EVA 102: Operational Space Medicine
EVA 102 course participants will learn about space medicine, wilderness medicine, human performance, leadership and psychological resilience. The course will dedicate a special focus to extreme environment and wilderness medicine, and how the spaceflight environments may inform triage and first aid scenarios. The on-site portion of this class will focus on wilderness medicine in extreme environments, culminating with triage instruction with scenarios and skills pertaining to wilderness medicine and employing remote techniques such as those that would be used on Mars.
Course Description: EVA 102 participants will learn about space medicine, wilderness medicine, human performance, leadership and psychological resilience. The course will dedicate a special focus to extreme environment & wilderness medicine, and how the spaceflight environments may inform triage and first aid scenarios. The on-site portion of this class will focus on wilderness medicine in extreme environments, culminating with a 4-day on-site lab portion devoted to triage, scenarios and skills pertaining to wilderness medicine. Basic and Advanced First Aid certifications and graduation from the PoSSUM Scientist-Astronaut program or Advanced PoSSUM Academy is prerequisite to EVA 102. EVA 101 is highly recommended.
It is anticipated that at the end of this course, participants will have gained 1) basic knowledge and understanding of space medicine and physiology, specifically the space environment as it pertains to human health pre-, post- and in-flight, 2) an appreciation of extreme environments and how they inform space exploration, and 3) a basic understanding of, and be able to demonstrate basic competency in skills related to wilderness medicine and outdoor survival.
- Pandya and von Kraus, Space and Remote Medicine
- Clement G. Fundamentals of Space Medicine, Third Edition, Springer
Scientific papers :
- Nicogossian A. Medicine and space exploration. Lancet Extrem medicine, 2003 Dec
- Stewart LH, Trunkey D, Rebagliati ? Emergency medicine in space. J Emerg Med. 2007 Jan;32(1):45-54
- Komorowski M et al. Fundamentals of Anesthesiology for Spaceflight. J Cardioth Vasc Anest. 2016 Jan
- Jennings RT et al. Medical Qualification of a Commercial Spaceflight Participant : Not Your Average Astronaut. Aviat Space Environ Med 2006 ; 77 :475-484
- Bogomolov VV et al. International Space Station Medical Standards and Certification for Space Flight Participants. Aviat Space Environ Med 2007 ;78 :1162-9
- Jennings RT et al ; The ISS Flight of Richard Garriott : a Template for Medicine and Science Investigation on Future Spaceflight Participant Missions.
NB: The practical component of this class will include a significant outdoor component. Participants will need to be medically cleared by their physician to take part and should expect to partake in strenuous physical activity. A suggested gear list will be sent out well in advance of the course.
Course Breakdown & Schedule: Online Seminars (12 hours) = 6 x 2 hours – Each 2 hour webinar will consist of a didactic component, self-study & pre-reading as preparation, discussion and a post-webinar evaluation.
Course Composition: Coursework, self-study, didactic lectures, office hours. Web portal with presentations, videos will host course material that students can access.
Webinar 1: Introduction to the Spaceflight Environment & Human Health Issues in Spaceflight
Webinar 2: Principles of Survival & Wilderness Medicine
Webinar 3: Overview of Classroom Component
Webinar 4: Introduction to the Space Medicine Challenges and Concepts.
Webinar 5: Introduction to Space Medicine specifications and developments: Commercial Spaceflight-Class, Exploration-Class, Settlement-Class.
Webinar 6: Introduction to Operational Space Medecine and Spaceflight Healthcare System.
Classroom component and survival course: Didactic Classroom & Practical Component (40 hours = 4.5 days)
Day 1: Arrival and check-in + ½ day classroom component
Day 2-4: Classroom component, skill building, triage, scenarios.
Day 5: Individual skills assessments, group and individual debrief, course evaluations, pack-up, leave
Webinar 1: Introduction to the Spaceflight Environment & Human Health Issues in Spaceflight (Pandya/von Kraus)
Topics include: radiation, microgravity, temperature, closed living quarters, altered day/night cycles, vibration, nutrition in space, physiological adaptations/maladaptations to space: cardiovascular, musculoskeletal, nervous, visual, immune, bone, deconditioning/post-landing physiology (impaired balance, orthostatic hypotension, muscle atrophy, etc.), counter-measures pre/post/in-flight. Continuation of post-flight physiology and impacts on post-flight medical scenarios. Overview of common post-flight medical scenarios. Webinar, discussion + post-seminar evaluation
Webinar 2: Principles of Survival & Wilderness Medicine I (Pandya/von Kraus)
Survival principles, Overview of Wilderness Medicine and introduction to Wilderness Triage & approach to a creating a medical kit, Teamwork, leadership, survival mentality & psychological resilience/resilience-building, decision-making, dealing with stress, discipline, situational awareness and professionalism. Webinar, discussion + post-seminar evaluation
Webinar 3: Overview of Classroom Component (von Kraus/Pandya)
Overview of practical component, Suggested gear list, gadgets and tech in the wild, further opportunities in space and wilderness medicine, including extreme and analog environments & space exploration. Webinar, discussion + post-seminar evaluation
Webinar 4: Introduction to the Space Medicine Challenges and Concepts (Saget)
Medicine concepts and challenges emerging from radiation, microgravity, confined isolation, social psychology, circadian rythm, vibrations, contaminants, nutritional aspects, adaptations, neuro-ocular syndrom, : cardiovascular, musculoskeletal, nervous, immune, bone, deconditioning upon landing, Life Support Systems. Management : prevention, mitigation, counter-measures, telemedicine. Discussion regarding expected medical scenarios, case studies.
Webinar 5: Introduction to Space Medicine specifications and developments: Commercial Spaceflight-Class, Exploration-Class, Settlement-Class. (Saget)
Rationales and discussions regarding previous and upcoming Spaceflight Range-Classes : Suborbital, LEO, Moon (CLO, Settlement), Deep Space (Flybys, Asteroïds, Phobos, Mars, Solar System exploration): Earthbound medical spin-offs and related applications, remote medicine. Basic, Advanced, Expert medical training. Development of commercial spaceflight and new clinical and surgical skills needs. Increased duration of missions and distance from Earth and new medical events to manage, new organization between ground control and crew resources.
Webinar 6: Introduction to Operational Space Medecine and Spaceflight Healthcare System (Saget)
Principles and state of the art. ISS medical support current organization and Astronauts medical pathway. Medical. Behavior and Human Performance aspects. Critical requirements for deep space exploration. Perspectives and prospective : focus on P3 medicine, NBIC biomedical innovations, crew wellness, nutrigenomics, VRAR, 3D printing, genetic tools (i.e. Crispr-Cas systems), telehealth (monitoring, telemedicine, telesurgery) technologies, robotics, autonomous and drones interaction. Applied emergency medicine and MEVA (medical extra-vehicular activity).
Classroom component and survival course
Didactic Classroom Component (20 hours = 2.5 classroom days or 2 x 10hr days)
Review of spaceflight-related changes and wilderness considerations in post-flight physiology state, Exposures & First Aid, Temperature Exposures: Frostbite, Hypothermia & Heat Stroke, Animal & Insect Exposure: Bites, stings, injuries, Triaging, Wound Management, Burn Management, Orthopedic Injuries, Botanical Encounters, Altitude Sickness, Submersion Injuries, Drowning, Sun exposure, Pre-existing conditions (less time on this, as astronaut candidates are presumably healthy), Approach to Triage in the Wilderness
Practical Drills: Team-building, approach to triage in the wilderness, focussed triage on specific problems, small group sessions (knots, splinting, shelter-building, wraps, taping, dealing with blisters, epipen, c-spine evaluation, lifts) – some can also be interspersed into the trek itself, litters, try a scenario in a deconditioned state
Outdoor Skills: Shelters, Fires, Water purification, Food
Practical Component (32 hours) – day survival trip + debrief
DAY 1: Arrival and check-in + ½ day classroom component
Day 2-5: Classroom component
principles of team-building and wilderness medicine trip +/- building shelter based on group experience, round robin events along triage, drills & survival scenarios.
Day 6: Individual & team skills assessments, group and individual debrief, individual evaluations, course evaluations, pack-up
PASS/FAIL – need to complete all components to pass course and receive certification
Pre-course seminars participation (PASS/FAIL)
Classroom component participation (PASS/FAIL)
Survival trek participation (PASS/FAIL)
Teamwork/Leadership – Evidence of progress – (Based on individual evaluations with course instructors)
Skills assessment – (Based on individual evaluations with course instructors)
Participation in debrief – group and individual debriefs
Completion of webinar and on-site course components’ evaluations