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NASA NTRSDate not supplied

Informing New Concepts for UAS and Autonomous System Safety Management using Disaster Management and First Responder Scenarios

As emerging flight operations become more prevalent and increasingly automated and distributed, the capabilities for managing safety of vehicles and operations will also need to evolve. To address this challenge, the National Academies has envisioned an In-Time Aviation Safety Management System (IASMS) capability for a wide range of aviation operations including current commercial operations as well as new entrants envisioned with advanced air mobility (AAM). The suite of IASMS services, functions, and capabilities (SFCs) would be implemented in a federated approach and would address trends as well as individual operations. Through predictive modeling and data analysis, IASMS is envisioned to identify arising risks so that they can be mitigated, in-time, before a safety incident occurs. IASMS and its requisite set of SFCs must leverage a wide range of information to perform. To better understand these new needs, FSF worked with the aviation and humanitarian communities to develop and validate scenarios that include traditional aviation operations and UAS operations intermingled as they are deployed for disaster management and first responder (DMFR) situations. The three scenarios developed include: • Post Natural disaster response, such as a hurricane, involving multiple parties utilizing traditional aviation and UAS to support rescue operations, surveil damage, and locate survivors needing assistance. • Wildfire fighting in remote locations with traditional aircraft for transport and fire-retardant delivery combined with UAS for surveillance of fire locations as well as to track individual firefighter locations. • Medical Operations and AAM in Urban Environments including passenger-carrying helicopters and AAM vehicles, medical missions (such as transport of radio-pharmaceuticals), and other UAS delivery operations (such as the delivery of defibrillators). Each scenario was developed and validated by representatives with expertise in humanitarian operations, urban and rural emergency response, air traffic management, UAS operations, and traditional flight operations. The scenario definitions address roles and responsibilities of individual actors, the appropriate utilization of UAS, and the actions taken by those actors to appropriately manage risks associated with the mission and environment. The risks to aviation traffic and to people on the ground explored included potential risks arising from incompatibilities in calculating reference altitudes (eg, differing uses of AGL, MSL, barometric, or GPS-derived values), loss of command and control (C2) communications, rapid changes in weather and winds, and physical interference. For each risk, IASMS SFCs were postulated in the context of monitoring services, risk assessment capabilities, and identifying appropriate mitigation strategies. The identified SFC capabilities were envisioned from known services postulated for IASMS and for UTM. For these unique environments, IASMS SFCs are needed to address conditions such as hazardous payloads, micro-climates and urban canyons, and the need to keep uninvolved air traffic out of the area where DMFR operations are being conducted. The second phase of analysis focused on inferring the specific information needs and the SFCs for IASMS, utilizing a structure of 16 information classes to organize requirements. For each of the risks identified in the workshops, it was postulated what data sources would be necessary to monitor critical aspects of the risk (eg, surrounding air traffic, ground population, terrain, etc). to be directly measured as well as data that would be derived, which implies additional SFCs for different actors to understand what information would likely be exchanged between parties. For an IASMS to be effective, additional research is needed to develop the advanced algorithms that can address the increasingly autonomous and complex operations in differing environments and to develop means of identifying unknown risks. Looking at these scenarios highlighted a number of research issues. These include the ability to quickly "cordon off" airspace thru temporary flight restrictions (TFRs) or other means, developing clear definitions to enable automation-based algorithms for prioritizing operations, defining airspace density metrics, standardization of altitude reporting, and establishing a basis for safety data metrics definition and collection. This paper seeks to outline the development of an IASMS in the context of the DMFR scenarios and resulting demonstrations. Utilizing this contextual approach, NASA will generate recommendations for an assured safety framework for AAM operations that enables AAM operations to safely access the NAS.

In Time Aviation Safety Management System↗
NASA NTRS2021

Novel Ways to use the International Spacer Station as an Exploration Analog: International Progress in Planning "ISS4Mars"

In October 2020, International Space Station (ISS) Partner Agencies held a set of international workshops to solicit and develop creative and forward-looking ideas for using the ISS as an analog for preparation for Mars missions during its 3rd decade of operations. The workshops brought together participants from nine international space agencies or organizations, with stakeholders consisting of research managers, discipline experts, technology developers, flight physicians, flight operators, and astronauts. Breakout meetings and brainstorming sessions were conducted focusing on the following topics: Critical hazards and countermeasures for the transit to Mars; gravity transitions and early surface operations; environmental control and life support systems; food systems; human microbiome, microbial monitoring, and planetary protection; medical operations for Mars missions; isolation and confinement; autonomous systems and crew-centered autonomy; and communications delay effects on operations. In many cases the scenarios and approaches identified were compelling but challenging to implement under the current utilization structure used to manage the ISS for experiments. Following the series of workshops, a team of utilization leaders across the ISS partnership worked to compile the workshop recommendations and extract a set of use-cases with their prerequisites and constraints. The work considered the following aspects: what can be effectively done on ISS; which new technologies, approaches and scenarios are feasible; what alternatives could be considered; and what steps should be taken to enable integrated testing and future use of ISS as an analog for Mars missions. The final report will be published so that the use cases can be considered in each agency’s strategic planning processes. This paper will cover the process of international assessment in detail and how this process has influenced and broadened the vision of ISS utilization beyond single experiments to integrated studies and testing for future Mars missions. This approach to international collaboration informs both the next decade of international exploration research on the ISS and advancement of its utilization as an analog for deep space missions. For many of the participating partners, it also helps to frame the strategy for human research in Artemis as we begin planning for human missions to the moon. We conclude with a summary of the progress on the actions in the report and the additional implementation discussions that have occurred across the partnership.

Julie A Robinson↗
NASA NTRS2007

Integrated Clinical Training for Space Flight Using a High-Fidelity Patient Simulator in a Simulated Microgravity Environment

This viewgraph presentation reviews the use of telemedicine in a simulated microgravity environment using a patient simulator. For decades, telemedicine techniques have been used in terrestrial environments by many cohorts with varied clinical experience. The success of these techniques has been recently expanded to include microgravity environments aboard the International Space Station (ISS). In order to investigate how an astronaut crew medical officer will execute medical tasks in a microgravity environment, while being remotely guided by a flight surgeon, the Medical Operation Support Team (MOST) used the simulated microgravity environment provided aboard DC-9 aircraft teams of crew medical officers, and remote flight surgeons performed several tasks on a patient simulator.

Hurst, Victor↗
NASA NTRSDate not supplied

Tailoring of NASA-STD-3001 to Lunar Gateway Program Requirements

The Gateway Program must meet NASA's Agency-level human rating requirements, which are intended to accommodate human capabilities and limitations while protecting the safety of the crew, and providing to the maximum extent practical, the capability to safely recover the crew from hazardous situations. Human systems integration represents a key human rating component of Moon to Mars systems to support the execution of Artemis missions, including compliance with mandatory standards for Health and Medical, Safety and Mission Assurance, and Engineering. The human system requirements, together with the human systems integration plan, medical operations requirements, and Gateway sub-system specifications, represent the flow-down of NASA Health and Medical Standards (NASA-STD-3001, Volumes 1 and 2) into the Gateway system. This paper discusses how these documents and other human systems integration activities provide full consideration of human capabilities and limitations as part of the total system design trade space, serving as an example on how the human must be effectively integrated as part of the system in order to achieve mission success. At a bigger scale, the paper con-tributes to the application of systems engineering standards to cutting-edge space exploration initiatives and to the dialogue on how systems engineering can continue to evolve to meet the needs of such ambitious projects.

Systems engineering↗
NASA NTRS2016

Integrated Medical Model (IMM) Optimization Version 4.0 Functional Improvements

The IMMs ability to assess mission outcome risk levels relative to available resources provides a unique capability to provide guidance on optimal operational medical kit and vehicle resources. Post-processing optimization allows IMM to optimize essential resources to improve a specific model outcome such as maximization of the Crew Health Index (CHI), or minimization of the probability of evacuation (EVAC) or the loss of crew life (LOCL). Mass and or volume constrain the optimized resource set. The IMMs probabilistic simulation uses input data on one hundred medical conditions to simulate medical events that may occur in spaceflight, the resources required to treat those events, and the resulting impact to the mission based on specific crew and mission characteristics. Because IMM version 4.0 provides for partial treatment for medical events, IMM Optimization 4.0 scores resources at the individual resource unit increment level as opposed to the full condition-specific treatment set level, as done in version 3.0. This allows the inclusion of as many resources as possible in the event that an entire set of resources called out for treatment cannot satisfy the constraints. IMM Optimization version 4.0 adds capabilities that increase efficiency by creating multiple resource sets based on differing constraints and priorities, CHI, EVAC, or LOCL. It also provides sets of resources that improve mission-related IMM v4.0 outputs with improved performance compared to the prior optimization. The new optimization represents much improved fidelity that will improve the utility of the IMM 4.0 for decision support.

risk assessment↗
NASA NTRS2010

Flight Crew Health Stabilization Program

This document establishes the policy and procedures for the HSP and is authorized through the Director, Johnson Space Center (JSC). This document delineates the medical operations requirements for the HSP. The HSP goals are accomplished through an awareness campaign and procedures such as limiting access to flight crewmembers, medical screening, and controlling flight crewmember activities. NASA's Human Space Flight Program uses strategic risk mitigation to achieve mission success while protecting crew health and safety. Infectious diseases can compromise crew health and mission success, especially in the immediate preflight period. The primary purpose of the Flight Crew Health Stabilization Program (HSP) is to mitigate the risk of occurrence of infectious disease among astronaut flight crews in the immediate preflight period. Infectious diseases are contracted through direct person-to-person contact, and through contact with infectious material in the environment. The HSP establishes several controls to minimize crew exposure to infectious agents. The HSP provides a quarantine environment for the crew that minimizes contact with potentially infectious material. The HSP also limits the number of individuals who come in close contact with the crew. The infection-carrying potential of these primary contacts (PCs) is minimized by educating them in ways to avoid infections and avoiding contact with the crew if they are or may be sick. The transmission of some infectious diseases can be greatly curtailed by vaccinations. PCs are strongly encouraged to maintain updated vaccinations.

Johnston, Smith L.↗
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 NTRS2009

Human Factors in Training - Space Medicine Proficiency Training

The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to ISS, medical equipment will be located on ISS, and carried into CEV in the event of an emergency. Flight Surgeons (FS) on the ground in Mission Control will be expected to direct the Crew Medical Officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. Work on medical training has been conducted in collaboration with the Medical Training Group at the Space Life Sciences Directorate and with Wyle Lab which provides medical training to crew members, Biomedical Engineers (BMEs), and to flight surgeons under the JSC Space Life Sciences Directorate s Bioastronautics contract. The space medical training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). Human factors researchers at Johnson Space Center have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground, and researchers at the Ames Research Center performed a literature review on medical errors. The work proposed for FY10 continues to build on this strong collaboration with the Space Medical Training Group and previous research. This abstract focuses on two areas of work involving Performance Support Tools for Space Medical Operations. One area of research building on activities from FY08, involved the feasibility of just-in-time (JIT) training techniques and concepts for real-time medical procedures. In Phase 1, preliminary feasibility data was gathered for two types of prototype display technologies: a hand-held PDA, and a Head Mounted Display (HMD). The PDA and HMD were compared while performing a simulated medical procedure using ISS flight-like medical equipment. Based on the outcome of Phase 1, including data on user preferences, further testing was completed using the PDA only. Phase 2 explored a wrist-mounted PDA, and compared it to a paper cue card. For each phase, time to complete procedures, errors, and user satisfaction ratings were captured.

Connell, Erin↗
NASA NTRS2010

NASA Medical Response to Human Spacecraft Accidents

Manned space flight is risky business. Accidents have occurred and may occur in the future. NASA's manned space flight programs, with all their successes, have had three fatal accidents, one at the launch pad and two in flight. The Apollo fire and the Challenger and Columbia accidents resulted in a loss of seventeen crewmembers. Russia's manned space flight programs have had three fatal accidents, one ground-based and two in flight. These accidents resulted in the loss of five crewmembers. Additionally, manned spacecraft have encountered numerous close calls with potential for disaster. The NASA Johnson Space Center Flight Safety Office has documented more than 70 spacecraft incidents, many of which could have become serious accidents. At the Johnson Space Center (JSC), medical contingency personnel are assigned to a Mishap Investigation Team. The team deploys to the accident site to gather and preserve evidence for the Accident Investigation Board. The JSC Medical Operations Branch has developed a flight surgeon accident response training class to capture the lessons learned from the Columbia accident. This presentation will address the NASA Mishap Investigation Team's medical objectives, planned response, and potential issues that could arise subsequent to a manned spacecraft accident. Educational Objectives are to understand the medical objectives and issues confronting the Mishap Investigation Team medical personnel subsequent to a human space flight accident.

Patlach, Robert↗
NASA NTRS1982

STS-3 medical report

The medical operations report for STS-3, which includes a review of the health of the crew before, during, and immediately after the third Shuttle orbital flight is presented. Areas reviewed include: health evaluation, medical debriefing of crewmembers, health stabilization program, medical training, medical 'kit' carried in flight, tests and countermeasures for space motion sickness, cardiovascular profile, biochemistry and endocrinology results, hematology and immunology analyses, medical microbiology, food and nutrition, potable water, shuttle toxicology, radiological health, and cabin acoustic noise. Environmental effects of shuttle launch and landing medical information management, and management, planning, and implementation of the medical program are also dicussed.

Pool, S. L.↗
NASA NTRSDate not supplied

Gas Related Problems Related to Spacesuits

Dr. Jonathan B. Clark is an adjunct Associate Professor of Neurology and Space Medicine at Baylor College of Medicine. From 1997 to 2005, he worked at NASA as a six-time Space Shuttle crew surgeon and was chief of the Medical Operations Branch at the Johnson Space Center. During this event, Dr. Clark discussed the hazards of low oxygen partial pressure (hypoxia) and high CO2 concentration (hypercarbia). This is one event of a medical series delivered to the SKC Program by Dr. Clark. This series focuses on spacesuit medical lessons learned and medical safety aspects of the suit.

Jonathan B. Clark↗
NASA NTRS1983

Shuttle OFT medical report: Summary of medical results from STS-1, STS-2, STS-3, and STS-4

The medical operations for the orbital test flights which includes a review of the health of the crews before, during, and immediately after the four shuttle orbital flights are reported. Health evaluation, health stabilization program, medical training, medical "kit" carried in flight, tests and countermeasures for space motion sickness, cardiovascular, biochemistry and endocrinology results, hematology and immunology analyses, medical microbiology, food and nutrition, potable water, Shuttle toxicology, radiological health, and cabin acoustical noise are reviewed. Information on environmental effects of Shuttle launch and landing, medical information management, and management, planning, and implementation of the medical program are included.

Pool, S. L.↗
NASA NTRS2021

Significant Incidents in Extravehicular Activity

Dr. Jonathan B. Clark is an adjunct associate professor of Neurology and Space Medicine at Baylor College of Medicine. From 1997 to 2005, he worked at NASA as a six-time Space Shuttle crew surgeon and was chief of the Medical Operations Branch at the Johnson Space Center. During this event, Dr. Clark delivered a historic review of Extravehicular Activity (EVA) events with an emphasis on EVA system hazards. This is one event of a medical series delivered to the SKC Program by Dr. Clark. This series focuses on spacesuit medical lessons learned and medical safety aspects of the suit.

Jonathan B. Clark↗
NASA NTRS2024

Evolution of Spaceflight Renal Stone Risks and Update to the NASA Human Research Program (HRP) Renal Stone Evidence Report and Integrated Concept of Operations

BACKGROUND: The NASA HRP Evidence Report on the Risk of Renal Stone Formation is being updated based on new information obtained from 9 years of data from NASA’s astronaut renal stone surveillance program. In addition, the Concept of Operations for missions beyond Low Earth Orbit (LEO) was created to supplement the Evidence Report, and the NASA clinical practice guideline(CPG)for renal stone surveillance was updated. OVERVIEW: A literature review was performed to evaluate the state of literature regarding renal stone prevention, mitigation, and management both in terrestrial and spaceflight environments. Current renal stone treatment guidelines for the ISS, which were created by the Inflight Clinical Medicine Working Group and approved by the Multilateral Medical Operations Panel (MMOP)were reviewed, as well as recent ultrasound technology demonstrations onboard the ISS. This information was used in conjunction with emerging evidence from the surveillance program to update the Evidence Report and in-flight Concept of Operations. DISCUSSION: There are known and emerging renal stone prevention strategies including astronaut selection, the use of medications and resistive exercise, early diagnosis with regular urine studies and ultrasound imaging. In-flight treatment options include pharmaceuticals, use of lithotripsy and propulsive ultrasound, placement of percutaneous drains and other modalities. This information is useful to gauge future risks and update our strategies for prevention and management of renal stones in astronauts to reduce the risk of in-flight renal stone colic that could cause morbidity and mission impact.

E Stratton↗
NASA NTRSDate not supplied

Developing a Medical System Foundation for Level of Care IV: Short-Duration Lunar Orbit

The Human Research Program (HRP) Exploration Medical Capability (ExMC) element has developed a Medical System Foundation for Level of Care IV, as defined by NASA’s space flight human-system standards, for short-duration lunar orbit missions by employing a systems engineering approach using model-based systems engineering tools. This Foundation includes a concept of operations, medical system architecture, associated functional and non-functional requirements and rationales, and medical conditions, capabilities, and resources. Collectively, these serve as a starting point (“Foundation”) for a medical system that meets the Level of Care IV requirement. The Foundation also includes traces to the current versions of NASA standards documents and lower (e.g., sub-system) and higher (e.g., vehicle system) level requirements. Stakeholders can use the Foundation to analyze the traces between medical capabilities, medical conditions, medical resources, and requirements; identify medical system interfaces with other vehicle systems/subsystems; and as a basis for performing trades on risks vs. medical system mass and volume allocation. To facilitate communication of the Foundation to stakeholders who do not have access to the modeling tools used, an HTML representation of the Foundation was created. This discussion will focus on the processes through which the Medical System Foundation was developed, how the Foundation builds a bridge between the medical and engineering domains and facilitates communication between these communities, and how these processes can be applied more broadly to a crew health and performance system and other system domains.

S. Lumpkins↗
NASA NTRS2011

Analogs and the BHP Risk Reduction Strategy for Future Spaceflight Missions

In preparation for future exploration missions to distant destinations (e.g., Moon, Near Earth Objects (NEO), and Mars), the NASA Human Research Program s (HRP) Behavioral Health and Performance Element (BHP) conducts and supports research to address four human health risks: Risk of Behavioral Conditions; Risk of Psychiatric Conditions; Risk of Performance Decrements Due to Inadequate Cooperation, Coordination, Communication, and Psychosocial Adaptation within a Team; and Risk of Performance Errors due to Sleep Loss, Fatigue, Circadian Desynchronization, and Work Overload (HRP Science Management Plan, 2008). BHP Research, in collaboration with internal and external research investigators, as well as subject matter experts within NASA operations including flight surgeons, astronauts, and mission planners and others within the Mission Operations Directorate (MOD), identifies knowledge and technology gaps within each Risk. BHP Research subsequently manages and conducts research tasks to address and close the gaps, either through risk assessment and quantification, or the development of countermeasures and monitoring technologies. The resulting deliverables, in many instances, also support current Medical Operations and/or Mission Operations for the International Space Station (ISS).

Whitmire, Sandra↗
NASA NTRSDate not supplied

The Evolution of the Impact Evidence Library Methods – What We Learned

During fiscal years 2020-2022 NASA’s Human Research Program, Exploration Medical Capability Element has worked to source this evidence for the model. During the process several lessons learned have been identified and drive recommendations for future efforts. The ICL 1.0: Spaceflight Medical Operational expertise should be consulted regarding the addition of future conditions. A clinician experienced with the nuances of spaceflight is recommended to have a minimum of 20 hours per condition to adequately source the evidence. Condition definitions should be carefully crafted to maintain mutual exclusivity. Common side effects from medications, common and consequential incidental findings in laboratory studies, and consequential side effects of diagnostic and procedural capabilities should be considered for inclusion as unique conditions in future iterations of the ICL 1.0. Incidence: Spaceflight incidence, although based on small population sizes, is the gold standard. Terrestrial incidence should be applied cautiously. Probability of minor vs. severe cases of the condition: Data informing severity probability of the medical condition are nearly always terrestrial. Special attention should be paid to this metric as it drives outcomes in the model and terrestrial data often overestimate severity of expected cases in spaceflight. Condition duration: Three clinical phases currently exist in the model. They represent the time necessary for diagnosis, treatment/convalescence/recurrence, and the remaining duration of the mission after maximal recovery, respectively. Further subdivision of acute and convalescent treatment/recurrence is recommended. Probability of need for evacuation: Surrogates for “Return to Definitive Care” were chosen prior to data collection. In most cases these surrogates were “need for hospitalization” or “need for surgery.” For many conditions these may not be realistic drivers of “Return to Definitive Care” and should be re-examined. Probability of Crew Mortality: Terrestrial mortality data is difficult to apply to astronauts who, invariably, have less comorbidities than terrestrial subjects. It must be applied judiciously. The proportion of mission tasks impaired by the condition: “Task Impairment” was assigned to each condition prior to the condition duration data becoming available. Future efforts should assign Task Impairment as the final step in sourcing the evidence.

A.J. Kreykes↗
NASA NTRS1974

Skylab mission report, third visit

An evaluation is presented of the operational and engineering aspects of the third Skylab visit, including information on the performance of the command and service module and the experiment hardware, the crew's evaluation of the visit, and other visit-related areas of interest such as biomedical observations. The specific areas discussed are contained in the following: (1) solar physics and astrophysics investigations; (2) Comet Kohoutek experiments; (3) medical experiments; (4) earth observations, including data for the multispectral photographic facility, the earth terrain camera, and the microwave radiometer/scattermometer and altimeter; (5) engineering and technology experiments; (6) food and medical operational equipment; (7) hardware and experiment anomalies; and (8) mission support, mission objectives, flight planning, and launch phase summary. Conclusions discussed as a result of the third visit to Skylab involve the advancement of the sciences, practical applications, the durability of man and systems in space, and spaceflight effectiveness and economy.

Source record↗