Download ď - Sites

Autonomous Medical Care

Bioastronautics Roadmap

Autonomous Medical Care






Monitoring and Prevention
Major Illness and Trauma
Pharmacology of Space Medicine Delivery
Ambulatory Care
Medical Informatics, Technologies, and Support
Systems
Medical Skill Training and Maintenance
17. Monitoring and Prevention



The risk of serious medical events may increase due to inadequate
monitoring and prevention capabilities. (Priority 2)
Current countermeasures:

Comprehensive physical exams

In-flight examination, monitoring and care

Selection standards
Projected countermeasures:

Additional screening criteria

Better in-flight monitoring

More autonomous medical diagnostic and therapeutic
hardware
17. Monitoring and Prevention




What are the key parameters for health
screening?
What diagnostic imaging procedures need
to be developed?
What is space-normal physiology?
What are signs and symptoms of illness in
reduced-G?
18. Major Illness and Trauma



Lack of capability to treat major illness and injuries increases the risk
to crew health and mission. (Priority 1)
Current countermeasures:

Return to Earth

On-board treatment (ventilator, IV, medications, etc)

Preventive measures
Projected countermeasures:

Autonomous capabilities for monitoring and treatment
18. Major Illness and Trauma



What resources are required for integrating autonomous diagnosis
and telemedical consultation?
How can major illness and trauma be managed in-flight?
What is needed for decompression sickness prevention, diagnosis,
and treatment?


Doppler U/S, gas mixes, hyperbaric oxygen delivery
What are the problems associated with in-flight surgery, wound
management, anesthesia, and blood replacement?
19. Pharmacology of Space
Medicine Delivery


Diminished drug efficacy due to reduced shelf life and alterations in
pharmacodynamics and pharmacokinetics may compromise
treatment capabilities. (Priority 2)
Current Countermeasures:


Re-supply of medications
Projected Countermeasures:

Shielding of medications from radiation

Alteration in dose and formulation of medication
19. Pharmacology of Space
Medicine Delivery



What are the effects of reduced-G on medication absorption,
metabolism, efficacy, and side effects?
What is the effect of long-duration space flight on drug stability and
how can we extend the duration of drug efficacy?
What are the optimal dosages and routes of administration for
reduced-G clinical effectiveness?
20. Ambulatory Care



Impaired performance and increased risk to crew health and mission
may occur due to lack of capability to diagnose and treat minor
illnesses. (Priority 3)
Current Countermeasures:

Crew training to recognize and treat medical conditions

Design of equipment to minimize likelihood of injury

Medical kits with capability to treat minor illnesses and
injuries

Real-time ground communication with medical experts
Projected Countermeasures:

More extensive medical kit

More extensive telemedicine capability
20. Ambulatory Care


How can we diagnose and treat minor
illnesses and trauma using autonomous
decision-making?
How can we incorporate telemedical
consultation for diagnosis and management
of minor illnesses and trauma?
22. Medical Informatics,
Technologies, and Support Systems



Limited communication capability during space flight results in the
compromised ability to provide medical care, and may have adverse
consequences for crew health. (Priority 2)
Current countermeasures:

Limited telemedicine capability

On-board computer-based training

Real-time ground support

Periodic on-orbit contingency drills

Medical checklist and preflight training
Projected countermeasures:

Development of autonomous medical support systems
22. Medical Informatics,
Technologies, and Support Systems


What decision support technologies are
needed to support clinical care?
What are the impacts of communication
latency on the ability to provide care during
space flight?
23. Medical Skill Training and
Maintenance



Inability to perform required medical procedures may result from
inadequate crew medical skills or medical training. (Priority 2)
Current Countermeasures:

Limited telemedicine capability

On-board computer based training

Crew Medical Officer (CMO) training

Real-time ground support

Periodic on-orbit contingency drills
Projected Countermeasures:

More extensive medical training, including medical and
surgical capabilities

Autonomous medical support systems
23. Medical Skill Training and
Maintenance



What are the necessary clinical skills/knowledge for a space medicine
physician?
How can the clinical skills and knowledge of space medical care
providers be maintained during missions?
What techniques can be used to train and maintain the skills of the
crew medical personnel to perform specific medical procedures when
needed?
References


Operational and Research Musculoskeletal Summit http://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/20070031573_2007030330.pdf
Intravenous Solutions for Exploration Missions http://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/20070018153_2007016639.pdf

Space Medicine Condition List (Patient Condition Database)

Apollo Medical Kits - http://history.nasa.gov/SP-4029/Apollo_18-42_Apollo_Medical_Kits.htm





Apollo Medical Screening http://lsda.jsc.nasa.gov/scripts/experiment/exp_descrp_pop_up.cfm?exp_id=AP001
Clinical Ultrasound Aboard the International Space Station http://www.nasa.gov/mission_pages/station/science/experiments/Ultrasound.html
The International Space Station Ultrasound Imaging Capability Overview for Prospective Users http://ston.jsc.nasa.gov/collections/TRS/_techrep/TP-2006-213731.pdf
Medical Transport from the Space Station - http://ston.jsc.nasa.gov/collections/TRS/_techrep/TM2001-210198.pdf
Pharmacokinetics and Pharmacodynamics in Space http://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/19930020313_1993020313.pdf