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At least 19 records
All sourcesNASA NTRSDOE OSTI
NASA NTRS2005

A WOUND CARE AND INTRAVENOUS ACCESS SUMMIT FOR ON-ORBIT CARE

Wound care issues and the ability to establish intravenous (IV) access among injured or ill crew members are a source of concern for NASA flight surgeons. Indeed, the microgravity environment and the remote nature of the International Space Station (ISS) pose unique challenges in diagnosing and treating an injured astronaut. Therefore, it is necessary to identify and adapt the best evidence based terrestrial practices regarding wound care, hemostasis, and IV access for use on the ISS. Methods: A panel of consultants was convened to evaluate the adequacy of the current ISS in-flight medical system for diagnosis and treatment of wounds and establishing IV access by a nonclinician crew medical officer. Participants were acknowledged experts in terrestrial wound care and/or operational medicine. Prior to the meeting, each panelist was encouraged to participate in a pre-summit online forum. Results: Eight external experts participated in a face-to-face meeting held at NASA-Johnson Space Center. Recommendations were made to augment the space station pharmacopoeia, as well as current wound care diagnostic, therapeutic, and deorbit criteria protocols. Additionally, suggestions were offered regarding IV access techniques and devices for use in the microgravity environment. Discussion: The results of the expert panel provide an evidence-based approach to the diagnosis and care of wounds in an injured astronaut on aboard the ISS. The results of the panel underscored the need for further research in wound therapy and IV access devices.

Scheuring, R.↗
NASA NTRS1975

Medical care of spacecrews, (Medical care, equipment, and prophylaxis)

Treatment and prevention of the physiologic problems of spacecrews are discussed. Preflight procedures, inflight monitoring and medication, and postflight examination are described. Specific factors covered include: medical screening and astronaut selection; health stabilization and exposure prevention; preflight medical examinations and training; biomedical data; medical kits; diagnosis and treatment; and implications of postflight findings.

Berry, C. A.↗
NASA NTRSDate not supplied

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↗
NASA NTRS2005

Autonomous Medical Care for Exploration

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

Johnson-Throop, Kathy A.↗
NASA NTRSDate not supplied

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↗
NASA NTRS1992

Medicine on Mars: Remote medical care and the space exploration initiative

Mars exploration missions as described in the Synthesis Group report will involve extended exposures of crew members to remote, hazardous environments for up to 100 days. Maintenance of crew health and performance will be critical to ensure mission success. Because of the great distances between the Earth and Mars, round trip telecommunication will take from seven to forty minutes and immediate return to Earth will not be feasible: an autonomous medical care system that integrates preventive, occupational, and environmental aspects of health care and provides diagnostic and treatment capabilities will be necessary. Providing medical care for Mars explorers will pose some unique technical and engineering challenges. Medical care equipment will need to be designed to be modular and portable to ensure that it is interchangeable between vehicle and planetary surface elements. Miniaturization will be necessary to reduce mass and volume. Computerized systems that automatically acquire and manage medical information and provide medical references (literature), decision support, and automated medical record keeping will be a crucial part of a Martian medical care system. Medical care will also rely on remote consultation with Earth-based specialists. This presentation will provide an overview of the health and medical concerns associated with Mars exploration missions and will describe some specific concepts for Mars medical care systems.

Simmons, S. C.↗
NASA NTRS2017

Defining Medical Levels of Care for Exploration Missions

NASA medical care standards establish requirements for providing health and medical programs for crewmembers during all phases of a mission. These requirements are intended to prevent or mitigate negative health consequences of long-duration spaceflight, thereby optimizing crew health and performance over the course of the mission. Current standards are documented in the two volumes of the NASA-STD-3001 Space Flight Human-System Standard document, established by the Office of the Chief Health and Medical Officer. Its purpose is to provide uniform technical standards for the design, selection, and application of medical hardware, software, processes, procedures, practices, and methods for human-rated systems. NASA-STD-3001 Vol. 1 identifies five levels of care for human spaceflight. These levels of care are accompanied by several components that illustrate the type of medical care expected for each. The Exploration Medical Capability (ExMC) of the Human Research Program has expanded the context of these provided levels of care and components. This supplemental information includes definitions for each component of care and example actions that describe the type of capabilities that coincide with the definition. This interpretation is necessary in order to fully and systematically define the capabilities required for each level of care in order to define the medical requirements and plan for infrastructure needed for medical systems of future exploration missions, such as one to Mars.

Hailey, M.↗
NASA NTRS1987

Correction, improvement and model verification of CARE 3, version 3

An independent verification of the CARE 3 mathematical model and computer code was conducted and reported in NASA Contractor Report 166096, Review and Verification of CARE 3 Mathematical Model and Code: Interim Report. The study uncovered some implementation errors that were corrected and are reported in this document. The corrected CARE 3 program is called version 4. Thus the document, correction. improvement, and model verification of CARE 3, version 3 was written in April 1984. It is being published now as it has been determined to contain a more accurate representation of CARE 3 than the preceding document of April 1983. This edition supercedes NASA-CR-166122 entitled, 'Correction and Improvement of CARE 3,' version 3, April 1983.

Rose, D. M.↗
NASA NTRS1991

Medical care delivery in the US space program

The stated goal of this meeting is to examine the use of telemedicine in disaster management, public health, and remote health care. NASA has a vested interest in providing health care to crews in remote environments. NASA has unique requirements for telemedicine support, in that our flight crews conduct their job in the most remote of all work environments. Compounding the degree of remoteness are other environmental concerns, including confinement, lack of atmosphere, spaceflight physiological deconditioning, and radiation exposure, to name a few. In-flight medical care is a key component in the overall support for missions, which also includes extensive medical screening during selection, preventive medical programs for astronauts, and in-flight medical monitoring and consultation. This latter element constitutes the telemedicine aspect of crew health care. The level of in-flight resources dedicated to medical care is determined by the perceived risk of a given mission, which in turn is related to mission duration, planned crew activities, and length of time required for return to definitive medical care facilities.

Stewart, Donald F.↗
NASA NTRS2003

Monitoring Outpatient Care

Each year, health care costs for managing chronically ill patients increase as the life expectancy of Americans continues to grow. To handle this situation, many hospitals, doctors practices, and home care providers are turning to disease management, a system of coordinated health care interventions and communications, to improve outpatient care. By participating in daily monitoring programs, patients with congestive heart failure, chronic obstructive pulmonary disease, diabetes, and other chronic conditions requiring significant self-care are facing fewer emergency situations and hospitalizations. Cybernet Medical, a division of Ann Arbor, Michigan-based Cybernet Systems Corporation, is using the latest communications technology to augment the ways health care professionals monitor and assess patients with chronic diseases, while at the same time simplifying the patients interaction with technology. Cybernet s newest commercial product for this purpose evolved from research funded by NASA, the National Institute of Mental Health, and the Advanced Research Projects Agency. The research focused on the physiological assessment of astronauts and soldiers, human performance evaluation, and human-computer interaction. Cybernet Medical's MedStar Disease Management Data Collection System is an affordable, widely deployable solution for improving in-home-patient chronic disease management. The system's battery-powered and portable interface device collects physiological data from off-the-shelf instruments.

Source record↗
NASA NTRS1995

Influence of the helicopter environment on patient care capabilities: flight crew perceptions

INTRODUCTION: Flight crew perceptions of the effect of the rotary-wing environment on patient-care capabilities have not been subject to statistical analysis. We hypothesized that flight crew members perceived significant difficulties in performing patient-care tasks during air medical transport. METHODS: A survey was distributed to a convenience sample of flight crew members from 20 flight programs. Respondents were asked to compare the difficulty of performing patient-care tasks in rotary-wing and standard (emergency department or intensive care unit) settings. Demographic data collected on respondents included years of flight experience, flights per month, crew duty position and primary aircraft in which the respondent worked. Statistical analysis was performed as appropriate using Student's t-test, type III sum of squares, and analysis of variance. Alpha was defined as p < 0.05. RESULTS: Fifty-five percent of programs (90 individuals) responded. All tasks were significantly rated more difficult in the rotary-wing environment. Ratings were not significantly correlated with flight experience, duty position, flights per month or aircraft used. CONCLUSIONS: We conclude that the performance of patient-care tasks are perceived by air medical flight crew to be significantly more difficult during rotary-wing air medical transport than in hospital settings.

Noise, Transportation/adverse effects↗
NASA NTRS1987

CARE 3 user-friendly interface user's guide

CARE 3 predicts the unreliability of highly reliable reconfigurable fault-tolerant systems that include redundant computers or computer systems. CARE3MENU is a user-friendly interface used to create an input for the CARE 3 program. The CARE3MENU interface has been designed to minimize user input errors. Although a CARE3MENU session may be successfully completed and all parameters may be within specified limits or ranges, the CARE 3 program is not guaranteed to produce meaningful results if the user incorrectly interprets the CARE 3 stochastic model. The CARE3MENU User Guide provides complete information on how to create a CARE 3 model with the interface. The CARE3MENU interface runs under the VAX/VMS operating system.

Martensen, A. L.↗
NASA NTRS1990

Ceramics Analysis and Reliability Evaluation of Structures (CARES). Users and programmers manual

This manual describes how to use the Ceramics Analysis and Reliability Evaluation of Structures (CARES) computer program. The primary function of the code is to calculate the fast fracture reliability or failure probability of macroscopically isotropic ceramic components. These components may be subjected to complex thermomechanical loadings, such as those found in heat engine applications. The program uses results from MSC/NASTRAN or ANSYS finite element analysis programs to evaluate component reliability due to inherent surface and/or volume type flaws. CARES utilizes the Batdorf model and the two-parameter Weibull cumulative distribution function to describe the effect of multiaxial stress states on material strength. The principle of independent action (PIA) and the Weibull normal stress averaging models are also included. Weibull material strength parameters, the Batdorf crack density coefficient, and other related statistical quantities are estimated from four-point bend bar or unifrom uniaxial tensile specimen fracture strength data. Parameter estimation can be performed for single or multiple failure modes by using the least-square analysis or the maximum likelihood method. Kolmogorov-Smirnov and Anderson-Darling goodness-of-fit tests, ninety percent confidence intervals on the Weibull parameters, and Kanofsky-Srinivasan ninety percent confidence band values are also provided. The probabilistic fast-fracture theories used in CARES, along with the input and output for CARES, are described. Example problems to demonstrate various feature of the program are also included. This manual describes the MSC/NASTRAN version of the CARES program.

Nemeth, Noel N.↗
NASA NTRS1991

A telemedicine health care delivery system

The Interactive Telemedicine Systems (ITS) system was specifically developed to address the ever widening gap between our medical care expertise and our medical care delivery system. The frustrating reality is that as our knowledge of how to diagnose and treat medical conditions has continued to advance, the system to deliver that care has remained in an embryonic stage. This has resulted in millions of people being denied their most basic health care needs. Telemedicine utilizes an interactive video system integrated with biomedical telemetry that allows a physician at a base station specialty medical complex or teaching hospital to examine and treat a patient at multiple satellite locations, such as rural hospitals, ambulatory health centers, correctional institutions, facilities caring for the elderly, community hospital emergency departments, or international health facilities. Based on the interactive nature of the system design, the consulting physician at the base station can do a complete history and physical examination, as if the patient at the satellite site was sitting in the physician's office. This system is described.

Sanders, Jay H.↗
NASA NTRS1992

Medical care capabilities for Space Station Freedom: A phase approach

As a result of Congressional mandate Space Station Freedom (SSF) was restructured. This restructuring activity has affected the capabilities for providing medical care on board the station. This presentation addresses the health care facility to be built and used on the orbiting space station. This unit, named the Health Maintenance Facility (HMF) is based on and modeled after remote, terrestrial medical facilities. It will provide a phased approach to health care for the crews of SSF. Beginning with a stabilization and transport phase, HMF will expand to provide the most advanced state of the art therapeutic and diagnostic capabilities. This presentation details the capabilities of such a phased HMF. As Freedom takes form over the next decade there will be ever-increasing engineering and scientific developmental activities. The HMF will evolve with this process until it eventually reaches a mature, complete stand-alone health care facility that provides a foundation to support interplanetary travel. As man's experience in space continues to grow so will the ability to provide advanced health care for Earth-orbital and exploratory missions as well.

Doarn, C. R.↗
NASA NTRS1994

Influence of the helicopter environment on patient care capabilities: Flight crew perceptions

Flight crew perceptions of the effect of the rotary wing environment on patient care capabilities have not been subject to statistical analysis. We hypothesized that flight crew perceived significant difficulties in performing patient care tasks during air medical transport. A survey instrument was distributed to a convenience sample of flight crew members from twenty flight programs. Respondents were asked to compare the difficulty of performing patient care tasks in rotary wing and standard (emergency department or intensive care unit) settings. Demographic data collected on respondents included years of flight experience, flights per month, crew duty position, and primary aircraft in which the respondent worked. Statistical analysis was performed as appropriate using Student's t-test, type 111 sum of squares, and analysis of variance. Alpha was defined as p is less than or equal to .05. Fifty-five percent of programs (90 individuals) responded. All tasks were rated significantly more difficult in the rotary wing environment. Ratings were not significantly correlated with flight experience, duty position, flights per month, or aircraft used. We conclude that the performance of patient care tasks are perceived by air medical flight crew to be significantly more difficult during rotary wing air medical transport than in hospital settings.

Meyers, K. Jeffrey↗
NASA NTRS2007

Autonomous Medical Care for Exploration Class Space Missions

The US-based health care system of the International Space Station (ISS) contains several subsystems, the Health Maintenance System, Environmental Health System and the Countermeasure System. These systems are designed to provide primary, secondary and tertiary medical prevention strategies. The medical system deployed in Low Earth Orbit (LEO) for the ISS is designed to enable a "stabilize and transport" concept of operations. In this paradigm, an ill or injured crewmember would be rapidly evacuated to a definitive medical care facility (DMCF) on Earth, rather than being treated for a protracted period on orbit. The medical requirements of the short (7 day) and long duration (up to 6 months) exploration class missions to the Moon are similar to LEO class missions with the additional 4 to 5 days needed to transport an ill or injured crewmember to a DCMF on Earth. Mars exploration class missions are quite different in that they will significantly delay or prevent the return of an ill or injured crewmember to a DMCF. In addition the limited mass, power and volume afforded to medical care will prevent the mission designers from manifesting the entire capability of terrestrial care. NASA has identified five Levels of Care as part of its approach to medical support of future missions including the Constellation program. In order to implement an effective medical risk mitigation strategy for exploration class missions, modifications to the current suite of space medical systems may be needed, including new Crew Medical Officer training methods, treatment guidelines, diagnostic and therapeutic resources, and improved medical informatics.

Hamilton, Douglas↗
NASA NTRSDate not supplied

Medicine in the Final Frontier Technologies to Enable Autonomous Prolonged (Field) Care in Space

N: The planning and execution of comprehensive “Prolonged Care” strategies are increasingly considered as fundamental operational concepts within the spheres of both military and non-military expeditionary medicine. Numerous advances in recent years have enabled the decentralization of health-related technology that has empowered medical - and even non-medical providers - to offer quality care farther afield and for increasingly extended periods of separation from traditional support structures. However, the operational concepts behind today’s Prolonged Care paradigms are still largely dependent upon external support, including high-bandwidth telemedicine communications technologies (that allow ready access to centralized expertise), robust resupply pathways, and ultimately, on the timely evacuation of the sick and injured. What would happen if none of these support systems were readily available? Extremely remote Prolonged Care is one of the most significant challenges that the National Aeronautics and Space Administration (NASA) faces when preparing to expand human space exploration beyond the International Space Station (ISS) to deep space including the Moon and Mars. Continuous human presence on the International Space Station (ISS) in low Earth orbit for the past 20 years has demonstrated that indeed medical operations can be successfully executed with continuous real-time communications, frequent resupply missions, and the availability of rapid evacuation options. However, as time-distance factors from Earth increase with our pursuit and changing focus towards deep space missions, these resources and capabilities will no longer be available. As a result, space medicine operations will need to become more autonomous and less dependent upon mission support from Earth – requiring our attention and efforts to build robust capabilities that support the ultimate expression of the term “Prolonged Field Care.”

K R Lehnhardt↗