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At least 55 records · Page 3

NASA Commercial Crew Program and Medical Operational Challenges

BACKGROUND: NASA embarked on the Commercial Crew Program to launch astronauts into low-earth orbit from US soil and dock with the International Space Station (ISS). The eventual industry providers selected were SpaceX (SpX) and Boeing. These commercial transportation systems are vital to ensure crew availability on ISS for research and discovery. OVERVIEW: NASA/SpaceX Demo-2 (DM2) mission launched from the Kennedy Space Center in 2020 as the historic first crewed test-flight of the Crew Dragon spacecraft with two NASA Astronauts onboard. DM2 represented the first flight in 9-years from US soil since STS-135 in 2011. The 63-day mission ended with splashdown in the Gulf of Mexico, the first US water recovery in 45-years since Apollo-Soyuz. Validation of system hardware and operations allowed four-person crews to launch on subsequently missions (Crew-1, Crew-2, Crew-3, Crew-4, Crew-5 to date), which included International Partner crewmembers. DISCUSSION: A multitude of operational, training, medical, and technical issues needed to be addressed between NASA Medical Operations, the commercial provider SpaceX, and the Department of Defense. These included Flight rule development, occupant protection, pressurized suit testing, communication plans during mission phases, and emergency simulations for supporting Flight Surgeons and Biomedical Engineers. In providing crew experience with expected launch and entry G-force profile, Centrifuge training was established. Preventive health measures via the Health Stabilization Program were especially vital during the global COVID-19 pandemic. Unique aspects arise for SpX Dragon parachute splashdown and shipboard recovery operations in the Atlantic Ocean and Gulf of Mexico. The new Commercial Crew Program is indeed a wonderfully challenging and exciting era for human spaceflight.

Joseph P Dervay↗

NASA Commercial Crew Program and Medical Operational Challenges

This abstract is submitted as part of the USSPACECOM Command Surgeon’s panel demonstrating the medical capabilities and challenges involved in human space flight support operations. BACKGROUND: NASA embarked on the Commercial Crew Program to launch astronauts into low-earth orbit from US soil and dock with the International Space Station (ISS). The eventual industry providers selected were SpaceX (SpX) and Boeing. These commercial transportation systems are vital to ensure crew availability on ISS for research and discovery. OVERVIEW: NASA/SpaceX Demo-2 (DM2) mission launched from the Kennedy Space Center in 2020 as the historic first crewed test-flight of the Crew Dragon spacecraft with two NASA Astronauts onboard. DM2 represented the first flight in 9-years from US soil since STS-135 in 2011. The 63-day mission ended with splashdown in the Gulf of Mexico, the first US water recovery in 45-years since Apollo-Soyuz. Validation of system hardware and operations allowed four-person crews to launch on subsequently missions (Crew-1, Crew-2, Crew-3, Crew-4, Crew-5 to date), which included International Partner crewmembers. DISCUSSION: A multitude of operational, training, medical, and technical issues needed to be addressed between NASA Medical Operations, the commercial provider SpaceX, and the Department of Defense. These included Flight rule development, occupant protection, pressurized suit testing, communication plans during mission phases, and emergency simulations for supporting Flight Surgeons and Biomedical Engineers. In providing crew experience with expected launch and entry G-force profile, Centrifuge training was established. Preventive health measures via the Health Stabilization Program were especially vital during the global COVID-19 pandemic. Unique aspects arise for SpX Dragon parachute splashdown and shipboard recovery operations in the Atlantic Ocean and Gulf of Mexico. The new Commercial Crew Program is indeed a wonderfully challenging and exciting era for human spaceflight.

Joseph Dervay↗

Medical/Scientific Illustration And Production Of Otological Health Awareness Materials

Over the past year, I have worked for my mentor, Beth Cooper, on a large variety of projects. Beth is the Manager of the Acoustical Testing Laboratory, which tests the acoustical emissions of payloads destined for the International Space Station. She is also responsible for educating, and developing new methods of educating, people of all occupational and educational backgrounds in hearing conservation. Beth spends much of her time developing new materials and strategies with which to train people and teach other people to train people in hearing conservation and noise emissions control. I have been helping Beth develop and market these materials by way of graphic design and scientific illustration. Last summer, I spent much of my time creating educational illustrations that visually explained particular concepts in Beth's presentations. Sometimes these illustrations were small "comics" while, at other times, they were an instructional series of illustrations. Since then, Beth and her lab have been developing and updating some materials which will be distributed free to hearing conservation and noise control professionals and others in related fields. I have helped with these projects by designing their packaging. In each instance, it was my responsibility to develop an aesthetically appealing package that would also, through its imagery, describe or summarize the contents of the product. I did this for 3 CD's (Auditory Demonstrations 11, MACSUG, and JeopEARdy) and saw them through their actual production and distribution. In addition to working with Beth, I work with the Imaging Technology Center on various imaging projects. Some of my activities include photo retouching and manipulation for videos and print. This summer, I also had the opportunity to develop a screen saver that would show of some of the photography contained on the soon-to-be-released "Highlights of the GRC Image Archives, vol. 2". I was also able to utilize my medical training to help several of ITC s videographers identify the best histological examples of cancerous cells for incorporation in one of their videos. Over the last part of this summer and then throughout the school year, I will be working with Beth to develop a "pre-packaged" lecture series about the physics of acoustics in the context of hearing conservation. These lectures will be used to teach people of all backgrounds the fundamental concepts involved in acoustical physics so they might be better aware of their own and others auditory health in and out of the work place, and, in the case of payload developers, to design and build more quiet science experiments for the ISS. Even though it may not seem as such, this project is precisely what I am learning to do as a student of the Cleveland Institute of Art's Medical Illustration Department. From my perspective, this project is about taking technical information and translating it into terms that anyone, regardless of background, can understand.

Hawes, Nicholas E.↗

Medical problems in space.

Interplanetary space travel medical problems during long duration missions, noting earth diagnostic and therapeutic methods adaptation, drugs selection, astronaut medical training, etc

Busby, D. E.↗

Small, low cost, artificial kidney

Disposable hemodialyzer is described that can be used at home by non-medically trained personnel. Short lengths of semipermeable membrane tubes are arranged in parallel, supported by plastic mesh and encased in epoxy at ends. Tubes are connected to input and output blood manifolds which are separated by dialysate chamber. Daily dialysis requires only two hours or less.

Lavender, A. R.↗

Skylab 4 crew observations

Comments on food, exercise, scheduling, medical training, the effect of fluid shift, and vestibular phenomena are briefly reported. A ballistocardiographic effect of around 60 beats per minute was observed several times for the whole Skylab cluster. Also experienced were light flashes that were well correlated with the South Atlantic anomaly.

E. G. Gibson↗

Vision Screening by Color Photography

Screening test developed for detecting a range of vision defects in eye, including common precursors to amblyopia. Test noninvasive, safe, and administered easily in field by operator with no medical training. Only minimal momentary cooperation of subject required: Thus, test shows promise for use with very young children. Test produces color-slide images of retinas of eyes under specially-controlled lighting conditions. Trained observer screens five children per minute.

Jayroe, R.↗

Medical Operation KC-135 Familiarization Flight

As new personnel join the Medical Operations Branch, it is critical that they understand the effects of microgravity on medical procedures, hardware, and supplies. The familiarization flight provided new personnel with a better understanding of the effects of microgravity on (1) medical procedures, (2) patient and rescuer restraint, (3) medical fluids, and (4) medical training for space flight. The flight process also provided experience in flight proposal preparation, flight test plan preparation and execution, and final report preparation. In addition, first time flyers gained insight on their performance level in microgravity for future flights.

Dawson, Chris↗

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↗

Comparison of Bystander Cardiopulmonary Resuscitation (BCPR) Performance in the Absence and Presence of Timing Devices for Coordinating Delivery of Ventilatory Breaths and Cardiac Compressions in a Model of Adult Cardiopulmonary Arrest

Astronaut crew medical officers (CMO) aboard the International Space Station (ISS) receive 40 hours of medical training during the 18 months preceding each mission. Part of this training ilncludes twoperson cardiopulmonary resuscitation (CPR) per training guidelines from the American Heart Association (AHA). Recent studies concluded that the use of metronomic tones improves the coordination of CPR by trained clinicians. Similar data for bystander or "trained lay people" (e.g. CMO) performance of CPR (BCPR) have been limited. The purpose of this study was to evailuate whether use of timing devices, such as audible metronomic tones, would improve BCPR perfomance by trained bystanders. Twenty pairs of bystanders trained in two-person BCPR performled BCPR for 4 minutes on a simulated cardiopulmonary arrest patient using three interventions: 1) BCPR with no timing devices, 2) BCPR plus metronomic tones for coordinating compression rate only, 3) BCPR with a timing device and metronome for coordinating ventilation and compression rates, respectively. Bystanders were evaluated on their ability to meet international and AHA CPR guidelines. Bystanders failed to provide the recommended number of breaths and number of compressions in the absence of a timing device and in the presence of audible metronomic tones for only coordinating compression rate. Bystanders using timing devices to coordinate both components of BCPR provided the reco number of breaths and were closer to providing the recommended number of compressions compared with the other interventions. Survey results indicated that bystanders preferred to use a metronome for delivery of compressions during BCPR. BCPR performance is improved by timing devices that coordinate both compressions and breaths.

Hurst, Victor, IV↗

Utilization of the Space Vision System as an Augmented Reality System For Mission Operations

Augmented reality is a technique whereby computer generated images are superimposed on live images for visual enhancement. Augmented reality can also be characterized as dynamic overlays when computer generated images are registered with moving objects in a live image. This technique has been successfully implemented, with low to medium levels of registration precision, in an NRA funded project entitled, "Improving Human Task Performance with Luminance Images and Dynamic Overlays". Future research is already being planned to also utilize a laboratory-based system where more extensive subject testing can be performed. However successful this might be, the problem will still be whether such a technology can be used with flight hardware. To answer this question, the Canadian Space Vision System (SVS) will be tested as an augmented reality system capable of improving human performance where the operation requires indirect viewing. This system has already been certified for flight and is currently flown on each shuttle mission for station assembly. Successful development and utilization of this system in a ground-based experiment will expand its utilization for on-orbit mission operations. Current research and development regarding the use of augmented reality technology is being simulated using ground-based equipment. This is an appropriate approach for development of symbology (graphics and annotation) optimal for human performance and for development of optimal image registration techniques. It is anticipated that this technology will become more pervasive as it matures. Because we know what and where almost everything is on ISS, this reduces the registration problem and improves the computer model of that reality, making augmented reality an attractive tool, provided we know how to use it. This is the basis for current research in this area. However, there is a missing element to this process. It is the link from this research to the current ISS video system and to flight hardware capable of utilizing this technology. This is the basis for this proposed Space Human Factors Engineering project, the determination of the display symbology within the performance limits of the Space Vision System that will objectively improve human performance. This utilization of existing flight hardware will greatly reduce the costs of implementation for flight. Besides being used onboard shuttle and space station and as a ground-based system for mission operational support, it also has great potential for science and medical training and diagnostics, remote learning, team learning, video/media conferencing, and educational outreach.

Maida, James C.↗

Design Constraints Regarding The Use Of Fluids In Emergency Medical Systems For Space Flight

The Exploration Medical Capability Project of the Human Research Program is tasked with identifying, investigating and addressing gaps existing gaps in either knowledge or technology that need to be addressed in order to enable safer exploration missions. There are several gaps that involve treatment for emergency medical situations. Some of these treatments involve the handling of liquids in the spacecraft environment which involve gas-liquid mixtures handling, dissolution chemistry and thermal issues. Some of the recent technology efforts include the Intravenous fluid generation (IVGEN) experiment, the In-Suit Injection System (ISIS) experiment, and medical suction. Constraints include limited volume, shelf life, handling biohazards, availability of power, crew time and medical training.

McQuillen, John↗

Exploration Atmosphere Demonstration of A Multi-Functional Integrated Medical Device (Tempus Pro)

INTRODUCTION The Exploration Medical Capability (ExMC) element within the Human Research Program and the Exploration Medical Integrated Product Team (XMIPT) within the Mars Campaign Office seek to advance medical system design and risk-informed decision-making for exploration missions. This includes assessment of candidate devices and their compatibility within a variety of increasingly Earth-independent medical scenarios. The Tempus Pro (Remote Diagnostic Technologies, Ltd., Philips Corp., Farnborough, UK) is a commercial-off-the-shelf (COTS), multi-functional integrated medical device capable of vital signs monitoring, with built-in procedure support (iAssist), patient record and telemedicine communication features, and medical imaging (e.g., camera, laryngoscope, ultrasound) that meets multiple exploration medical capability needs. One of several hypobaric atmospheres being considered for exploration vehicles is 8.2 psi with 34% oxygen. To assess the useability of the Tempus Pro in such environments by individuals without formal medical training, the unit was tested in May and June of 2023 at the Johnson Space Center 20-Foot Exploration Atmosphere Chamber in conjunction with the Exploration Atmospheres-2 (EA-2) study. TECHNOLOGY DEMONSTRATION Eight subjects in the EA-2 study were assigned roles as the caregiver or patient – or both in the case of a self-exam – and caregivers were asked to place sensors for 3-Lead ECG, non-invasive blood pressure (NIBP), pulse oximetry (SpO2), and temperature using Tempus Pro’s iAssist. Depending on the procedure, additional tasks included an oropharyngeal exam of the throat with the laryngoscope and capturing ultrasound images of a cardiac subxiphoid view or of the user’s choice from a pre-specified list. Scenarios ranged from remote-guided to fully autonomous operations and surveyed the effectiveness of support, amount of support desired, and importance of support by type (e.g., written crew procedures, iAssist and device guidance, remote console guidance, etc.). Feedback from the subjects and the support personnel was also gathered to inform future designs for training and support and to determine what operations are plausible given different levels of each. An unweighted NASA task load index (TLX) was used to profile the demands of using the device, however the sample size does not support statistics. The research was exploratory in nature and qualitative information was the main goal. Calibration checks on the Tempus Pro were conducted before and after chamber testing to ensure the device was in useable condition. RESULTS All subjects performed their tasks successfully and found the Tempus Pro easy to use with the support provided. The calibration checks outside the chamber showed that the Tempus Pro remained unchanged and measurements inside the chamber were within normal values. Caregivers taking the NASA TLX reported mean scores ≤ 41/100 showing the tasks to be undemanding and less demanding with repeated use (~20/100). Novice users were able to easily connect sensors and take vital signs with the guidance from Tempus Pro’s iAssist feature. For more complex tasks, such as the oropharyngeal exam and ultrasound image acquisition, guidance beyond iAssist was needed, primarily from a supporting physician. Feedback on the importance of support types varied by person and scenario but greater than 50% of the support used by each was non-native to the device. Overall opinions were positive, but the ultrasound users expressed a lack of confidence in their results and 3 out of 4 desired more time, training, or support. Subjects found the sensors to be comfortable and comparable to prior experiences with such devices, except for the blood pressure cuff, which squeezed too tightly for uncomfortably long periods. Many observations provoked discussion, especially regarding ultrasound, that will aide decisions about future demonstrations.

R. S. Miller↗

Earth Independent Medical Operations (EIMO) Training Technical Interchange Meeting, 26th October 2023: Background and Summary of Discussion

On 26th October 2023, ExMC convened a panel of Subject Matter Experts (SMEs) from NASA, broadly representing Headquarters, the Human Research Program, Medical Operations, the Human Health and Performance Directorate at JSC, the Health and Medical Technical Authority, the Flight Operations Directorate, and representation from other Centers including: Ames Research Center (ARC), and Glenn Research Center (GRC). Representatives from the Canadian Space Agency also participated in this TIM. In addition, SMEs from industry included representation from the following entities: Axiom Space, Space Exploration Technologies Corporation, Level Ex, Shiny Box Interactive. Additional SMEs from academia included: University of Houston, Touro University, Weill Cornell Medical College and the Translational Research Institute for Space Health at Baylor College of Medicine. This group of stakeholders discussed the training issues related to facilitating EIMO. Sub-topics for this discussion included the following: - Pre-launch medical curriculum development - Ground-based training on medical hardware - Dental health - Behavioral health - Telemedicine - Just-in-time training - Simulation-based training (extended reality)

CMO Training↗

Medical Support for ISS Crewmember Training in Star City, Russia

Medical support of spaceflight training operations across international lines is a unique circumstance with potential applications to other aerospace medicine support scenarios. KBRwyle's Star City Medical Support Group (SCMSG) has fulfilled this role since the Mir-Shuttle era, with extensive experience and updates to share with the greater AsMA community. OVERVIEW: The current Soyuz training flow for assigned ISS crewmembers takes place in Star City, Russia. Soyuz training flow involves numerous activities that pose potential physical and occupational risks to crewmembers, including centrifuge runs and pressurized suit simulations at ambient and hypobaric pressures. In addition, Star City is a relatively remote location in a host nation with variable access to reliable, Western-standard medical care. For these reasons, NASA's Human Health & Performance contract allocates full-time physician support to assigned ISS crewmembers training in Star City. The Star City physician also treats minor injuries and illnesses as needed for both long- and short-term NASA support personnel traveling in the area, while working to develop and maintain relationships with local health care resources in the event of more serious medical issues that cannot be treated on-site. The specifics of this unique scope of practice will be discussed. SIGNIFICANCE: ISS crewmembers training in Star City are at potential physical and occupational risk of trauma or dysbarism during nominal Soyuz training flow, requiring medical support from an on-duty aerospace medicine specialist. This support maintains human health and performance by preserving crewmember safety and well-being for mission success; sharing information regarding this operational model may contribute to advances in other areas of international, military, and civilian operational aerospace medicine.

Chough, Natacha↗

Medical Support for ISS Crewmember Training in Star City, Russia

Medical support of spaceflight training operations across international lines is a unique circumstance with potential applications to other aerospace medicine support scenarios. KBRwyle's Star City Medical Support Group (SCMSG) has fulfilled this role since the Mir-Shuttle era, with extensive experience and updates to share with the greater AsMA community. OVERVIEW: The current Soyuz training flow for assigned ISS crewmembers takes place in Star City, Russia. Soyuz training flow involves numerous activities that pose potential physical and occupational risks to crewmembers, including centrifuge runs and pressurized suit simulations at ambient and hypobaric pressures. In addition, Star City is a relatively remote location in a host nation with variable access to reliable, Western-standard medical care. For these reasons, NASA's Human Health & Performance contract allocates full-time physician support to assigned ISS crewmembers training in Star City. The Star City physician also treats minor injuries and illnesses as needed for both long- and short-term NASA support personnel traveling in the area, while working to develop and maintain relationships with local health care resources in the event of more serious medical issues that cannot be treated on-site. The specifics of this unique scope of practice will be discussed. SIGNIFICANCE: ISS crewmembers training in Star City are at potential physical and occupational risk of trauma or dysbarism during nominal Soyuz training flow, requiring medical support from an on-duty aerospace medicine specialist. This support maintains human health and performance by preserving crewmember safety and well-being for mission success; sharing information regarding this operational model may contribute to advances in other areas of international, military, and civilian operational aerospace medicine.

Chough, Natacha↗

Extreme Environments Development of Decision Processes and Training Programs for Medical Policy Formulation

The purpose of this workshop was to survey existing health and safety policies as well as processes and practices for various extreme environments; to identify strengths and shortcomings of these processes; and to recommend parameters for inclusion in a generic approach to policy formulation, applicable to the broadest categories of extreme environments. It was anticipated that two additional workshops would follow. The November 7, 2003 workshop would be devoted to the evaluation of different model(s) and a concluding expert evaluation of the usefulness of the model using a policy formulation example. The final workshop was planned for March 2004.

Stough, Roger↗

Scripting Scenarios for the Human Patient Simulator

The Human Patient Simulator (HPS) is particularly useful in providing scenario-based learning which can be tailored to fit specific scenarios and which can be modified in realtime to enhance the teaching environment. Scripting these scenarios so as to maximize learning requires certain skills, in order to ensure that a change in student performance, understanding, critical thinking, and/or communication skills results. Methods: A "good" scenario can be defined in terms of applicability, learning opportunities, student interest, and clearly associated metrics. Obstacles to such a scenario include a lack of understanding of the applicable environment by the scenario author(s), a desire (common among novices) to cover too many topics, failure to define learning objectives, mutually exclusive or confusing learning objectives, unskilled instructors, poor preparation , disorganized approach, or an inappropriate teaching philosophy (such as "trial by fire" or education through humiliation). Results: Descriptions of several successful teaching programs, used in the military, civilian, and NASA medical environments , will be provided, along with sample scenarios. Discussion: Simulator-based lessons have proven to be a time- and cost-efficient manner by which to educate medical personnel. Particularly when training for medical care in austere environments (pre-hospital, aeromedical transport, International Space Station, military operations), the HPS can enhance the learning experience.

Bacal, Kira↗