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At least 127 records · Page 7
All sourcesNASA NTRSDOE OSTI
NASA NTRS1992

A prototype Crew Medical Restraint System (CMRS) for Space Station Freedom

The Crew Medical Restrain System (CMRS) is a prototype system designed and developed for use as a universally deployable medical restraint/workstation on Space Station Freedom (SSF), the Shuttle Transportation System (STS), and the Assured Crew Rescue Vehicle (ACRV) for support of an ill or injured crewmember requiring stabilization and transportation to Earth. The CMRS will support all medical capabilities of the Health Maintenance Facility (HMF) by providing a restraint/interface system for all equipment (advance life support packs, defibrillator, ventilator, portable oxygen supply, IV pump, transport monitor, transport aspirator, and intervenous fluids delivery system) and personnel (patient and crew medical officers). It must be functional within the STS, ACRV, and all SSF habitable volumes. The CMRS will allow for medical capabilities within CPR, ACLS and ATLS standards of care. This must all be accomplished for a worst case transport time scenario of 24 hours from SSF to a definitive medical care facility on Earth. A presentation of the above design prototype with its subsequent one year SSF/HMF and STS/ACRV high fidelity mock-up ground based simulation testing will be given. Also, parabolic flight and underwater Weightless Test Facility evaluations will be demonstrated for various medical contingencies. The final design configuration to date will be discussed with future space program impact considerations.

Johnston, S. L.↗
NASA NTRSDate not supplied

Developing Mars-Based Clinical Scenarios for an Earth Independent Medical Operations (EIMO) – Based Decision Support Service

As crewed missions move beyond Low-Earth Orbit, pre-mission planning cannot fully buy down the medical risks of exploration-class missions. Martian missions, where increased hazards exist, (such as long-duration spaceflight, surface-level EVA operations, and communications delays) will require a paradigm shift in the structure of a medical system. An Earth-Independent Medical Operations-based Medical System (EIMO-MS) will need to optimize four critical domains to help provide medical care: utilization of Pre-Mission Planning, augmentation of Acute and Prolonged Medical Decision Making, automated tracking of Resource Management, and assistance in Task Load Balance. The ideal EIMO-MS will be able to accomplish this goal by having an interactive, adaptable interface that will be able to provide real-time medical services. It must respond based on the level of crewmember training, medical situation, and available medical and non-medical resources. To showcase the capabilities and requirements of such a sophisticated automated MS, a series of clinical scenarios of escalating complexity were developed with clinical and systems engineering input. These scenarios describe in clinical detail what a theoretical future medical system, enhanced with multiple information streams (such as a medical database, an AI-based Decision Support System, real-time monitoring, enhanced in-situ laboratory imaging, etc.) can achieve in conjunction with a trained and experienced crew. Scenarios are comprised of: a context section including objectives and applicable spaceflight environment, a highlighted assumptions section, a clinical narrative section, and a systems engineering activity diagram demonstrating the integrated Medical System (MS). The “swim lanes” of the activity diagram act as the logistical core of each scenario and show how the MS will interact with the crew, ground support, and other in-flight systems. The Design Reference Mission that is used for the scenarios is based on existing reference mission profiles [1] with a projected 30-sol stay on the Martian surface. Scenarios span the spectrum from planned evaluations, minor medical care, urgent care, surgical guidance, critical and expectant management, and behavioral health care. Mission complexity will exponentially increase during deep space and Mars exploration-class missions, and medical support for these missions will likewise need to increase in autonomy and adaptability. The integrated system that will support these missions will need to provide assistance in a variety of anticipated and unforeseen scenarios. These medical scenarios, guided by clinician input, are initial steps in crafting the requirements for an EIMO-based medical system. By working in a systems engineering framework, requirements and capabilities can be extracted and mapped while maintaining a clinical core.

Prashant Parmar↗
NASA NTRS2020

Medical Data Architecture Platform and Recommended Requirements for A Medical Data System for Exploration Missions

Minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm of medical data management on the International Space Station. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products derived from the third MDA prototype development will directly inform exploration medical system requirements for Level of Care IV in Gateway missions.In fiscal year 2019, the MDA project developed Test Bed 3, the third iteration in a series of prototypes, that featured integrations with cognition tool data, ultrasound image analytics and core Flight Software (cFS). Maintaining a layered architecture design, the framework implemented a plug-in, modular approach in the integration of these external data sources. An early version of MDA Test Bed 3 software was deployed and operated in a simulated analog environment that was part of the Next Space Technologies for Exploration Partnerships (NextSTEP) Gateway tests of multiple habitat prototypes. In addition, the MDA team participated in the Gateway Test and Verification Demonstration, where the MDA cFS applications was integrated with Gateway-in-a-Box software to send and receive medically relevant data over a simulated vehicle network. This software demonstration was given to ExMC and Gateway Program stakeholders at the NASA Johnson Space Center Integrated Power, Avionics and Software (iPAS) facility. Also, the integrated prototypes served as a vehicle to provide Level 5 requirements for the Crew Health and Performance Habitat Data System for Gateway Missions (Medical Level of Care IV). In the upcoming fiscal year, the MDA project will continue to provide systems engineering and vertical prototypes to refine requirements for medical Level of Care IV and inform requirements for Level of Care V.

Krihak, M.↗
NASA NTRS1976

Portable medical status system

The hazards inherent in the Portable Medical Status System are identified, and the measures taken to reduce them to an acceptable level are described. Identification of these hazards is a prerequisite to use of the system on humans in the earth environment. One hazard which is insufficiently controlled and which is considered a constraint to use on humans is the level of current possible in the electrodes for the EEG (electroencephalograph) circuitry. It exceeds the maximum specified. A number of procedural and design recommendations for enhancement of safety are made.

Lindsey, O. C.↗
NASA NTRSDate not supplied

Improving the Fidelity of Capability & Resource Weighting in A Probalistic Risk Assessment Model for Spaceflight

INTRODUCTION NASA’s Informing Mission Planning via Analysis of Complex Tradespaces (IMPACT) tool uses Probabilistic Risk Assessment (PRA) to provide an evidence-based, data-driven estimate of how medical system capabilities affect mission outcomes. IMPACT maps condition incidence to available resources thereby facilitating the calculation of outcome metrics that allow the estimation of mission medical risk. Conditions can be nominally categorized as either treated or untreated depending on the availability of necessary diagnostic and therapeutic capabilities. This categorization enables IMPACT to estimate the effect of various medical system configurations on mission outcomes such as crew mortality, disability, crew member down-time, return to duty/recovery, and need for evacuation. IMPACT currently employs an equal weighting, “partial credit” approach to define treatment in which each of the capabilities associated with a given condition contributes an equal amount to management of the condition. This feature enables IMPACT to report values in between “fully untreated” and “fully treated” based on the proportion of capabilities available within the model. However, as is normal in medical/clinical practice, not all individual capabilities contribute equally to medical care. For example, the ability to provide intramuscular epinephrine during an anaphylactic episode contributes more likelihood of overall management success than does the administration of oral diphenhydramine. We hypothesize that weighting the relative contribution of each capability to each specific condition will improve outcome prediction and therefore will better provide mission planners with more nuanced and accurate options when designing space medical systems. METHODS Using a five-point Fibonacci scaling sequence (1, 2, 3, 5, 8) subject matter experts from NASA’s Exploration Medical Capabilities (ExMC) element assigned relative contribution weighting values to each identified capability within IMPACT. Since the relative importance of each capability varies depending on the specific condition, the resulting “partial” weighting was completed for more than 1,600 individual weighting assignments for 666 capabilities across 121 conditions. Each assignment required three-physician concurrence based on the overall importance of the capability to the diagnosis and management of the condition being considered and the difficulty with which it could be improvised by the crew. Once complete, 100,000 IMPACT simulations were run for a 6-month Lunar mission with a 30-day surface stay to evaluate the effect of this modification of the model. RESULTS Partial weighting significantly decreased predicted task time loss (TTL), evacuation, and loss of crew life without causing significant changes to the recommended medical system design. CONCLUSIONS The paucity of real-world referent data to support long-duration space missions of this type limits the ability to judge one predictive analytics method as superior to another. However, since the proposed method significantly reduces and optimizes outcome risks—without changing the medical system design—incorporating a partial weighting methodology is likely to provide a more accurate and operationally-relevant representation of medical risk without compromising IMPACTs ability to inform overarching medical system requirements.

Steller JG↗
NASA NTRSDate not supplied

What Has ExMC Systems Engineering Been Up To Since Last IWS?

Long duration Lunar and Martian missions will change the way NASA currently practices medicine. The missions will require more autonomous capability compared to current low Earth orbit operations. For the medical system, lack of consumable resupply, evacuation opportunities, and real-time ground support are key drivers toward greater autonomy. Recognition of the limited mission and vehicle resources available to carry out exploration missions motivates the Exploration Medical Capability (ExMC) Element’s approach to enabling the necessary autonomy. This element promotes human health and performance in space by advancing medical systems design and risk-informed decision-making for long-duration deep-space exploration missions (LDEMs). ExMC is using system engineering processes and Model-Based System Engineering (MBSE) tools to identify the user needs and requirements of LDEM medical systems. The MBSE approach to medical system design offers a paradigm shift toward greater integration between the vehicle and the medical system, and directly supports the transition of Earth-reliant International Space Station operations to the Earth-independent operations envisioned for LDEMs. This talk will provide a high-level overview of what the ExMC SE team has accomplished since the last IWS, an introduction to upcoming SE talks, and the ongoing systems engineering work.

K. McGuire↗
NASA NTRS1991

Medical Imaging System

The MD Image System, a true-color image processing system that serves as a diagnostic aid and tool for storage and distribution of images, was developed by Medical Image Management Systems, Huntsville, AL, as a "spinoff from a spinoff." The original spinoff, Geostar 8800, developed by Crystal Image Technologies, Huntsville, incorporates advanced UNIX versions of ELAS (developed by NASA's Earth Resources Laboratory for analysis of Landsat images) for general purpose image processing. The MD Image System is an application of this technology to a medical system that aids in the diagnosis of cancer, and can accept, store and analyze images from other sources such as Magnetic Resonance Imaging.

Source record↗
NASA NTRSDate not supplied

Bringing the Flight Surgeon Console Into the Artemis Era: Constructing A Quick Reference Guide for the Orion Vehicle

BACKGROUND: Historically, NASA flight surgeons working on control console have had access to a quick reference guide that provides tailored clinical information for a variety of medical conditions, symptoms, and events that crew members may experience on the International Space Station (ISS). With the development of the Orion vehicle and its new medical system intended for the Artemis missions, a new quick reference guide is required to reflect the capabilities of this new medical system. OVERVIEW: The Flight Surgeon Quick Reference Guide(FSQRG)offers a variety of information to flight surgeons. For each condition/symptom/event, the guide describes what actions and procedures crew members will perform either automatically or at the instruction of the flight surgeon. The guide describes what further information should be collected, lists potential diagnoses, and further actions available to be taken by the Flight Surgeon or crew. The guide also describes what medications are available to the crew, common clinical decision-making tools, and other terrestrial practices. Due to the significant differences between the ISS and the Orion vehicle in both structure and mission scope, Orion’s medical system is significantly smaller than the ISS’s. When constructing the new guide for the Orion vehicle we began with the ISS version of the guide as a template. We then replaced ISS crew procedure references with their Orion counterpart if one existed. We also added new Orion crew procedure references where clinically appropriate. Reductions or additions to the medical equipment/medication references were made until they were consistent with resources available on Orion. Finally, we constructed a resource matrix that allows flight surgeons to easily identify the location of medications and equipment required for crew procedures. DISCUSSION: The information provided in the updated FSQRG allows flight surgeons to make quick and clinically accurate decisions that can be accomplished within the scope of the Orion vehicle medical system. This timely and accurate decision making becomes more important as missions go beyond low earth orbit and communication becomes more delayed. Such quick reference guides also have the potential to reflect medical systems on future vehicles, missions, and partner vehicles.

Anderson carter↗
NASA NTRS1990

Cardiac Imaging System

Although not available to all patients with narrowed arteries, balloon angioplasty has expanded dramatically since its introduction with an estimated further growth to 562,000 procedures in the U.S. alone by 1992. Growth has fueled demand for higher quality imaging systems that allow the cardiologist to be more accurate and increase the chances of a successful procedure. A major advance is the Digital Cardiac Imaging (DCI) System designed by Philips Medical Systems International, Best, The Netherlands and marketed in the U.S. by Philips Medical Systems North America Company. The key benefit is significantly improved real-time imaging and the ability to employ image enhancement techniques to bring out added details. Using a cordless control unit, the cardiologist can manipulate images to make immediate assessment, compare live x-ray and roadmap images by placing them side-by-side on monitor screens, or compare pre-procedure and post procedure conditions. The Philips DCI improves the cardiologist's precision by expanding the information available to him.

Source record↗
NASA NTRS2019

8.4 M Deep Space Habitat– Medical Bay Concept Design and Human Factors Engineering Analysis

Maintaining crew health throughout long duration deep space missions presents significant new design challenges. Since communication with Earth will be limited and it is not possible to return in the event of a medical emergency it is critical that medical care on a deep space mission be as autonomous as possible. The goal of this project was to design and assess a medical system concept for the Deep Space Habitat Concept Demonstrator derived from the core stage of the Space Launch System. The Medical Bay was designed as a primary location to support the medical care of4 crew members on a1000-daymission. It includes workspace, stowage, and direct access to all necessary medical equipment and supplies. A Human Factors Engineering Analysis was conducted to test ergonomic effectiveness and system requirement compliance. This initial design will continue to be used by the Human Factors Engineering Team and the Advanced Concepts Office at NASA’s Marshall Spaceflight Center for further demonstration, analysis, and design conception for deep space travel.

Mary Claire Mancl↗
NASA NTRS1999

Profile of Ambulance Runs at the Kennedy Space Center

The Kennedy Space Center (KSC) has four onsite ambulances staffed with Paramedics at two fire stations that respond to 911 Emergency Medical System (EMS) medical dispatches. These ambulances serve over 22,000 NASA, military, government, and contractor employees in an area of approximately 520 square miles. Included in this coverage are several public areas such as beaches, a wildlife refuge and a popular Visitor Center. Reports are filled out on each patient encountered. However. the only element tracked has been the ambulance response time. Now that reports are filed electronically, it is possible to enter them into an electronic database for analysis. Data analyses reveal trends and assist in better allocation of resources.

Scarpa, Philip J.↗
NASA NTRS2021

Exploration Medical Capability Medical Scenarios

Medical systems supporting exploration class missions to cislunar space, the lunar surface, and the vicinity of Mars require an evolution in medical capability beyond that available for today’s low Earth orbit centric paradigm. Progress in developing more capable medical systems will be driven by the requirements of prolonged mission duration, increasing distance from Earth, and the realities of orbital mechanics, all necessitating a concomitant need for progressively Earth independent medical decision-making capabilities. These medical systems (which include the crewmembers) are expected to be capable of evaluating, diagnosing, treating and managing a defined list of medical conditions as well as addressing unanticipated medical conditions that may arise. The prioritized medical capabilities and associated resources needed to treat these medical conditions and support anticipated inflight medical events provide robust content that informs system designers and allows for a more complete evaluation of both medical and overall mission risk. Communication of these medical capabilities to system, vehicle, and mission designers can be enhanced using scenarios that characterize the system’s operations. Carefully considered scenarios provide the context needed to explore expected human and system interfaces, roles of ground and inflight crew (including periods of interrupted or delayed communications), identify training needs, assess data needs, etc. Mission-based scenario content varies dependent upon the needs, medical capabilities, conditions and context they are intended to illustrate. This document explicitly seeks to capture and codify those scenarios that have been useful to the Exploration Medical Capability Element of the Human Research Program in defining the enhanced medical systems required for future space exploration. It is expected that this document will continue to evolve through the refinement and characterization of current and future scenarios, respectively, as our knowledge grows, and requirements increasingly focus on Earth independent spaceflight operations.

Derek M Nusbaum↗
NASA NTRS2025

Human Spaceflight Applications of Novel Miniature X-Ray Technologies

INTRODUCTION: Radiography (XR) has long been a cornerstone of terrestrial medical imaging, though it has not yet been used in the spaceflight environment. Medical systems for human spaceflight missions are constrained by mass, volume, and power, and until recently, XR systems have been considered too large and power-consuming for spaceflight diagnostic and therapeutic applications. However, the rise of commercial spaceflight and NASA’s refocused efforts on returning crews to the Moon for long-duration missions have introduced a higher degree of medical risk to human spaceflight and require a re-evaluation when optimizing medical system design. Over the last decade, XR devices have miniaturized while maintaining good diagnostic and therapeutic sensitivity and specificity, making new in-flight medical and non-medical XR applications a possibility. Initial research identified several medical conditions where miniature XR would be beneficial for the diagnosis and/or management of medical conditions arising in space, though a more in-depth analysis is required to identify whether XR may add value to the management of such conditions. With this presentation, we aim to introduce the potential utility of miniature XR, review prior work highlighting where XR may be beneficial, and evaluate how miniature XR may reduce medical risk in human spaceflight missions. METHODS: IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a risk assessment tool developed by NASA to advance exploration mission medical system design by quantitatively estimating mission medical risk. IMPACT v1.0 includes a novel evidence library baselined to exploration environments, an expanded list of 119 medical conditions, medical capabilities and resources critical for management of these medical conditions, and the ability for rapid and iterative analysis in the setting of modifiable design reference missions (DRMs). Our first analysis identified which of the 119 medical conditions XR had diagnostic or therapeutic utility for. Subject matter experts (SMEs) recorded which XR views would be performed under ideal terrestrial circumstances for diagnosis/management of each condition, as well as which views are pragmatic for spaceflight limitations. A second analysis utilized IMPACT to identify significant conditions that contribute greatest to medical risk during a notional long-duration Lunar orbit and Lunar surface DRM. Medical system risk estimates include loss of crew life (LOCL), need for return to definitive care (RTDC; medical evacuation), and an estimate of crew task time affected (TTA). Using a standardized semi-quantitative scoring methodology, a deeper evaluation of each of the most significant medical conditions was performed. Data from both of these separate analyses were used to hypothesize what ideal and pragmatic XR studies may impact clinical management of the most significant conditions predicted to lead to medical risk. RESULTS: Approximately 1/3 of the IMPACT conditions were identified as being more effectively or comprehensively assessed or treated with the addition of miniature XR technology. The resulting conditions benefitting diagnostically and therapeutically from XR are revealed, as well as the ideal and pragmatic XR views and medical procedures benefitting from XR. The conditions of clinical significance and those most contributing to risk are also displayed. Among the conditions that contribute greatest to LOCL, four conditions for which XR may improve the diagnosis and management of include: decompression sickness, traumatic shock, dental abscess, and respiratory failure. Among conditions that contributed to RTDC, the evaluation and management of wrist fracture is likely improved by XR. For conditions leading to crew TTA, evaluation and management of EVA shoulder injuries, upper and lower extremity strains, back strains, and EVA hand injuries are likely improved by XR. DISCUSSION: Miniature XR in spaceflight has the potential to improve the evaluation and management of a substantial portion of conditions that most contribute to medical risk. This presentation is an introduction to the possibilities miniature XR provides for future human spaceflight missions and subsequent presenters will expand on potential applications in more detail. LEARNING OBJECTIVES: 1) Understand the previous limitations of using radiography in the management of spaceflight medical conditions; 2) Evaluate the findings from the IMPACT tool analysis, which allows quantification of the benefit miniature XR could provide for managing high-risk medical conditions in long-duration lunar orbit and surface missions, focusing on improvements in crew health outcomes; 3) Analyze case studies where miniature XR technology could reduce the medical risks associated with spaceflight missions, specifically in diagnosing and managing conditions such as decompression sickness, traumatic shock, and EVA-related injuries.

A Anderson↗
NASA NTRS1985

A prototype space flight intravenous injection system

Medical emergencies, especially those resulting from accidents, frequently require the administration of intravenous fluids to replace lost body liquids. The development of a prototype space flight intravenous injection system is presented. The definition of requirements, injectable concentrates development, water polisher, reconstitution hardware development, administration hardware development, and prototype fabrication and testing are discussed.

Colombo, G. V.↗
NASA NTRSDate not supplied

Supply and Resource Management to Progressively Enable EIMO

BACKGROUND: Current medical operations in Low Earth Orbit (LEO) allow for real-time audio-video communication with a flight surgeon at mission control, resupply, and medical evacuation to earth on the order of hours. As mission profiles change from LEO to the Moon, Mars, and beyond, medical risk as a contribution to overall mission risk is anticipated to rise substantially. Concurrently, due to the distance, the medical systems on board vehicles proposed for these mission types are expected to have reduced mass and volume allocation. Together, astronaut crews will be at a higher risk of major medical events, be required to perform a broader set of tasks, and have substantially reduced resources and support to do so. Earth Independent Medical Operations (EIMO) aims to identify and fill the gaps present in this progressively changing paradigm. OVERVIEW: Medical supplies, resources, and skills are central to spaceflight medical systems. Vehicles used for non-LEO missions are anticipated to be smaller and thus the medical system will also need to have reduced mass, volume, and power. Medical resources are another form of consumable and may need resupply or pre-deployment to meet crew needs. One particular concern is the degradation of medications which become less efficacious and potentially toxic with time, particularly given environmental conditions such as temperature, humidity, oxygen, and radiation which have not yet been fully studied. Supply and resource management in LEO is dependent on resupply, however the supply chain of transporting equipment does not yet have a clear infrastructure for missions beyond LEO. DISCUSSION: EIMO is intended to systemically identify and fill these gaps with forward-looking solutions. In mission monitoring of resources with technology like RFID, improving medical resource longevity, targeted resupply and careful pre-mission planning will be central to facilitate crew health and performance. One approach to optimizing resources is the Informing Mission Planning via Analysis of Complex Tradespaces (IMPACT) tool, which uses probabilistic risk assessment (PRA) to quantitatively predict medical risk and identify resources and skills that mitigate this risk. This evidence based, quantitative analysis prediction tool and several other approaches to meeting the challenge of supply and resource management are discussed.

Arian Anderson↗