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Evaluating the Medical Kit System for the International Space Station
A Paradigm RevisitedMelinda Hailey, Michelle Urbina, Jessica Hughlett, Stevan Gilmore, James Locke, Baraquiel Reyna, Gwyn E. Smith
82nd Annual Scientific and Human Performance Meeting
Melinda Hailey RN BSNMay 2011
https://ntrs.nasa.gov/search.jsp?R=20110010924 2020-06-02T08:49:13+00:00Z
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• Kit history, function
• Additional considerations driving update
• Users
• Implementation of new kits
• Lessons learned
Overview
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• System functions – Nominal preventive health care
– Treatment for minor illness / injury
– Some advanced life support capability
• Launched in support of ISS Expedition 1– Designed to support crew of three for a 6-month mission
– Designed to be prepared on the ground and resupplied in total on a shuttle with each crew rotation
– Shuttle program events required real-time change to support paradigm• Logistic support via international partner vehicles
• On-board crew required to do inventory and integration work to keep kits contents up to date and in a known configuration.
History & Function
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• Hardware Obsolescence
• Medication Issue– Medication no longer available
– Delivery system obsolete
– Unable to procure injectable medications in desired packaging
• Adapt design to accommodate multi-country shipping and logistics chain and on-board maintenance by the crew.
• Accommodate addition/deletion/change of hardware in kits– Updates to required testing
• Example Eye equipment
– Identify and certify COTS hardware where possible as opposed to in-house development.
Additional Considerations
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• 6 Crewmembers on ISS– 4 trained as Crew Medical Officers (CMO)
– CMO• Wide spectrum of professional and health system backgrounds
– IP crew can also be CMO
– Typical CMO has a technical/engineering background
– Approximately 25 hours of crew training available to learn CMO role
• In-flight support of CMO duties is augmented with– Communication with medical support team
• (video conference, email, phone)
– ISS Medical Checklist• Provide directive steps in support of routine activities and medical intervention
ISS Medical Kit Users
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Defibrillator
Restraint /
Electrical Isolation
Ventilator / Oxygen
Supplementation
Personal Protective Equipment
System Components
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Durable and consumable medical items:
•Medications
•Tools (wound repair, dental)
•Bandaging supplies
•Bladder catheterization items
•IV catheterization
•Physical exam hardware
Ambulatory Medical Pack (AMP)
Advanced Life Support Pack (ALSP)
HMS Ancillary Support Pack (HASP)
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New ISS Medical Kits
Medical DiagnosticConvenience Medications
Oral Medications
Topical & Injectable Medications
1.
2.
3.
4.
Emergency Medical Treatment9.
Medical Supply6.
Minor Treatment5.
IV Supply7.
Physician’s Equipment8.
Non-Emergency Medication
Emergency Medication and Hardware
Non-Emergency Hardware
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Exterior/Interior SoftgoodsDesign
Front
Inside with locator card
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Injectable Medications
•Small, consistently sized footprint
•No air in syringe
•Reduced shelf life due to repackaging
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Injectable Medications
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Efficiency - Crew OperationsCrew Efficiency - Ops
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Need image of
emer med tx
pack here
Crew Efficiency - Ops
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Advanced Life Support Pack (ALSP)
Ambulatory Medical Pack (AMP)
Short Shelf-Life Items (medications, consumables)
Crew Efficiency –Resupply
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Accommodate Hardware Modifications
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Miscellaneous Improvements
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• Thoroughly define requirements are a challenge to develop– All requirements revisions have significant system impacts
– Huge variability in commercially available equipment• Imprecisely worded requirements make capturing the correct equipment difficult.
• Use of commercially acquired goods requires flexibility – Kit design
– Procedures and training
• Think Efficiency when selecting hardware– Make items serve multiple purposes
• Communicate– Engineering and clinical stakeholders don’t always speak the same
language
– Miscommunication impacts can have broad impacts (procedures, training)
Lessons Learned
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• Launched to ISS via a Russian Progress on 30 April
• Planned on-board implementation in June 2011
• Expedition 27/28 will be first users
• Miscellaneous– Rewrote >120 ISS Medical Checklist procedures
– Modified 10 training lesson plans and classes
– >200 unique medical items included in new kits
Questions?
Implementation
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82nd Annual Scientific and Human Performance Meeting Disclosure StatementWe have no financial relationships to disclose.
We will not discuss off-label use and/or investigational use of medications in this presentation .