| Autor: |
Kutz, Craig J., Makowski, Matthew S., LaBarbera, Michael A., Pattarini, James M., Auñón-Chancellor, Serena M. |
| Předmět: |
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| Zdroj: |
Aerospace Medicine & Human Performance; Aug2024, Vol. 95 Issue 8, p507-507, 1/3p |
| Abstrakt: |
INTRODUCTION: This case report presents a hypothetical lunar decompression sickness (DCS) event with consideration of treatment approach and disposition. BACKGROUND: Lunar extravehicular activities (EVA) pose a risk of developing DCS from operational shifts in pressure between suits and lunar habitats. Although prebreathe protocols theoretically decrease the risk of DCS through denitrogenation, the consequences of an event are mission critical. Type I DCS represents the majority of hypobaric pathology and many medical organizations implement 'return-to-duty' guidelines following treatment. This case will overview a hypothetical occurrence of Type I DCS on a lunar surface EVA in an experienced astronaut and will highlight treatment, return to flying status, and mission impact. CASE PRESENTATION: A 55-year-old female crewmember with extensive EVA experience developed right knee pain during her first lunar surface sortie. The pain severity distracted her from mission objectives and the EVA was aborted by the supervising flight surgeon given suspicion for DCS. The crewmember was treated with an in-suit repressurization protocol and her symptoms resolved. She had no prior history of DCS and subsequent EVA for the following three days were cancelled by flight medicine due to the risk of recurrence and performance decrement. DISCUSSION: Exploration missions will require extensive EVA capabilities for sustained space operations, including the lunar surface and beyond. Although recurrence of treated DCS is plausible, a clear delineation of risk factors makes 'return-to-duty' difficult so mitigation continues to be the best treatment for DCS. Clinical guidelines to minimize post-treatment risk of DCS recurrence exist within the Department of Defense, commercial diving, and recreational diving sectors, however, there is a paucity of literature for cases such as this astronaut treated with hyperbaric pressures utilizing in-suit protocols. This case report will highlight the current mission implications of DCS including unavailability of standard 41.1 psia (2.8 ATA) hyperbaric oxygen, difficulty in medical evacuation from the lunar surface, and approach to returning a crewmember back to mission EVA status. Learning Objectives 1. The audience will gain an appreciation of risk assessment for recurrent decompression sickness in a hypothetical astronaut crewmember on a long-duration lunar surface mission. 2. The audience will learn how existing medical guidelines may apply to return-to-duty assessment for individuals operating in a hypobaric lunar habitat environment and lunar surface EVA. [ABSTRACT FROM AUTHOR] |
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