Healthcare of ESA Astronauts in Space and on Earth

Transcription

1 Healthcare of ESA Astronauts in Space and on Earth Royal Aeronautical Society London 27. October 2014 Volker R. Damann, MD Head Space Medicine Office Cologne, Germany European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany

2 European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany 2

3 Space Medicine The ESA Space Medicine Office is responsible to maintain the health and well-being of the ESA astronauts The WHO defines health as: Status of complete physical, mental and social well-being and not only absence of disease or infirmity European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany 3

4 Space Medicine Tasks Astronaut Selection, Certification and Re-Certification Flight Clinic Preventive Health Program Fitness Nutrition Radiation Human Behaviour & Performance Program Family Physician Operational Research Groundsegment development and implementation Communication Infrastructure, IT and Telemedicine Medical Training for Crew Medical support to training events, scientific activities and hazardous operations Mission Support European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany 4

5 The Team Physicians / Nurse Filippo Castrucci Urich Straube Brigitte Godard Ben Douglas Peter Sinnwell Biomedical Engineers Frits de Jong Petra Mittler Deihiem Afchine Joerg Lindner Timothy Irawan Beate Fischer Jennifer Struble Projects, IT, Education Simon Evetts Alex Frechette Marco Scheer Mareike Czybulka Lothar Mies Fitness Team / Psychologist Nora Petersen Patrik Jaekcke Gunda Lambrecht Andre Rosenberger Dietrich Manzey Yvonne Pecena Management, Administration Volker Damann Casey Pruett Henny Vollmann European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany 5

6 Launch to Space European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany 6

7 Weightlessness European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany 7

8 Types of Medical Risks Medical risks related to technical systems mitigate risk through technical measures Medical risks related to the space- and microgravity environment mitigate risk through countermeasures, monitoring Medical risks related to the biological system mitigate risk through selection and preventive medical program In case of an incidence: Provision of adequate on-board and terrestrial medical resources and capabilities European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany 8

9 Technological & Environmental Challenges (LEO) habitable Atmosphere pressure & gas composition P r o g r e s S e r v i c e M o d u l e F G B P M A 1 N o d e 1 U S L a b N o d e 2 temperature & humidity Potable Water & Waste Water Electrical Systems Toxicology propellants (Hydrazine) cooling agents (Freon, Glycol) off-gassing products Noise Nutrition Microbiology Radiation about msv/day D c k i n g C o m p a r t m e n t S o y u z P M A 3 J o i n A i r l o t c k C O L P M A 2 European Astronaut Centre Directorate of Human Spaceflight and Operations Crew Medical Support Office Cologne, Germany 9

10 Physiological Challenges in Microgravity Neurovestibular Bones Cardiovascular VIIP Muscles European Astronaut Centre Directorate of Human Spaceflight and Operations Crew Medical Support Office Cologne, Germany 10

11 Medical Challenges due to Space Environment! Visual Impairment & Intracranial Pressure Eye Injuries (foreign bodies) Genito-Urinary Tract (Urolithiasis) Dermatologic Infections Hypothermia (EVA) Infections Radiation induced impairments Psychiatric/Psychological Issues European Astronaut Centre Directorate of Human Spaceflight and Operations Crew Medical Support Office Cologne, Germany 11

12 Risks due to limited Resources and Capabilities extended diagnostic or therapeutic measures necessary on-board medications and supplies used up pharmacology medical skill maintenance ethical aspects: treatment vs. resources European Astronaut Centre Directorate of Human Spaceflight and Operations Crew Medical Support Office Cologne, Germany 12

13 Medical Risk Assessment & Incidence Probabilities (ISS) The terrestrial risk of a significant disease or injury requiring ER evaluation or hospitalisation is at approx. 6-7 % per person/year The terrestrial risk of a significant disease or injury requiring intensive care is at approx. 1-2 % per person/year for a 6-person Crew: 5.5 years per evacuation based on data US and Russion Space Medicine US Navy submarines polar analogues NASA and US Air Force data FUTRON study 2001 NASA Medical Risk Study 1996 European Astronaut Centre Directorate of Human Spaceflight and Operations Crew Medical Support Office Cologne, Germany 13

14 Risks - a comparison Major Events: Medical Emergency >3 in 15 years or 1 evacuation in 5.5 years Radiation Event 25% in 15 years or 1 evacuation in 60 years Micro-meteorite or debris 7% in 15 years or 1 evacuation in 214 years System Malfunction/Failure 2% in 15 years or 1 evacuation in 750 years! source: NASA Medical Risk Study 1996 und FUTRON Studie 2001 European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany 14

15 Risk Mitigation through Ground Control private conferences (limited) telemedicine capabilities Store-and-Forward und Real-Time data analysis monitoring of technical systems Timeline & Scheduling experiments and hazards European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany 15

16 Medical Risk-Mitigation Strategies Strict Selection Criteria Intensive Annual Medical Check Preventive Measures Medical Check 10 days prior to mission Quarantine 8 days prior launch Training of 2 Crew Medical Officers to operate as Paramedics On-Board Medical Infrastructure Routine Private Medical and Psychological Conferences with the crew surgeon and crew psychologist Routine Private Family Voice/Video Conferences European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany 16

17 Direct Return Direct Return from Scotland to Cologne Crew Quarters Medical examinations Science BDC PR and Briefings Integrated Schedule European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany 17

18 Astronaut Selection 2008/2009! 6 phases of the ESA astronaut selection 1. Preparation Phase (expected >10000) Upload of private pilot medical certificate 2. Online Application (8400) computer based evaluation manual evaluation 3. Cognitive Functions Testing (920) 4. Psychological Testing/Assessment Center (190) 5. Medical Evaluations (45) 6. Professional Interview (22) European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany 18

19 Life Boat Rescue capability for up to 7 astronauts provision of emergency medical care Stabilize and Transport or Stand and Fight European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany 19

20 On-Board Medical Capabilities Crew Medical Officer basic medical knowledge, nomenclature Basic Life Support routine and emergency medical procedures 3-day Medical Field Course Medical Checklists bi-lingual catalogue of medical procedures and algorithms medications-list Medical Hardware basic medical supplies (non-prescription) emergency medical kit Defibrillator, Intubation, Infusion Clean-Up Kit European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany 20

21 Training and Testing European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany 21

22 Impressions European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany 22

23 The Evolution of the Ship Doctor Ship Doctor Bones Doctor a hologram - that can be turned off! European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany 23

24 fundamental research applied/operational research Collaboration Therapy / Prevention Medications (pharmacology, resupply & production) Food, Water (resupply & production) Robotics, minimally invasive surgery Diagnostics Imaging, clinical lab, microbiology Crew Physician novel academic pathways Space Physiology & Health (Kings) European Space Medicine Academy Selection, Training, Skill Maintenance Avoid Dead Weight Human Patient Simulators Genomics Autonomy European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany 24

25 Thank you for your attention! Healthcare of ESA Astronauts in Space and on Earth European Astronaut Centre Directorate of Human Spaceflight and Operations Space Medicine Office Cologne, Germany 25