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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