Space medicine – limbs retainer splint manufacturer – foam cervical collar
History
Hubertus Strughold (1898-1987), a former Nazi physician and physiologist, was brought to the United States after World War II as part of Operation Paperclip. He first coined the term “space medicine” in 1948 and was the first and only Professor of Space Medicine at the School of Aviation Medicine (SAM) at Randolph Air Force Base, Texas. In 1949 Strughold was made director of the Department of Space Medicine at the SAM (which is now the U.S. Air Force School of Aerospace Medicine [USAFSAM] at Brooks Air Force Base, Texas). He played an important role in developing the pressure suit worn by early American astronauts. He was a co-founder of the Space Medicine Branch of the Aerospace Medical Association in 1950. The aeromedical library at Brooks AFB was named after him in 1977, but later renamed because documents from the Nuremberg War Crimes Tribunal linked Strughold to medical experiments in which inmates of the Dachau concentration camp were tortured and killed.
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Who benefits from space medicine research?
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Astronauts are not the only ones who benefit from space medicine research. Several medical products have been developed that are space spinoffs, that is practical applications for the field of medicine arising out of the space program. Because of joint research efforts between NASA, the National Institutes on Aging (a part of the National Institutes of Health), and other aging-related organizations, space exploration has benefitted a particular segment of society, seniors. Evidence of aging related medical research conducted in space was most publicly noticeable during STS-95 (See below).
Medical space spinoffs from the early space exploration years (pre-Mercury through Apollo projects)
Radiation therapy for the treatment of cancer. In conjunction with Cleveland Clinic,
the cyclotron at NASA center in Cleveland, Ohiohich had been utilized for testing nuclear propulsion systems for air and space craftas used in the first clinical trials for the treatment and evaluation of neutron radiation therapy for cancer patients.
Foldable walkers. Made from a lightweight metal material developed by NASA for aircraft and spacecraft, foldable walkers are portable and easy to manage.
Personal alert systems. These are emergency alert devices that can be worn by individuals who may require emergency medical or safety assistance. When a button is pushed, the device sends a signal to a remote location for help. To send the signal, the device relies on telemetry technology developed at NASA.
CAT Scans and MRIs. These devices are used by hospitals to see inside the human body. Their development would not have been possible without the technology provided by NASA after it found a way to take better pictures of the Earth moon.
Muscle stimulator device. This device is used for hour per day to prevent muscle atrophy in paralyzed individuals. It provides electrical stimulation to muscles which is equal to jogging three miles per week. Christopher Reeves used these in his therapy.
Orthopedic evaluation tools. Equipment to evaluate posture, gait, and balance disturbances was developed at NASA, along with a radiation-free way to measure bone flexibility using vibration.
Diabetic foot mapping. This technique was developed at NASA center in Cleveland, Ohio to help monitor the effects of diabetes in feet. These efforts helped
Foam cushioning. Special foam used for cushioning astronauts during liftoff is used in pillows and mattresses at many nursing homes and hospitals to help prevent ulcers, relieve pressure, and provide a better night sleep.
Kidney dialysis machines. These machines rely on technology developed by NASA in order to process and remove toxic waste from used dialysis fluid.
Talking wheelchairs. Paralyzed individuals who have difficulty speaking may use a talking feature on their wheelchairs which was developed by NASA to create synthesized speech for aircraft.
Collapsible, lightweight wheelchairs. These wheelchairs are designed for portability and can be folded and put into trunks of cars. They rely on synthetic materials that NASA developed for its air and space craft
Surgically implantable heart pacemaker. These devices depend on technologies developed by NASA for use with satellites. They communicate information about the activity of the pacemaker, such as how much time remains before the batteries need to be replaced.
Implantable heart defibrillator. This tool continuously monitors heart activity and can deliver an electric shock to restore heartbeat regularity.
EMS Communications. Technology used to communicate telemetry between Earth and space was developed by NASA to monitor the health of astronauts in space from the ground. Ambulances use this same technology to send informationike EKG readingsrom patients in transport to hospitals. This allows faster and better treatment.
Weightlessness. While not an invention per se, the weightlessness of space one day may allow individuals with limited mobility on Earthven those normally confined to wheelchairshe freedom to move about with ease. A notable individual to take advantage of weightlessness in the “Vomit Comet” during 2007 was physicist Stephen Hawking.
Major historical medical investigations in space during the Space Shuttle era
STS-95
John Glenn, the first American astronaut to orbit the Earth, returned with much fanfare to space once again at 77 years of age to confront the physiological challenges preventing long-term space travel for astronautsoss of bone density, loss of muscle mass, balance disorders, sleep disturbances, cardiovascular changes, and immune system depressionll of which are problems confronting aging people as well as astronauts. Once again Glenn stepped forward to play an historic role in the future of space exploration, but this time he would provide new medical research in the field of gerontology as well.
What are the effects of space on the body?
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Accident investigation
Decompression sickness
Decompression illness in spaceflight
In space, astronauts use a space suit, essentially a self-contained individual spacecraft, to do spacewalks, or extra-vehicular activities (EVAs). Spacesuits are generally inflated with 100% oxygen at a total pressure that is less than a third of normal atmospheric pressure. Eliminating inert atmospheric components such as nitrogen allows the astronaut to breathe comfortably, but also have the mobility to use their hands, arms, and legs to complete required work, which would be more difficult in a higher pressure suit.
After the astronaut dons the spacesuit, air is replaced by 100% oxygen in a process called a “nitrogen purge”. In order to reduce the risk of decompression sickness, the astronaut must spend several hours “pre-breathing” at an intermediate nitrogen partial pressure, in order to let their body tissues outgas nitrogen slowly enough that bubbles are not formed. When the astronaut returns to the “shirt sleeve” environment of the spacecraft after an EVA, pressure is restored to whatever the operating pressure of that spacecraft may be, generally normal atmospheric pressure. Decompression illness in spaceflight consists of decompression sickness (DCS) and other injuries due to uncompensated changes in pressure, or barotrauma.
Decompression sickness
Decompression sickness is the injury to the tissues of the body resulting from the presence of nitrogen bubbles in the tissues and blood. This occurs due to a rapid reduction in ambient pressure causing the dissolved nitrogen to come out of solution as gas bubbles. In space the risk of DCS is significantly reduced by using a technique to wash out the nitrogen in the body tissues. This is achieved by breathing 100% oxygen for a specified period of time before donning the spacesuit, and is continued after a nitrogen purge. DCS may result from inadequate or interrupted pre-oxygenation time, or other factors including the astronaut level of hydration, physical conditioning, prior injuries and age. Other risks of DCS include inadequate nitrogen purge in the EMU, a strenuous or excessively prolonged EVA, or a loss of suit pressure. Non-EVA crewmembers may also be at risk for DCS if there is a loss of spacecraft cabin pressure.
Symptoms of DCS in space may include chest pain, shortness of breath, cough or pain with a deep breath, unusual fatigue, lightheadedness, dizziness, headache, unexplained musculoskeletal pain, tingling or numbness, extremities weakness, or visual abnormalities.
Primary treatment principles consist of in-suit repressurization to re-dissolve nitrogen bubbles, 100% oxygen to re-oxygenate tissues, and hydration to improve the circulation to injured tissues.
To date there have been no reported cases of DCS in the NASA space program.
Barotrauma
Barotrauma is the injury to the tissues of air filled spaces in the body as a result of differences in pressure between the body spaces and the ambient atmospheric pressure. Air filled spaces include the middle ears, parananal sinuses, lungs and gastrointestinal tract. One would be predisposed by a pre-existing upper respiratory infection, nasal allergies, recurrent changing pressures, dehydration, or a poor equalizing technique.
Positive pressure in the air filled spaces results from reduced barometric pressure during the depressurization phase of an EVA. It can cause abdominal distension, ear or sinus pain, decreased hearing, and dental or jaw pain. Abdominal distension can be treated with extending the abdomen, gentle massage and encourage passing flatus. Ear and sinus pressure can be relieved with passive release of positive pressure. Pretreatment for susceptible individuals can include oral and nasal decongestants, or oral and nasal steroids.
Negative pressure in air fill spaces results from increased barometric pressure during repressurization after an EVA or following a planned restoration of a reduced cabin pressure. Common symptoms include ear or sinus pain, decreased hearing, and tooth or jaw pain.
Treatment may include active positive pressure equalization of ears and sinuses, oral and nasal decongestants, or oral and nasal steroids, and appropriate pain medication if needed.
Ultrasound and Space
Medicine in Space
The Advanced Diagnostic Ultrasound in Microgravity Study is funded by the National Space and Biomedical Research Institute and involves the use of ultrasound among Astronauts including former ISS Commanders Leroy Chiao and Gennady Padalka who are guided by remote experts to diagnose and potentially treat hundreds of medical conditions in space. This study has a widespread impact and has been extended to cover professional and Olympic sports injuries as well as medical students. It is anticipated that remote guided ultrasound will have application on Earth in emergency and rural care situations. Findings from this study were submitted for publication to the journal Radiology aboard the International Space Station; the first article submitted in space.
References
Altitude Decompression Sickness Susceptibility, MacPherson, G; Aviation, Space, and Environmental Medicine, Volume 78, Number 6, June 2007 , pp. 630-631(2)
Decision Analysis in Aerospace Medicine: Costs and Benefits of a Hyperbaric Facility in Space, John-Baptiste, A; Cook, T; Straus, S; Naglie, G; et al. Aviation, Space, and Environmental Medicine, Volume 77, Number 4, April 2006 , pp. 434-443(10)
Incidence of Adverse Reactions from 23,000 Exposures to Simulated Terrestrial Altitudes up to 8900 m, DeGroot, D; Devine JA; Fulco CS; Aviation, Space, and Environmental Medicine, Volume 74, Number 9, September 2003 , pp. 994-997(4)
Decreased immune system functioning
Astronauts in space have weakened immune systems, which means that in addition to increased vulnerability to new exposures, viruses already present in the bodyhich would normally be suppressedecome active. In space, T-cells (a part of white blood cells that produces antibodies) do not reproduce properly. T-cells that do exist are less able to fight off infection. NASA research is measuring the change in the immune systems of its astronauts as well as performing experiments with T-cells in space.
Effects of fatigue
Human performance
Loss of balance
Leaving and returning to Earth gravity causes pace sickness, dizziness, and loss of balance in astronauts. By studying how changes can affect balance in the human bodynvolving the senses, the brain, the inner ear, and blood pressureASA hopes to develop treatments that can be used on Earth and in space to correct balance disorders. Until then, NASA astronauts must rely on a medication called Midodrine (an nti-dizzy pill that temporarily increases blood pressure) to help carry out the tasks they need to do to return home safely.
Loss of bone density
Unlike people with osteoporosis, astronauts eventually regain their bone density.[citation needed] After a 3-4 month trip into space, it takes about 23 years to regain lost bone density.[citation needed] New techniques are being developed to help astronauts recover faster. Research in the following areas holds the potential to aid the process of growing new bone:
Diet and Exercise changes may reduce osteoporosis.
Vibration Therapy may stimulate bone growth.
Medication could trigger the body to produce more of the protein responsible for bone growth and formation.
Loss of muscle mass
In space, muscles in the legs, back, spine, and heart weaken and waste away because they no longer are needed to overcome gravity, just as people lose muscle when they age due to reduced physical activity. Astronauts rely on research in the following areas to build muscle and maintain body mass:
Exercise may build muscle if at least two hours a day is spent doing resistance training routines.
Hormone supplements (hGH) may be a way to tap into the body natural growth signals.
Medication may trigger the body into producing muscle growth proteins.
Man-machine interface
Orthostatic intolerance
In space, astronauts lose fluid volumencluding up to 22% of their blood volume. Because it has less blood to pump, the heart will atrophy. A weakened heart results in low blood pressure and can produce a problem with rthostatic tolerance, or the body ability to send enough oxygen to the brain without fainting or becoming dizzy. “Under the effects of the earth’s gravity, blood and other body fluids are pulled towards the lower body. When gravity is taken away or reduced during space exploration, the blood tends to collect in the upper body instead, resulting in facial edema and other unwelcome side effects. Upon return to earth, the blood begins to pool in the lower extremities again, resulting in orthostatic hypotension.”
Psychological factors
Radiation effects
Soviet cosmonaut Valentin Lebedev, who spent 221 days in the orbit in 1982 (an absolute record for stay in Earth orbit), loses his eyesight to progressive cataract. Lebedev stated: suffered from a lot of radiation in space. It was all concealed back then, during the Soviet years, but now I can say that I caused damage to my health because of that flight.7]
Safety/habitability
Sleep disorders
Fifty percent of space shuttle astronauts take sleeping pills and still get two hours less sleep. NASA is researching two areas which may provide the keys to a better night sleep, as improved sleep decreases fatigue and increases daytime productivity:
Environmental cues and practices may be able to retrain the body circadian rhythm.
Medication could improve sleep by increasing the production of melatonin, a sleep hormone
Spatial disorientation
Medical interventions
Exercise to maintain muscle strength and function
Sleep cap
Medication, including hormone replacement therapy
How does one prepare for a career in space medicine?
Educational programs
Naval Operations Medical Institute (NAMI) – Pensacola, Florida
U.S. Air Force School of Aerospace Medicine – Brooks City-Base, San Antonio, Texas
University of Texas Medical Branch at Galveston (UTMB) – Aerospace Medicine Residency Program
Wright State University School of Medicine – Dayton, Ohio
Vanderbilt Center for Space Physiology and Medicine – (Dr. David Robertson)
Space Studies Department at the University of North Dakota
Related degrees, areas of specialization, and certifications
Aeromedical certification
Aerospace Medicine
Aerospace Studies
Emergency Medicine
Family Practice
Internal Medicine
Occupational and Preventive Medicine
Ophthalmology
Otolaryngology
Public Health
Professional organizations
Aerospace Human Factors Association
Aerospace Medical Association
Air Medical Physician Association
American Psychological Association
Association of Air Medical Services
Aviation & Aerospace Medicine
Federal Aviation Administration Office of Aerospace Medicine
Human Factors & Ergonomics Society
Human Performance in Extreme Environments
See also
Spaceflight osteopenia
Artificial gravity
Human adaptation to space
Microgravity University
Vomit Comet
Health threat from cosmic rays
External links
Description of space medicine
NASA History Series Publications (many of which are online)
References
^ BBC NEWS | Magazine | Project Paperclip: Dark side of the Moon
^ Associated Press (2006-05-19). “Former Nazi removed from Space Hall of Fame”. MSNBC. http://msnbc.msn.com/id/12869190/. Retrieved 2006-05-19.
^ http://www.nasa.gov/mission_pages/station/science/experiments/ADUM.html
^ A Pilot Study of Comprehensive Ultrasound Education at the Wayne State University School of Medicine: http://www.jultrasoundmed.org/cgi/content/abstract/27/5/745
^ Evaluation of Shoulder Integrity in Space: First Report of Musculoskeletal US on the International Space Station: http://radiology.rsna.org/content/234/2/319.abstract
^ When Space Makes You Dizzy
^ Soviet cosmonauts burnt their eyes in space for USSR glory
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