BOX 4–1 Health Care Opportunities in Space Medicine

  1. Developing a resource-based medical triage system that contains guidelines for the management of individual and multiple casualties during space travel.

  2. Developing an anesthetic approach associated with rapid and comfortable recovery using anesthetic drugs with short durations of action or for which there are antagonists.

  3. Creating guidelines for withdrawal of care in space and for dealing with the death of a crewmember from physiological and behavioral health points of view.

  4. Developing a mechanism for skill maintenance and retraining in psychomotor skills during long-duration space missions.

  5. Recording routine surveillance of health status measures, incidents of illnesses and injuries, and their treatments in a database with standardized rates of occurrence so that data between studies and missions can be compared.

  6. Developing and maintaining a centralized catalogue of all written materials related to space and analog-environment biomedical research and experience according to current medical informatics standards.

the spacecraft crew functions more autonomously, adapts to unexpected situations, and makes real-time decisions.

  • NASA, because of its mission and history, has tended to be an insular organization dominated by traditional engineering. Because of the engineering problems associated with early space endeavors, the historical approach to solving problems has been that of engineering. Long-duration space travel will require a different approach, one requiring wider participation of those with expertise in divergent, emerging, and evolving fields. NASA has only recently begun to recognize this insufficiency and to reach out to communities, both domestic and international, to gain expertise on how to remedy it.

  • Engineering and biology are increasingly integrated at NASA, and this integration will be of benefit to the flexibility and control of long-duration missions into deep space. NASA’s structure does not, however, easily support the rapidly advancing integration of engineering and biology that is occurring throughout the engineering world outside NASA. NASA does not have a single entity that has authority over all aspects of astronaut health, health care, habitability, and safety that could facilitate integration of astronaut health and health care with engineering.

  • The human being must be integrated into the space mission in the same way in which all other aspects of the mission are integrated. A comprehensive organizational and functional strategy is needed to coordinate engineering and human needs.

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