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Billica, Roger

Publications and source records attributed to Billica, Roger.

Vision Aspects of Space Flight

Vision, being one of our most important senses, is critically important in the unique working environment of space flight. Critical evaluation of the astronauts visual system begins with pre-selection examinations resulting in an average of 65% of all medical disqualification's caused by ocular findings. With an average age of 42, approximately 60% of the astronaut corps requires vision correction. Further demands of the unique training and working environment of microgravity, variable lighting from very poor to extreme brightness of sunlight and exposure to extremes of electromagnetic energy results in unique eyewear and contact lens applications. This presentation will describe some of those unique eyewear and contact lens applications used in space flight and training environments. Additionally, ocular findings from 26 shuttle and 5 MIR mission post-flight examinations will be presented.

Manuel, Keith

Clinical Space Medicine Panel

The practice of space medicine is diverse. It includes routine preventive medical care of astronauts and pilots, the development of inflight medical capability and training of flight crews as well as the preflight, inflight, and postflight medical assessment and monitoring. The Johnson Space Center Medical Operations Branch is a leader in the practice of space medicine. The papers presented in this panel will demonstrate some of the unique aspects of space medicine.

Baisden, Denise L.

Toxicological Assessment of the International Space Station Atmosphere

Space-faring crews must have safe breathing air throughout their missions to ensure adequate performance and good health. Toxicological assessment of air quality depends on the standards that define acceptable air quality, measurements of pollutant levels during the flight, and reports from the crew on their in-flight perceptions of air quality. Air samples from ISS flight 2A showed that contaminants in the Zarya module were at higher concentrations than the Unity module. At the crew's first entry, the amount of non-methane volatile organic compounds (NMVOCs) in Zarya was 23 Mg/cubic meter, whereas in the amount of NMVOCs in Unity was 5.3 mg/cubic meter. Approximately 26 hours later at egress from the modules, the NMVOCs were comparable indicating good mixing of the atmospheres. The 2A crew reported no adverse health effects related to air pollution during their flight. Ingress air samples from 2A.1, which was flown more than 5 months after 2A, again showed that the Zarya had accumulated more unscrubbed pollutants than Unity. The NMVOCs in Unity were 3.5 mg/cubic meter, whereas the were 20 mg/cubic meter in Zarya. After almost 80 hours of ISS operations, the NMVOCs were 7.5 and 12 mg/cubic meter in Unity and Zarya, respectively. This suggests that the atmospheres in the modules were not mixing very well. The 2A.1 crew felt that the air quality in Zarya deteriorated when they were working in a group at close quarters, when the panels had been removed, and after they had worked in an area for some time. The weight of evidence suggests that human metabolic products (carbon dioxide, water vapor, heat) were not being effectively removed from the crew's work area, and these caused their symptoms. Additional local measurements of pollutants are planned for the 2A.2 mission to the ISS.

James, John T.

Toxicological Risks During Human Space Exploration

The goal of toxicological risk assessment of human space flight is to identify and quantify significant risks to astronaut health from air pollution inside the vehicle or habitat, and to develop a strategy for control of those risks. The approach to completing a toxicological risk assessment involves data and experience on the frequency and severity of toxicological incidents that have occurred during space flight. Control of these incidents depends on being able to understand their cause from in-flight and ground-based analysis of air samples, crew reports of air quality, and known failures in containment of toxic chemicals. Toxicological risk assessment in exploration missions must be based on an evaluation of the unique toxic hazards presented by the habitat location. For example, lunar and Martian dust must be toxicologically evaluated to determine the appropriate control measures for exploration missions. Experience with near-earth flights has shown that the toxic products from fires present the highest risk to crew health from air pollution. Systems and payload leaks also present a significant hazard. The health risk from toxicity associated with materials offgassing or accumulation of human metabolites is generally well controlled. Early tests of lunar and Martian dust simulants have shown that each posses the potential to cause fibrosis in the lung in a murine model. Toxicological risks from air pollutants in space habitats originate from many sources. A number of risks have been identified through near-earth operations; however, the evaluation of additional new risks present during exploration missions will be a challenge.

James, John T.

Training Select-in Interviewers for Astronaut Selection: A Program Evaluation

Psychological factors critical to the success of short and long-duration missions have been identified in previous research; however, evaluation for such critical factors in astronaut applicants leaves much room for human interpretation. Thus, an evaluator training session was designed to standardize the interpretation of critical factors, as well as the structure of the select-in interview across evaluators. The purpose of this evaluative study was to determine the effectiveness of the evaluator training sessions and their potential impact on evaluator ratings.

Hysong, S.

Medical Training Issues and Skill Mix for Exploration Missions

The approach for treating in-flight medical events during exploration-class missions must reflect the need for an autonomous crew, and cannot be compared to current space flight therapeutic protocols. An exploration mission exposes the crew to periods of galactic cosmic radiation, isolation, confinement, and microgravity deconditioning far exceeding the low-Earth orbital missions performed to date. In addition, exploration crews will not be able to return to Earth at the onset of a medical event and will need to control the situation in-flight. Medical consultations with Earth-based physicians will be delayed as much as 40 minutes, dictating the need for a highly-trained medical team on board. This presentation will address the mix of crew medical skills and the training required for crew health care providers for missions beyond low-Earth orbit. Both low- and high-risk options for medical skill mix and preflight training will be compared.

Janney, R. P.

Evaluation of Gas Chromatography/Mini-IMS to Detect VOCs

The Toxicology Laboratory at Johnson Space Center (JSC) has pioneered the use of gas chromatography-ion mobility spectrometry (GC/IMS) for measuring target volatile organic compounds (VOCs) aboard spacecraft. Graseby Dynamics, under contract to NASA/Wyle, has built several volatile organic analyzers (VOA) based on GC/IMS. Foremost among these have been the volatile organic analyzer-risk mitigation unit and the two flight VOA units for International Space Station (ISS). The development and evaluation of these instruments has been chronicled through presentations at the International Conference on Ion Mobility Spectrometry over the past three years. As the flight VOA from Graseby is prepared for operation on ISS at JSC, it is time to begin evaluations of technologies for the next generation VOA, Although the desired instrument characteristics for the next generation unit are the same as the current unit, the requirements are much more stringent. As NASA looks toward future missions beyond Earth environs, a premium will be placed upon small, light, reliable, autonomous hardware. It is with these visions in mind that the JSC Toxicology Laboratory began a search for the next generation VOA. One technology that is a candidate for the next generation VOA is GC/IMS. The recent miniaturization of IMS technology permits it to compete with other, inherently small, technologies such as chip-sized sensor arrays. This paper will discuss the lessons learned from the VOA experience and how that has shaped the design of a potential second generation VOA based upon GC/IMS technology. Data will be presented from preliminary evaluations of GC technology and the mini-IMS when exposed to VOCs likely to be detected aboard spacecraft. Results from the evaluation of an integrated GC/mini-IMS system will be shown if available.

Limero, Thomas

The Effects of Liquid Cooling Garments on Post-Space Flight Orthostatic Intolerance

Post space flight orthostatic intolerance among Space Shuttle crew members following exposure to extended periods of microgravity has been of significant concern to the safety of the shuttle program. Following the Challenger accident, flight crews were required to wear launch and entry suits (LES). It was noted that overall, there appeared to be a higher degree of orthostatic intolerance among the post-Challenger crews (approaching 30%). It was hypothesized that the increased heat load incurred when wearing the LES, contributed to an increased degree of orthostatic intolerance, possibly mediated through increased peripheral vasodilatation triggered by the heat load. The use of liquid cooling garments (LCG) beneath the launch and entry suits was gradually implemented among flight crews in an attempt to decrease heat load, increase crew comfort, and hopefully improve orthostatic tolerance during reentry and landing. The hypothesis that the use of the LCG during reentry and landing would decrease the degree of orthostasis has not been previously tested. Operational stand-tests were performed pre and post flight to assess crewmember's cardiovascular system's ability to respond to gravitational stress. Stand test and debrief information were collected and databased for 27 space shuttle missions. 63 crewpersons wearing the LCG, and 70 crewpersons not wearing the LCG were entered into the database for analysis. Of 17 crewmembers who exhibited pre-syncopal symptoms at the R+O analysis, 15 were not wearing the LCG. This corresponds to a 21% rate of postflight orthostatic intolerance among those without the LCG, and a 3% rate for those wearing LCG. There were differences in these individual's average post-flight maximal systolic blood pressure, and lower minimal Systolic Blood pressures in those without LCG. Though other factors, such as type of fluid loading, and exercise have improved concurrently with LCG introduction, from this data analysis, it appears that LCG usage provided a significant degree of protection from post-flight orthostatic intolerance.

Billica, Roger

Emergency medical services

When NASA was established in 1958, it was known that space flight would require efforts beyond those of NASA to ensure the health and safety of our astronauts. On 10 Aug. 1958, a Secretary of Defense memorandum was signed that assigned the first Department of Defense (DOD) Manager to provide support to NASA for Project Mercury. This established a chain of command through the Joint Chiefs of Staff to the Secretary of Defense. The current charter is dated 19 Mar. 1986 and assigns the DOD Manager responsibilities to the Commander and Chief, US Space Command. The DOD Managers charter has many support areas and among them are recovery of astronauts and medical support. Today these efforts support the Space Shuttle and Space Station Programs. Briefly, the program works with each organization tasking the other through a requirements document. Level of care, communications, and recovery requirements are established; NASA and the DOD provide the capability to meet them. NASA is also responsible for the specialized training and equipment needed to meet these requirements. A Shuttle launch a KSC requires an Emergency Medical Services (EMS) coordinator on console to facilitate communications, ensure proper coverage, and coordinate with area hospitals. A contingent of NASA medical personnel are assembled to provide triage and medical support capabilities. The DOD provides medical evacuation (MEDEVAC) helicopters with surgeons and pararescue specialists (PJ's) or emergency medical technicians (EMT's). Each helicopter is equipped with at least one doctor and one PJ/EMT per astronaut crew member. Transoceanic abort landing (TAL) sites and end of mission (EOM) sites have similar structures, with TAL sites utilizing fixed wingg aircraft for MEDEVAC. The DOD also supports contingency planning for the support and return of crew members from the Space Station Freedom. Much of this support has been directed at the recovery of crew members following the landing of an Assured Crew Return Vehicle.

Billica, Roger

The Portable Dynamic Fundus Instrument: Uses in telemedicine and research

For years ophthalmic photographs have been used to track the progression of many ocular diseases such as macular degeneration and glaucoma as well as the ocular manifestations of diabetes, hypertension, and hypoxia. In 1987 a project was initiated at the Johnson Space Center (JSC) to develop a means of monitoring retinal vascular caliber and intracranial pressure during space flight. To conduct telemedicine during space flight operations, retinal images would require real-time transmissions from space. Film-based images would not be useful during in-flight operations. Video technology is beneficial in flight because the images may be acquired, recorded, and transmitted to the ground for rapid computer digital image processing and analysis. The computer analysis techniques developed for this project detected vessel caliber changes as small as 3 percent. In the field of telemedicine, the Portable Dynamic Fundus Instrument demonstrates the concept and utility of a small, self-contained video funduscope. It was used to record retinal images during the Gulf War and to transmit retinal images from the Space Shuttle Columbia during STS-50. There are plans to utilize this device to provide a mobile ophthalmic screening service in rural Texas. In the fall of 1993 a medical team in Boulder, Colorado, will transmit real-time images of the retina during remote consultation and diagnosis. The research applications of this device include the capability of operating in remote locations or small, confined test areas. There has been interest shown utilizing retinal imaging during high-G centrifuge tests, high-altitude chamber tests, and aircraft flight tests. A new design plan has been developed to incorporate the video instrumentation into face-mounted goggle. This design would eliminate head restraint devices, thus allowing full maneuverability to the subjects. Further development of software programs will broaden the application of the Portable Dynamic Fundus Instrument in telemedicine and medical research.

Hunter, Norwood

Health maintenance facility: Dental equipment requirements

The objectives were to test the effectiveness of the Health Maintenance Facility (HMF) dental suction/particle containment system, which controls fluids and debris generated during simulated dental treatment, in microgravity; to test the effectiveness of fiber optic intraoral lighting systems in microgravity, while simulating dental treatment; and to evaluate the operation and function of off-the-shelf dental handheld instruments, namely a portable dental hand drill and temporary filling material, in microgravity. A description of test procedures, including test set-up, flight equipment, and the data acquisition system, is given.

Young, John

Dental equipment test during zero-gravity flight

The overall objectives of this program were to establish performance criteria and develop prototype equipment for use in the Health Maintenance Facility (HMF) in meeting the needs of dental emergencies during space missions. The primary efforts during this flight test were to test patient-operator relationships, patent (manikin) restraint and positioning, task lighting systems, use and operation of dental rotary instruments, suction and particle containment system, dental hand instrument delivery and control procedures, and the use of dental treatment materials. The initial efforts during the flight focused on verification of the efficiency of the particle containment system. An absorptive barrier was also tested in lieu of the suction collector. To test the instrument delivery system, teeth in the manikin were prepared with the dental drill to receive restorations, some with temporary filling materials and another with definitive filling material (composite resin). The best particle containment came from the combination use of the laminar-air/suction collector in concert with immediate area suction from a surgical high-volume suction tip. Lighting in the treatment area was provided by a flexible fiberoptic probe. This system is quite effective for small areas, but for general tasks ambient illumination is required. The instrument containment system (elastic cord network) was extremely effective and easy to use. The most serious problem with instrument delivey and actual treatment was lack of time during the microgravity sequences. The restorative materials handled and finished well.

Young, John

Application and use of spinal immobilization devices in zero-gravity flight

A KC-135 parabolic flight was performed for the purpose of evaluation of spinal immobilization techniques in microgravity. The flight followed the standard 40 parabola profile with four NASA/KRUG experimenters involved. One performed as coordinator/recorder, one as test subject, and two as the Crew Medical Officers (CMO). The flight was to evaluate the application of spinal immobilization devices and techniques in microgravity as are performed during initial stabilization or patient transport scenarios. The sequence of detail for examination of the following objectives included: attempted cervical spine immobilization with all free floating, the patient restrained to the floor, various hand positioning techniques; c-collar placement; Kendrick Extrication Device (KED) application with various restraints for patient and CMO; patient immobilization and transport using the KED; patient transported on KED and spine board. Observations for each task are included. Major conclusions and issues are also included.

Krupa, Debra T.

Minor surgery in microgravity

The purpose is to investigate and demonstrate equipment and techniques proposed for minor surgery on Space Station Freedom (SSF). The objectives are: (1) to test and evaluate methods of surgical instrument packaging and deployment; (2) to test and evaluate methods of surgical site preparation and draping; (3) to evaluate techniques of sterile procedure and maintaining sterile field; (4) to evaluate methods of trash management during medical/surgical procedures; and (4) to gain experience in techniques for performing surgery in microgravity. A KC-135 parabolic flight test was performed on March 30, 1990 with the goal of investigating and demonstrating surgical equipment and techniques under consideration for use on SSF. The flight followed the standard 40 parabola profile with 20 to 25 seconds of near-zero gravity in each parabola.

Billica, Roger

Venipuncture and intravenous infusion access during zero-gravity flight

The purpose of this experiment is to establish the difficulty associated with securing an intravenous (IV) catheter in place in microgravity flight and the techniques applicable in training the Crew Medical Officer (CMO) for Space Station Freedom, as well as aiding in the selection of appropriate hardware and supplies for the Health Maintenance Facility (HMF). The objectives are the following: (1) to determine the difficulties associated with venipuncture in a microgravity environment; (2) to evaluate the various methods of securing an IV catheter and attached tubing for infusion with regard to the unique environment; (3) to evaluate the various materials available for securing an intravenous catheter in place; and (4) to evaluate the fluid therapy administration system when functioning in a complete system. The inflight test procedures and other aspects of the KC-135 parabolic flight test to simulate microgravity are presented.

Krupa, Debra T.

Evaluation of cardiopulmonary resuscitation techniques in microgravity

Cardiopulmonary resuscitation (CPR) techniques were investigated in microgravity with specific application to planned medical capabilities for Space Station Freedom (SSF). A KC-135 parabolic flight test was performed with the goal of evaluating and quantifying the efficacy of different types of microgravity CPR techniques. The flight followed the standard 40 parabola profile with 20 to 25 seconds of near-zero gravity in each parabola. Three experiments were involved chosen for their clinical background, certification, and practical experience in prior KC-135 parabolic flight. The CPR evaluation was performed using a standard training mannequin (recording resusci-Annie) which was used in practice prior to the actual flight. Aboard the KC-135, the prototype medical restraint system (MRS) for the SSF Health Maintenance Facility (HMF) was used for part of the study. Standard patient and crew restraints were used for interface with the MRS. During the portion of study where CPR was performed without MRS, a set of straps for crew restraint similar to those currently employed for the Space Shuttle program were used. The entire study was recorded via still camera and video.

Billica, Roger

Fluid handling 2: Surgical applications

The methods proposed for managing fluids and particulate debris during minor surgery on Space Station Freedom (SSF) were investigated and demonstrated. A KC-135 parabolic flight test was performed, in which the flight followed the standard 40 parabola profile with 20 to 25 seconds in near-zero gravity in each parabola. The equipment (suction and laminar flow device) was evaluated. While this equipment performed satisfactorily previously in the dental simulation, the purpose of the current flight was to reconfigure the equipment in support of a minor surgical situation in order to evaluate its efficacy and establish clear requirements for the actual flight hardware. To accomplish the study the Health Maintenance Facility medical restraint system was deployed as for surgical use and mannequin suture arm was restrained to its surface. The surgical area was established as for performing minor surgery with standard tray and suture instruments employed.

Billica, Roger

Evaluation of prototype air/fluid separator for Space Station Freedom Health Maintenance Facility

A prototype air/fluid separator suction apparatus proposed as a possible design for use with the Health Maintenance Facility aboard Space Station Freedom (SSF) was evaluated. A KC-135 parabolic flight test was performed for this purpose. The flights followed the standard 40 parabola profile with 20 to 25 seconds of near-zero gravity in each parabola. A protocol was prepared to evaluate the prototype device in several regulator modes (or suction force), using three fluids of varying viscosity, and using either continuous or intermittent suction. It was felt that a matrixed approach would best approximate the range of utilization anticipated for medical suction on SSF. The protocols were performed in one-gravity in a lab setting to familiarize the team with procedures and techniques. Identical steps were performed aboard the KC-135 during parabolic flight.

Billica, Roger