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All sourcesNASA NTRSDOE OSTI
NASA NTRS2023

Flight Surgeon Survey Results Review: Long-Duration Artemis Medical System ConOps

Background: The Artemis Mission Functional Medical Concept of Operation (ConOp) is an operational document that describes the functional medical capabilities and concept of operations for early Artemis missions of around 30 days duration. It is currently under revision for longer missions (180+ days), aiming to build a foundational diagnostic and treatment capabilities list considering mission parameters, crew selection and training, and mass/volume constraints. An interview of NASA operational flight surgeons was completed to start the revision of the medical ConOp. Methods: In the survey, 20 experienced NASA flight surgeons responded to 57 standardized questions covering 17 categories, 22 questions of which were covered in this analysis including 4 categories: Cardiovascular, Catastrophic Situations, Pulmonary, and Respiratory/O2 Support. These results were categorized into recommendations and observations. The recommendations were used to objectively quantify the responses to look for consensus, differences and uncertainty among responses. The observations remain important but were not included in this review. Analysis: Regarding questions related to changes in medical conditions treated for long-duration missions, percentage of “No Change” responses varied from 20% to 75%. In the “Change” treatment plan responses, a variety of recommendations were made, which were further made into graphics for better illustration. Additionally, recommendations on capability questions in multiple systems were visualized altogether in one product. Discussion: This work demonstrates the importance of collaboration and thorough analysis amongst experienced NASA flight surgeons for helping establish medical systems and contributing to the likelihood of mission success during Artemis long-duration missions. Through this review, we were able to identify some positive attributes as well as areas for improvement, which will facilitate further discussions.

Andrew Bushong↗
NASA NTRS2023

Flight Surgeon Survey Results Review: Long-Duration Artemis Medical System ConOps

The Artemis Mission Functional Medical Concept of Operation (ConOp) is an operational document that describes the functional medical capabilities and concept of operations for early Artemis missions of around 30 days duration. It is currently under revision for longer missions (180+ days), aiming to build a foundational diagnostic and treatment capabilities list considering mission parameters, crew selection and training, and mass/volume constraints. An interview of NASA operational flight surgeons was completed to start the revision of the medical ConOp.

Andrew Bushong↗
NASA NTRS2016

Conceptual Drivers for an Exploration Medical System

Interplanetary spaceflight, such as NASA's proposed three-year mission to Mars, provides unique and novel challenges when compared with human spaceflight to date. Extended distance and multi-year missions introduce new elements of operational complexity and additional risk. These elements include: inability to resupply medications and consumables, inability to evacuate injured or ill crew, uncharted psychosocial conditions, and communication delays that create a requirement for some level of autonomous medical capability. Because of these unique challenges, the approaches used in prior programs have limited application to a Mars mission. On a Mars mission, resource limitations will significantly constrain available medical capabilities, and require a paradigm shift in the approach to medical system design and risk mitigation for crew health. To respond to this need for a new paradigm, the Exploration Medical Capability (ExMC) Element is assessing each Mars mission phase-transit, surface stay, rendezvous, extravehicular activity, and return-to identify and prioritize medical needs for the journey beyond low Earth orbit (LEO). ExMC is addressing both planned medical operations, and unplanned contingency medical operations that meld clinical needs and research needs into a single system. This assessment is being used to derive a gap analysis and studies to support meaningful medical capabilities trades. These trades, in turn, allow the exploration medical system design to proceed from both a mission centric and ethics-based approach, and to manage the risks associated with the medical limitations inherent in an exploration class mission. This paper outlines the conceptual drivers used to derive medical system and vehicle needs from an integrated vision of how medical care will be provided within this paradigm. Keywords: (Max 6 keywords: exploration, medicine, spaceflight, Mars, research, NASA)

Antonsen, Erik↗
NASA NTRS2006

Recommendations from NASA's Operational and Research Musculoskeletal Summit

Introduction: Continuously evolving medical standards of care, limited crew training time, and the inherent constraints of space flight necessitate regular revisions of the mission medical support infrastructure and methodology. A three-day Operational and Research Musculoskeletal Summit was held to review NASA s current strategy for preflight health maintenance and injury screening, risk mitigation for musculoskeletal injuries or syndromes, treatment methods during flight, and research topics to mitigate risks to astronaut health. The Summit also undertook consideration of the best evidence-based terrestrial musculoskeletal practices to recommend their adaptation for use in space. Methods: The types and frequencies of musculoskeletal injuries sustained by short- and long-duration astronauts were obtained from the Longitudinal Study of Astronaut Health. The Summit panel was comprised of experts from the clinical and research communities, as well as representatives from NASA Headquarters, the Astronaut corps, and the offices of JSC Medical Operations, JSC Human Adaptation and Countermeasures, Glenn Research Center Human Research, and Astronaut Strength Conditioning and Rehabilitation. Before the summit, panelists participated in a Web-based review of NASA s Space Medical Conditions List (SMCL). Results: The Summit generated seventy-five operational and research recommendations to the NASA Office of Space Medicine, including changes to the SMCL and to the musculoskeletal section of the ISS debrief questionnaire. From these recommendations, seven were assigned highest value and priority, and could be immediately adopted for the exploration architecture. Discussion: Optimized exercise and conditioning to improve performance and forestall musculoskeletal damage on orbit were the primary area of focus. Special attention was paid to exercise timing and muscle group specificity. The panel s recommendations are currently in various stages of consideration or integration into the ISS and Exploration programs. This effort serves to enhance the on-orbit system so comprehensive treatment can be delivered in a more effective and standardized manner.

Jones, J. A.↗
NASA NTRS2010

Concept of Operations Evaluation for Mitigating Space Flight-Relevant Medical Issues in a Planetary Habitat

Introduction: Analogue environments assist the NASA Human Research Program (HRP) in developing capabilities to mitigate high risk issues to crew health and performance for space exploration. The Habitat Demonstration Unit (HDU) is an analogue habitat used to assess space-related products for planetary missions. The Exploration Medical Capability (ExMC) element at the NASA Johnson Space Center (JSC) was tasked with developing planetary-relevant medical scenarios to evaluate the concept of operations for mitigating medical issues in such an environment. Methods: Two medical scenarios were conducted within the simulated planetary habitat with the crew executing two space flight-relevant procedures: Eye Examination with a corneal injury and Skin Laceration. Remote guidance for the crew was provided by a flight surgeon (FS) stationed at a console outside of the habitat. Audio and video data were collected to capture the communication between the crew and the FS, as well as the movements of the crew executing the procedures. Questionnaire data regarding procedure content and remote guidance performance also were collected from the crew immediately after the sessions. Results: Preliminary review of the audio, video, and questionnaire data from the two scenarios conducted within the HDU indicate that remote guidance techniques from an FS on console can help crew members within a planetary habitat mitigate planetary-relevant medical issues. The content and format of the procedures were considered concise and intuitive, respectively. Discussion: Overall, the preliminary data from the evaluation suggest that use of remote guidance techniques by a FS can help HDU crew execute space exploration-relevant medical procedures within a habitat relevant to planetary missions, however further evaluations will be needed to implement this strategy into the complete concept of operations for conducting general space medicine within similar environments

Barsten, Kristina↗
NASA NTRS1994

Seventh Annual Workshop on Space Operations Applications and Research (SOAR 1993), volume 2

This document contains papers presented at the Space Operations, Applications and Research Symposium (SOAR) Symposium hosted by NASA/Johnson Space Center (JSC) on August 3-5, 1993, and held at JSC Gilruth Recreation Center. The symposium was cosponsored by NASA/JSC and U.S. Air Force Materiel Command. SOAR included NASA and USAF programmatic overviews, plenary session, panel discussions, panel sessions, and exhibits. It invited technical papers in support of U.S. Army, U.S. Navy, Department of Energy, NASA, and USAF programs in the following areas: robotics and telepresence, automation and intelligent systems, human factors, life support, and space maintenance and servicing. SOAR was concerned with Government-sponsored research and development relevant to aerospace operations. More than 100 technical papers, 17 exhibits, a plenary session, several panel discussions, and several keynote speeches were included in SOAR '93. These proceedings, along with comments and suggestions made by panelists and keynote speakers, will be used to assess progress made in joint USAF/NASA projects and activities to identify future collaborative/jolnt programs. SOAR '93 was the responsibility of the USAF NASA Space Technology Interdependency Group Operations Committee. Symposium proceedings include papers presented by experts from NASA, the USAF, USA, and USN, U.S. Department of Energy, universities, and industry.

Navigation↗
NASA NTRSDate not supplied

Information Systems for Crew-Led Operations Beyond Low-Earth Orbit

On past and present human space missions, the management of vehicle health and status has primarily been executed from Earth. Missions such as Apollo, Space Shuttle, and ISS have relied on a safety net of ground-based experts with access to real-time telemetry data, broad and deep systems expertise, and powerful analytical and computing capabilities. The ground team monitors and manages the vehicle’s health in real-time and responds quickly to critical situations and malfunctions. Ground operators also provide real-time oversight and verbal guidance to flight crew members, especially during complex procedure execution and high-risk activities like extra-vehicular activities. However, this operational paradigm, in place for 60 years, will not transfer to long duration exploration missions beyond low Earth orbit (LEO). Lunar and deep-space crewed missions will encounter delayed communications that prohibit real-time operational and medical support. Additionally, there will be infrequent resupply and a diminished capacity to evacuate or rescue crew members. A small crew must operate independently, managing the vehicle’s state, responding to time-critical events, and executing complex procedures, all without the safety net of real-time support.

data representation↗
NASA NTRS2011

Aerospace Medical Support in Russia

This slide presentation reviews the role of the flight surgeon in support of aerospace medical support operations at the Gagarin Cosmonaut Training Center (GCTC), also known as Star City, in Russia. The flight surgeon in this role is the medical advocate for non-russian astronauts, and also provides medical care for illness and injury for astronauts, family members, and guests as well as civil servants and contractors. The flight surgeon also provides support for hazardous training. There are various photos of the area, and the office, and some of the equipment that is used.

Castleberry, Tara↗
NASA NTRS1975

Bioinstrumentation

The Apollo bioinstrumentation system (BIS) and related hardware is described. The BIS requirements evolved as a continuation and refinement of medical monitoring systems utilized throughout the Mercury and Gemini programs. The BIS provided physiological data to ground-based medical personnel for operational inflight safety monitoring, for inflight medical experiments; and for ground-based operations safety monitoring. The overall performance of the BIS is evaluated.

Stanley M. Luczkowski↗
NASA NTRS1977

Skylab medical program overview

The following major medical subsystems in Skylab are outlined: (1) operational equipment; (2) life science experiments; (3) medical operations; and (4) operational experience. Throughout the Skylab flight program, alterations in equipment and procedures were made for each succeeding mission to capitalize on the flight experience of the previous mission.

Johnson, R. S.↗
NASA NTRS1991

Pharmacokinetic consequences of spaceflight

Spaceflight induces a wide range of physiological and biochemical changes, including disruption of gastrointestinal (GI) function, fluid and electrolyte balance, circulatory dynamics, and organ blood flow, as well as hormonal and metabolic perturbations. Any of these changes can influence the pharmacokinetics and pharmacodynamics of in-flight medication. That spaceflight may alter bioavailability was proposed when drugs prescribed to alleviate space motion sickness (SMS) had little therapeutic effect. Characterization of the pharmacokinetic and/or pharmacodynamic behavior of operationally critical medications is crucial for their effective use in flight; as a first step, we sought to determine whether drugs administered in space actually reach the site of action at concentrations sufficient to elicit the therapeutic response.

NASA Center JSC↗
NASA NTRS2007

Space Medicine Issues and Healthcare Systems for Space Exploration Medicine

This viewgraph presentation reviews issues of health care in space. Some of the issues reviewed are: (1) Physiological adaptation to microgravity, partial gravity, (2) Medical events during spaceflight, (3) Space Vehicle and Environmental and Surface Health Risks, (4) Medical Concept of Operations (CONOPS), (4a) Current CONOPS & Medical Hardware for Shuttle (STS) and ISS, (4b) Planned Exploration Medical CONOPS & Hardware needs, (5) Exploration Plans for Lunar Return Mission & Mars, and (6) Developing Medical Support Systems.

Scheuring, Richard A.↗
NASA NTRSDate not supplied

Medical System Requirements Development for Lunar Operations

The major health hazards of spaceflight include higher levels of damaging radiation, altered gravity, extended periods of isolation and confinement, a closed and potentially hostile living environment, and the stress associated with being a long distance from Earth. As we increase the duration of lunar stays with foreseeable communication latencies and disruptions, there will be a progressive need for crew to maintain their own health and independently respond to critical medical events. The Exploration Medical Capability element of the NASA Human Research Program is developing a set of Medical System requirements for lunar transit and surface operations. These requirements specify the capabilities, processes and procedures of a habitat Medical System needed for a range of conditions known to occur during spaceflight. Requirement text is written so as not to constrain innovative design solutions necessary for a resilient system. The requirement set includes attributes and functions the Medical System imposes on eight additional habitat systems. A key property of the Medical System is the provision of medical knowledge that will be stored, updated, analyzed, and secured within a Habitat Data System. A Task Performance Support System will aid in medical data acquisition and interpretation, crew training, medical condition prevention, diagnosis and treatment, provide interactive procedures, and track medical inventory. A Wellness System will focus on the provision of countermeasures to prevent, mitigate or treat adverse physical and behavioral health effects while the Medical System recommends adjustments to these countermeasures to maintain crew health. An Environmental Monitoring System will share out-of-bounds readings of air and water quality, acoustics, and radiation exposure levels with the Medical System to help identify issues before they affect crew health and performance. A Communications System will provide secured and private consultations between crew and the ground medical team and their loved ones on Earth. The Medical System also imposes requirements on a Research & Testbed System, fostering advanced medical science such as human research. A Waste Management System provides biohazard waste containment and waste disposal options (recycle and reuse). An Extravehicular Activity System supports crew health during lunar surface activities. And finally, a Maintenance Support System ensures that medical equipment is performing as expected. These requirements are being specifically developed for lunar surface operations but could help to identify Medical System requirements for any space habitat (e.g., I-Hab, commercial endeavors, etc.).

technology↗
NASA NTRS2015

Evaluation of the Oxygen Concentrator Prototypes: Pressure Swing Adsorption Prototype and Electrochemical Prototype

An oxygen concentrator is needed to provide enriched oxygen in support of medical contingency operations for future exploration human spaceflight programs. It would provide continuous oxygen to an ill or injured crew member in a closed cabin environment. Oxygen concentration technology is being pursued to concentrate oxygen from the ambient environment so oxygen as a consumable resource can be reduced. Because oxygen is a critical resource in manned spaceflight, using an oxygen concentrator to pull oxygen out of the ambient environment instead of using compressed oxygen can provide better optimization of resources. The overall goal of this project is to develop an oxygen concentrator module that minimizes the hardware mass, volume, and power footprint while still performing at the required clinical capabilities. Should a medical event occur that requires patient oxygenation, the release of 100 percent oxygen into a small closed cabin environment can rapidly raise oxygen levels to the vehicles fire limit. The use of an oxygen concentrator to enrich oxygen from the ambient air and concentrate it to the point where it can be used for medical purposes means no oxygen is needed from the ultra-high purity (99.5+% O2) oxygen reserve tanks. By not adding oxygen from compressed tanks to the cabin environment, oxygen levels can be kept below the vehicle fire limit thereby extending the duration of care provided to an oxygenated patient without environmental control system intervention to keep the cabin oxygen levels below the fire limits. The oxygen concentrator will be a Food and Drug Administration (FDA) clearable device. A demonstration unit for the International Space Station (ISS) is planned to verify the technology and provide oxygen capability. For the ISS, the demonstration unit should not exceed 10 kg (approximately 22 lb), which is the soft stowage mass limit for launch on resupply vehicles for the ISS. The unit's size should allow for transport within the spacecraft to an ill crewmember. The user interface needs to be designed for ease of use by the local care provider and with consideration to the limited amount of training available to the astronaut corps for medical equipment and procedures.

Gilkey, Kelly M.↗
NASA NTRS2006

Operational and Research Musculoskeletal Summit: Summit Recommendations

The Medical Informatics and Health Care Systems group in the Office of Space Medicine at NASA Johnson Space Center (JSC) has been tasked by NASA with improving overall medical care on the International Space Station (ISS) and providing insights for medical care for future exploration missions. To accomplish this task, a three day Operational and Research Musculoskeletal Summit was held on August 23-25th, 2005 at Space Center Houston. The purpose of the summit was to review NASA#s a) current strategy for preflight health maintenance and injury screening, b) current treatment methods in-flight, and c) risk mitigation strategy for musculoskeletal injuries or syndromes that could occur or impact the mission. Additionally, summit participants provided a list of research topics NASA should consider to mitigate risks to astronaut health. Prior to the summit, participants participated in a web-based pre-summit forum to review the NASA Space Medical Conditions List (SMCL) of musculoskeletal conditions that may occur on ISS as well as the resources currently available to treat them. Data from the participants were compiled and integrated with the summit proceedings. Summit participants included experts from the extramural physician and researcher communities, and representatives from NASA Headquarters, the astronaut corps, JSC Medical Operations and Human Adaptations and Countermeasures Offices, Glenn Research Center Human Research Office, and the Astronaut Strength, Conditioning, and Reconditioning (ASCR) group. The recommendations in this document are based on a summary of summit discussions and the best possible evidence-based recommendations for musculoskeletal care for astronauts while on the ISS, and include recommendati ons for exploration class missions.

Scheuring, Richard A.↗
NASA NTRSDate not supplied

Ground Testing of an Oxygen Concentrator in a Simulated International Space Station (ISS) Cabin Environment

The method for supplying medical oxygen to respiratorily-compromised astronauts on the International Space Station (ISS) and in future Orion missions consists of drawing oxygen from high pressure oxygen tanks. An Oxygen Concentrator Module (OCM) is a device that pulls in ambient air and separates out the nitrogen, resulting in a high concentration oxygen source. This technology has the potential to eliminate resupply and oxygen-enrichment issues associated with using high pressure oxygen tanks and become an alternative technology to support medical oxygen operations for future exploration missions. In this study, we test the long-term performance of a Commercial Off-the-Shelf (COTS) OCM in a simulated ISS cabin environment. Humidified air, carbon dioxide, and fifteen representative trace contaminants are continuously injected through an enclosed test chamber where the OCM is challenged. This study included the first successful demonstration of the Trace Gas Injection System (TGIS), which reliably and continuously produced ISS levels of trace contaminants, carbon dioxide, and humidity in an enclosed environment. The TGIS is a new and unique ground capability with significant implications for Test Readiness Level (TRL) advancement of COTS items and Government Furnished Equipment (GFE). This study demonstrated that the tested OCM reliably delivers enriched oxygen mostly at desired performance specifications. This study also demonstrated that the OCM does not inadvertently concentrate trace gases in its oxygen product stream, as detectable concentrations of trace contaminants in the oxygen product stream were at all times below the simulated ISS levels.

medical oxygen↗
NASA NTRSDate not supplied

Ground Testing of an Oxygen Concentrator in a Simulated International Space Station (ISS) Cabin Environment

The method for supplying medical oxygen to respiratorily-compromised astronauts on the International Space Station (ISS) and in future Orion missions consists of drawing oxygen from high pressure oxygen tanks. An Oxygen Concentrator Module (OCM) is a device that pulls in ambient air and separates out the nitrogen, resulting in a high concentration oxygen source. This technology has the potential to eliminate resupply and oxygen-enrichment issues associated with using high pressure oxygen tanks and become an alternative technology to support medical oxygen operations for future exploration missions. In this study, we test the long-term performance of a Commercial Off-the-Shelf (COTS) OCM in a simulated ISS cabin environment. Humidified air, carbon dioxide, and fifteen representative trace contaminants are continuously injected through a enclosed test chamber where the OCM is challenged. This study included the first successful demonstration of the Trace Gas Injection System (TGIS), which reliably and continuously produced ISS levels of trace contaminants, carbon dioxide, and humidity in an enclosed environment. The TGIS is a new and unique ground capability with significant implications for Test Readiness Level (TRL) advancement of COTS items and Government Furnished Equipment (GFE). This study demonstrated that the tested OCM reliably delivers enriched oxygen mostly at desired performance specifications. This study also demonstrated that the OCM does not inadvertently concentrate trace gases in its oxygen product stream, as detectable concentrations of trace contaminants in the oxygen product stream were at all times below the simulated ISS levels.

medical oxygen↗
DOE OSTI2020

Fast GPU 3D diffeomorphic image registration

3D image registration is one of the most fundamental and computationally expensive operations in medical image analysis. Here, we present a mixed-precision, Gauss–Newton–Krylov solver for diffeomorphic registration of two images. Our work extends the publicly available CLAIRE library to GPU architectures. Despite the importance of image registration, only a few implementations of large deformation diffeomorphic registration packages support GPUs. Our contributions are new algorithms to significantly reduce the run time of the two main computational kernels in CLAIRE: calculation of derivatives and scattered-data interpolation. Additionally, we deploy (i) highly-optimized, mixed-precision GPU-kernels for the evaluation of scattered-data interpolation, (ii) replace Fast-Fourier-Transform (FFT)-based first-order derivatives with optimized 8th-order finite differences, and (iii) compare with state-of-the-art CPU and GPU implementations. As a highlight, we demonstrate that we can register clinical images in less than 6 s on a single NVIDIA Tesla V100. This amounts to over 20 speed-up over the current version of CLAIRE and over 30 speed-up over existing GPU implementations.

97 MATHEMATICS AND COMPUTING↗