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33 records · Page 2

Crew factors in flight operations 9: Effects of planned cockpit rest on crew performance and alertness in long-haul operations

This study examined the effectiveness of a planned cockpit rest period to improve alertness and performance in long-haul flight operations. The Rest Group (12 crew members) was allowed a planned 40 minute rest period during the low workload, cruise portion of the flight, while the No-Rest Group (9 crew members) had a 40 minute planned control period when they maintained usual flight activities. Measures used in the study included continuous ambulatory recordings of brain wave and eye movement activity, a reaction time/vigilance task, a wrist activity monitor, in-flight fatigue and alertness ratings, a daily log for noting sleep periods, meals, exercise, flight and duty periods, and the NASA Background Questionnaire. The Rest Group pilots slept on 93 percent of the opportunities, falling asleep in 5.6 minutes and sleeping for 25.8 minutes. This nap was associated with improved physiological alertness and performance compared to the No-Rest Group. The benefits of the nap were observed through the critical descent and landing phases of flight. The nap did not affect layover sleep or the cumulative sleep debt. The nap procedures were implemented with minimal disruption to usual flight operations and there were no reported or identified concerns regarding safety.

Rosekind, Mark R.↗

Logistics resupply and emergency crew return system for Space Station Freedom

Sometime in the late 1990's, if all goes according to plan, Space Station Freedom will allow the United States and its cooperating partners to maintain a permanent presence in space. Acting as a scientific base of operations, it will also serve as a way station for future explorations of the Moon and perhaps even Mars. Systems onboard the station will have longer lifetimes, higher reliability, and lower maintenance requirements than seen on any previous space flight vehicle. Accordingly, the station will have to be resupplied with consumables (air, water, food, etc.) and other equipment changeouts (experiments, etc.) on a periodic basis. Waste materials and other products will also be removed from the station for return to Earth. The availability of a Logistics Resupply Module (LRM), akin to the Soviet's Progress vehicle, would help to accomplish these tasks. Riding into orbit on an expendable launch vehicle, the LRM would be configured to rendezvous autonomously and dock with the space station. After the module is emptied of its cargo, waste material from the space station would be loaded back into it. The module would then begin its descent to a recovery point on Earth. Logistics Resupply Modules could be configured in a variety of forms depending on the type of cargo being transferred. If the LRM's were cycled to the space station in such a way that at least one vehicle remained parked at the station at all times, the modules could serve double duty as crew emergency return capsules. A pressurized LRM could then bring two or more crew-persons requiring immediate return (because of health problems, system failure, or unavoidable catastrophes) back to Earth. Large cost savings would be accrued by combining the crew return function with a logistics resupply system.

Ahne, D.↗

Inflight application of three pilot workload measurement techniques

Three inflight techniques for workload measurement were tested in nine pilots flying the NASA Kuiper Airborne Observatory: subjective ratings, heart rate, and communication performance. The activities that contributed to the crew-member workload varied; the commander was responsible for aircraft control and navigation whereas the copilot handled communications. The three workload measures were found to provide different information. Pilot ratings of workload, effort, and stress were sensitive to variations in flight-related task demands across flight segments but did not reflect specific differences in the type of demands imposed on the commander and the copilot. The heart rate was sensitive to the differential impact of duties, being higher for the commander than for the copilot. The rate of communications per minute of flight proved to be the most sensitive indicator. It was related to workload, stress, effort rating, and average heart rate across flight segments.

Hart, Sandra G.↗

Psychophysiological Assessment of Fatigue in Commercial Aviation Operations

The overall goal of this study is to improve our understanding of crew work hours, workload, sleep, fatigue, and performance, and the relationships between these variables on actual flight deck performance. Specifically, this study will provide objective measures of physiology and performance, which may benefit investigators in identifying fatigue levels of operators in commercial aviation and provide a way to better design strategies to limit crew fatigue. This research was supported by an agreement between NASA Ames Research Center and easyJet Airline Company, Ltd., Luton, UK. Twenty commercial pilots volunteered to participant in the study that included 15 flight duty days. Participants wore a Zephyr Bioharness ambulatory physiological monitor each flight day, which measured their heart rate, respiration rate, skin temperature, activity and posture. In addition, pilots completed sleep log diaries, self-report scales of mood, sleepiness and workload, and a Performance Vigilance Task (PVT). All data were sent to NASA researchers for processing and analyses. Heart rate variability data of several subjects were subjected to a spectral analysis to examine power in specific frequency bands. Increased power in low frequency band was associated with reports of higher subjective sleepinesss in some subjects. Analyses of other participants data are currently underway.

Hernandez, Norma↗

Crew factors in flight operations. Part 3: The operational significance of exposure to short-haul air transport operations

Excessive flightcrew fatigue has potentially serious safety consequences. Laboratory studies have implicated fatigue as a causal factor associated with varying levels of performance deterioration depending on the amount of fatigue and the type of measure utilized in assessing performance. These studies have been of limited utility because of the difficulty of relating laboratory task performance to the demands associated with the operation of a complex aircraft. The performance of 20 volunteer twin-jet transport crews is examined in a full-mission simulator scenario that included most aspects of an actual line operation. The scenario included both routine flight operations and an unexpected mechanical abnormality which resulted in a high level of crew workload. Half of the crews flew the simulation within two to three hours after completing a three-day, high-density, short-haul duty cycle (Post-Duty condition). The other half flew the scenario after a minimum of three days off duty (Pre-Duty) condition). The results revealed that, not surprisingly, Post-Duty crews were significantly more fatigued than Pre-Duty crews. However, a somewhat counter-intuitive pattern of results emerged on the crew performancemeasures. In general, the performance of Post-Duty crews was significantly better than that of Pre-Duty crews, as rated by an expert observer on a number of dimensions relevant to flight safety. Analyses of the flightcrew communication patterns revealed that Post-Duty crews communicated significantly more overall, suggesting, as has previous research, that communication is a good predictor of overall crew performance.

Foushee, H. C.↗

Cabin Crew Alertness and Performance During Long-Haul Flights

INTRODUCTION: -Sleep loss and circadian disruption pose a significant risk in aviation. -Previous literature has shown that inflight rest facilities influence alertness and performance among pilots, but few studies have evaluated cabin crew. -The aim of this research was to assess alertness and performance among cabin crew members sleeping in different rest locations during a long-haul out-and-back trip. METHODS: -Twenty-nine cabin crewmembers flew the same long-haul route (outbound and inbound). -Participants were randomly assigned to fly on an aircraft with a bunk in both directions or to fly an aircraft with a bunk in one direction and with a high comfort jump seat (HCJS) in the other direction. -Throughout the study they completed a Karolinska Sleepiness Scale (KSS) and a 5-minute Psychomotor Vigilance Task (PVT) at the beginning and at the end of each flight. RESULTS: -A series of mixed-effects models were performed to assess the changes in KSS and PVT when crewmembers slept in the bunk during both directions of flight (bunk-only) compared to when sleep was obtained in the HCJS during one direction and bunk in the other (bunk + HCJS). -There was no significant difference in KSS alertness between the two conditions. - There were no significant differences in PVT response speed or lapses between the two conditions. CONCLUSIONS: -Limitations: small number of participants. Our study stopped abruptly because of the COVID-19 pandemic which limited our sample size. -Further research is needed to understand how other factors such as duty start time and workload might influence the sleep of cabin crewmembers during long-haul flights.

long-haul↗

Introduction and Mission Response Team (MRT)

On February 1, 2003 the Space Shuttle Columbia, returning to Earth with a crew of seven astronauts, disintegrated along a track extending from California to Louisiana. Observers on the ground filmed breakup of the spacecraft. Debris fell along a 567 statute mile track from Littlefield, Texas to Fort Polk, Louisiana; the largest ever recorded debris field. At the time of the accident the National Aeronautics and Space Administration (NASA) flight surgeon on-duty at the Mission Control Center (MCC) in Houston, Texas initiated the medical contingency response. The DOD surgeon at Patrick Air Force Base was notified, NASA medical personnel were recalled and the services of Armed Forces Institute of Pathology (AFIP) were requested. Subsequent to the accident the NASA flight surgeons that had supported the crew on orbit now provided medical support to the crewmember s families. Federal Emergency Management Agency (FEMA), the National Transportation Safety Board (NTSB), the Federal Bureau of Investigation (FBI) and numerous other federal, state and local agencies along with the citizens of Texas and Louisiana responded to the disaster. Search and recovery was managed from a Disaster Field Office (DFO) established in Lufkin, Texas. Mishap Investigation Team (MIT) medical operations were managed from Barksdale Air Force Base, Louisiana. Accident investigation teams (Columbia Accident Investigation Task Force (CAITF) and Columbia Accident Investigation Board (CAIB)) appointed immediately after the disaster included current and former authorities in space medicine. In August 2003, the CAIB concluded its investigation and released its findings in a report published in February 2004.

Pool, Sam↗

Sensitive Quantitative Assessment of Balance Disorders

Computerized dynamic posturography (CDP) has become a standard technique for objectively quantifying balance control performance, diagnosing the nature of functional impairments underlying balance disorders, and monitoring clinical treatment outcomes. We have long used CDP protocols to assess recovery of sensory-motor function in astronauts following space flight. The most reliable indicators of post-flight crew performance are the sensory organization tests (SOTs), particularly SOTs 5 and 6, which are sensitive to changes in availability and/or utilization of vestibular cues. We have noted, however, that some astronauts exhibiting obvious signs of balance impairment after flight are able to score within clinical norms on these tests, perhaps as a result of adopting competitive strategies or by their natural skills at substituting alternate sensory information sources. This insensitivity of the CDP protocol could underestimate of the degree of impairment and, perhaps, lead to premature release of those crewmembers to normal duties. To improve the sensitivity of the CDP protocol we have introduced static and dynamic head tilt SOT trials into our protocol. The pattern of postflight recovery quantified by the enhanced CDP protocol appears to more aptly track the re-integration of sensory-motor function, with recovery time increasing as the complexity of sensory-motor/biomechanical task increases. The new CDP protocol therefore seems more suitable for monitoring post-flight sensory-motor recovery and for indicating to crewmembers and flight surgeons fitness for return to duty and/or activities of daily living. There may be classes of patients (e.g., athletes, pilots) having motivation and/or performance characteristics similar to astronauts whose sensory-motor treatment outcomes would also be more accurately monitored using the enhanced CDP protocol. Furthermore, the enhanced protocol may be useful in early detection of age-related balance disorders.

Paloski, Willilam H.↗

NASA Exercise Physiology and Countermeasures Project Overview

Efficient exercise countermeasures are necessary to offset or minimize spaceflight-induced deconditioning and to maximize crew performance of mission tasks. These countermeasure protocols should use the fewest crew and vehicle resources. NASA s Exercise Physiology and Countermeasures (ExPC) Project works to identify, collect, interpret, and summarize evidence that results in effective exercise countermeasure protocols which protect crew health and performance during International Space Station (ISS) and future exploration-class missions. The ExPC and NASA s Human Research Program are sponsoring multiple studies to evaluate and improve the efficacy of spaceflight exercise countermeasures. First, the Project will measure maximal aerobic capacity (VO2max) during cycle ergometry before, during, and after ISS missions. Second, the Project is sponsoring an evaluation of a new prototype harness that offers improved comfort and increased loading during treadmill operations. Third, the Functional Tasks Test protocol will map performance of anticipated lunar mission tasks with physiologic systems before and after short and long-duration spaceflight, to target system contributions and the tailoring of exercise protocols to maximize performance. In addition to these studies that are actively enrolling crewmember participants, the ExPC is planning new studies that include an evaluation of a higher-intensity/lower-volume exercise countermeasure protocol aboard the ISS using the Advanced Resistive Exercise Device and second-generation treadmill, studies that evaluate bone loading during spaceflight exercise, and ground-based studies that focus on fitness for duty standards required to complete lunar mission tasks and for which exercise protocols need to protect. Summaries of these current and future studies and strategies will be provided to international colleagues for knowledge sharing and possible collaboration.

Loerch, Linda↗

Assessing fatigue

Despite impressive advances in aircraft technology over the past several decades and an overall decline in the airline accident rate since the introduction of turbine-powered aircraft, flight crew performance problems continue to dominate air transport accident statistics. Researchers have offered many hypotheses to explain this finding, and interest in pilot fatigue has stimulated a large volume of laboratory research. Much of this work, however, is difficult to generalize and to apply to the real world of flight operations, and researchers disagree about the extent and operational significance of fatigue-related reductions in pilot performance. As a result, in 1980 Congress asked the National Aeronautics and Space Administration to undertake a comprehensive research program to assess whether fatigue-related problems are prevalent in long- and short-haul flying. The two major goals of this project are: (1) to assess the psychophysiological effects on pilot performance of flying various types of flight and duty cycles, and (2) to determine the operational significance to flight safety and efficiency of flying these flight and duty cycles.

NASA Discipline Space Human Factors↗

Factors in International Space Station Integration Feasibility Assessments

The International Space Station, ISS, is a growing vehicle. The ISS configuration changes internally and externally with each ISS flight. Each flight adds resources and capabilities such as docking/berthing ports, power, stowage volume, heat rejection, and data processing capability. The configuration, capabilities and performance characteristics of the vehicle will be in flux until assembly complete. At the same time the knowledge about what is required to support humans involved in long duration space flight is also being greatly expanded. In addition to the changes occurring on-orbit, the situation on the ground is also very dynamic. Proposals for new ISS elements, proposed deletions of elements, changes to the ISS requirements, and changes to the planned configuration are always under evaluation. Furthermore, budgetary issues have driven the need to explore alternative options for the ISS . This environment has made the role of the technical integrator in the ISS program unique in that the baseline against which proposals are evaluated is always changing. The nature of the International Space Station Program adds another dimension to the integrators task. ISS program activities are spread across several centers: KSC, MSFC, GRC, DFRC, ARC and JSc. There are six International Partners/participants each with their own unique organizations. The prime contractor is in Texas, California and Alabama. And, the Space Shuttle Program as the launch vehicle provider is another major interface. In spite of the fluidity of the technical baseline, projections and organizational complexity, in the course of evaluating proposals and producing feasibility assessments there are factors, which frequently emerge as significant. These factors tend to be the limiting conditions when they come into play. The finite resources, which tend to limit the options for ISS are: upmass, life support and crew rescue capability, crew time, utilities, exercise equipment, and docking/berthing ports. Upmass requirements need to be developed for each option proposed. Short term and long term impacts to upmass are the result of the implementation and long term operations. The upmass requirements need to be met by the existing launch vehicles and any change in flight rate will be a significant cost driver. In addition, when any item is brought to the ISS careful consideration must be given to the on-board stowage and crew time available to unpack, transfer, stow and use these items. If stowage is not available then something must be returned, use of non-standard stowage negotiated or the item in question stays on the ground. Additional crew time requirements will impact available utilization time or crew off-duty time. When the human element is affected, such as, by increasing the number of crew members or changing the duration of the crew stay (longer or shorter) there is an additional set of factors that come into play. The main considerations are: rescue capability, exercise requirements and availability of equipment, resupply, and life support capability.

Watson, Patricia M.↗

Circadian rhythms, sleep, and performance in space

Maintaining optimal alertness and neurobehavioral functioning during space operations is critical to enable the National Aeronautics and Space Administration's (NASA's) vision "to extend humanity's reach to the Moon, Mars and beyond" to become a reality. Field data have demonstrated that sleep times and performance of crewmembers can be compromised by extended duty days, irregular work schedules, high workload, and varying environmental factors. This paper documents evidence of significant sleep loss and disruption of circadian rhythms in astronauts and associated performance decrements during several space missions, which demonstrates the need to develop effective countermeasures. Both sleep and circadian disruptions have been identified in the Behavioral Health and Performance (BH&P) area and the Advanced Human Support Technology (AHST) area of NASA's Bioastronautics Critical Path Roadmap. Such disruptions could have serious consequences on the effectiveness, health, and safety of astronaut crews, thus reducing the safety margin and increasing the chances of an accident or incident. These decrements oftentimes can be difficult to detect and counter effectively in restrictive operational environments. NASA is focusing research on the development of optimal sleep/wake schedules and countermeasure timing and application to help mitigate the cumulative effects of sleep and circadian disruption and enhance operational performance. Investing research in humans is one of NASA's building blocks that will allow for both short- and long-duration space missions and help NASA in developing approaches to manage and overcome the human limitations of space travel. In addition to reviewing the current state of knowledge concerning sleep and circadian disruptions during space operations, this paper provides an overview of NASA's broad research goals. Also, NASA-funded research, designed to evaluate the relationships between sleep quality, circadian rhythm stability, and performance proficiency in both ground-based simulations and space mission studies, as described in the 2003 NASA Task Book, will be reviewed.

Review↗

CIPHER: Egress Fitness

The transition between gravity environments will involve one of the most complex, high-risk phases of exploration missions. The reduced functional capacity caused by physiological deconditioning adaptations in microgravity coupled with the stressors of re-entry into partial gravity environments will increase risks to crew, even with rigorous adherence to inflight countermeasures. Specifically, two high-risk scenarios may be required to be performed soon after gravity transitions: 1) nominal and/or emergency unassisted capsule egress task after return to Earth, and 2) planetary extravehicular activity (EVA) soon after landing on Mars or the Moon. Quantification of crewmember’s functional performance after long-duration spaceflight is necessary to inform concepts of operations for future exploration missions. The overarching aim of this study is to quantify post-landing functional performance with deconditioning after long-duration ISS missions. This study is broken down into two phases. Phase 1 includes a pilot study to assess the overall feasibility and demonstrate the capability to perform mission-like tasks shortly after landing. Phase 2, the Egress Fitness study, which is part of the Complement of Integrated Protocols for Human Exploration Research (CIPHER), uses a task-based approach to characterize functional performance in long-duration ISS crewmembers before flight and shortly after return to Earth. The pilot and full Egress Fitness study includes pre-flight and post-flight testing of simulated emergency egress out of a functional capsule mockup and a Mars gravity EVA simulation at the Active Response Gravity Offload System (ARGOS) facility. The EVA simulation tasks include suit donning, hatch egress, ladder descent, task board cable operations, baggage transfer over sand/rocky regolith, alignment with a rear entry port, and suit egress. The post-flight simulated capsule egress test occurs 1–4 h after landing and the planetary EVA simulation occurs 18–36 h after landing. The full CIPHER Egress Fitness study has additional pre-flight sessions, longer EVA tasks that include traverse and geology sampling, and post-flight sessions on R+1, 4, and 8 to characterize the timeframe of recovery. Pilot Egress Fitness has completed baseline and post-flight testing on four crewmembers. That study remains open. Originally this was to cover the Boeing CFT mission, but now also includes private astronauts on commercial spaceflights. CIPHER study data collection is ongoing with 2 subjects completed and 4 additional subjects consented. This study will quantify post-landing functional performance in operationally relevant simulations to help inform fitness for duty standards and future planetary concepts of operations shortly after landing.

Jason Norcross↗

Configuration and Projected Capabilities of the Common Habitat Medical Care Facility

The Common Habitat is a large, long-duration habitat being explored as part of a conceptual study (not an active NASA program) that uses an SLS core stage Liquid Oxygen (LOX) tank as its primary structure. It is intended for use on the Moon as part of a permanently occupied outpost, on Mars as part of an outpost that will be occupied for hundreds of days at a time, and in deep space as part of the Deep Space Exploration Vehicle where it will support crewed missions up to 1200 days in duration. A study of internal orientation and crew size resulted in a Common Habitat configuration sized for a crew of eight with a three-deck horizontal orientation. Additional work outside the scope of this paper is developing a vertical translation system, a crew mobility aids system based on wearable gecko-derived grippers, and a crew seating/restraint system. These systems are all assumed for use in conjunction with the Medical Care Facility, which is needed to maintain crew well-being during these missions, where distance from Earth precludes the possibility of evacuation to Earth. This paper describes recent improvements in the Common Habitat Medical Care Facility and associated benefits for crew survivability in long duration missions beyond Earth orbit. These improvements were made with the assistance of a NASA Pathways intern whose experience includes a tour of duty in Afghanistan as an Army combat medic with the 691st GHOST-T, attached to the 1st and 7th US Special Forces Groups as part of Operation Freedom’s Sentinel, where he helped provide far-forward surgical capabilities in austere combat environments. The initial baseline Medical Care Facility was developed working in conjunction with University of Houston Space Architecture graduate students. The facility was placed on the upper deck of the Common Habitat in a location that provided privacy, operational volume, and was close to the vertical translation pathway. The notional outfitting repurposed component CAD models from unrelated studies and notionally indicated a level of care roughly equivalent to that aboard the International Space Station. The CAD modeling provided notional stowage volumes, a deployable surface, some fixed equipment, an ultrasound, and a potentially reconfigurable treatment table. While this facility is clearly a competent arrangement, it was desired to leverage available expertise and upgrade the station given the vast distances from Earth to be experienced by the Common Habitat. Key driving requirements applied to the upgrade included to provide Medical Level of Care V, offer enhanced telemedicine capabilities, provide patient physical accommodation, provide caregiver access to the patient from all sides, include sliding pocket doors for access to hygiene and to the Vertical Translation System, and to add any additional capability possible for the best achievable medical care. The first step in the facility upgrade was to quantify the current medical inventory on the International Space Station and ensure that sufficient stowage volume was present for this purpose. To that end, the ISS medical kits were reviewed, and eight full size mid deck lockers were placed in the facility. A number of additional devices were also added, based on the intern’s combat medic experience. Also, two fixed shelves and one horizontal work surface were added to the Medical Care Facility, with the shelves providing storage space for the additional devices and the work surface providing a location for the caregiver to work or stage equipment. Four display monitors were added to the wall above the horizontal work surface, supporting data display, telemedicine, conferencing, or other needs. The existing treatment table was replaced with a mobile surgical stretcher-chair. Two additional doors were added to the Medical Care Facility. One leads directly to the hygiene compartment, allowing it to support medical operations in addition to providing galley/wardroom support. The other door leads directly into the Vertical Translation System. The wall adjacent to the subsystems bay was moved, adding additional volume to the Medical Care Facility. This improved caregiver access to the patient and allowed for a larger number of caregivers to be present. It also provided options for relocation of support equipment relative to the patient as needed. In the upgraded Medical Care Facility, the Surgical Stretcher-Chair and the Vertical Translation System can work together to provide incapacitated crew member transport from a site of injury on any deck of the Common Habitat to the Medical Care Facility. It can also support patient treatment in a variety of positions including a variety of sitting postures and a supine posture at a variety of pitch angles. The facility can also support caregiver office work for review of examination results, private consultation, inventory and maintenance, and a variety of other purposes. A forward activity will be to conduct evaluations of the Medical Care Facility with different medical scenarios. Additionally, ambient and task lighting selections remain as forward work. The eight mid deck lockers can be augmented to use as portable equipment carts, similar to a manner in which maintenance facility stowage was used as portable carts during the NASA Desert Research and Technology Studies in the Constellation Program. Trash accommodation will also need forward work to assess, including provision for wet trash, dry trash, and biological waste. It will be important to assess a redesign of the surgical stretcher-chair. The commercial version used in the upgrade can only enable vertical translation in the seated configuration, requiring the patient to bend both hips and knees. A possible redesign of the chair will allow for vertical translation without requiring any bending at the hip or knees. Also, the commercial version is wheeled, making it mobile in gravity but unanchored in microgravity. Work will be needed to adapt the chair for gravity-independent performance. The hygiene compartment can be redesigned for dual-use medical scrub and galley handwash facility. Pending sufficient volume, it may also be possible to place sanitation equipment in this location to clean medical tools. Finally, most space architectures have never allowed for more than one incapacitated crew member, but several scenarios could potentially injure two or more crew in the same incident. This facility could be assessed to determine its present ability to address two or more injured crew in parallel and determine the potential upper limit for number of treatable crew in a multi-crew injury scenario, or to treat polytrauma of a single patient.

Habitat↗

Configuration and Projected Capabilities of the Common Habitat Medical Care Facility

The Common Habitat is a large, long-duration habitat being explored as part of a conceptual study (not an active NASA program) that uses an SLS core stage Liquid Oxygen (LOX) tank as its primary structure. It is intended for use on the Moon as part of a permanently occupied outpost, on Mars as part of an outpost that will be occupied for hundreds of days at a time, and in deep space as part of the Deep Space Exploration Vehicle where it will support crewed missions up to 1200 days in duration. A study of internal orientation and crew size resulted in a Common Habitat configuration sized for a crew of eight with a three-deck horizontal orientation. Additional work outside the scope of this paper is developing a vertical translation system, a crew mobility aids system based on wearable gecko-derived grippers, and a crew seating/restraint system. These systems are all assumed for use in conjunction with the Medical Care Facility, which is needed to maintain crew well-being during these missions, where distance from Earth precludes the possibility of evacuation to Earth. This paper describes recent improvements in the Common Habitat Medical Care Facility and associated benefits for crew survivability in long duration missions beyond Earth orbit. These improvements were made with the assistance of a NASA Pathways intern whose experience includes a tour of duty in Afghanistan as an Army combat medic with the 691st GHOST-T, attached to the 1st and 7th US Special Forces Groups as part of Operation Freedom’s Sentinel, where he helped provide far-forward surgical capabilities in austere combat environments. The initial baseline Medical Care Facility was developed working in conjunction with University of Houston Space Architecture graduate students. The facility was placed on the upper deck of the Common Habitat in a location that provided privacy, operational volume, and was close to the vertical translation pathway. The notional outfitting repurposed component CAD models from unrelated studies and notionally indicated a level of care roughly equivalent to that aboard the International Space Station. The CAD modeling provided notional stowage volumes, a deployable surface, some fixed equipment, an ultrasound, and a potentially reconfigurable treatment table. While this facility is clearly a competent arrangement, it was desired to leverage available expertise and upgrade the station given the vast distances from Earth to be experienced by the Common Habitat. Key driving requirements applied to the upgrade included to provide NASA’s Medical Level of Care V, offer enhanced telemedicine capabilities, provide patient physical accommodation, provide caregiver access to the patient from all sides, include sliding pocket doors for access to hygiene and to the Vertical Translation System, and to add any additional capability possible for the best achievable medical care. The first step in the facility upgrade was to quantify the current medical inventory on the International Space Station and ensure that sufficient stowage volume was present for this purpose. To that end, the ISS medical kits were reviewed, and eight full size mid deck lockers were placed in the facility. A number of additional devices were also added, based on the co-author’s combat medic experience. Also, two fixed shelves and one horizontal work surface were added to the Medical Care Facility, with the shelves providing storage space for the additional devices and the work surface providing a location for the caregiver to work or stage equipment. Four display monitors were added to the wall above the horizontal work surface, supporting data display, telemedicine, conferencing, or other needs. The existing treatment table was replaced with a mobile surgical stretcher-chair. Two additional doors were added to the Medical Care Facility. One leads directly to the hygiene compartment, allowing it to support medical operations in addition to providing galley/wardroom support. The other door leads directly into the Vertical Translation System. The wall adjacent to the subsystems bay was moved, adding additional volume to the Medical Care Facility. This improved caregiver access to the patient and allowed for a larger number of caregivers to be present. It also provided options for relocation of support equipment relative to the patient as needed. In the upgraded Medical Care Facility, the Surgical Stretcher-Chair and the Vertical Translation System can work together to provide incapacitated crew member transport from a site of injury on any deck of the Common Habitat to the Medical Care Facility. It can also support patient treatment in a variety of positions including a variety of sitting postures and a supine posture at a variety of pitch angles. The facility can also support caregiver office work for review of examination results, private consultation, inventory and maintenance, and a variety of other purposes. A forward activity will be to conduct evaluations of the Medical Care Facility with different medical scenarios. Additionally, ambient and task lighting selections remain as forward work. The eight middeck lockers can be augmented to use as portable equipment carts, similar to a manner in which maintenance facility stowage was used as portable carts during the NASA Desert Research and Technology Studies in the Constellation Program. Trash accommodation will also need forward work to assess, including provision for wet trash, dry trash, and biological waste. It will be important to assess a redesign of the surgical stretcher-chair. The commercial version used in the upgrade can only enable vertical translation in the seated configuration, requiring the patient to bend both hips and knees. A possible redesign of the chair will allow for vertical translation without requiring any bending at the hip or knees. Also, the commercial version is wheeled, making it mobile in gravity but unanchored in microgravity. Work will be needed to adapt the chair for gravity-independent performance. The hygiene compartment can be redesigned to serve both as a medical scrub facility and for galley hand washing. Pending sufficient volume, it may also be possible to place sanitation equipment in this location to clean medical tools. Finally, most space architectures have never allowed for more than one incapacitated crew member, but several scenarios could potentially injure two or more crew in the same incident. This facility could be assessed to determine its present ability to address two or more injured crew in parallel and determine the potential upper limit for number of treatable crew in a multi-crew injury scenario, or to treat polytrauma of a single patient.

Common Habitat↗