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NASA NTRS2018

Validation of the Nasa Integrated Medical Model: a Space Flight Medical Risk Prediction Tool

The Human Research Program funded the development of the Integrated Medical Model (IMM) to quantify the medical component of overall mission risk. The IMM uses Monte Carlo simulation methodology, incorporating space flight and ground medical data, to estimate the probability of mission medical outcomes and resource utilization. To determine the credibility of IMM output, the IMM project team completed two validation studies that compared IMM predicted output to observed medical events from a selection of Shuttle Transportation System (STS) and International Space Station (ISS) missions. The validation study results showed that the IMM underpredicted the occurrence of ~10% of the modeled medical conditions for the STS missions and overpredicted ~20% of the modeled medical conditions for the ISS missions. These findings imply that the strength of IMM predictions to inform decisions depends on simulated mission specifications including length. This discrepancy could result from medical recording differences between ISS and STS that possibly influence observed incidence rates, IMM combining all "mission type" data as constant occurrence rate or fixed proportion across both mission types, misspecification of symptoms to conditions, and gaps in the literature informing the model. Some of these issues will be alleviated by updating the IMM source data through incorporation of the observed validation data.

medical equipment↗
NASA NTRS2018

Validation of the NASA Integrated Medical Model: a Space Flight Medical Risk Prediction Tool

The Human Research Program funded the development of the Integrated Medical Model (IMM) to quantify the medical component of overall mission risk. The IMM uses Monte Carlo simulation methodology, incorporating space flight and ground medical data, to estimate the probability of mission medical outcomes and resource utilization. To determine the credibility of IMM output, the IMM project team completed two validation studies that compared IMM predicted output to observed medical events from a selection of Shuttle Transportation System (STS) and International Space Station (ISS) missions. The validation study results showed that the IMM underpredicted the occurrence of ~10% of the modeled medical conditions for the STS missions and overpredicted ~20% of the modeled medical conditions for the ISS missions. These findings imply that the strength of IMM predictions to inform decisions depends on simulated mission specifications including length. This discrepancy could result from medical recording differences between ISS and STS that possibly influence observed incidence rates, IMM combining all "mission type" data as constant occurrence rate or fixed proportion across both mission types, misspecification of symptoms to conditions, and gaps in the literature informing the model. Some of these issues will be alleviated by updating the IMM source data through incorporation of the observed validation data.

risk assessment↗
NASA NTRS1972

Apollo experience report: Crew provisions and equipment subsystem

A description of the construction and use of crew provisions and equipment subsystem items for the Apollo Program is presented. The subsystem is composed principally of survival equipment, bioinstrumentation devices, medical components and accessories, water- and waste-management equipment, personal-hygiene articles, docking aids, flight garments (excluding the pressure garment assembly), and various other crew-related accessories. Particular attention is given to items and assemblies that presented design, development, or performance problems: the crew optical alinement sight system, the metering water dispenser, and the waste-management system. Changes made in design and materials to improve the fire safety of the hardware are discussed.

Mcallister, F.↗
NASA NTRS2000

Hardware Development Process for Human Research Facility Applications

The simple goal of the Human Research Facility (HRF) is to conduct human research experiments on the International Space Station (ISS) astronauts during long-duration missions. This is accomplished by providing integration and operation of the necessary hardware and software capabilities. A typical hardware development flow consists of five stages: functional inputs and requirements definition, market research, design life cycle through hardware delivery, crew training, and mission support. The purpose of this presentation is to guide the audience through the early hardware development process: requirement definition through selecting a development path. Specific HRF equipment is used to illustrate the hardware development paths. The source of hardware requirements is the science community and HRF program. The HRF Science Working Group, consisting of SCientists from various medical disciplines, defined a basic set of equipment with functional requirements. This established the performance requirements of the hardware. HRF program requirements focus on making the hardware safe and operational in a space environment. This includes structural, thermal, human factors, and material requirements. Science and HRF program requirements are defined in a hardware requirements document which includes verification methods. Once the hardware is fabricated, requirements are verified by inspection, test, analysis, or demonstration. All data is compiled and reviewed to certify the hardware for flight. Obviously, the basis for all hardware development activities is requirement definition. Full and complete requirement definition is ideal prior to initiating the hardware development. However, this is generally not the case, but the hardware team typically has functional inputs as a guide. The first step is for engineers to conduct market research based on the functional inputs provided by scientists. CommerCially available products are evaluated against the science requirements as well as modifications needed to meet program requirements. Options are consolidated and the hardware development team reaches a hardware development decision point. Within budget and schedule constraints, the team must decide whether or not to complete the hardware as an in-house, subcontract with vendor, or commercial-off-the-shelf (COTS) development. An in-house development indicates NASA personnel or a contractor builds the hardware at a NASA site. A subcontract development is completed off-site by a commercial company. A COTS item is a vendor product available by ordering a specific part number. The team evaluates the pros and cons of each development path. For example, in-bouse developments utilize existing corporate knowledge regarding bow to build equipment for use in space. However, technical expertise would be required to fully understand the medical equipment capabilities, such as for an ultrasound system. It may require additional time and funding to gain the expertise that commercially exists. The major benefit of subcontracting a hardware development is the product is delivered as an end-item and commercial expertise is utilized. On the other hand, NASA has limited control over schedule delays. The final option of COTS or modified COTS equipment is a compromise between in-house and subcontracts. A vendor product may exist that meets all functional requirements but req uires in-house modifications for successful operation in a space environment. The HRF utilizes equipment developed using all of the paths described: inhouse, subcontract, and modified COTS.

Bauer, Liz↗
NASA NTRS1979

Automatic Data Processing Equipment (ADPE) acquisition plan for the medical sciences

An effective mechanism for meeting the SLSD/MSD data handling/processing requirements for Shuttle is discussed. The ability to meet these requirements depends upon the availability of a general purpose high speed digital computer system. This system is expected to implement those data base management and processing functions required across all SLSD/MSD programs during training, laboratory operations/analysis, simulations, mission operations, and post mission analysis/reporting.

Source record↗
NASA NTRS2003

An Independent Human Factors Analysis and Evaluation of the Emergency Medical Protocol Checklist for the International Space Station

Emergency medical capabilities aboard the ISS include a Crew Medical Officer (CMO) (not necessarily a physician), and back-up, resuscitation equipment, and a medical checklist. It is essential that CMOs have reliable, usable and informative medical protocols that can be carried out independently in flight. The study evaluates the existing ISS Medical Checklist layout against a checklist updated to reflect a human factors approach to structure and organization. Method: The ISS Medical checklist was divided into non-emergency and emergency sections, and re-organized based on alphabetical and a body systems approach. A desk-top evaluation examined the ability of subjects to navigate to specific medical problems identified as representative of likely non-emergency events. A second evaluation aims to focus on the emergency section of the Medical Checklist, based on the preliminary findings of the first. The final evaluation will use Astronaut CMOs as subjects comparing the original checklist against the updated layout in the task of caring for a "downed crewmember" using a Human Patient Simulator [Medical Education Technologies, Inc.]. Results: Initial results have demonstrated a clear improvement of the re-organized sections to determine the solution to the medical problems. There was no distinct advantage for either alternative, although subjects stated having a preference for the body systems approach. In the second evaluation, subjects will be asked to identify emergency medical conditions, with measures including correct diagnosis, time to completion and solution strategy. The third evaluation will compare the original and fully updated checklists in clinical situations. Conclusions: Initial findings indicate that the ISS Medical Checklist will benefit from a reorganization. The present structure of the checklist has evolved over recent years without systematic testing of crewmember ability to diagnose medical problems. The improvements are expected to enable ISS Crewmembers to more speedily and accurately respond to medical situations on the ISS.

Marshburn, Thomas↗
NASA NTRS2024

Uncrewed Aerial Systems for Emergency Medical First Response: A Market Research Report

This report presents the findings from market research conducted for NASA’s Aerial Aid Convergent Aeronautics Solutions (CAS) exploration project, which aims to assess the current state of the market and technological readiness for Uncrewed Aerial Systems (UAS) for medical emergency first response. The research reveals a robust and rapidly growing market for UAS, with a notable emerging sector for Drones as First Responders (DFR). Despite this growth, DFR applications are currently limited by regulatory, technical, and other challenges, which restrict their use primarily to manned remote video surveillance, and therefore are primarily employed by police units. To our knowledge, there is no evidence of UAS being utilized by medical first responders for scene assessment. Limited evidence exists for closely related applications; however, these are mostly confined to pilot programs for the delivery of medical supplies or equipment. Although there has been discussion around fully autonomous DFR applications for medical purposes such as UAS ambulances or patient transport drones, these applications are generally not yet operational in practice. The technology for full autonomy, especially in guidance and control, has seen significant advancements, and recent Federal Aviation Administration (FAA)regulations are likely to accelerate adoption. Computer vision algorithms for fully autonomous medical emergency response scene surveillance are primed for advancement and deployment. A notable gap likely exists between advancements in computer vision research and what is being integrated in the commercial DFR sector. This gap is primarily due to challenges such as quality assurance for autonomous systems, the availability of application-specific training datasets for computer vision algorithms, regulatory constraints, and public perception and privacy concerns.

Joshua M Fody↗
NASA NTRS2014

Arusha Rover Deployable Medical Workstation

The NSBE Arusha rover concept offers a means of human transport and habitation during long-term exploration missions on the moon. This conceptual rover calls for the availability of medical supplies and equipment for crew members in order to aid in mission success. This paper addresses the need for a dedicated medical work station aboard the Arusha rover. The project team investigated multiple options for implementing a feasible deployable station to address both the medical and workstation layout needs of the rover and crew. Based on layout specifications and medical workstation requirements, the team has proposed a deployable workstation concept that can be accommodated within the volumetric constraints of the Arusha rover spacecraft

Rover↗
NASA NTRS2004

Creating Simulated Microgravity Patient Models

The Medical Operational Support Team (MOST) has been tasked by the Space and Life Sciences Directorate (SLSD) at the NASA Johnson Space Center (JSC) to integrate medical simulation into 1) medical training for ground and flight crews and into 2) evaluations of medical procedures and equipment for the International Space Station (ISS). To do this, the MOST requires patient models that represent the physiological changes observed during spaceflight. Despite the presence of physiological data collected during spaceflight, there is no defined set of parameters that illustrate or mimic a 'space normal' patient. Methods: The MOST culled space-relevant medical literature and data from clinical studies performed in microgravity environments. The areas of focus for data collection were in the fields of cardiovascular, respiratory and renal physiology. Results: The MOST developed evidence-based patient models that mimic the physiology believed to be induced by human exposure to a microgravity environment. These models have been integrated into space-relevant scenarios using a human patient simulator and ISS medical resources. Discussion: Despite the lack of a set of physiological parameters representing 'space normal,' the MOST developed space-relevant patient models that mimic microgravity-induced changes in terrestrial physiology. These models are used in clinical scenarios that will medically train flight surgeons, biomedical flight controllers (biomedical engineers; BME) and, eventually, astronaut-crew medical officers (CMO).

Hurst, Victor↗
NASA NTRS2006

Development and Testing of a Radial Halbach Magnetic Bearing

The NASA John H. Glenn Research Center has developed and tested a revolutionary Radial Halbach Magnetic Bearing. The objective of this work is to develop a viable non-contact magnetic bearing utilizing Halbach arrays for all-electric flight, and many other applications. This concept will help reduce harmful emissions, reduce the Nation s dependence on fossil fuels and mitigate many of the concerns and limitations encountered in conventional axial bearings such as bearing wear, leaks, seals and friction loss. The Radial Halbach Magnetic Bearing is inherently stable and requires no active feedback control system or superconductivity as required in many magnetic bearing designs. The Radial Halbach Magnetic Bearing is useful for very high speed applications including turbines, instrumentation, medical applications, manufacturing equipment, and space power systems such as flywheels. Magnetic fields suspend and support a rotor assembly within a stator. Advanced technologies developed for particle accelerators, and currently under development for maglev trains and rocket launchers, served as the basis for this application. Experimental hardware was successfully designed and developed to validate the basic principles and analyses. The report concludes that the implementation of Radial Halbach Magnetic Bearings can provide significant improvements in rotational system performance and reliability.

Eichenberg, Dennis J.↗
NASA NTRS2010

Acoustics Critical Readiness Review

This presentation reviews the status of the acoustic equipment from the medical operations perspective. Included is information about the acoustic dosimeters, sound level meter, and headphones that are planned for use while on orbit. Finally there is information about on-orbit hearing assessments.

Ballard, Kenny↗
NASA NTRS1975

Medical Support and Findings of the Skylab Program

Specific equipment used in carrying out Skylab medical experiments is outlined and illustrated. Also included are reviews of the techniques, frequency, and protocols of the tests designed to study the long term effects of weightlessness on the human body. In-flight investigations were an evaluation of the cardiovascular system, a study of metabolic activity, investigations in the field of neurophysiology, the determination of changes in body fluids, a precise measurement of total body metabolism, and a study of crew performance by use of a time and motion experiment. Significant data obtained from in-flight and postflight tests are outlined.

Johnston, Richard S.↗
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 NTRS1974

Skylab medical technology utilization

To perform the extensive medical experimentation on man in a long-term, zero-g environment, new medical measuring and monitoring equipment had to be developed, new techniques in training and operations were required, and new methods of collecting and analyzing the great amounts of medical data were developed. Examples of technology transfers to the public sector resulted from the development of new equipment, methods, techniques, and data. This paper describes several of the examples that stemmed directly from Skylab technology.

Stonesifer, J. C.↗
NASA NTRSDate not supplied

An Automated Medical Inventory System (AMIS) to Enable Earth-Independent Medical Operations

BACKGROUND: Inventory of medical consumables and durables (medications, treatment aids, diagnostic equipment, etc.) aboard the International Space Station is a manual process whereby crewmembers reach out to their flight surgeon to relay when items are used. Performing a full medical system inventory is time intensive. However, as exploration progresses to long duration missions with little to no resupply or evacuation capabilities, maintaining an accurate account of inventory and location for medical systems across the mission will become increasingly critical. A new system must be developed for future exploration missions to meet the need for a crew-facing, real time method of managing medical inventory. OVERVIEW: NASA’s Exploration Medical Integrated Product Team (XMIPT) is funding the AMIS project to mature the technology readiness level and to conduct a flight demonstration of a medical inventory capability. AMIS will leverage lessons learned from a Medical Consumables Tracking project previously demonstrated aboard the ISS in 2016 and 2017. Key components of AMIS include a database, supporting hardware and software, and interfaces to power, communications, or other vehicle or medical systems. Some medical inventory capability may be provided by the vehicle inventory management system which relies upon RFID-based technology and can track larger items such as medical kits or medical hardware. AMIS will augment these capabilities to enable tracking of individual medical kit contents. Efforts are underway to characterize the optimal solution trade space by comparing system specifications (e.g. mass and volume, etc.) across maintenance and operational use cases (e.g. crew time saved, total inventory automated, etc). DISCUSSION: The contents of a Mars Medical System have not been fully defined which poses challenges to defining an inventory system and requires assumptions regarding medical kit contents and medical system design. Other important considerations include minimizing crew time required, avoiding access restrictions to medical inventory in the event of an emergency, and ensuring that data is accessible to other medical system elements to enable crew autonomy in provision of medical care.

Automated Medical Inventory System↗
NASA NTRS2021

Exploration Medical Capability Clinical Decision Support System Concept of Operations

The Clinical Decision Support (CDS) project supports the Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP). Specifically, the CDS project addresses the ExMC gap, Medical-701: Enhance medical capabilities within an exploration medical system. For long-duration, deep space missions, computational and data resources will play an important role in maintaining crew health, wellness and performance where the crew will need to be more self-reliant as we enter a new era in space exploration to return to the moon and explore Mars. These ambitious goals will require significant change in in-flight medical care due to constraints on mass, volume, power, crew time, skills reduction over time and medical evacuation capabilities. These constraints make it absolutely necessary to develop transformative solutions using new technologies. Unlike the current paradigm for crew health in low-Earth orbit missions that rely on constant communication with Mission Control, the deep space missions will experience communication delays and possibly, no communications for finite periods of time. Hence, crew health management will benefit from analytics’ capabilities to augment decision support. A comprehensive, multi-functional on-board clinical decision support system (CDSS) will help crews assess and diagnose conditions, decide appropriate responses, and guide the provision of tailored and evidence-based treatments, while reflecting contextual factors and constraints. The context may include present and historical data, viable diagnostic equipment, available supplies and medications, and vehicle and environmental health. Communication time with ground-based personnel is delayed or non-existent during significant portions of the mission so the crew will need to autonomously respond to health, performance and medical situations, particularly those that are unplanned. The CDSS must also provide additional capabilities as complex as training for an emergency situation while augmenting non-expert practitioner skillsets if the Crew Medical Officer (CMO) is incapacitated, and as routine as facilitating delayed communication with flight surgeons on the ground. The CDSS must connect complex issues involving health, wellness, task performance and environmental domains. Furthermore, CDSS functionality will focus on semi-autonomous and autonomous decision-making by the crew that is necessary to address challenges in executing a self-contained medical system that enables health care without assistance from ground clinical experts. The document, ExMC CDSS Architecture Recommendation, (HRP- 48032) establishes a description of the envisioned CDSS architecture. The analytics, descriptive or advanced, contained in a CDSS will interface with the integrated crew health and performance architecture that provides the appropriate data sets. The aim of the CDS project is to develop requirements for a CDSS through a series of test-bed prototype developments and demonstrations.

HRP↗