Operational Medicine 



preventive medicine. In addition, the HMF has capabilities for definitive diagnosis 

 and treatment, such as for minor surgery and dental work. Currently, use of the 

 HMF for clinical biomedical research purposes is under consideration. Accordingly, 

 the dividing line between operational and research usage may become increasingly 

 indistinct, and Operational Medicine must be prepared to deal with this situation 

 if it materializes. 



As mission scenarios mature and medical experience increases, periodic review 

 and revision of HMF requirements will be necessary. Extended missions to the 

 Moon or Mars would pose quite different requirements from those of Space 

 Station missions (3). In addition, provision of a Crew Emergency Return Vehicle 

 (CERV) would necessitate reassessment of HMF capabilities. 



Future Manned Spacecraft 



Since medical requirements for space vehicles can influence engineering design, 

 Operational Medicine needs to contribute to and influence engineering decisions 

 in the early design stages of future manned spacecraft. For example, Operational 

 Medicine concerns for the National Aerospace Plane should be fully addressed 

 (currently, the NASP program has not had any direct communication with NASA 

 Operational Medicine). Additionally, the program will need to define the specific 

 medical requirements for the Orbital Maneuvering Vehicle (OMV) and/or the 

 Orbital Transfer Vehicle (OTV) if they are man-rated. 



It is difficult to predict accurately the incidence of medical emergencies on the 

 Space Station, as explained in a status report commissioned by JSC concerning 

 epidemiologic analysis of Space Station disease/event rates (4). Moreover, the 

 Agency has not clearly defined an acceptable level of health risk. It seems likely, 

 however, that if a medical emergency should arise and the Shuttle be unable to 

 arrive in time to effect a successful rescue, the consequences for the Space Station 

 program could be catastrophic. 



Two medical emergencies have been recorded requiring use of a return vehicle on 

 a Soviet space station. Given the likelihood of a medical emergency during the life 

 of the U.S. Space Station program, the medical requirements with respect to 

 internal volume, capabilities, reentry profile, and vehicle recovery times of a CERV 

 need to be firmly established. Further consideration must be given to the 

 operational impact of a CERV with additional capabilities, such as one having an 

 ability to function as a safe haven from environmental dangers (including 

 accidental release of atmospheric toxins or pyrolytic products, sudden Space 

 Station decompression, and/or radiation exposure from internal sources or from 

 solar flare activity) or a resupply and/or waste removal vehicle to supplement the 

 Shuttle. 



Information Processing 



As the number of space missions grows and their length and complexity increase, 

 the need for Operational Medicine to maintain a flexible, computerized data-base 



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