S. Yule1,3,4, J. Robertson3, A. Gupta4, R. Dias3, T. Doyle5, S. Lipsitz4, C. Pozner3, D. Musson2, D. S. Smink1,3,4 1Brigham And Women’s Hospital,Surgery,Boston, MA, USA 2Northern Ontario School Of Medicine,Thunder Bay, ON, Canada 3Brigham And Women’s Hospital,STRATUS Center For Medical Simulation,Boston, MA, USA 4Brigham And Women’s Hospital,Center For Surgery And Public Health,Boston, MA, USA 5McMaster University,Electrical And Computer Engineering,Hamilton, ON, Canada
Introduction: Analysis of spaceflight medical events detail a number of surgical and trauma events. Inability to manage these during space flight represents a significant risk to astronaut crew health and can lead to mission failure. Effective coordination between the astronaut crew, mission control and ground-based flight surgeon is essential. In proposed deep space missions to Mars, crew may be in space for up to three years. In the event of a medical emergency, the possibility of returning to Earth or consulting with the flight surgeon via long distance communications may be challenging. In surgery, simulation training and non-technical skills (NTS) assessment tools ameliorate this risk. However, a valid simulation-training framework and objective measures of NTS are currently lacking for spaceflight. In order to develop these, we must first determine the survivability of potential space medical emergencies and the extent to which effective NTS in the early management of these conditions could save lives.
Methods: This was a cross-sectional expert panel analysis, based on current NASA evidence of 80 potential medical conditions in space. A multidisciplinary panel of surgeons, health service researchers, astronauts, human factors scientists and space medicine practitioners were recruited. Panel members rated each of the 80 conditions using a 5-point Likert scale on three criteria: (i) utility of NTS in managing the emergency, (ii) survivability in space, (iii) ease of developing a quality simulation for training.
Results: A frequency-severity-skill matrix was developed from analysis of panelists’ ratings. From this initial analysis, we identified ten traumatic and medical emergencies (Table 1) that present the greatest opportunity for the development of simulation scenarios. Of specific interest are traumatic injuries such as pneumothorax, burns, lower extremity fracture, head injury and penetrating abdominal injury. Developing simulation training that emphasize NTS will ultimately increase survivability of these spaceflight medical events. Complete results of the matrix will be presented at the conference.
Conclusion: In-flight medical emergencies represent a significant risk to the safety and wellbeing of the crew, as well for the success of the mission. By involving surgeons, space medicine experts, astronauts, and human factors scientists we ranked all possible medical conditions in space and prioritized survivable traumatic injuries for inclusion in spaceflight NTS training curricula. This will support proficiency in medical event management on long-duration space exploration missions, such as mission to Mars.
