Autonomous Medical Care for Exploration Class Space Missions

Abstract

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

Space medicine innovation and telehealth concept implementation for medical care during exploration-class missions

“…Although the terrestrial real-time telemedicine paradigm may apply to low-earth orbit missions and even to missions to the moon, communication delays during exploration-class missions will be such that effective real-time interactions will be impossible (2). Telehealth is nevertheless the bridge to medical autonomy.…”

“…Store-and-forward telemedicine will be the primary method to communicate crew medical information to the ground. In support to the CMO, and in the absence of communication with ground, smart technologies and decision support capabilities will reinforce the concept of medical autonomy to allow timely medical intervention (2). The application of telehealth concepts for exploration-class missions involve the development of methods to acquire, transmit and analyze medical data.…”

“…In preparation for future missions beyond LEO, medical concepts of operations are being developed to ensure adequate support for the new mission profiles: increased distance, duration and communication delays, as well as impossibility of emergency returns and limitations in terms of medical equipment availability (2). The current ISS paradigm of medical care would no longer be adequate due to these new constraints.…”

Prophylactic surgery prior to extended-duration space flight: Is the benefit worth the risk?

“…In the coming years, the National Aeronautics and Space Administration (NASA) in the United States and similar programs in other countries expect to return to the moon with the anticipation of lunar inhabitance. 1 Furthermore, a move toward the human exploration of Mars is in the planning stages. 1 Private industry is also rapidly developing space-faring technology and hardware.…”

“…1 Furthermore, a move toward the human exploration of Mars is in the planning stages. 1 Private industry is also rapidly developing space-faring technology and hardware.…”