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All sourcesNASA NTRSDOE OSTI
NASA NTRSDate not supplied

Modeling Provider Creativity in Medical System Design Simulating a Medical MacGyver

This presentation describes a method for modeling provider creativity during the requirements building and risk assessment phase of medical system design. Practicing medicine in isolated, confined, and extreme environments requires providers to use limited supplies in creative ways. This is necessary to handle unexpected medical events or make better use of limited storage capacity by leaving low-use, bulky equipment behind in favor of in situ or dual-use resources. This is a highly-valued skillset in remote environments, however, the ability to simulate this care creativity computationally is difficult.

Brian Lonquich↗
NASA NTRSDate not supplied

Selection of Next Priority IMPACT Medical Conditions Based on Available Terrestrial and Spaceflight Data

BACKGROUND: As the era of exploration class missions begins, identification of medical conditions that may occur and require management becomes essential for the modeling of medical risk. To this end, NASA has developed IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces), a suite of tools to assist in assessment of medical risk analysis. It has incorporated an initial list of the 120 conditions of highest concern, labeled the IMPACT condition list 1.0 (ICL 1.0). This abstract describes a method for prioritizing the 92 conditions included on the Proposed Future Conditions List (PFCL) for inclusion in future iterations of the ICL. OVERVIEW: To construct the Prioritized Proposed Future Conditions List (P-PFCL), each condition on the PFCL was scored as “low,” “medium,” or “high” on each of four variables: incidence, likelihood of significant task impairment, diagnostic and treatment complexity, and treatment futility. Qualitative assessment using clinical judgement was utilized to score complexity, futility, and likelihood of impairment. Incidence was assessed quantitatively using spaceflight data and/or analog populations where available then assigned a score using established cutoffs. Logarithmic numerical values were assigned to each category label. A Prioritization Score was generated for each condition by taking the product of incidence and likelihood of task impairment (risk) divided by the product of complexity and futility (difficulty of care), with higher values corresponding to higher priority for future inclusion in the ICL. DISCUSSION: The described methods allow for the generation of a ranked P-PFCL to act as a decision support tool for selection of the next generation of modeled medical conditions. Some of the conditions ranked highly on the P-PFCL include EVA-related upper and lower extremity sprain/strain, iron deficiency, delirium, and hypertension, among others. While this effort does not attempt to quantify the absolute risk associated with each condition, it does attempt to semi-quantitatively estimate the risk of each condition relative to the other possible conditions. This tool in concert with subject matter expert opinion could optimize the future use of limited resources thereby producing a more accurate medical risk model, which will be essential to the upcoming exploration class missions.

Michael Pohlen↗
NASA NTRS1969

Apollo 7 to 11 - Medical Concerns and Results

The goal of the Apollo Program is to land men on the moon and safely return them to earth. The medical task thus outlined required confirmation of the Gemini findings and definition and solution of any problems encountered in the four Apollo flights prior to the Apollo 11 lunar landing. The medical concerns included the following: 1. The effect of decreased red blood cell mass and decreased exercise capacity and of cardiovascular de conditioning on the ability of the crew to do lunar-surface activity; 2. The capability to work effectively in one-sixth the force of gravity and the energy cost of such work; 3. The ability to get adequate rest and sleep in flight and on the lunar surface; 4. The prevention of preflight, inflight, and post-flight illness by proper preventive medicine; 5. The possible development of motion sickness of vestibular origin; 6. The conduct of a post-flight quarantine of crew and lunar samples. The results of the Apollo 7 to 11 missions, demonstrating the ability of man to handle this difficult task and the environment successfully, are discussed in detail and are related to the future of manned flight.

Berry, C. A.↗
NASA NTRS2007

Intravenous Solutions for Exploration Missions

This paper describes the intravenous (IV) fluids requirements being developed for medical care during NASA s future exploration class missions. Previous research on IV solution generation and mixing in space is summarized. The current exploration baseline mission profiles are introduced, potential medical conditions described and evaluated for fluidic needs, and operational issues assessed. We briefly introduce potential methods for generating IV fluids in microgravity. Conclusions on the recommended fluid volume requirements are presented.

Miller, Fletcher J.↗
NASA NTRS2013

Intravenous Fluid Generation System

The ability to stabilize and treat patients on exploration missions will depend on access to needed consumables. Intravenous (IV) fluids have been identified as required consumables. A review of the Space Medicine Exploration Medical Condition List (SMEMCL) lists over 400 medical conditions that could present and require treatment during ISS missions. The Intravenous Fluid Generation System (IVGEN) technology provides the scalable capability to generate IV fluids from indigenous water supplies. It meets USP (U.S. Pharmacopeia) standards. This capability was performed using potable water from the ISS; water from more extreme environments would need preconditioning. The key advantage is the ability to filter mass and volume, providing the equivalent amount of IV fluid: this is critical for remote operations or resource- poor environments. The IVGEN technology purifies drinking water, mixes it with salt, and transfers it to a suitable bag to deliver a sterile normal saline solution. Operational constraints such as mass limitations and lack of refrigeration may limit the type and volume of such fluids that can be carried onboard the spacecraft. In addition, most medical fluids have a shelf life that is shorter than some mission durations. Consequently, the objective of the IVGEN experiment was to develop, design, and validate the necessary methodology to purify spacecraft potable water into a normal saline solution, thus reducing the amount of IV fluids that are included in the launch manifest. As currently conceived, an IVGEN system for a space exploration mission would consist of an accumulator, a purifier, a mixing assembly, a salt bag, and a sterile bag. The accumulator is used to transfer a measured amount of drinking water from the spacecraft to the purifier. The purifier uses filters to separate any air bubbles that may have gotten trapped during the drinking water transfer from flowing through a high-quality deionizing cartridge that removes the impurities in the water before entering the salt bag and mixing with the salt to create a normal saline solution.

McQuillen, John↗
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 NTRS2015

Alternative Nonvolatile Residue Analysis with Contaminant Identification Project

Cleanliness verification is required in numerous industries including spaceflight ground support, electronics, medical and aerospace. Currently at KSC requirement for cleanliness verification use solvents that environmentally unfriendly. This goal of this project is to produce an alternative cleanliness verification technique that is both environmentally friendly and more cost effective.

Technology Portfolio System↗
NASA NTRS2019

IMPACT Concept of Operations

NASA’s future exploration missions mandate a significant paradigm change for mission planning, spacecraft design, human systems integration, and in-flight medical care due to constraints on mass, volume, power, resupply missions, and medical evacuation capabilities. These constraints require further development of the human health and performance system, which includes the medical, task performance, wellness, data, human and other systems necessary to keep the crew healthy and functioning optimally. The human health and performance system will be tightly integrated with mission and habitat design to provide a sufficient human health and performance infrastructure to enable mission success. A suite of systems engineering tools will aid in the decision making process for the development of such a human health and performance system. This Concept of Operations provides a vision for a tool suite to conduct evaluations of human health and performance system options, inform research prioritization, and provide trade study support, based on evidence, risks, and systems engineering principles. The integrated tool suite under development is IMPACT.

Lumpkins, Sara↗
NASA NTRS2015

Evaluation of the Oxygen Concentrator Prototypes: Pressure Swing Adsorption Prototype and Electrochemical Prototype

An oxygen concentrator is needed to provide enriched oxygen in support of medical contingency operations for future exploration human spaceflight programs. It would provide continuous oxygen to an ill or injured crew member in a closed cabin environment. Oxygen concentration technology is being pursued to concentrate oxygen from the ambient environment so oxygen as a consumable resource can be reduced. Because oxygen is a critical resource in manned spaceflight, using an oxygen concentrator to pull oxygen out of the ambient environment instead of using compressed oxygen can provide better optimization of resources. The overall goal of this project is to develop an oxygen concentrator module that minimizes the hardware mass, volume, and power footprint while still performing at the required clinical capabilities. Should a medical event occur that requires patient oxygenation, the release of 100 percent oxygen into a small closed cabin environment can rapidly raise oxygen levels to the vehicles fire limit. The use of an oxygen concentrator to enrich oxygen from the ambient air and concentrate it to the point where it can be used for medical purposes means no oxygen is needed from the ultra-high purity (99.5+% O2) oxygen reserve tanks. By not adding oxygen from compressed tanks to the cabin environment, oxygen levels can be kept below the vehicle fire limit thereby extending the duration of care provided to an oxygenated patient without environmental control system intervention to keep the cabin oxygen levels below the fire limits. The oxygen concentrator will be a Food and Drug Administration (FDA) clearable device. A demonstration unit for the International Space Station (ISS) is planned to verify the technology and provide oxygen capability. For the ISS, the demonstration unit should not exceed 10 kg (approximately 22 lb), which is the soft stowage mass limit for launch on resupply vehicles for the ISS. The unit's size should allow for transport within the spacecraft to an ill crewmember. The user interface needs to be designed for ease of use by the local care provider and with consideration to the limited amount of training available to the astronaut corps for medical equipment and procedures.

Gilkey, Kelly M.↗
NASA NTRS2012

In-Flight Laboratory Analysis

One‐year study objectives align with HRP requirements. HRP requirements include measurement panels for research and medical operations - These measurement panels are distinctly different. Instrument requirements are defined - Power, volume and mass not quite a critical limitation as for medical operations (deep space exploration missions). One‐year evaluation goals will lead HHC towards in‐flight laboratory analysis capability.

Baumann, David↗
NASA NTRS2003

The TERESA project: from space research to ground tele-echography

Ultrasound examinations represent one of the major diagnostic modalities of future healthcare. They are currently used to support medical space research but require a high skilled operator for both probe positioning on the patient's skin and image interpretation. TERESA is a tele-echography project that proposes a solution to bring astronauts and remotely located patients on ground quality ultrasound examinations despite the lack of a specialist at the location of the wanted medical act.

Space Flight/instrumentation↗
NASA NTRS2010

Effectiveness of Needleless Vial Adaptors and Blunt Cannulas for Drug Administration in a Microgravity Environment

Fluid Isolation in the medication vial: Air/ fluid isolation maneuvers were used to move the medication to the septum end of vial. This isolation may be achieved in multiple ways based on the experience of the astronaut with fluid management in microgravity. If vial adaptors/blunt cannula or syringe assembly is inserted into the to vial before fluid isolation commences, the stability of this assembly should be considered in an effort to limit the risk of "slinging off" of the vial during isolation. Alternatively, fluid isolation can be performed prior to attaching the syringe/vial adaptor assembly. Terrestrial practices for medication withdrawal from a nonvented vial require injection of an equivalent amount of air as the expected medication volume prior to withdrawing liquid. In microgravity, this action is still valid, however the injection of additional air into the vial creates a multitude of micro bubbles and increases the volume of medication mixed with air that then must be withdrawn to achieve the desired drug volume in syringe. This practice is more likely to be required when using vials >30ml in size and injection volumes >10mL. It is felt that based on the microgravity flight, the practice of air injection is more of a hindrance than help.

Hailey, M.↗
NASA NTRSDate not supplied

Comparison of Artemis 2 and Artemis 5 Model Outcomes Using the Impact Probabilistic Risk Assessment Tool

BACKGROUND The Artemis campaign is a Moon exploration program with a series of six planned missions, five of which will be crewed. These five crewed missions will contain a single mission segment (space flight), or multiple mission segments involving space flight (Orion), lunar landing (LTV) and/or space habitat (Gateway). Each crewed segment faces the risk of unique medical conditions, necessitating medical sets/kits tailored to those specificities. To support and enable a data-driven and evidence-based decision-making process through out a mission’s life cycle, a software tool called IMPACT was developed. Using probabilistic risk assessment (PRA) methodologies, IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a novel tool built for analyzing the possibility of encountering complex medical risks during space flight, and for identifying the medical resources and capabilities needed to treat those potential at-risk medical conditions. This presentation will seek to compare IMPACT’s computational results upon potential complex space medical conditions (e.g., sprain/strain back or sleep disturbance) using IMPACT’s risk metrics and the associated optimized medical sets/kits between two Artemis missions: single segment Artemis 2 and multi-segmented Artemis 5. OVERVIEW By identifying potential medical conditions in space using input criteria such as crew quantity and composition, certain crew physical characteristics, mission duration and mission activities, IMPACT can produce analyses on the type of medical resources and capabilities needed to produce an optimized medical set/kit to address those medical conditions. IMPACT achieves this by performing hundreds of thousands of Monte Carlo simulations of missions to build aggregate pictures of medical risk. IMPACT’s risk metrics include loss of crew life (LOCL) – a measure of crew mortality due to medical conditions in space, return to definitive care (RTDC) – the need to perform crew evacuation, and task time lost (TTL) – a measure of the inability to perform activities due to crew disability. These risk metrics are applied to every medical condition identified by IMPACT’s computation analyses for every segment of the mission. Medical sets/kits are optimized to address these medical conditions but must fit within the stated Artemis Design Reference Mission (DRM) request for mass and volume physical size constraints. ANTICIPATED ANALYSIS AND CONCLUSION Using two Artemis missions, Artemis 2 and Artemis 5, IMPACT will provide the analyses for comparison of medical set/kit contents based upon mass and/or volume requirements and identify the at-risk medical conditions within both missions. This paper serves as an initial exploration of probabilistic risk assessment (PRA) medical risk calculations between two crewed Artemis missions and is not intended to be deemed the official medical response for the Artemis campaign.

probabilistic risk assessment↗
NASA NTRS2025

Limitations and Feasibility of Mini X-Ray Devices in Space Environments

LIMITATIONS AND FEASIBILITY OF MINI X-RAY DEVICES IN SPACE ENVIRONMENTS As space exploration advances toward long-duration missions, reliable medical diagnostic tools become increasingly critical. The miniature x-ray (XR) technology demonstrations by the Exploration Medical Capability (ExMC) and the Exploration Medical Integrated Product Team (XMIPT) aim to assess the feasibility and utility of miniature XR devices in spaceflight. This abstract explores the limitations of current miniature XR systems, the challenges of training crew members, the potential role of clinical decision support systems (CDSS), and the feasibility of ground-based image interpretation. We also propose the integration of miniature XR into other ExMC efforts aimed at identifying the capabilities and resources needed for future exploration class missions. One of the primary challenges with miniature XR devices is the ability to achieve specific anatomical views, particularly in the confined and weightless conditions of a spacecraft. Operators may struggle to acquire diagnostic-quality images when space is limited for proper patient positioning and the volume of the imaging device. Since space radiation and detector limitations may further impact image quality, the flexibility of the operating procedures of these devices will be critical for their success in space applications. CHALLENGES IN TRAINING CREW TO OPERATE IMAGING DEVICES Training in the skills necessary to acquire diagnostic-quality scans may be a barrier for non-clinician crewmembers. The curriculum developed for crew medical officers (CMOs) will require simplification and adaptation to fit into the highly truncated pre-flight training period. Therefore, hands-on familiarization and simulation, both pre-flight and just-in-time training during missions, will be crucial to ensuring the crew can operate the devices in real-life situations. The ability to adjust acquisition parameters must be simplified or made automatic through exam selections on equipment user interfaces, and subject and operator positioning should be assisted with laser guidance and pictorial guides. POTENTIAL FOR CDSS OR ARTIFICIAL INTELLIGENCE (AI)-ASSISTED CDSS CDSS and AI-assisted CDSS offer significant promise in assisting crew members with limited medical training. These systems could provide real-time feedback on image quality and interpretation, helping to mitigate the risks of human error during space missions. Integrating procedural guidance tools, such as virtual and augmented reality, will support crewmembers in accurately positioning patients and obtaining high-quality images. However, the success of such systems will depend on the development of robust training datasets, integration with spaceflight-rated hardware, and the medical decision-making capabilities of operators. FEASIBILITY OF GROUND INTERPRETATION AND DATA TRANSMISSION Reliance on ground-based interpretation may prove difficult for acute care during exploration class-missions due to delays in transmission with increasing distance from Earth or complete communication blackout periods. In such instances where immediate interpretation for clinical intervention is required, crew must be able to interpret the images independently or utilize AI-based assistance to do so. File sizes for XR exams can also be large if numerous images are acquired and bandwidth constraints may limit data transmissions for both radiography and ultrasound exams. FUTURE WORK AND INTEGRATION INTO THE EVIDENCE LIBRARY Future work proposes integrating miniature XR devices into NASA’s Evidence Library to address medical conditions identified as significant contributors to crew morbidity and mortality. The possibility of combining miniature XR with other imaging modalities, such as ultrasound devices, is also under investigation. In conclusion, while miniature XR technology holds potential for extraterrestrial medical systems, there are significant challenges to overcome. Training, integration of AI tools, dedicated exam protocols for microgravity, and improved data transmission systems will be key to realizing the full benefits of miniature XR technology in space.

A M Nelson↗
NASA NTRS1979

Cardiology Mannequin

Education of medical students in cardiology requires access to patients having a variety of different forms of heart disease. But bringing together student, instructor and patient is a difficult and expensive process that does not benefit the patient. An alternate approach is substitution of a lifelike mannequin capable of simulating many conditions of heart disease. The mannequin pictured below, together with a related information display, is an advanced medical training system whose development benefited from NASA visual display technology and consultative input from NASA's Kennedy Space Center. The mannequin system represents more than 10 years of development effort by Dr. Michael S. Gordon, professor of cardiology at the University of Miami (Florida) School of Medicine.

Source record↗
DOE OSTI2021

Gene expression for biodosimetry and effect prediction purposes: promises, pitfalls and future directions – key session ConRad 2021

In a nuclear or radiological event, an early diagnostic or prognostic tool is needed to distinguish unexposed from low- and highly exposed individuals with the latter requiring early and intensive medical care. Radiation-induced gene expression (GE) changes observed within hours and days after irradiation have shown potential to serve as biomarkers for either dose reconstruction (retrospective dosimetry) or the prediction of consecutively occurring acute or chronic health effects. The advantage of GE markers lies in their capability for early (1–3 days after irradiation), high-throughput, and point-of-care (POC) diagnosis required for the prediction of the acute radiation syndrome (ARS).

61 RADIATION PROTECTION AND DOSIMETRY↗
NASA NTRS2013

The Lifetime Surveillance of Astronaut Health (LSAH) Project

From 1989-2010 NASA conducted a research study, the Longitudinal Study of Astronaut Health, to investigate the incidence of acute and chronic morbidity and mortality in astronauts and to determine whether their occupational exposures were associated with increased risk of death or disability. In 2004, the Institute of Medicine recommended that NASA convert the longitudinal study into an occupational health surveillance program and in 2010, NASA initiated the Lifetime Surveillance of Astronaut Health project. The new program collects data on astronaut workplace exposures, especially those occurring in the training and space flight environments, and conducts operational and health care analyses to look for trends in exposure and health outcomes. Astronaut selection and retention medical standards are rigorous, requiring an extensive clinical testing regimen. As a result, this employee population has contributed to a large set of health data available for analyses. Astronauts represent a special population with occupational exposures not typically experienced by other employee populations. Additionally, astronauts are different from the general population in terms of demographic and physiologic characteristics. The challenges and benefits of conducting health surveillance for an employee population with unique occupational exposures will be discussed. Several occupational surveillance projects currently underway to examine associations between astronaut workplace exposures and medical outcomes will be described.

Bopp, Eugenia↗
NASA NTRS2023

Exploration Medical Capability Clinical Decision Support System Architecture Recommendation

A new era in space exploration has arrived with the goal of establishing a long-term presence on the Moon and using those learning to take the next giant leap: sending the first astronauts to Mars. These ambitious goals will require significant changes in in-flight medical care due to constraints on mass, volume, power, crew time, and medical evacuation capabilities. Furthermore, while crews currently rely on real-time communications with ground-based medical providers, as distance from Earth increases, so do communication delays and disruptions. The crew will need to autonomously detect, diagnose, treat, and prevent medical events. These constraints require development of transformative solutions and new technologies. Through participation in the Human Research Program’s (HRP) Exploration Medical Capability (ExMC) research, NASA has developed and demonstrated a Medical Data Architecture (MDA), a platform upon which a robust capability of Clinical Decision Support (CDS) can be built. As a result, NASA is now positioned to build an advanced autonomous CDS System (CDSS) which will aid in crew health decision-making. The CDSS combines data management aspects of a system that would lead to the autonomy required by NASA-STD-3001, Section 3, Health and Medical Care Standards. The project addresses the ExMC gap Medical-701: We need to increase inflight medical capabilities and identify new capabilities that (a) maximize benefit and/or (b) reduce “costs” on human system/mission/vehicle resources. This architecture recommendation document introduces an integrated data architecture that provides self-sufficient medical care for crews on long-duration spaceflight missions.

ExMC↗