Medical treatment

Launch of Artemis I paves the way for medical treatment in the final frontier

The Apollo missions had a medical accessory kit containing medical supplies, drugs and small medical equipment which included compression bandages, adhesive bandages and an oral thermometer and a biomedical harness worn under the spacesuit which measures ECG and the astronaut’s heart rate. What factors do you consider when determining the capabilities needed in a medical system on the moon?

The answer to this question is highly dependent on the particular details of the mission. We divide the hazards of manned spaceflight into five categories: distance from Earth, isolation and containment, radiation, altered gravity fields, and hostile and enclosed environments. These hazards interact with each other to expose astronauts to a large number of medical conditions. Some are medical conditions we might see on the ground, like appendicitis, and others are unique to spaceflight, like spaceflight-associated neuro-ocular syndrome.

The likelihood and consequences of these conditions then depend on the duration of the mission, the design of the spacecraft or habitat, the types of activities undertaken by the astronauts, and the location of the mission, which has a impact on gravitational fields and medical evacuation time. We use large computer models that take into account the characteristics of the mission to generate an initial estimate of the clinical capabilities needed, which are then refined and finalized by flight surgeons and other clinical experts.

The Artemis Medical System will need to integrate capabilities across Orion, Gateway and the Human Landing System. NASA flight surgeons strive to assess the set of diagnostic and treatment capabilities that make the most sense based on spacecraft and mission designs, including system limitations. Additionally, work is underway to examine how astronauts and flight surgeons can record information generated by the medical system during the mission, and how this information can be transmitted back to Earth.

There were a few notable medical issues during the Apollo space program. These included colds, rashes caused by urine collection devices, eye irritation, dehydration, irregular heartbeats and pulled muscles. What have we learned from these instances that come into play as we prepare to return?

As we plan for future missions to the Moon, we are reviewing data from all previous human spaceflight experiments, but in particular from Apollo, as this mission is most similar to future Artemis missions. We also accumulated a wealth of knowledge thanks to the International Space Station (ISS), where we learned much more about the effects of spaceflight on the human body during missions of 6 to 12 months.

There is an excellent report on “Apollo Biomedical Results”. As a simple example, prolonged wearing of a urine collection device on Apollo 13 resulted in a urinary tract infection, and potentially sepsis, in an astronaut. This led to plans to include toilets in the Orion and Gateway programs.

The ISS is loaded with equipment and medicines deemed essential. What have we learned about treatment on the ISS that can be taken to the Moon and what additional steps need to be taken?

The ISS has provided invaluable insight into how the human body reacts to 6-12 months in space. It helped us identify common medical conditions that occur in space and learn how to treat them. These epidemiological data help inform how we design medical systems for spacecraft. However, there are important differences between the ISS and the Moon.

The most obvious is that a lunar habitat will be on the surface of the moon, and astronauts will work in about one-sixth of Earth’s gravity. The increase in spacewalks on the surface of the Moon may put astronauts at higher risk of traumatic injuries. They will also be exposed to moon dust, which is definitely a contact irritant and can be an allergen. Medical evacuation times are also very different. From the ISS, the crew could be back on Earth in a few hours to a day. Due to the distance to the moon and the orbit of the Gateway spacecraft, it could take up to two weeks to evacuate an injured astronaut to Earth.

As mentioned above, lunar gravity presented unexpected problems and close calls for several astronauts (e.g., falls, pulled muscles, balance issues) during the Apollo missions despite the months of training that took place. been conducted on Earth. What kind of testing/training is currently taking place – now that we know more about the “real world” lunar surface challenges?

A big key to this question goes back to planned improvements for spacesuits. The spacesuits used by the Artemis program will allow greater joint mobility than previous spacesuits allowed. Prototypes of the next generation of surface exploration spacesuits have been tested using microgravity simulators (using a system called ARGOS as well as the Neutral Buoyancy Lab in NASA’s pool) and with simulated planetary surfaces at NASA’s Johnson Space Center.

How are the medical needs of each space mission determined and what kinds of safety protocols exist for astronauts?

The Artemis program involves missions that increase in duration and complexity over time. Artemis III, currently scheduled for the first moon landing, will have two astronauts on the surface for about a week. Determining medical capabilities for a mission requires an understanding of the likelihood and consequences of specific medical conditions as well as spacecraft constraints. The mass, in particular, is extremely limited. In the Apollo program, the number of dressings in the lunar module had to be reduced to help keep the vehicle within its mass constraint. And there’s no free lunch – more medicine means less fuel or less spare parts. Engineers use a process called swap space analysis to understand how “swapping” a capability to or from a system affects risks and constraints.

The health of astronauts is closely monitored. NASA has a standard medical screening program before, during and after missions. During the mission, the diagnostic and treatment capabilities of a medical system are designed to resolve problems quickly. The spacecraft and suits are designed with layers of redundancy to minimize the risk of catastrophic system failures and to protect occupants from all dynamic forces present during launches and landings. Spacewalking objectives, tasks, and equipment are also designed with safety in mind to reduce the risk of injury.

Taking this into account, the medical capacity can be adapted. For example, the need to perform superficial procedures for minor injuries is more likely than the need to perform complex procedures during the mission.

What will medical personnel be looking for during the Artemis I mission?

The overall function of spacecraft is necessary to support human health and performance, and to ensure that the design meets the requirements to support the human. We will be collecting data from Artemis I in several areas, including understanding the radiation environment with human-like dummies, using microphones to capture sound levels in the spacecraft throughout the mission, and also the use of accelerometers to understand the gravitational forces on the vehicle throughout the mission. launch and landing. Heat shield performance is a primary goal of the Artemis I mission to demonstrate that it will protect the crew from the heat generated during re-entry, which will be approximately half the temperature of the Sun’s surface.

How does going to the Moon help us prepare for an ultimate human mission to Mars?

We have a lot of experience in the area of ​​human health and normal Earth gravity performance, and thanks to more than 20 years of continuous human presence on the International Space Station, we also have a much better understanding of how the body reacts to prolonged weightlessness. We lack meaningful data on all intermediate points. The Artemis missions will have humans working on the surface of the moon, which is about one-sixth the Earth’s gravity, for months at a time. This gives us an additional data point between 0g and 1g to better understand how each of the body’s systems respond to different gravitational fields. The response may be linear, exponential, or level off at some point, and is likely different for each system. Artemis will help us answer this question.