exams. FUTURE WORK AND INTEGRATION INTO THE EVIDENCE LIBRARY Future work proposes integrating miniature XR devices into NASA’s Evidence Library to address medical conditions identified as significant contributors to crew morbidity and mortality. The possibility of combining miniature XR with other imaging modalities, such as ultrasound devices, is also under investigation. In conclusion, while miniature XR technology holds potential for extraterrestrial medical systems, there are significant challenges to overcome. Training, integration of AI tools, dedicated exam protocols for microgravity, and improved data transmission systems will be key to realizing the full benefits of miniature XR technology in space.

A M Nelson↗
NASA NTRS2009

Management of Service Projects in Support of Space Flight Research

Goal:To provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration . [HRP-47051] Specific Objectives: 1) Develop capabilities, necessary countermeasures, and technologies in support of human space exploration, focusing on mitigating the highest risks to human health and performance. 2) Define and improve human spaceflight medical, environmental, and human factors standards. 3) Develop technologies that serve to reduce medical and environmental risks, to reduce human systems resource requirements (mass, volume, power, data, etc.) and to ensure effective human-system integration across exploration systems. 4) Ensure maintenance of Agency core competencies necessary to enable risk reduction in the following areas: A. Space medicine B. Physiological and behavioral effects of long duration spaceflight on the human body C. Space environmental effects, including radiation, on human health and performance D. Space "human factors" [HRP-47051]. Service projects can form integral parts of research-based project-focused programs to provide specialized functions. Traditional/classic project management methodologies and agile approaches are not mutually exclusive paradigms. Agile strategies can be combined with traditional methods and applied in the management of service projects functioning in changing environments. Creative collaborations afford a mechanism for mitigation of constrained resource limitations.

Love, J.↗
NASA NTRS2025

Innovative Drug Selection, Storage, and Shelf-Life Strategies for Exploration Spaceflight

Medications have been a part of space travel dating back to the Apollo missions. A safe and effective medication formulary is essential to maintaining crew health and performance during long-duration spaceflight outside of low Earth orbit (LEO). Distance from Earth creates four key operational changes that increase medical risks, including communication, resupply, crewmember health, and evacuation. The current spaceflight pharmaceutical formulary consists of medications indicated to treat a variety of anticipated medical events and healthcare needs during spaceflight, but depends on a robust consumables resupply chain, which may be strained for a Lunar, and possibly non-existent for a Mars mission. The specific medications selections for the formulary may change to optimally align with the mission, crew compliment, and spacecraft design. Medical support at long-duration exploration missions will differ from LEO missions due to mission duration, lack of consumables resupply, prolonged exposure to space radiation, and the absence of emergency medical return capability. Loss of medication resupply limits or removes the ability to replace medications that have been exhausted or degraded, potentially exacerbating the medical risk posture. To address these anticipated risks, long-duration missions must consider use of novel medical technologies, treatment modalities, and smart medical systems that offer greater crew autonomy, such as physiologically based pharmacokinetic modeling, drug repurposing, on demand drug synthesis, or wearable drug delivery / monitoring devices. Once an ideal formulary for exploration space is determined, it is essential to establish the chemical and physical stability of each medication compound, as well as its safety by identifying its degradation profiles and products. Although few studies have been conducted to provide evidence on the physicochemical stability of pharmaceuticals during space missions, the data suggests that the spaceflight environment may promote degradation in some pharmaceuticals. Formulary drug purity and efficacy should be verified by pharmaceutical stability assessments, and can be realized non-destructively, and accessed in remote environments. Non-destructive pharmaceutical analysis and statistical modelling techniques could optimize exploration spaceflight medical care by enabling early detection of suboptimal therapeutics. Likewise, novel packaging, storage strategies, and dosage form innovations are promising countermeasures to optimize pharmaceutical shelf life, purity, and quality of exploration spaceflight medications. As we prepare for more distant exploration missions, risk management planning for astronaut healthcare should include the assembly of a medication formulary that is comprehensive enough to prevent or treat anticipated medical events, remains safe and chemically stable, and retains sufficient potency to last for the duration of the mission. Following extensive review of the literature, we will present innovative formulary optimization strategies, pharmaceutical stability assessment techniques, and storage and packaging solutions that could enhance drug safety and efficacy for future exploration spaceflight missions.

Vernie R Daniels↗
NASA NTRS1970

The integration of system specifications and program coding

Experience in maintaining up-to-date documentation for one module of the large-scale Medical Literature Analysis and Retrieval System 2 (MEDLARS 2) is described. Several innovative techniques were explored in the development of this system's data management environment, particularly those that use PL/I as an automatic documenter. The PL/I data description section can provide automatic documentation by means of a master description of data elements that has long and highly meaningful mnemonic names and a formalized technique for the production of descriptive commentary. The techniques discussed are practical methods that employ the computer during system development in a manner that assists system implementation, provides interim documentation for customer review, and satisfies some of the deliverable documentation requirements.

Luebke, W. R.↗
NASA NTRS2005

Autonomous Medical Care for Exploration

The goal of Autonomous Medical Care (AMC) is to ensure a healthy, well-performing crew which is a primary need for exploration. The end result of this effort will be the requirements and design for medical systems for the CEV, lunar operations, and Martian operations as well as a ground-based crew health optimization plan. Without such systems, we increase the risk of medical events occurring during a mission and we risk being unable to deal with contingencies of illness and injury, potentially threatening mission success. AMC has two major components: 1) pre-flight crew health optimization and 2) in-flight medical care. The goal of pre-flight crew health optimization is to reduce the risk of illness occurring during a mission by primary prevention and prophylactic measures. In-flight autonomous medical care is the capability to provide medical care during a mission with little or no real-time support from Earth. Crew medical officers or other crew members provide routine medical care as well as medical care to ill or injured crew members using resources available in their location. Ground support becomes telemedical consultation on-board systems/people collect relevant data for ground support to review. The AMC system provides capabilities to incorporate new procedures and training and advice as required. The on-board resources in an autonomous system should be as intelligent and integrated as is feasible, but autonomous does not mean that no human will be involved. The medical field is changing rapidly, and so a challenge is to determine which items to pursue now, which to leverage other efforts (e.g. military), and which to wait for commercial forces to mature. Given that what is used for the CEV or the Moon will likely be updated before going to Mars, a critical piece of the system design will be an architecture that provides for easy incorporation of new technologies into the system. Another challenge is to determine the level of care to provide for each mission type. The level of care refers to the amount and type of care one will render based on perceived need and ability. This is in contrast to the standard of care which is the benchmark by which that care is provided. There are certainly some devices and procedures that have unique microgravity or partial gravity requirements such that terrestrial methods will not work. For example, performing CPR on Mars cannot be done in exactly the same way as on Earth because the reduced gravity causes too large a reduction in the forces available for effective compression of the chest. Likewise, fluid behavior in microgravity may require a specialized water filtration and mixing system for the creation of intravenous fluids. This paper will outline the drivers for the design of the medical care systems, prioritization and planning techniques, key system components, and long term goals.

Johnson-Throop, Kathy A.↗
NASA NTRS2006

Human Factors Engineering as a System in the Vision for Exploration

In order to accomplish NASA's Vision for Exploration, while assuring crew safety and productivity, human performance issues must be well integrated into system design from mission conception. To that end, a two-year Technology Development Project (TDP) was funded by NASA Headquarters to develop a systematic method for including the human as a system in NASA's Vision for Exploration. The specific goals of this project are to review current Human Systems Integration (HSI) standards (i.e., industry, military, NASA) and tailor them to selected NASA Exploration activities. Once the methods are proven in the selected domains, a plan will be developed to expand the effort to a wider scope of Exploration activities. The methods will be documented for inclusion in NASA-specific documents (such as the Human Systems Integration Standards, NASA-STD-3000) to be used in future space systems. The current project builds on a previous TDP dealing with Human Factors Engineering processes. That project identified the key phases of the current NASA design lifecycle, and outlined the recommended HFE activities that should be incorporated at each phase. The project also resulted in a prototype of a webbased HFE process tool that could be used to support an ideal HFE development process at NASA. This will help to augment the limited human factors resources available by providing a web-based tool that explains the importance of human factors, teaches a recommended process, and then provides the instructions, templates and examples to carry out the process steps. The HFE activities identified by the previous TDP are being tested in situ for the current effort through support to a specific NASA Exploration activity. Currently, HFE personnel are working with systems engineering personnel to identify HSI impacts for lunar exploration by facilitating the generation of system-level Concepts of Operations (ConOps). For example, medical operations scenarios have been generated for lunar habitation in order to identify HSI requirements for the lunar communications architecture. Throughout these ConOps exercises, HFE personnel are testing various tools and methodologies that have been identified in the literature. A key part of the effort is the identification of optimal processes, methods, and tools for these early development phase activities, such as ConOps, requirements development, and early conceptual design. An overview of the activities completed thus far, as well as the tools and methods investigated will be presented.

Mihriban Whitmore↗
NASA NTRS2011

Integration and Cooperation in the Next Golden Age of Human Space Flight Data Repositories: Tools for Retrospective Analysis and Future Planning

As NASA transitions from the Space Shuttle era into the next phase of space exploration, the need to ensure the capture, analysis, and application of its research and medical data is of greater urgency than at any other previous time. In this era of limited resources and challenging schedules, the Human Research Program (HRP) based at NASA s Johnson Space Center (JSC) recognizes the need to extract the greatest possible amount of information from the data already captured, as well as focus current and future research funding on addressing the HRP goal to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. To this end, the Science Management Office and the Medical Informatics and Health Care Systems Branch within the HRP and the Space Medicine Division have been working to make both research data and clinical data more accessible to the user community. The Life Sciences Data Archive (LSDA), the research repository housing data and information regarding the physiologic effects of microgravity, and the Lifetime Surveillance of Astronaut Health Repository (LSAH-R), the clinical repository housing astronaut data, have joined forces to achieve this goal. The task of both repositories is to acquire, preserve, and distribute data and information both within the NASA community and to the science community at large. This is accomplished via the LSDA s public website (http://lsda.jsc.nasa.gov), which allows access to experiment descriptions including hardware, datasets, key personnel, mission descriptions and a mechanism for researchers to request additional data, research and clinical, that is not accessible from the public website. This will result in making the work of NASA and its partners available to the wider sciences community, both domestic and international. The desired outcome is the use of these data for knowledge discovery, retrospective analysis, and planning of future research studies.

Thomas, D.↗
NASA NTRS2011

NASA Life Sciences Data Repositories: Tools for Retrospective Analysis and Future Planning

As NASA transitions from the Space Shuttle era into the next phase of space exploration, the need to ensure the capture, analysis, and application of its research and medical data is of greater urgency than at any other previous time. In this era of limited resources and challenging schedules, the Human Research Program (HRP) based at NASA s Johnson Space Center (JSC) recognizes the need to extract the greatest possible amount of information from the data already captured, as well as focus current and future research funding on addressing the HRP goal to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. To this end, the Science Management Office and the Medical Informatics and Health Care Systems Branch within the HRP and the Space Medicine Division have been working to make both research data and clinical data more accessible to the user community. The Life Sciences Data Archive (LSDA), the research repository housing data and information regarding the physiologic effects of microgravity, and the Lifetime Surveillance of Astronaut Health (LSAH-R), the clinical repository housing astronaut data, have joined forces to achieve this goal. The task of both repositories is to acquire, preserve, and distribute data and information both within the NASA community and to the science community at large. This is accomplished via the LSDA s public website (http://lsda.jsc.nasa.gov), which allows access to experiment descriptions including hardware, datasets, key personnel, mission descriptions and a mechanism for researchers to request additional data, research and clinical, that is not accessible from the public website. This will result in making the work of NASA and its partners available to the wider sciences community, both domestic and international. The desired outcome is the use of these data for knowledge discovery, retrospective analysis, and planning of future research studies.

Thomas, D.↗
NASA NTRS2017

The Integrated Medical Model: Outcomes from Independent Review

In 2016, the Integrated Medical Model (IMM) v4.0 underwent an extensive external review in preparation for transition to an operational status. In order to insure impartiality of the review process, the Exploration Medical Capabilities Element of NASA's Human Research Program convened the review through the Systems Review Office at NASA Goddard Space Flight Center (GSFC). The review board convened by GSFC consisted of persons from both NASA and academia with expertise in the fields of statistics, epidemiology, modeling, software development, aerospace medicine, and project management (see Figure 1). The board reviewed software and code standards, as well as evidence pedigree associated with both the input and outcomes information. The board also assesses the models verification, validation, sensitivity to parameters and ability to answer operational questions. This talk will discuss the processes for designing the review, how the review progressed and the findings from the board, as well as summarize the IMM project responses to those findings. Overall, the board found that the IMM is scientifically sound, represents a necessary, comprehensive approach to identifying medical and environmental risks facing astronauts in long duration missions and is an excellent tool for communication between engineers and physicians. The board also found IMM and its customer(s) should convene an additional review of the IMM data sources and to develop a sustainable approach to augment, peer review, and maintain the information utilized in the IMM. The board found this is critically important because medical knowledge continues to evolve. Delivery of IMM v4.0 to the Crew Health and Safety (CHS) Program will occur in the 2017. Once delivered for operational decision support, IMM v4.0 will provide CHS with additional quantitative capability in to assess astronaut medical risks and required medical capabilities to help drive down overall mission risks.

medical equipment↗
NASA NTRSDate not supplied

A Strategy for Advancing Earth Independent Medical Operations

Exploration medical operations to the Moon and Mars present unprecedented challenges for providing in-mission medical care. The greater distance from Earth is the primary hazard that drives the need for a medical operations paradigm shift from low earth orbit mission. Increasingly complex long duration and long distance missions will have resource constraints (ex: mass, power, volume, data), a paucity of resupply or evacuation opportunities, and disruptions in real-time communications. In order to advance a more autonomous medical approach, a multi-faceted strategy will need to optimize all aspects of human health and performance in space. This strategy will include: increasing onboard medical autonomy through the development of novel crew health and performance systems; decision support capabilities to augment astronauts’ abilities in preventing, diagnosing, and treating medical conditions; creating new procedures and training tools for skill maintenance and just-in-time training; and enabling rapid crew access to data from all on-board systems, leading to better-informed, real-time, autonomous decisions. Collectively, this approach can be referred to as “Earth Independent Medical Operations” (EIMO). The Exploration Medical Capability Element of NASA’s Human Research Program has undertaken a longitudinal planning process to consensus around EIMO. Technical interchange meetings will occur with key constituents in late 2022 and again in early 2023 to define EIMO in practical terms and identify key elements of an EIMO system, with greater conceptual articulation and dissemination planned for the second half of 2023. We will share insights into the strategy for internal and external consensus building around EIMO, with a particular focus on the approach to partner stakeholders within NASA as well as commercial agencies.

Jay Lemery↗
DOE OSTI2025

Empowering Lineworkers: The Case for Active Exoskeletons in Utility Work

Exoskeletons have evolved from early medical prototypes to advanced systems capable of addressing physical demands in various industries. This report explores the potential of active exoskeleton technology within the utility sector, focusing on its application for linemen who face significant risks of work-related musculoskeletal disorders (WMSDs). By analyzing existing literature on exoskeletons across industries such as construction, manufacturing, and military, the study identifies a gap in utility-specific applications. Task-specific design features like gravity compensation, limb support, and advanced safety measures, improve exoskeletons’ potential to alleviate physical strain, reduce workplace injuries, and enhance productivity. This review emphasizes the need for targeted research and development to optimize exoskeleton designs for the utility sector to provide benefits for workers, companies, and the broader community.

60 APPLIED LIFE SCIENCES↗
NASA NTRS2005

Effective Crew Operations: An Analysis of Technologies for Improving Crew Activities and Medical Procedures

NASA's vision for space exploration (February 2004) calls for development of a new crew exploration vehicle, sustained lunar operations, and human exploration of Mars. To meet the challenges of planned sustained operations as well as the limited communications between Earth and the crew (e.g., Mars exploration), many systems will require crews to operate in an autonomous environment. It has been estimated that once every 2.4 years a major medical issue will occur while in space. NASA's future travels, especially to Mars, will begin to push this timeframe. Therefore, now is the time for investigating technologies and systems that will support crews in these environments. Therefore, this summer two studies were conducted to evaluate the technology and systems that may be used by crews in future missions. The first study evaluated three commercial Indoor Positioning Systems (IPS) (Versus, Ekahau, and Radianse) that can track equipment and people within a facility. While similar to Global Positioning Systems (GPS), the specific technology used is different. Several conclusions can be drawn from the evaluation conducted, but in summary it is clear that none of the systems provides a complete solution in meeting the tracking and technology integration requirements of NASA. From a functional performance (e.g., system meets user needs) evaluation perspective, Versus performed fairly well on all performance measures as compared to Ekahau and Radianse. However, the system only provides tracking at the room level. Thus, Versus does not provide the level of fidelity required for tracking assets or people for NASA requirements. From an engineering implementation perspective, Ekahau is far simpler to implement that the other two systems because of its wi-fi design (e.g., no required runs of cable). By looking at these two perspectives, one finds there was no clear system that met NASA requirements. Thus it would be premature to suggest that any of these systems are ready for implementation and further study is required.

Harvey, Craig↗
NASA NTRSDate not supplied

Proof-of-Concept for a Long-Term Health Metric to Quantify End of Mission Health Status in Astronauts

NASA has long used Probabilistic Risk Assessment (PRA) when high-stakes decisions need to be made about complex systems. For spaceflight medical risk, the Human Research Program’s Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT) is a significant step towards robustly quantifying the risk to crew health during exploration missions. However, there remains a significant gap in the ability to comprehensively characterize and assess risk across the disparate functionalities and capabilities which comprise the entire Crew Health and Performance (CHP) system. To fill this gap, the Crew Health and Performance – Probabilistic Risk Assessment (CHP-PRA) project aims to perform risk characterization for the CHP system by assessing performance risk in addition to medical risk. This effort also includes quantifying Long-Term Health (LTH) risk in addition to in-mission risk outcomes within the CHP-PRA results. LTH risk encompasses the timeframe from immediately post-flight, through the rest of an astronaut’s career, through retirement, and until death. A proof-of-concept LTH risk metric is based on medical condition end-state, as defined by the Evidence Library, capturing the spaceflight specific medical impacts persisting into post-flight[1]. Condition outcomes in the Evidence Library progress through three Clinical Phases (CP): the diagnostic phase (CP1), the treatment/convalescent phase (CP2), and the end-state phase (CP3) which represents the detrimental effects of the condition after the crew member has recovered to the maximal extent. Each CP has an associated Task Impairment (TI), defined as the degree of crew incapacity due to experiencing the condition, and is quantified with a 0-1 range. Conditions with an associated CP3 (e.g. Sepsis, Traumatic Hypovolemic Shock, Sudden Cardiac Arrest, etc.) typically have serious consequences that can cause an astronaut to be fully or partially debilitated throughout the remainder of the mission. Consequently, the Cumulative CP3 TI End-of-Mission Health Status Metric is developed by CHP-PRA to quantify the cumulative effects of all conditions which progressed to the CP3 state throughout the entirety of the mission. Hence, this End-of-Mission Health Status Metric attempts to serve as an indicator of an astronaut’s health state at the time of landing. The severity of the lingering effects of in-mission medical events are dependent on mission activities and the level of available in-mission medical care. This allows the associated cumulative TI metric to be used in comparison with the crew’s end of mission health status for different levels of in-mission resources. This presentation provides the strategy for using CP3 as an LTH metric component, as well as a proof-of-concept demonstration of LTH risk characterization using this component.

long term health↗
NASA NTRS1998

Applications of telemedicine in the United States space program

Since the beginning of human space flight, NASA has been placing humans in extreme and remote environments. There are many challenges in maintaining humans in outer space, including the provision of life-support systems, radiation shielding, and countermeasures for minimizing the effect of microgravity. Because astronauts are selected for their health, among other factors, disease and illness are minimized. However, it is still of great importance to have appropriate medical care systems in place to address illness and injury should they occur. With the exception of the Apollo program, exploration of space has been limited to missions that are within several hundred miles of the surface of the Earth. At the drawn of the 21st century and the new millennium, human exploration will be focused on operation of the International Space Station (ISS) and preparation for human missions to Mars. These missions will present inherent risks to human health, and, therefore, appropriate plans must be established to address these challenges and risks. Crews of long-duration missions must become more independent from ground controllers. New systems, protocols, and procedures are currently being perfected. Application of emerging technologies in information systems and telecommunications will be critical to inflight medical care. Application of these technologies through telemedicine will provide crew members access to information, noninvasive procedures for assessing health status, and guidance through the integration of sensors, holography, decision-support systems, and virtual environments. These technologies will also serve as a basis to enhance training and medical education. The design of medical care for space flight should lead to a redesign of the practice of medicine on Earth.

Review, Tutorial↗