the human body a complex and sometimes
fragile machine as new plans are set
into motion for exploring space
new medical challenges will have to be
met
previous space flights have demonstrated
the physiological changes that may be
expected after living in a microgravity
environment
areas of particular concern include
cardiovascular deconditioning
loss of muscle and bone mass and changes
in blood chemistry in addition to the
physiological changes astronauts and
scientists on space station will need to
cope with common ailments such as two
things as well as more serious medical
conditions such as kidney stones crew
members must also be prepared to face
many of the hazards which are found in
comparable industrial settings on earth
with longer missions larger crews and
the complexities of a medical rescue the
health of the crew will be an important
factor to the success of the mission the
space station health maintenance
facility or h MF will provide necessary
in-flight medical care including
prevention diagnosis treatment and care
during transport if the patient must be
evacuated the hmf is currently under
development by NASA at the Johnson Space
Center in Houston Texas because of its
specialized function the hmf is being
designed primarily by a team of NASA
physicians biomedical engineers and
other allied health professionals in
building the hmf current off-the-shelf
equipment will be used as much as
possible however existing technology
must be adapted in order to operate in
microgravity and conform to space
station weight and size constraints
the kc-135 provides a testing
environment for equipment and procedures
to be used in space using a parabolic
flight path the kc-135 can simulate
weightlessness for a few valuable
seconds here a prototype of the patient
restraint system is analyzed this piece
of equipment must be both flexible and
portable on space station it will be
used as a stretcher a treatment area a
dental chair and an x-ray table the
health maintenance facility has been
divided into flight subsystems as well
as ground support these subsystems are
similar to the medical services found in
a large Hospital
for example the hmf will be designed to
provide emergency medical care for
injuries medical life-support with
patient monitoring capabilities
respiratory support intravenous or IV
fluid and nutritional support a variety
of physicians instruments imaging for
diagnostics and therapeutic procedures a
clinical laboratory to provide tests and
analysis in areas such as microbiology a
pharmacy containing necessary
medications and a computerized inventory
control system central supply and a
hyperbaric facility for treatment of
decompression sickness although each of
these capabilities will be needed on the
space station it isn't feasible to
launch a large hospital facility into
orbit as a result the entire health
maintenance facility with its preventive
diagnostic and therapeutic capabilities
must be designed to fit into a very
limited space
in a hospital a large staff of highly
trained professionals provides health
care services the space station will not
have those resources because of limited
medical personnel the hmf equipment will
be user-friendly and easily maintained
in order to provide maximum flexibility
the hmf will have a modular design each
piece of equipment will be
self-contained and will be held in
standard space station equipment racks
this modular design will allow the
components to be switched out easily for
repairs or to be upgraded as new
technology becomes available the patient
restraint system which provides the
treatment area will be located in front
of the racks and will be stowed when not
in use preventive health care is another
major objective of the hmf exercise
protocols will be designed to meet the
individual needs of each crew member in
addition to providing a cardiovascular
workout these protocols will be used to
help prevent the detrimental effects of
weightlessness on bone and muscle
exercise sessions will also generate
physiological data for later analysis by
NASA scientists here a computerized
video system is being developed for use
with the exercise equipment this system
is designed to motivate the crew member
and monitor the progress of the workout
another piece of equipment currently
being studied is a bicycle
which converts to a rower this machine
will provide a cardiovascular workout
with the added feature of offering a
choice of exercise activities unlike a
hospital with its mounds of forms and
stacks of paper the hmf will use the
space station's computer resources to
integrate all the information from each
subsystem dr. James Logan manager of the
Medical Sciences Space Station office at
the Johnson Space Center explains this
innovative approach one of the things
that we're developing at Johnson Space
Center is a concept known as the medical
information bus or MIB the MIB would
enable all the medical devices on the
health maintenance facility to not only
interact with each other but also
interact with the hmf computer
additional things that would be housed
in the health maintenance facility
computer would be things like diagnostic
and treatment protocols or inventory
management for the hmf another aspect
would be the crew performance data
especially as it related to the exercise
devices if there was an illness on board
the space station after the crew medical
officer did a diagnostic physical exam
he would enter the results of that
physical exam on a keyboard which would
put those results in an electronic
medical record however all the
laboratory data and the radiographic
data and the electrophysiologic data
such as an electrocardiogram would
automatically be entered into an
electronic medical record this is the
Mission Control Center in Houston Texas
this is the nerve center for the entire
mission the flight director and all the
flight controllers stay in this room
throughout the duration of the mission
this is also where the mission surgeon
sits after the crew medical officer on
the space station gathers all the
medical data and the data is collated by
the medical information bus that
information is downlink to the earth and
reconstructed at this console here in
Mission Control when the information is
reconstructed the mission surgeon has to
make several key decision
the first decision he or she would have
to make is whether or not to activate a
group of consultants which would be
other physicians and surgeons located
all across the country to have them
actually look at the data with him or
her the next decision that the doctor
would have to make is whether or not the
medical condition can be treated
definitively at the hmf onboard the
space station or whether a rescue needs
to be even considered it becomes obvious
then when you consider the mission and
the cost of medical rescue that one of
the prime goals of having a health
maintenance facility on board the space
station is to be able to treat as many
medical conditions as possible in flight
without having a rescue here on earth
the development of a health maintenance
facility may alter some current concepts
for medical care the key to the hmf
concept is the ability to combine
existing equipment with computer
technology this integrated package of
health care resources can be used to
assist in the diagnosis and management
of medical problems which occur in
remote environments such as isolated
rural communities also the medical
information bus can improve the quality
of care in areas such as a hospital
intensive care unit by integrating the
information gathered from all the
monitoring equipment the medical
information bus will simplify the
various equipment connections and
eliminate most of the paperwork burden
this will allow the care providers more
time to spend in direct patient care
on previous space flights there was
nothing comparable to the hmf during
those missions the need for in-flight
health care was not as great as it will
be on Space Station
in order to successfully live and work
on the space station crew members will
have to maintain their health without
relying on frequent rescues
the space station health maintenance
facility the hmf will be an important
step in understanding the intricacy of
the human body as it answers the
challenge of living in space