STS-1 Medical Report

8/7/2019 STS-1 Medical Report

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S I S - 1A3 1

STSliMedicalReportn E C l C A L n E F O B I ( t i ASA)csci Jel?

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NASA Techical Memorandum 58240S T S IMedicalReportEdited by3tartr I.. Pool. N.D .Phillip ('. Johtuon. Jr., Jl.D.John .1.MusonL y n d m 13. Joiittson S p a c - t p C m t e rHouston. Tc.scrci


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Table of ContentsTITLE PAGE1. tnttoduction .......................... 12 Evaluationof Crew Health ................... 5

Craig L. Fischer and Joseph Dqioanni3 InflightObranations ....................... - 7

MichaelA. Berry4. Crew MedicalDebriefing .................... 11

(Interviews& Comments)nh Ilti-Input

5. Heatth Stabilization Program ................ 19Jaines K. Ferguson

6. Emergency Medical Services System ........... 23(EMS4Sam L. Pool

7. Crew Medical Training ..................... .29James M. Vanderploeg

8. Shuttle Orbital Medical System .............. 31James M. Vanderploeg

9. Validation of Predictive Tests and ............ 37Countermeasuresfor Space MotionSickma

Jerry L. Homick10. Crew CardiovascularProfile ................. 39

Michael W. Bungo11. Biochemistry and Endocrinology ............. -47

ResultsCarolyn S. Leach

PAGEITLE12 Hematological 81 mmundogieal ............. 51

AnalysesGerald R. Taylor

13. Medical Microbiology of Crewmemben ........ 53DuaneI.ierson

14. Food and Nutrition ....................... -59Richard L. Suer and Rita M. Rapp

15. Th e PotableWater .................... -63Richard L. Sauer

16. Shuttle ToxicologV ........................ .67Wayland J. Rippstein

17. Radiological Health .................... -77Charles M. Barnes

18. Cabin Acoustical Noise. .................... .79Jerry L. Homick

19. Environmental Effects of Shuttle ............. 81Launch and Landing

Andrew E. Potter20. Medical Information Management ............ 93

EdwardC. Moseley21. Management, Planning, and ................. 99

ImplementationNorman Belasca

2 2 Acknowledgements ...................... .111

PRECEDUYG PAGE BLANK NOT eLWE0

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e,--I , .

IntroductionThe Space Tr a n sp o r t a t i o n System One(STS-11, was t h e f i r s t o f f o u r p l an ne dmanned o r b i t a l t e s t f l i g h t s o f t h e Spac?Sh u t t l e veh i c le . S ince i t was the f irs:.t i m e t h a t h e r i c a n s p a c e c ra f t ha d beenp u t i n t o o r b i t w i t h o u t p r i o r unmannedf l i g h t o r b i t a l t e s t i n g , t he m i ss io n wasc o n s er v a ti v e ly p la nn ed i n t h e i n t e r e s tof safety.The pr im ary purpose o f STS-1 was t odemonstrate a safe ascen t and re tu rn o ft he Or b i t e r and crew. Ad d i t i on a l l y , i tp r o v i d e d d at a t o s u p p o r t e n g i n e e r i n gv e r i f i c a t i o n o f t he f o ll o w in g :

Combined Shut t le veh ic le (Orb i te r ,Sol i d Rocket Booster (SRB), Ex terna lTank ( E T ) , and Space Shutt le MainEng ine (SSME) perform ance, i c l ud ingS R B and E T s e p a r a t i o n , S R Brecovery; r e t r ieval and ET di posal .Combined Shutt le vehicle aerodynamic,s t ru c t u r e and sys tems cha rac ter i s -t i c s , and pred ic ted loads.O r b i t e r e n t r y c h e r a c t e r i s t i c s andp e r f o r m a n c e i c l u d i n g c r o s s r a n g ecapab i l i t i e s , Thermal Cont ro l Sys tem(TCS) per fo rmance, co nt ro l pe r fo r -mance, a nd p r e d i c t e d s t r u c t u r a l1oads.Orbi ter vehic le hardware and sof twaresystems checkout and performance.I n f l g h t v e h i c l e h ard wa re a nd s o f t -wa re sys tems checkou t and pe r -formance.A1 t i u d e c o n t r o l c a p a b i l i i e s , a n dg u id a n c e a s w e l l a s n a v i g a t i o nperformance.

The medical obj ec t iv es o f S T S - 1 i n c lude :o Medica l eva lua t ion o f crew health.

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V e r i f i c a t i o n o f p r e f l i g h t th ro ug hp o s t f l i g h t o f the emergency medicalsupport system.D e t e r m i n a t i o n o f w h e t he r S h u t t l ea tm o sp h er es c o n t a i n e d t o x i c s ub -stances.D e t e rm i n a ti o n o f c a b i n a c o u s t i c a lno i se 1eve1s .E x a mi na ti on d nd u s e o f S h u t t l eOrbi ter Medical System (SOMS) k i twhich was unique f o r mission.Pr ed ict io n and measurement o f crewr a d i a t i o n e xp os ure s o f t h e crew .

* * * *s pa ce sh ip C o l m b i a 1 f t e d o f f fromKennedy %ace C en te r's la un ch Rada t 7:06 am EST on A p r i l 12, 1981' ( -102: 1 : 0: 3.9 g .m. t. f o l 1owi ng sev era ld e la y s . A f t e r 2 d ay s, 6 h o u r s 2 0minutes and 52 seconds, i t landed onRunway 23 o f Rogers Dry Lake a t EdwardsA i r Force Base i n th e Mohave Deser t o fC a l i f o r n i a r o l l i n g 8993 f e e t , w i t h i n 2 00f e e t o f t h e e s t i m a t e d l a n d i n g / s t o p p i n gp o i n t.T h i s was th e f i r s t a i r p l a n e - l i k e l a n d in go f a c r a f t f ro m o r b i t . M oreo ve r,Col unbia appeared h ard ly th e worse f o rwear a f t e r i t s s e a r i n g at mo sp he ri c e n t r ywhen, t em pera hure s excee ded pe rha ps1650 C ( 3000 F ) . F r o m a c a r e f u li n s p e c t i o n o f C o lu nb ia , NASA t echn i c iansc on fi r me d t h a t i t s c o n d i t i o n wasexce l l en t and es t ima ted tha t Co lunb iashou ld be capab le o f mak ing a t l e as t 100r o u nd t r i p s b e tw e en E a r t h and E a r t ho r b i t .John W. Young s erve d as Commander o fCjTS-1, Robert L. Crippen (C ap tain USN)serv ed as P i l o t . The backup Commanderwas Joe H. Engle (Colonel , USAF ) , andthe backup P i l o t was Richard H. T r u l y( Captain, US N .

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R i s i n g o n t h e p o we r o f 6.6 m i l l i o npounds o f th ru s t Co lunb ia f i r s t f l e wsteeper than programmed, w i t h i t s th re zr a i n hydrogen-powered engines and twos o l i d r o c k e t m o t o rs p o i n t e d s ky wa rd .Co l lmb ia made a 100 degree r o l l t o th er i g h t , h ea din g f o r i t s i ma g in a ry ta r g e t .Two minutes and 1 2 seconds la te r , thes o l i d r o c k e t b o o st e rs were j e t t i s o n e d .They we re l a t e r r e c ov e r ed , v i a aparachute system, 151 m ile s downranoe i nthe At lant ic Ocean of f Daytona Beach,F lo r ida . As i n post - launch and recov-er ies, operat ions were observed by USSRt r aw l e r s .Eight minutes and 34 seconds l a te r , t hemain engines c u t o f f . The speed was25,670 f e e t pe r second. The ex te rn altank was jett isoned and broke up overth e Indi an Ocean. The de br is landed, asplanne d, 21,000 mi le s downrange from t h eKennedy Space Center. A t 10 minutes,t h e t h i r d s ta ge , c o n s i s t i n g o f the twoengine O rb it a l Haneuveri ng System (OMS) ,took over f i r e d f o r 1 minute and 27seconds, e s tab l i sh i ng an o rb i t o f 132 by57 n a u t i c a l m i l e s . A second OMS bu rna c h i e v e d a 1 3 0 m i l e c i r c u l a r o r b i t . At h i r d a t 6 hours, 20 minutes set th eo r b i t a t 148 by 131.7 miles and a f o u r t ha dd ed 30 fe e t - p e r- s e c o n d t o s e t t h ec i r c u l a r o r b i t a t 149.3 by 147.6.On launc h day, A p r i l 12, 1981, the ca bintem pera ture and pr es su re was 83F and15.04 ps ia a t l i f t - o f f . The a i rre v i ta l i z a t i o n sys tem performance wasno rmal and th e sys tem ope ra te d asexpec ted th roughout t he f l i g h t w i t h on l yt w o except ions. The cab in cond i t i onswere warmer than expected a t t a k e - o f f( a s n o t e d a b o v e ) a n d c o l d e r t h a nc .x pe c+ -d d u r i n g t h e o n - o r b i t s l ee pp e r i00s. A v a i l ab1 e o p e r a t i o n a li n s t r u n e n t a t i o n d ata i n d i c a t e t h a t t h et e m p e r a tu r e c o n t r o l s y st em o p e r a t e dw i t h i n s p e c i f i e d l i m i t s d u r i n g a l lf l ght phases.A s e r i e s o f t e s t s and checkouts werethe n begun. As t ro na uts Young andC rip pe r! t r i e d o u t a l l systems andchecked the con iputers, the j e t t h ru s te rs

used i n orienting Colunbia, and tho p en in g a nd c l o s i n g o f t h e c a r go( p a y l o a d ) b a y doors. Columbia wam a i nt a in e d i n a t a i l - f o r w a r d p o s i t i oand ups ide down re la t i v e t o Ea r th . Thupside-dow n p s i i o n p r ov id e d a b e t t zv ie w o f E a r t h and i t s h o r iz o n f oo r i e n t a t i o n .The Commander and P i l o t docunented t h e if l i g h t us!ng a s t i l l cam era as w e l l aTV and mot ion p ic tu re cmercls. One v iewo f th e cargo bay, which was te le ca st t oEar th i nd i ca ted , tndt a l l o r p a r t o f 1h ea t s h ie l d in g t i l e s l o c at ed i n t w o podon the t a i l sect ion , were l o s t probardue t o s tr esses o f launch. l h e l os s wasno t cons ide red se r i ous .Young and Crippen wore ordinary covera l l s w h i l e i n o r b i t ; f o r launch anlan din g they wore space pressure su i ts .On l an d in g they wore an t i G -su i ts wh ichwere no t i n f l a ted .The morning o f Day 3 t h e a s t r o n a n t sr e a d i e d f o r t h e p r e m i e r t e s t o f a wingedE ar th e n t r y and wheel s -down 1 and ing .Previous spacec ra f t e tu rned t o Ea r thw i t h parac hutes and sp l sshdown. Ea rthen t ry l as te d about 31 minu tes , w i th thes p a c e c r a f t e n t e r i n g t h e a t m o s p h e r eapp roxim ately 400,000 fe e t above Earth .A t t h i s po in t , Colunbia was about 4,390m i l e s f ro m Edwards l a n d i n g s t r i p i nC ali o r n i a. Temperatures ranged from2,500 t o 3,000 degrees Fahrenheit onsome p ar ts o f th e t i l e s . CommandeYoung too k manual co nt ro l o f Columbia a15 ,000 fee t . A doub le son i c boo inannounced the approach o f Col unbi a whi 1et h e v e h i c le was s t i l l a t an a l t i t u d e o54,000 f ee t. About 400 f e e t above th edeser t , the landing gear was lowered.The space s h i p l a rd e d on EdwardsAirforce Base Runway 23 a t 1:21 pm ESTo n A p r i l 14, 1981.After the crew landed they were examinedby the C r e w Phys ic ians and debr ie fed .T h i s r e p o r t w i l l no t on l y d i scuss ther e s u l t s o f t h es e m e d i c a l t e s t s /d e b r i e f i n g s , b u t w i l l d e s c r i b e a lm e d i ca l ly r e l a t e d a c t i v i t i e s , r a ng in g


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from pr e f l ig h t th rough pos t f l ig h t . Th is STS-1 m i s s i o n p u b l i s h e d by NASAr e pr e s e n ts a d e ta i l e d r e po r t , a s a H ea dqua rter s, May 26, 1981 (Post f l ightsfol low-on, supplementing and amplify ing Mi ss io n O pe ra t i on Re po rt No.the general ne di ca l assessment o f th e S-989-81-01).

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The b a s i c p h i lo s o p h y f o r STS-1 wa scou ch ed i n t h e p re mis e t h a t t h e f l i g h twas a ve hi c le checkout, the refo re, th em e d i c a l p ro g ra m was d i r e c t e d t o w a r drout ine c rew heal th maintenance and thei m p l e m e n t a t i o n o f a s o p h i s t i c a t e dEmergency Med ical System, ra th e r tha nt h e c on du ct o f d e t a i 1e d p h y s io l o g i ceva lua t ions p re and po s t f l i gh t . TheSTS-1 Me dica l Program was de signed t op r o t e c t and m a i n t a in f l i g h t cr ew h e a l t hdur in g a l l phases of the miss ion. Th isgoal was acco mplished by a program wh iche nco mp asse d t h e f o l l o w in g e l ements :( 11 H e a l th S t a P l z a t i o n Program, (2)C r i t i ca l Persona l Re1 i a b i l t y Program,( 3 ) P r e and P o s t f l i g h t M e dic al F l i g h tCrew Eva1 ua ti on s, ( 4 ) I n f l g h t m ed ic a lco nsu l t a t i o n a v a i l a b i l i t y v i a M i s s i o nC o n t r o l C e n t e r ( MCC ) Surgeons, and( 5 ) I m p l e m e n t a t i o n o f a n E me rg en cyM e d i ca l S yste n, a t a l l l a u n c h an drecovery s i tes .Physical examinations were conducted onF-30 (March 2, 19811, F-19 (March 31,19811, Launch Day ( A p r i l 10 , 1981) ,Landing Day (Apr i l 14, 19811, and L+3( A p r i l 17, 1981 ). See Ta ble 2-1 f o rd e t a i l s.The Crew Physician (Craig L. Fischer ,M.D . ) and Deputy Crew Physician (JosephDegioanni, M . D . ) pc rfo rmed a l l p re andpo s t f l g h t phys ica l examinations . Eachphys ic ian had the okp or tu n i ty t o examineboth c rewnen pref l ight (F-30 and F-10)and the same crewnan post landing as heexamined on lau nch morning.

Results and DiscussionThe pr ef l ig h t in te rv a l was compl ica te dby an on-pad m iss ion abor t i n the f i n a lmoments o f countdown. The cr eb had beeni n t h e l au n ch p o s i t i o n f o r a p pr ox im a te lyc,ix hours by the t ime t h i s ma l fun c t ionwas encountered and i t was decided thatthe launch had to be recyc led i n 48

hours. The second countdown went quitesmoothly and the lau nc h was nom inal. I tshould be noted that the c rew remainedi n good s p i r i t s t h ro u g ho u t t h i s u np ro -rammed de lay and remained a t a h ig h9eve1 o f readiness . Conversat ion w i t hbo th c rewembers revea led tha t s i x hewsi n th e lau nch p o s i t i o n i s a t t h e l e v e lof to lerance from a comfort s tandpoin: .T h is i s i n agreement w i t h a pre-missio;e s ti m at e and m is si on r u l e l i m i t i n g t h ecrew res idence t ime t o s i x hours i n t h elaunch pos i t i on . No s ign i f ican: medica lp ro ble m o cc ur re d i n t h e p r e f l i g h ti n t e r v a l.Unl i ke p rev ious space f l i g h ts , the crewr e -e n te re d i n t h e s ea te d p o s i t i o n ,t h e r e b y p u l l i n g r e - e n t r y G i n t h e Gax is . Th is fa c t , coupled with an a c t i dc re w r o l e i n t h e O r b i t e r r e - e n t r ysequence, necessi ta te d th e donning ofa n t i- G g arm en ts p r i o r t o r e - e n tr y w i t hthe c rew p repared t o i n f l a t e them i f anypresyncopal signs occurred.The re-entry G p r o f i l e was nominal anda t no t i m e d i d t h e c re w r e p o r t anya dve rse e f f e c t s o f G l o a d i n g . A f t e rl a n d in g , m i n o r d i f f i c u l t y was e x p e ri -enced i n ex t rac t in g the c rew f rom th eO r b i t e r due t o t o x i c fu ne s o u t s i d e t h eveh ic le i n the ha tch a rea. Th is p roblemwas so lved by repo s i t io n in g th e w indmachine. Hatch opening occu rre d one hourand twen ty minutes af t e r wheel s top.Dur ing the pos t l and ing wa i t f o r I i a t chopen ing, th e Commander g o t qu i t e w2.qand i n je c te d coo l wa te r i n t o h i s spaces u i t fr om th e water gun loca ted or: t h em id deck. The P i l o t , however, was com-fo r tab le . Th is may be a re f l ec t i o n ont h e f a c t t h a t t h e P i l o t was n o t a sp h y s i c a l l y a c t i v e p o s t f l i 2 h t as t h eCommander. The P i l o t rema'ned on t h ef l i g h t deck whereas th e Commander hadr e s p o n s i b i l i t i e s w h i c h r e q u i r e d t h a t h emove between the f l i g h t and mid-decks.

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A f t e r r e mo va l f ro m t h e O r b i t e r b o t h Concluding Remarksc r e n n e n w a l k e d w i t h o u t d i f f i c u l ty an dexperienced no untoward symptomatology. No s i g n i f i c a n t c l i n i c a l p ro ble m wasD e s ui ti ng o cc ur re d i n t h e crew van o n i d e n t i f i e d p o s t f l i g h t . O f i n t e r e s tthe way back t o the f l i g h t l i n e exam me dica l ly was the expected hyp er re f lex iaf a c i l i t y . A1 though th e Comnmder was and dependent venous st as is ex hi b i te d byd re n ch e d, b o t h c re ww en d o f f e d t h e i r b o t h c r e w e n .su i t s eas i l y . Ne i t he r c reman had any -t h i n g t o e a t or d r i n k i n t h e c re w va nand d i d n o t c om pla in o f t h i r s t .

EXAMCOMPONENTS

I

Table r-1STS-1 Pre and Postflight Medical Evaluations

LM LM LM PXPX ST0 PXW AT

r rAYS DAYS DAYSLMST WPX

LOCATIONAPPROXIMATEDURATION

ST T-38 ST - (Cardiovascular) Stress Tests,D CHECK induding 80%treadmill

OUT ST W - Stand Ted-WeightTA T - TonometryPX V - Visual Examination

LEGEND:L+7

A - AudiometryL+ o I L+3 l L + 3 I

LEGEND:L+7

A - AudiometryI I { D - Dental ExaminationLM - LaboratorpMicrobiologyPX - Physical ..amination

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InfIightMichae l A.

ObservationsBerry, M.D.

The medical mo ni to r ing o f space crewsd u r i n g f l i g h t b y gro un d based F l i g h tS u rg eo ns h a s bee n r o u t i n e s i n c e t h ef i r s t Me rcury sub -o rb i t a l m iss ions . Themedica l mon i to r ing has been cont inua l lye v o l v i n g t h ro u g ho u t t h i s 20 yea r pe r i od .The i n f l i g h t m e d ic a l m o n i t o r in g of t h ec rew o f STS-1 b u i l t u pon t h e p r ev io u sy e a r s and y e t w as u n iq u e i n manyr e s p e c t s . T he c o n c e r n a b o u t m a n sa b i l i t y t o w i th st an d t h e s tr es se s o fspace f l i g h t ha ve d i m i n i s he d i n t h el i g h t o f many h o u r s o f e x p e r i e n c e .Therefore, minimum biomedical i s t r u -me nta tion o f the crew was used. Themon! t o r i ng was ca r r ie d ou t by reco rd inge l e c t r o - c a r d i o g r a m (ECG) d u r i n g p r e -l aunch , l aunch , ea r l y o r b i t t ime , en t r y ,and l a n d i n g ; m o n i t o r i n g c re w v o i c et ransmiss ion th roughout the miss ion ; andconduct ing a d a i l y p r i v a t e c r e w m e d i c a lcommunication. The personne l perf orm ingt h e i n f l i g h t m o n i t o r in g o f t h e c re w wereF1 i g h t Surgeons and Biom edical Enginee rs(BME). The mon i to r ing took p lace i n theM is si on O per atio ns C on tro l Room (MOCR)F igu re 3-1 , the Med ica l St a f f SupportRoom (SSR), and i n t h e M i s s io n C o n t r olCenter (MCC)There were three Fl ight Contro l Teams,one fo r each major phase o f the miss ion :a s ce n t, o r b i t , a nd e n t r y . A M O C RSurgeon and BME were assigned t o each o fth es e teams. The MOCR Surgeon providedthe medical exp er t ise , and the BME t h ee n g in e e r in g e x p e r t i se conce rned w i hme dic al ly re la te d systems. The moni-to r i n g, conducted by th e medical team,in c l uded vo ice and ECG, environmentalco nt ro l systems, food, w ater , and per-sonal hygiene. The team was b a s ic a l l yc o nc e rn e d w i t h a n y sy s te m t h a t h a dp o t e n t i a l d i r e c t e f f e c t s on crew h e a l t h .Tr ain in g o f th e medical team was con-d a t e d t h r o u g h S h u t t l e s ys te ms w o rk -books, 1ectures , and in te gr a t ed s imu-l a t i o n s . The t r a i n i n g p e r i o d f o r S T S - I

l a s ted app rox ima te l y 2 y e a r s. The l a s t6 months were spent i n ~ e e k l y i m u l a t i o nt r a i n i n g w i t h t h e f l i g h t c o n t ro l teamand th e prime o r back-up crew i n e i t h e rthe m o t ion base o r f i x ed base s imula -t o r .The pu rpose o f t he i n f l i g h t med ica l mon-i t o r i n g o f t h e c rew was t o e ns ur e m i s -s io n success by mak ing ce r t c tn o f t h eh e a l t h and s a f e t y o f thr crew. Thiswas, i n f a c t , t h e b as ic p re m is e f o r a l lp ha se s o f t h e STS-1 m i s s i o n m e d i c a lsuppor t .

DiscussionS T S - 1 was t o launch a t 0700 EST, t he re -fo re th e c rew was t o be awakened f o rp re f l i g h t p rocedu res a t app rox ima te l ymidn igh t the morn ing be fore launch. I no r d e r t o be i n peak mental and physicalco nd i t i o n t he c rews c f r cad ian rhy thmswere adjusted several hcurs each daydur ing the 5 days be fore launch, wh ichwas scheduled fo r A p r i l 10, 1981.ascent MOCR Surgeon and BM E came onso le a t app rox ima te l y 0110 CST, 4 rsbefore launch. As s o o n a s t h e p r e f l i g h tphysicals w?re accomplished by the CrewSurgeon, t he exce l l e n t hea l t h s ta tus o fthe Comnander (LDR! and P i l o t (PLT) wasre layed t o t he Surgeon i n t h e MOCR. Goodq u a l i t y ECG was rec e ived i n the MCC soona f t e r t h e c r e w i gressed the Orb i te r .The EC G dnd hea r t r a t e f o r t he C D R andPLT w ere f e l t t o b e n or ma l a n d a sexpected.D u r i n g t h e co un td ow n , C a u t i o n a n dWarning (C&W) alarms were tr ig g e re d i nt h e O r b i t e r b y a 15.5 p s i . cab in p res-st ire. Since t h i s was due t o h igh purgeg as t e m p er a tu r e a nd f l o w r a t e w h i c hw ou ld l e v e l o f f s oon a f t e r l a u n ch t h i swas n o t f e l t t o be a p roblem. A h o l dwas c a l l e d sh o r t l y a f t e r T-20 m inu tesdue t o a c o m pu t er p r o b l e m w i t h t h eBack-up F1 i g h t S ystem . A t t e m p t s a t

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The f i r s t sleep per iod cmwenced a f t e r av e r y f u l l 18 hour uo rk day. Cabin tem-pera ture a t th is t ime was reading 77OF,and the crew repor ted being cold. Itwas be i iwed tha t a t empera tu re t r ans -ducer was biased high and causing theproblem. P r i o r t o s leep the crew se tt h e te mp era tu re c o n t r o l l e r t o f u l l warn.They also reset the l i m i t f o r pp0from 2.8 p s i . t o 2.7 p s i . The medica?contingency 1 m i t fo r ppO i s 2.6 p s i.There was concern th a t s i& e the noma1decay o f cabin pressure had not causedany gas f l o w th e 2.8 p s i l i m i t might bereached and cause an alarm during sleep.The sleep period ' lasted approximately 7hours and 45 min utes . There had been noalarms du rin g t h i s perio d. On wake-upthe crew rep or ted they had been co ld a l ln ig h t and had awakened several t imes t ogo below t o t he mid-deck t o ge t ex t r acloth es f o r warmth. Bc th COR and PLThad s le p t i n t h e i r usual seats on t h ef l g h t d eck .The c re w a c t i v i t i e s f o r t h e s ec ondf l i g h t day were performed as per thenormal crew a c t i v i t y p lan. The T V newsconference wi th the V i -e-President con-f irmed th a t they f e l t they were do ingvery we1 1.Dur ing the second day env i r onmen ta lproblems caused by the Pressure ControlSystem-1 ( P CS ) and the cabin temperaturewere resolved by the crew and the K C .A smal l le ak was detected c lose t o thePCS-I 0 /M con t ro? ?e r va lue apd wascausing %om$ fa lse pressure readings. Itwas f e l t t h i s s i t u a t i o n p u t no con-s t r a i n t on th e u s a b i l i t y o f the system;the re fo re PC S-2 was se lec ted wi th PC S-1as a f u l l y usable back-up. The cabintemperature was warned by man ipu ia t ingw a t e r l o o p f l o w t h ro u g h t h e h e a texchanger wh ich seemed t o so lve th eproblem.Approximately 3 hours in to the second

sleep per iod, the crew was awakened by aSystems Management (S ) alarm, The PLTand CD R were awake for approximately 15minu tes tak ing ca re o f t h e s i t u a t i o n .There was no other problem dur ing th en i g h t and th e crew awoke approximately40 minutes e ar ly . Both creuaen reportedthey had s le p t very soundly, even w i t hth e wake-up, and much b e t te r than th epre viou s n!ght. They d i d not complainof any temperature problems and bothsounded i n e x c e l l e nt s p i r i t s .The p re - e n t r y a c t i v i t i e s p ro ce ed ednormal ly. EG G vas pich-d up on the PLTf i r s t on a s ta tes ide pass two revo lu -t i o n s b e fo r e e n t r y a nd o n t h e CDRs h o r t l y t h e r e a f t e r a t Ascension TrackingStation. Mormal ECGs were rece ived onthe cremembers.One a d d i t i o n a l i n f l i g h t p ro b le m c on -cerned the Waste Control System M S ) .Th i s w a s n o t r e p o r t e d u n t i l p o s t f l i g h t .The WCS conmode did not work proper lyfrom the beg inn ing , caus ing u r i ne sp i l l -age and odor problems that increasedwitn each use. By en t r y day i t ha dceased t o funct ion. The crew f e l t th erewas no t enough suct io n i n the systemb ut , t h e re was n o t s u f f i c i e n t t h e t ot roubt eshoot th e problem. P os t f l g h teva lua t ion revea led t h e d i f f i c u l t y wasaue t o a c lo sg ed f i l t e r w hic h d i d n o ta l l o w a f u l l vacuun t o be genera ted .

Concluding RemarksThe cr ew p e rf or m ed i n a n e x c e l l e n twanner. No medical problems o f any k in dw e re e x p e r i e n c e d b y t h e c re w . Nomedica i t rea tment i n f l i g h t r equ i r edexcept f o r t he p rophy lac t i c use o f anant i -mot ion sickness medfcation that hadbeen p l anned pr e f l gh t . Several m i norsystem prob!ems occurred a ff e c ti n g crewcomfor t b ut had no rea l m ission i m p rc t .

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PRECEDIIW; PAGE BLANK NOT FUMEDCrew Medical DebriefingJoseph Degioanni, M.D. and Craig L. Fischer, M.D.

882-157'14 ?3Or. Degioanni's postflight d e b r i e f i n g c f Degioanni: Any p r o b i e l a s w i t h r e a c h i n gastronaut John Young took place d u r i n g f o r , o r p o i n t i n g t o o b j ec t st h e f i r s t m e d i c a l e x a m i n a t io n p o s t - i n t h e c o c kp i t?fl ight, L-0, a t DfRC on April 14, 1981.The fo l lo wi ng d fa logue was taken from Young: Not h e tape reco rd ing o f the session.

Degioanni : Any perceptua l i 1u s io n ,I n f l i g h t , d u r i n g re-entry or after e.g., displacement o f v i s u a lla nding : f i e l d , f a l s e s e n s a ti o n s o ft u r n i n g o r i 1u s i o n o fOeg ioanni : Symptoms o f space mo t ion p i ched -up o r p i ched -downs ic k ne s s, ch an ge i n s k i n a t t i u de o f veh ic le?te m p e r a tu r e , s we a t i n g o rsal ivat ion? Young: NoYcung: No In f l sh t:I n f l i g h t , d u r i n g r e - e n t r y o r a f t e r D egioanni: D id you n o t i ce t h i r s t on Day1 nd i ng: 1 n f l i g h t ?Degioanni : Any spa t ia l d iso r ien t a t io n a ta ny t im e , e v en m i l dJ i s o r ie n ta t o n ?Young: NoDegioann i: Was an i l l u s i o n o f b e i n gupside down ever experienced?Young: NoDegioanni : Any p rob lems w i t h mo to rcoo rd ina t ion?Young: NoDegioanni: Po' int ing t o o b j e c t s , m a i n -t a i n ing desi re d body o r i en-t a t i o n w i t h r e s p e c t t o space-c r a f t ?

Young: NoDegioanni: Thirst, Day 2?Young: No

D egioa nni: D u r i n g l a u n c h o r b i t o rr e - e n t r y , d i d y ou n o t i c ev a w r s ?

Young: No

Degioanni : Odors?Young: NoD egioanni: D i d y o u r f l i g h t s u i t o re qu i p e n t cause i t c h i n g ?

Young: No Young: No

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Degioanni :

Young:Degi an n i :Young:Degi anniYoung:Degioanni :Young:Degi oanni :Young:Degioanni :Young:

Degi an n i :Young:Degi oanni :Young:

D i d t h e i nc re as e i n h e i g h td u r i n g o r b i t a l f l i g h ti n t e r f e r e wi th t h e v i s i o nfrom the spacesu i t?NoO r make th e s u i t uncomfor-tab1 e?wo

During re -en t ry d id you fee l1 ghtheaded?NoWhen di d fac ia l pu ff in ess andhead f u l 1ness 1eave?D ur in g t he f i r s t 5 o r 6 hoursA f t e r 1 a n d in g were y o ul igh theaded?NoDid yo u n o t i c eh e a r t r a te ?I think maybe

an increase i na l i t t l e b i twhen we h i t th e ground.

Did you sweat?NoD i d y o u see l i g h t f l a s h e sdur ing o rb i t?No

D i d s p a c e cr a f t a c o u s t i c a l n o i s ei n t e r f e r e with:

Young:Deyioanni:Young:Degi oanni :Young:

No, b u t we were so busy sleepwasn't a problem.Speech connuni a ti ns?No. We coul d converse witheach o ther rea l we l l .Performance?No t tha t I not iced.

Dr . F is c h e r 's p o s t f l i g h t d e b r i e f i n g ofa s t r o n a u t R o b e r t C r i pp e n t o o k p l a c edur ing th e second medical exam inat ionp o s t f l i g h t , L+3, JSC on April 17, 1981.The fo l l ow in g d ia logue was taken from atape reco rd ing o f th e sess ion.F i scher:

C r i ppen:F i sc her :

Crippen:

F i sc her :

C r i ppen:F i schsr :C r i ppen:

D id y o u h av e a ny s p a c ia ld i s o r i e n t a t i o n a t any t i m ee i t h e r d u r in g i n f l g h t o rre -e nt ry o r even now?No, 1 d i d n ot .Ok, d i d you have any problemswi th i l l u s i o n s o r h ave as e n s a t i o n o f b e i n g u p s i d edown when i t wasinapprop r ia te?Not any more so than I hadexper ienced c l imb ing i n theBFO p r e f l g h t . J u s to r i e n t i n g y o u r s e l f t o w ha twas usual antics.Any d i f f i c u l t y a t a l l w i t hmotor coord inat ion?

NO

A t a n y p h a s e d u r i n g t h ef l i g h t ?NO

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Fisc f ie r : Any d i f f i c u l t y i n p o in t i n g t oo b j e c t s o r r e a c h i n g o u t a n dg e t t i n g a ho ld o f t he r i y h tt h i n g ?Cr i r pen : No, i n f a c t i t was exact lyo p p o s i t e o f t h a t . I found i tvery easy t o grab hold andpush yourse l f here and theref o r m a n eu v e ri ng a r o u n d t h espacecra f tF i::her: And you had no d i f f i c u l t y i nma in ta in ing the des i r ed bodyo r i e n t a t i o n w i t h r e s p e c t t othe spacecraf t .Crippen: No, i n f a c t I i n i t i a l l y

s t a r t e d o f f based on theadv ice f r o m my predecessorso f t r y i n g t o en su re t h a t Is t a y e d b a s i c a l l y u p r i g h t w i t hrespec t t o the sur round ingso f t h e s p a c e c ra f t f o r t h ef i r s t t h ree o r f ou r hou rs ,and I f ound tha t that wasc o m p l e t e l y u n n e c e s s a r y . Ir e a l l y f o u n d that out when Iwas d e t t i ng ou t o f my s u i tb'. ause I d i d i t f r e e froma n y t h i n g a n d c a m e o u tb a s i c a l l y my head popped outo f t h e s u i t I was anywhichway i n the c abin and foundth a t no t t o be any prob leman d so I q u i t c o n c e r n i n gmyssl f t i b u t t h a t.F i s c h r r : h - r e t h e r e an y p e r c e p t u a lill s ion s , you know,d is pla ce m en t o f v i s u a l f i e l d ,fa1 se sensat ions o f tu r n in go r i l l u s i o n s o f p it ch ed -u p o rpi tched down?C r i p p m : N o t a t a l l , n o th i n g l i k etha t .

F ische r : D id you have any d l F f i c u l t ya t a l l with a n y v e s t i b u l a re f t h e r C u r i n g f l i g h t o rd u r i n g t h e r e - e n t r y and1and i ng phase?Crippen: NoF ische r : Any C o r i o l i s when your headspur!?Crippen: NoF ische r : O r w i t h t h e h e a d m o v e m e n td i d n ' t b o t he r you a t a l l ?Crippen: No, g e t much mo re o u t o f

a i r p l a n e a c r o b a t i c s t h a n Ie v e r e xp e ri en c ed i n f l g h t .

I n f l i g h t :F i sche r : H ow impor tan t were the v isua lc ue s t o m a i n t a i n i n g yo u ro r i e n t a t i o n ? D i d y o u u se t h ev i s u a l c u e s m o r e t h a na n y th in g e l s e t o o r i e n tyourgsel ?Cr ippen: Bas ica l y yes. There r e a l l ywere no o th er sensat ions o fwhere you were except whatwas h a p p e n in g t o y o uv i s u a l l y .F i sche r : If ou closed your eyes, youwou ldn ' t sp in ou t?Crippen: NoF i s ch e r : R i g h t a f t e r l a n d in g d i d y o uhave any d i f f i c u l t y w i t h

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m o t i o n s i c k n e s s o r f u n n yf e e l i n g s a f t e r t h e wh ee lsstopped.with your f l i g h t s u i t o re qu ip me nt i t c h i n g o r m ores k i n i r r i t a t i o n on p re ss urep o i n t s ?C r i ppen: No, n o t a t a l l . I guess t h e

f i r s t t im e I stood up I f e l t' i k e 1 n ee de d t o b ou nc earound on my l e g s a ' t i t t l eb i t j u s t t o make them f e e lgood, b u t oth er than that If e l t complete ly normal.

C ri pen: N ot a t a l l . The s u i t wasa b o u t a s c o m f o r t a b l e a s ap ressu re su i t can ge t .F ischer: So i t w a s a p r e t t ycomfo r tab le su it.

F i c h e r: Ok, you had no d i f f i c u l t y i fI r e c a l l w i t h l oc o mo ti on o req ui l ibr ium . You seem t o bebouncing arouqd p re t t y we11.D i d y o u e v e r h a v e a nys e n s a ti o n d u r i n g r e - e n t r y o fbe ing 1 ghtheaded?No, n o t a t a l l .

F i scher:

C r i ppen:F i scher :

C r i ppen: There was no pro ble m w i t ht h a t . When we see those p i c tu res o fy o u a l l i n the spacecra f t aswe have observed on a l l o th erf l i g h t s , t he re i s a d e f i n i t ech an ge i n f a c i a l c on fo rm a -t i o n . D i d y o u h av e anysensa t i on a long w i th t ha t?

F i sc he r :Crippen:

Any form o f t h i r s t o n t h ef i r s t day o f f l i g h t ?No, on the second day I t h i n kwe d i d t en d t o g et s l i g h t l ydehydrated main ly ju s t due t owork and no t ta ki ng enought i m e t o d r i n k a n a de qu ateamount o f f l u i d . Bu t we wentdown and f i x e d a coup le o fd r i n ks and th a t was r ap id l yrecovered, but I t h i n k b o t hJohn and 1 f e l t s om eth in gs i m i l a r t o t h a t .

Crippen: The o n l y t h i n g t h a t I m i g h th av e n o t i c e d was s h o r t l ya f t e r we we re o r b i t i n g b e f o r ef s t a r t e d t o g e t o u t o f t h eseats, t h a t maybe fny head d idf e e l a s l i g h t f u l ln e s s k i n dof sensat ion , I am n o t evensure o f how t o desc r i be tha t ,b u t I...F ische r :C r i ppen:F i sc he r :

You had tha t appa ren t l y t hesecond day bu t no t the f i r s t . F i scher:Crippen:

A stand ing on top o f you rhead t ype o f t h ing?Not t he f i r s t , no. Someth ing similar t o t h a tp e r h ap s . B u t e v en t h a te i t h e r went away complete ly3r I g o t so busy 1 f o r g o tabout it. 1 don t remembert h a t b e in g w i t h me very long,b u t i t seemed l i k e th a t wasw i t h me abou t t he t ime tha t Ig o t o u t o f t h e se a t t h a t i twas s t i l l t he re and tha t wasone o f the reasons tha t I wasb e i n g so cau t . i ous abou t

D u r in g l au n ch , o r b i t , o rr e -en t r y d id you no t i ce anyvapors or odors o f any kind?

C r i ppen: On ly what we genera tedourselves and those weren' ts i g n i f i c a n t .F i scher: D i d y ou ha ve any d i f f i c u l t i e s

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F i scher:

C r i ppen:

F i scher :C r i ppen:

F i scher :Crippen:

F i scher:

moving s low t o make sure t h a tI as sta yin g head's up t omake sure tha t there wasn ' tany th ing the re . Bu t i t wasn e v e r a n y t h i n g 1 k e m o t i o ns ic kn es s o r a n t h i ng l i k e t h a ts o r t D f sensation. It wasj u s t a sensat ion . My headf e l t a l i t t l e b i t f u l l and Id i d n o t i c e , and I am n o tr e a l l y s ure t h a t I ven pa idth a t much a t t e n t i on t o i t ont h e f i r s t day, a t l e a s t onthe second day I o t ic e d t h a tJ o h n ' s f a c e s eemed f u l l e rthan what i t was and I endedup l ook ing i n a m i r r o r when Iwas shaving t h a t morning andn o t i c e d a s i m i l a r l o o k t o myface.D i d t h a t c hange o r d i d y o uhave t o r e - e n te r t o g e t i tb ac k t o w h a t y o u w o u ldcons ider you r normal f ac ia ?confo rmat i on?No, b a s i c a l l y t h a t s t a y e d t h esame way t h r o u g h o u t t h ef l i g h t . B u t i t s t i l l w asn 'ta l l t ha t d rama t i c .There was se m at io n w i t h it,j u s t t he fac t . . .No. You c o u l d t e l l t h a tyour... It was main ly tha ty ou l o ok e d l i k e i t was sorto f a round the eyes..... e ig h t o f g r a v i t y , Ith ink tencis.And I t h i n k t h a t t h a t w a sp r i m a r i l y w h a t i t was. Thatg r a v i t y p u l l e d i t o u t ,espec ia l l y us o ld guys youknow i t p u l l s o u t o u rwr ink les o r someth ing .Ok, d i d you have any

Crippen:

F i sc he r:

C r i ppen:

F i scher:

d i f f i c u l ty w i t h s w e a t i n g a l o tdu r i ng e i t he r t he coun tdowno r lau nch phase?I was r e a l l y p l e a s a n t l ys u r p r i s e d t h a t J oh n a nd Iwere ve ry conscious o f t r y i n gn o t t o b u i l d t h e h e a t l o a d upi n t h e s u i t and were v e r yc a r e f u l t o k ee p c o o l i n g o nand no t t o do a n y t h i n g t ooverexer t ourse lves by whenwe were str ap pin g i n we l e tt he Joe S m i t h do most o f tha tand s u i t was comple te ly d ryw hen we g o t o u t o f t he m.There was n ot any pe rs p ir -a t i o n i n them w h at so ev er .And I d o n ' t r e c a l l e v e rw o rk in g up a s we at i n f l i g h ta t a l l i n t h e s pa c ec ra f ti t s e l f I m no t sure whatr u n s m a i n t a i n s t h e r e l a t i v eh u m id i t y y e t b u t i t wasalways dry.Were you aware o f any, wec a l l i t pa l ya ta t ions , whereyou are aware o f you r hea r t -b e a t o r r a p i d h e a rt b e a t o ri r e g u l a r hear tbeat .Well I cou ld t e l l somewherep r i o r t o 1 f t - o f f somewherea t t h a t l a s t min ute I c o u l df e e l t h e o l d h e ar t r a t e s t a r tgoing upwards and I thought"boy we a re r e a l l y go ing t odo it". And I o r g o t a b o u ttha t . And th e on l y o the rt h i n g t h a t I w a s a c t u a l l yconscious of was the f i r s tn i g h t w h e n I w a s g e t t i n gready t o go t o bed and 1s t r apped myse l f w i t h t he l apb e l t v ery l o o s e ly i n th e s e atand I was k ind o f l ea n ingback aga ins t the seat and Ic o u l d a c t u a l l y f e e l R\Y bodymove w i h.. .B a l l s t i ca rd iog ram , we c a l l

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Cri ppen:

f i sc he r :

Cri ppen :F i scher:Crippen:

F i cher :Cri ppen :

Fi scher :Cri ppen:

i t a ba l l i s tocard iog ran .B u t you could feel your bodyk i n d of moving i n respect t oyou r hear t .On a c c ou n t o f y o ur h e a r twould p u t k i n d of acce le r -a t i o n o n t h e body w i t hp a r k i n g . I t ' s interesting.You could feel t h a t .Was i t a n n oy i n g t o y ou ?Coul d you get t o sleep?No. I t d i d n ' t . I t i s k i n do f l i k e , y o u c a n a l s osometimes when you p u t yourhead laying on your arm youcan feel your.D i d you have any d i f f i c u l t yw i t h sleep a t a l l ?No, the f i r s t n i g h t i t was al i t t l e b i t cool and t h a t youcou ld ca l l i t some problemw i t h sleep. I t was one ofthese k i n d of t h i n g s whereyou sleep for awhile and wakeup and d isc over you ar e toocold and I ended u p goingdown and p u t t i n g on some morec l o t h e s - extra socks and at-shirt and jacket and by t h etime I d i d a l l o f t h a t i t wass t i l l colder than I wantedi t . The second n i g h t I sleptl ike a log u n t i l we had analarm that went off and weg o t u p a n d w or ke d t h a tpart icular problem and t h e nwent r i g h t back to s l eep so Iw en t b ac k t o s l e e p p r e t t ygood.Any s e n s a t i o n o f 1 ighthead-ednesss a f t e r 1andi ng .No

F i scher :C r i ppen :

F i scher :Cri ppen:

F i scher :

Cri ppen:

F i scher :Crippen :

F i scher :

C i pen :

Did you see any l i g h t f la sdur ing the o r b i t s ?No, d i d n ' t see any.

Very good. How aboutn o i s e from the s p a c e c r a f tI t hough t t h a t the noise ft he s p a c e c r a f t w a s vreasonab2e. I t was cf o r t a b l e . W endea up mu r i n g a b o u t 60 d b andforward where we slept , ab65 db back i n the a f t i nf l i g h t deck, and 67 db onm i d - d e c k . B u t , a n d t ht h i n g s were r e l a t i v e l y qt o me. The frequency ofno i se diis s u c h t h a t t h a t not annoying, d i d no t inf e r e w i t h t a l k i n g t o ano ther o r any th i ng el se.No problem w i t h communicao r sleep o r i t c e r t a id i d n ' t a f f e c t y ou r p e r fmance?No

O k . How about food? Doreckon you a t e pr et t y we1 lI a t e just ahout every tht h a t we had i n t h e m eexcept what I t o l d R i tprobably wasn ' t going t o eSome t h i n g s l ike the f rcocktai l and s t u f f l i ke tw hic h I d o n ' t p a r t i c u l ac a r e f o r .So you e s t i m a t e t h a t o n so f t he d a ys t h a t you someplace between 75 andpercen t?C l o s e r t o a bo ut 9 5 percenthe food .

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Fisc her : Cn occassion were you hungry? Fisc her : And any th ing th a t comes t om in d t h a t we d i d n ' t c o v e rCrippen: I neve r d i d b re ak ou t any th a t would be f rom a man-snacks or anyth ing wh ich I o r ien ted s tandpo in t?had a n t i c i p a t e d t h a t I might ,w i t h t h e e x c e p t i o n o f some Crippen: No. Expect i t i s l o t s o fbeverages and I had a fun.reasonable appet i te and I wasconscious also from knowing Fis ch er: Very good.t h a t I was going t o make suret h a t I managed t o e a t as muchas I d id .

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PRECEDING PAGE BLANK NOT F6t.MESHealth Stabilization ProgramJames K. Ferguson, Ph.D.A w e l l d e f i n e d H e a lt h S t a b i l i z a t i o n Pro-gram (HSP) was f i r s t i nt ro d u ce d i n t o t h eSpace Program on th e Ap ol lo 14 mis sio n.The Prog raa was i n i t i a t e d fo l l ow ing anumber of pr ime crew i l ln es s es and crewe x po s u re t o p e r s o n s w i t h i n f e c t i o u si l ln e s s e s d u ri n g t he c r i t i c a l p e ri od s o ft h e e a r l i e r A p o l l o m i s s io n s . As ar e s u l t of +,Sese occurrences, 'it was rec-ogni zed through out the Na t iona l Aeronau-t i c s a i d Space A d m i n i s t r a t io n t h a t c re wi l l n e s s c o u l d cause l o s s i n v a lu a bl ecrew t r a in in g t ime, postponement o f m is-s ions, o r could even compromise crewsa fet y, and mi ss ion success.The Apollo 14 HSP was sucessful ly com-p le ted w i thou t an i l l n e ss occu rrence i nth e crewmen. Fo l low ing th e Ap ol lo 14m i s s i o n , t h e p ro gr am was e f f e c t i v e l yused fo r t he r ema inder o f t h e Apo l l o,Skylab, and ASTP miss ions. No i l l n e s shas o ccurred i n th e crewmembers d ur in gc r i t i c a l m i ss io n ti m es s i nc e t h e HSP wasi n i t i a t e d . A comparison between theresu l t s obse rved w i th and w i thou t t heprogram showed a s igni f icant (p < .001)dec rease i n t he number o f i l l n e s s even tswhen th e program was used.The o b j e c t i v e o f t h e HSP i s t o prov'dean environment surrounding the pr ime andb a c k u p c r e m e n w h i c h w i l l r e d uc e o re l im in a te t he exposu re o f t he c rew t oin fec t i ous agen ts .

Results and DiscussionA l l personnel th a t were requ i red t o bei n t he crew work a reas were i d en t i f i eda nd w er e g i v e n m e d i c a l e x a m i n a t i o n s .Those Versonnel who were found medical yq u a l i f i e d were i d e n t i f i e d as p r im a r ycon tacts . Se cu r i ty was p laced a t t h edoor o f th e t r a i n i n g b u i l d i n g as w e ll asthe p r i nc ipa l wo rk a rea , and on l y p r i -mary contac ts were a l lowed t o en te r .

19

ON82 1 5 7 15Pr imary con tac t s we re i ns t r u c te d t o wea rsurg ica l masks when wi th in 6 f e e t o fcrewnen. Each pri ma ry co nt ac t was askedt o v o l u n ta r i ly r e p or t h i s o r h er i l l n e s st o t h e i r s i t e c l i n i c . An e x am i na ti onwas g iven t o t he pr imary con tac t whennecessary. I f an i n f e c t i o u s i l l n e s s wasfound t o be present , th e person was n o ta l l owed t o r e tu rn t o t he c rew work a rea.Crew housing was prov ided f o r th e pr imeand backup crewmen t the Johnson SpaceC e n t e r (JSC), Kennedy Space Center(KSC), and Dryden F l i g h t and ResearchCenter (DFRC) lo ca t i on s and on ly pr ima ryconta c ts were a l lowed t o en ter . Foodcor r t ro l and sp ec i f i c s ec ur i ty measureswere c a r r i e d ou t .The S T S - 1 HS P w a s i n i t i a t e d a t 0800 onA p r i l 4, 1981, and con t inue d f o r 11 daysu n t i l t h e O r b i t e r l a nd ed o n A p r i l 14,1981. The i l l n e s s prev ent io n measuresf o r c re w p r o t e c t i o n w ere c a r r i e d o u t a ndo u t 1 n e d i n t h e d oc um en t JS C-1 18 52,H e a l th S t a b i l t a t i o n P rogram (OFT).The S T S - 1 Hea l th S tab i li at ion Programprov ided coverage f o r t he 1argest nunbero f p r imary conta c ts s ince th e programwas i n i t i a t e d o n A p o l l o 14. T heincrease i n number o f p r imary contac tswas p r i m a r i l y d ue t o t h e a d d i t i o n o f tw os h i f t s o f p erso nn el i n b u i l d i n g 5 i nsuppo r t o f t he S hu t t l e s imu l a to r s .The S T S - 1 p rog ram e f fec t i ve l y kep t 38known ill persons ou t o f crew work areasand thereby prevented crew exposure andp o s s i b l e i l l n e s s . It i s su spe cted t h a tmany ill persons d i d no t en ter c rewareas and d i d no t r epor t, t h e i r ill-nesses, b u t t h i s cannot be documented.Personnel awayeness o f p os sib le f l g h tcrew i l l n e s s i s p r o ba b ly one o f the moste f f e c t i v e e le me nts o f t h e HSP.


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The nunber, ty pe, and lo c a t io n o f personnel th a t were g iven mea ica l examinat ionsand were approved as pr imary c onta cts f o r the program are as fo l low s:LOCATIO N

TY Pe J SC KSC DFRC ARC; Head quarters Sub t o t a lNASA 216 35 7 1 5 264Con t rac to r 643 42 12 0 0 697Others 10 1 0 0 0 11

-72-ub to ta l 863 78 19 1 5GRAND TOTAL

I l l ne ss o r con tac t t o i l l n es s was repo r ted by t he pyimary con tac t s a t t h reeNASA Cen te rs and th e i r r ep o r t s were d i s t r i bu te d as fo l l ows :Number and Location of Primary Contact Reports

Report JSC KSC DFRC Other T o ta l11lner-s 31 4 3 0 38Coptacts to I l l n e s s 6 2 0 0 8

The i l l n e s s r a t e i n t h e p ri m ar y c o n t a c t p o p u l a t i o n d u r i n g t h e p ro gra m was 28i l l n e s s e s p er 1000 persons per week. A summary o f t he t ypes o f i l l n e s s wh ichoccurred i shown be l ow :Types o f I l ln es se s Reported by Pr imary Contac ts

~~ ~

I l l n e s s *Upper Resp i ra to ry In fec t ionBronch i i sPnemoni aUpper Enter ic I11nessLowe. Ent .er ic I l lnessFever PresentHeadache PresentS k i n I nCect ion PresentC t h e r I n f e c t i o u s I1 1ness

~

JSC2410324101

K S C300000001

DFRC300000000

~ ~ ~~

Percent To a l813085

11305

* One i l l n e s s may co nt ai n more th an one symptom complex.


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E i g h t c o n ta c t s t o i l l n e s s were r e p o r t e d d u r i n g t h e 11-day program and wered is t r ib u te d as shown below:Types o f I 1 ness Contac ts Repor ted by Pr imary Contacts

KSC J SC Other Percent To ta lUpper Enteric 1 0 0 13Lower Enter ic 0 1 0 13Upper Respiratory 1 4 0 0 2Scar1e t Fe ve r 0 1 0 13

Concluding RemarksThe program 1 m ite d th e access o f l a rg enunbers o f newspersons t o th e crew andenab led the i den t i f i ca t i on and med ica le x am i na ti on o f a l l V I P ' s who v i s i t e d t h ecrew. P, so, la rg e numbers of personnelw ere r e s t r i c t e d fr om e n t e r i n g b u i l d i n g5, i n c lu d ing NASA personnei , c o n t r a c t o rp er so nn el , and p u b l i c v i s i t o r s t o t h ee x h i b i t s , t he re b y e l i m i n a t i n g o v e r -crowding and reducing possib le expos-ures. A1 though sev era l pr imary co nt ac ts

were observed n o t ,,ty masks a tr equ i r ed times, t he g rea t ma jo r i . ty o fpr im ary co nta cts d id wear masks, inc lud -in g some c re w en when the y be l iev ed theneed existed.I t s h o u l d b e n o t e d t h a t t h e o v e r a l lr esponse o f t h e 972 p e o p l e p a r t i c i p a t i n gi n t he p rogram con fo rmed to t he r equ i r e -m ents i d e n t i f i e d f o r t h e HSP. T his i sev idenced by the heal th y 5 6 - 1 crewmenz t !eunch t i m e .

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-3N82-15716Emergency Madical Senices System (EMS)sarn L. Pool, n.0.hergef tcy medica? suppor t was mobi l izedi n s u pp o rt o f t h e l au n ch a nd l a n d i n gopera t ions o f the Space Shutt le, SpaceTransportat ion System (STS) fl g h t 1.The objective o f t h e EMSS was t o pro videth e ill o r i n j u r e d c r e m a n w i t h r a p i daccess t o t he app rop r ia te l e ve l o f med-i c a l c are . I n o r d e r t o meet the ob jec-t i ve , t he fo l l ow ing fac to r s were ca re -f u l l y c on sid ere d i n d e v el op in g t h e EMSSfo r STS-!: a c c e s s i b i l i t y t o h e a l t h c a r ecenters, personnel , t r a i n i n g, expe r i-ence, t r a n s p o r t .. io n, response t imes,commun ica t i ons , med ica l r eco rds , andspec ia l env i rom ent a l hazards .

DiscussionThe launch and lan di ng s it e s were care-f u l l y exam ined t o determine the capab i l -i t y of the 1 ca1 heal th care centers asw e l l as . e c c e s s i b i l i t y t o r e m o te l yl o c a te d h e a l t h ca re f a c i l i i e s t h a tcoul d prov ide defi iti e care. Trans-po rt at io n means and rout es were care-f u l l y ana lyzed and a d c i s i o n was madet o use h e l i c o p t e r s f o r t r a n s p o rt a t io n o fill o r i n j u r e d c r em e n . I 1 1 o r i n j u r e dcremen would need t o b e s t a b i l i z e d a tthe scene pr io r t o t r a n s p o r t a t i o n o f anydistan ce. In most cases, a l o c a l h o s p i -t a l was a v a i l a b l e t o a s s i s t i n t h es t ab i l i z a t i o n p rocess , as r eq il i red . Themeans f o r m o s t o f t h e s t a b i l i z a t i o nprocess were in cluded i n the equ ipnentf l o w on the he l ico p te rs . The phys i -cians who were assigned t o f l y OR t h ehe1 ic op te rs a1 ong w it h the paramedicswere g iven spec ia l t r a i n i ng i n emergencyme dic ine proced ures. A1 1 p h y s i c i a n swere g iv e n a d d i t i o n a l i n s t r u c t i o n i ncare o f t rauma v i c t ims . A comnunicationsystem w as es tab l i shed a t Keanedy SpaceCenter (KSC), t he l aunch s i t e , wh ichwould permit an Emergency Medical Systemcoo rd inq to r i n the Launch Cantrol Center

6(LCC) to coo rd ina te the a c t i v i t e s of t h eem ergency m e d i c a l h e1 c o p t e r s i n t h ee ve nt o f a probiem. The h e l ic o p t er i nt u r n c o u l d c m u n i c a t e w i t h t h e l o c a lt l o s p i t a i s as w e l l a s t h e d e f i n i t i v e c a ref a c i l i t y . I n t h e c a s e o f r e c o v e r ys i t e s , b o t h Dryden R i g h t Research Cen-t e r - Pr imary Land ing Si te and Nor th ropS tr io , Secondary Landing Si te had s im i-l a r a r r a n g m e n t s f o r c o m m un ic at io ns .The EMSS c o o r d i n a t o r a t D ry de n wassomewhat hampered by t h e ne ed f o rspecial procedures because he had to askpe rm iss ion t o use some o f th e cosri luni-c a t i o n l o o p s i f he needed t o speakd i r e c t l y w i t h t h e he: i c o p t e rs , h o m v e r ,P h i s p a r t i c u l a r u e f i c i e n c y has beenc o r re c t ed f o r STS-2.Ei gh t ma jor egress modes were i d e n t i f i e dfn r l aun ch and l an d in g . Modes 1 -4a p p l i e d t o l a u nc h es a n d k d e s 5-7appl ie d t o 1andi ng. M d e 8 app l i e d bo tht o l aunch and land ing (See Def in i t ions) .Kennedy Space Center was i d e n t i f i e d ast h e 1aunch s i t e and re tu rn - to -1 and ings i t e f o r STS-1. Edwards A i r Force Basewas i d e n t i f i e d as t h e p r i m a r y la n d i n gs i t e f o r STS-1. N o r t h ru p S t r i p , ac on tin ge nc y l a n d i y s i t e a t W hite SandsM is si le Range i n New Mexico, was con-s i d e r e d t h e b ackup l a n d i n g s i t e f o rSTS-1. No rthr up S t r i p woul d a1 so be usedt o l a n d t h e O r b i t e r i f an underburnoccurred and an Abort-Once-Around wasrequ i red . Other kp ar t me nt o f Defensecontingency i ndi ng s i t e s were i d e n t i -f i e d a t HickPam ACE, WMii, Kadena AB,Japan, and Rota, 5pd in.T h e r e s p o n s i b i l i y f o r p l a n n i n g a n di m p l m e n t a t i o n o f the hergency Med ica lS e r v i c e S y s t e m f o r t h e f i r s t SpaceS h u t t l e f l i g h t r e s i d e d w i t h t h e Spaceand L i f e Sciences Directorate, JohnsonSpace Center. Thi s respons ib i li y was


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executed by a phys i c ian EMSS c o o r d i n a t o ro p e r a t i ng through t he M iss ion Con t ro lCenter. It wds h i s r e s p o n s i b i l i t y d ur-i ng the Ope ra t i ons t o a s s u r e t h a t t h ef i e l d c e n t e r s w oul d b e a p p r o p r i a t e l ys t a f f e d a nd r e ad y f o r a ny e m er ge nc yope ratio ns. He co ul d al s o communicatewi th t h e EHSS c o o rd i na t o r s a t t h erespe c t i ve l aunch and l and ing s i t es .The Emergency Medical System as imple-mented a t Edwards AFB i n C a l i fo rn ia i sv e ry s i m i l a r t o s ystem s a t K S C andMor th rup S t r i p . The EMSS phys i c ian i nH i s s i o n C o n tr o l c o u l d r e l a y any i n f l i g h tp rob lems tha t m igh t a f f ec t t he recoveryo p e ra t io n s t o t h e EHSS c o o r d i n a to r a tDryden F1 i g h t R e s e ar c h C e n t e r . T heemergency medical co ord ina tor a t Drydenc o u l d m o b i l i z e s p e c i a l l y e qu ip pe d h e l i -c o p t e r s ( 2) f o r s u p p or t o f S h u t t l ee g r e s s a n d t r a n s p o r t a t i o n o f ill o rin ju re d crem en. Each medical evacua-t i o n h e l i c o p t e r was s t a f f e d b y aphysiciar: and two Department of Defense( D O D ) pa rare sc ue emergency me d ic a ltechn ic ians.Once *.he ill o r i n ju r ed cremnan s h ea l t h~rclrblemshave been a isessed, and i n i t i a ls t a b i l z a t i o n g i ve n , t h e h e l i c o p t e rp h y s ic i a n c o u ld e l e c t t o t r a n s p o r t t h ec reunan to an i n te rmed ia te ca re f a c i l i t ya t Edwards AFB hosp i t a l o r t o t he LomaLinda Hosp i ta l loca ted i n Loma L inda,C a l i f o r n i a , w h i c h u8s designdted as th ed e f i n i t i v e c are f a c i l i t y .An emergency medical reco rd would berequ i r ed f o r any patient emergency care.I t would conta in the fo l lowing in fonna-t i o n : a h i s t o r y o f p hy s ic a l f i n d i n g sr e le v a n t t o t h e i n j u r y o r i l l n e s st rea ted ; a medical d iagnosis or impres-s ions ; comp le te l i s t o f any t r ea tmen tsg i ven ; p a t i e n t s response t o therapy;p a t i e n t s cona; t i o n L pon d e l i v e r y t oh o s p i t a l : and s ignature o f the respon-s i b l e p h y s i c i a n .

Concluding RemarksI n c o n c l u s i o n t h e E mergency M e d i c a lService s System which was est ab l ish edf o r STS-1 was on s ta t ion , appropr ia te lyequipped, and ready t o deal w i t h anymedical emergency.

DefinitionsCont ingency Land ing S i t e (CLS)P r e f l i g h t s e l e c t e d D O 0 a f f i l i a t e da i r f i e l d s t h a t , i n c o nj un c ti on with th epr imary and secondary a i r f i e ld s , p rov idel a n d i n g o p p o r t u n i t i e s as o f t e n as prac-t i c a l f o r q u ic k r es po ns e ( l e s s th a n s i xhou rs ) o rb i t t e rm ina t i on and l and ing .De f i n i t i ve Med ica l Ca re Fac i l i t y (DMCF)An i n - p a t i e n t m e dic a l c a re f a c i l i t ycapable of comprehensive d iagnosis andt rea tment o f a c reunember s i n j u r i e s o ri 1ness w i thou t ou ts ide ass i s tance. 1tsha l l be an emergency and io r t r aumat r e a t m e n t f a c i l i t y h a v i n g a c c r e d i t a t i o nby t he j o i n t h o s p i t a l a c c r e d i t a t i o ncomni s s i on.Deorb it UnderburnI n s u f f i c i e n t d e l t a v e l o c i t y ( 3 v )o b t a i n e d d u r i n g t h e d e o r b i t maneuverwhich may cause a l a n d i n g a t a hackups i t e .EJrcss C on dit io n Red-An announcement by t he O X , the convoyCommamter. th e A ir bo rn e C O D , o r t h eRescue Crew Leader wnen they have know-l e d g e t h a t a c a t a s t r o p h i c c o n d i t i o nposing a s e r i o u s t h r e a t t o life or :imbo f the rescue crew i s imminent. I n theabsence o f im md ia t e f o l l ow-on d i r ec -tion, the Rescue Crew lpader w i l l d i r e c tsuch ac t ion a s he determines necessaryd t t h a t i n s t a n t r e g a r d i n g th e s a f e t y o fthe rascue crew and the rescup c f t h ef l ght c rew.

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Emergency Medical CareThe ac t i v e de l i ve r y o f med ica l t rea tmen tand/or heal th se rv i ces .

-mergency Medical Services (EMS)S e rv iL es u t i l i z e d i n r es po nd in g t o ac r em e m b e r' s p e rc e iv e d need f o r i n e d i -a t e m ed ic al c a r e i n o rd e r t o p re v e ntl o s s o f l i f e o r c g g ra v at io n o f p h ys ic a lor psycho1og ica l cond i t i on .Emeroency Medical Services System ( EMSS )

a lt h ou g h a l a n d i n g a t KS C o r a con t i n -gency s up po r t a i r f i e l d i s p o s s i b l e .This mode allows th e O r b i t e r t o remaini n o r b i t f o r s ev er al r e v o l u t i o n s be f o redeo rb it .MODE I. Eoressl'kcaDe. UnaidedMay be ' n i t i a t e d a f t e r o ne o r m ore o ft h e f l i g h t crew i s S ngressed i n t o t h eOrb i te r c rew module . The f l i g h t c rew i sab le t o eg ress w i tho u t ass is tance. Theclo se ou t crew may o r may n o t be ons t a t i o n .

A c o m bi na ti on o f p er so nn el , f a c i l i t i e s .a n d e q u i p m e n t f o r t h e i m m e d i a t e a n dc o o r d i na te d d e l i v e r y o f h e a l t h c a r eserv ices .Launch Aborts

MODE 11 , Egress/ 'Exape, AidedI s i n i t i a t e d when the c loseou t crew i son s t a t i o n and t he r e i s p o s s ib l e f l i g h tc re w i n c a p a c i t a t i o n and O r b i t e r s i d eh a tc h i s c lo se d.

I n c l u d c a l l e v e n t s a nd f u n c t i o n snecessary t o = i f e l y l a n d t h e O r b i t e r i fe a r l y f l g h t t e r m i n a t i o n becom esnecessary dur ing the t ime f rom so l idb o o s te r i g n i t i o n o n th e l au nc h pa dthrough the maneuvering i n t o a s tab le ,sa fe o r b i t . Three launch abo r t modes( o r m eth ods ) r e s u l t i n g i n a i r f i e l dland ings e x i s t :(1 ) R e t u r n t o Launch S i t e (RTLS) -Becomes a v a i l abre-ut 1 2 5 secondsa f t e r l i f t - o f f and exte nd s t o about 290s e c o n d s a f t e r l i f t - o f f . Th is mode endsw i t h a l and ing a t K S C SLI'.(2) Abort.-Once-Around (A091 - decomesava j rab le about 197 secorxs a f t e r l i f t -o f f and extends t o s af e o r b i t i n s e r t io n ,about 614 seconds a f t e r * , i f t - o t ' f . T h i smode ends w i t h a l a n d i n g a t N S o rIAFB --depen ding upon p rep1 afined 1andings i t e s e l e c t i o n s - - a p p r o x i m a t e l y 90minutes a f t e r l i f t - o f f .( 3 ) A b o r t - t o - O r b i t ( A T O ) - Brrgifjs 207seconds a f t e r 1m-mand ex t r nds t os a f e o r b i t i n s e r t i o n . Th is mcde w i l lend normal ly w i th a i and ing a t EAFB ,

MODE 1 1 1 , EgressiEscape, AidedIs i n i t i a t e d when t h e c l o s e o u t c re w i sn o t on s t a t i o n . I h e f i r e r es cu e c re wper fo rms the ope ra ti on . The f l i g h t c rewcannot egress wi thout assistance and t h eO r b i t e r z id e h a tc h i s c lo se d.MODE I V , Egress/Escape, AidedIs i n i t i a t e d when the c loseou t c rew i son s ta t io n . The f i r e rescue crew i sd i re c te d t o per fo rm a ided egress /escapefo r the f i g h t crew and an incdpac i ta tedc los eou t c rew. The O rb i t e r s ide ha tchmay o r may n ot be clo se d.MODE V. Unaided EaressKscaDeI s t he cond i t i on when the f l i g h t c-ew i si n the O rb i te r c rew compartment and i sa b le t o e g re ss a f t e r l a n d i n g w i t h o u ta s s i stancc . Ground pararescuemen w i 11a i d t h e f l i g h t crew a s r e q u i r e d t oescape t o a safe area.

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MODE V I , Landing Hishap on RunwqyIs a l a n d i n g o f t h e O r b i t e r o n t h eShutt le Land1ng Fac l l I t y (SLF) runway( c o l la p s e d l a n d i n g g ea r, b l o m t i r e s ,f i r e , e x p lo s i on , p r o p e l l a n t ( s ) o rhydrau l ic leaks , whee ls up on land ing ,e t c ) whfch requ l res a ided fl g h t c r e weg re ss /ai ded escape.MODE V I I , L a n d in g M i s h a p O f f Runway-Land o r Water Impa ct)Is a con ti ngency (occu r r i ng du r i ng RTLS,r e t u r n from o r b l t or e a r l y f l i g h t t er m i-n a t io n ) r e s u l t i n g i n a l and o r wa te ri mp a ct of t h e O r b i t e r and r e q u i r i n ga i d e d f l i g h t crew egressfescape.

MODE V I I I , F l i g h t I'--ew E j e c t i o nIs a con t i ngency (occu r r i ng du r i ng th elaunch, RTLS, return from o r b i t o r c4rl:rf l g h t t e r m in a t i o n ) r e s u l t i n g i?h:necess i t y fo r t h e f l i g h t crew t o ebtndcnt h e O r b i t e r , e j e c t a nd d e s c r j d byp ar ac hu te t o e i t h k r a l a n d o r w a 'le rarea.Pr imary Land ing Si te (PLS)A p re f l i gh t des igna ted End o f l r l i s s la~ .( E N ) l an d in g a i r f i e l d .Secondary Landing Si te (SLS)A p r e f l i g h t des igna ted backup 1andinga i r f i e l d t o t h e P L S .

bbh?6- 1FLIGHT SURGEON STAFFIN0 AND DEPLOYMENT (JSC)

FUNCTION

CTWUPhvsrdon

NAM Sum T W nM.A. BayM.W. B u w1 C . Dkttoins.1 -1

-

C.L. Fbrchu

P. BuchscunJ. lhgiomniN . 1

C.L. FlrcwtJ. wornncJ.P. BagtanA.L. FIJI.1C.L. Filehat

C.K. LoPlnlaM.R. SoddosW.C. Fhhar

MISSION PHASEEntryAmenta1*itW n t . On Orbtt. Enhy-1. On Orbit. Enhy

Thru launch; a ) M launch. lorw SL P It t h u r n an RTLS. orto PL S I no RTLS.Lmnon thtu IondinpTo PL S dkr RTLSL a u d hru RTLS

AOA. Undwburn. CL. OMAOA. Ilnduburn. CL . OMAOA, Undorburn,CL, OM

26


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Crew Medical TrainingJames M . Vmderploeg, M.D. PRECEDING PAGE BLANK NOt FILMEDEach astronaut 's ini t ia l t ra ining i n themedical dis cip l ines occurred d u r i n g thef i rs t year following selection. Themedical curricul un encompassed approxi-mately 16 hours of instruction d u r i n gthe year. The princip al a rea s coveredare listed i n Table 7-1. For each ofthese areas the astronauts were taughtthe basics of anatomy an d physiology.In addition, they were introduced tophysic al examination tech ni ques ,diagnosis, and treatment of the morecomnon ailments of the d i f f e r e n t organsystems.

OiscussionIncl uded d u r i n g th e f i rs t year of t r a i n -in g was the initial two-day course i na1 ti tu d e physiology. This course pro-v id e d t ra ining i n the following areas:composition of the atmosphere; the GasLaws; signs, symptoms and treatment ofhypox ia ; ope r a t ion o f l i f e s u p p o r tequipment; effects of increased G I s ; th eL - 1 and M - 1 anti-G maneuvers; use of theanti-G sui t ; and an altitude chamberr i d e w i t h demonstra t ion of hypoxia .T h i s material i s reviewed every threeyears by means of a one-day refreshercourse. In add ition to the above t r a i n -i n g , astronaijts Young and Engle receiveddetailcd medical briefings that had beena p a r t o f mission preparation d u r i n g theApollo program. These b ri ef in gs weredesigned ta aquaint the cremembers w i t hpre and p o s t f l i g h t medical procedures;t o discuss crew preventive medicine mea-sures; to instruct the crew i n the con-ten ts and uses o f the medical k i t ; t odemonstrate the configuration an d opera-tion of the biomedical harness; and t ofamil ia r i ze the crew w i t h toxicolog icalconsiderations.The overall objective o f crew medicalt r a i n i n g f o r STS-1 was to provide crewsA a r d 9 w i t h the knowledge a n d s k i l l snecess&ry to respond t o i n f l i g h t i l l -nesses, i n j uri es , and medical errergep-c i e s i n a n a pp r op r i a t e a n d t ime lymanner.

29

7'he STS-1 pre-mission medical trainingbegan i n mid-1975. The first t r a in ingaccompl ished was the sel f study courseentitled MED EQ 2102. This i nvo lvedeach crew member working through th e"Medical Equi pmen t Workbook". Thetopics covered i n this workbook were (1)t h e S h u t t l e O rb it er Medical System(SOMS): contents, uses, 1ocation andstowage; ( 2 ) the Operational Bioinstru-mentation System (OBS): components,donned conf igura t ion a nd on-orbi tcontingency use; (3) the Anti-gravityS u i t (AGS 1: components and pressurec o n t r o l l e r o p e r a t i c i ; a n d ( 4 ) t h eRa diat ion Equipment: components,1oc at i ons and on-orbi t c c i t igency use.Following completion of MED EQ 2102 thecrewembers were given 9 hours of medi-cal procedures training i n three coursese n t i t l e d MED PROC 2102, 2201, and 2301.The areas of i n s t r e t i o n provided d u r i n gthese courses are l is ted i n Table 7-2.The f i n a l aspect of the STS-1 crew medi-cal t r a i n i n g was conducted on March 23 ,1981. This consisted of a 3 hour brief-f n g d u r i n g which th e ma terial of th epr ior t r a i n i n g sessions was reviewed andvarious mission specific items were d i s -cussed. The d e ta i ls o f this brief inga re ou t l ined i n Table 7-3.

Table 7-1CURRICULUM OF INITIAL MEDICAL TRAINING

Central and Peripheral Nervous SystemsAudiiry and Vestibular SystemsVisual SystemDental HealthCardiovascular SystemPulmonary SystemGastrointestinal SystemGenitourinary SystemMusculoskeletal System


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A l l members o f crews A and B completedthe prescr ibed medica l t ra in in g . Theon ly p rob leal encountered with the t r a i n-in g was the need fo r exte nsive review ofthe medical procedures tr a i n i ng . Thiswas due t o th e prolonged t im e pe riodbetween courses MED PROC 2102, 2201 and2301 (g ive n i n 1979) and th e prem issionmedical b r i e f i n March, 1981. Thispro longed t ime in terva l shou ld not beencountered for future STS crewsT8bb 7-2

STS-1 CREW MEDICAL TRAININGVITAL SIGNS:PHYSICAL EXAMINATION:AND TREATMENT

Pulor. BIoodR.aws. Trmp.ntun. Respi.ratow Rate. Pupil Size and Reaction

EYE - Ophthalmoscopy. Lid Eveion. Fmi gnl3ody Reaction and Trsament. Flucrm-win StainingNOSE - Control of N w leedsEAR - Otoscopy

THROAT - Exuninatlon. Oral Airway lnrsrtionAUSCULTATION - Heart. Lung. and Bowel SoundsEMERGENCY PROCEDURES: Om-man CPR. Heiml irh Mantuver, Cri-

mthvrotomyHEMORRHAGE CONTROL: Direct Prrrrun. Pro uun Points.

fwmiqmts, Presvre BandagingBANDAGING: Exm et ia s. Chest. AbdomenSPLINTING: Neck. Fingers. Upper and LowerExtmatmtLACERATION TREATMENT: Birding Control. Sterirtrip Appli-

cationDENTAL PROCEDURES: Temporary F i l l i w Gingival Injec-

tionsEKG: urn of 0 6MOTION SICKKESS: Prophylact'c Mediu tions . Treatment.SOMS-A: Olpuliution. DNO Urrrgl. Medial

Head Paritionin9 an d MouemntChecklist Organization and Use

Concluding RemarksThe STS-1 prime and back-up cremembersr e c e i v e d e x t e n s i v e m e d ic a l t r a i n i n g ;b ot h e n e r a l t r a i n i q p r i o r t o c rewbe ing se lec ted fo r STS. T h i s t r a i n i n gadequa te ly met the ob j ec t i ve o f p ro -v id ing the crewembers with the know-ledge and s k i l l s t o respond t o i n f l i g h ti l l n e s s e s , i n j u r i e s and m e d ic a lemergencies .

s e l e c t3on and s p e c i f i c t r a i n i n g a f t e r

Table 7-3PREMISSION MEDICAL BRIEFING

SOMS-A: Dir;uEdon of EMK and MJ K amteaits. drugmap. use of tho MedicalCh.ddist mdrecording of pr t innt medml findings.Review of th e procedures !imd in Tsbk 2R e v h of th e Operation and Use of the AGS.regardingdonning anduse of AGS for entry.Discussionof rymptoms and s igns of toxicexposums Use of POS if oxic fumMnoted Rouiew of possible toxic exporumduring egms.

PRIVATE MEDICA L Discussion of pwpog of Priuam ModidCOMMUNICATIONS: CommuniGaionr and tvws of informationAEROMED FLIGH T Review of Ri@t ruler. particularly thosaRULES: dealing with EVA preh th ing . Pr ivmMedial Communications and AGS use onentry.

REVIEW:A N T I 4 SUIT: R W ~ Wf A m & Flight R u h 13-20TOXICOLOGY:

mquested.

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3 7Shuttle OrbitalJames M. Vanderpl oeg , M.D .The use of on-board medical kits i s ani n t e g r a l p a r t o f a s t r o n a u t m ed ic alt r a in i ng . As t ronau t s a re g iven i nstruc-t i o n i n physio logy , physical d iagnosis ,and t reatment as well a s use of the med-i c a l k i t . I n a d d i t i o n , a l l a s t r o n a u t sa r e tested for sensit ivi ty t o d ru gscontained i 11 the medical k i t .

Medical System

During the Apollo program a d e t a i l e dmedical b r i e f i n g was provided f o r e a c hc reb a p p r o x i m a t e l y o n e month b e f o r e1aunch . T h i s p r e l a u n c h b r i e f i n gincluded a review of the Apollo medicalk i t an d i t s uses a s well a s a refreshercourse i n pertinent aspe cts of physio-1ogy , d iagnos i s, nd treatment.The pre f l ig h t medica l t r a in in g d u r i n gthe Skylab program was considerably moreex tens ive . Each crewnan underwent 80hours of paramedical t r a i n i ng i n thed i a g n o s i s a nd t r e a t m e n t o f injur ies ,i 11nesses , and dental probl enis. T h i st r a i n i ng i ncl uded extensive use of theSky1ab I n f l i gh t . Medical Support System.The S h u t t l e Orbiter Medical System( SOMS-A) was desi gned t o p rov ide t r e a t -ment f o r 1 fe- threaten ing emergenciesand to permit diag nosis and t reatme l i t o fa l l less severe injuries and illnesses.The i nven to ry o f the SUM - A i s i n t e n d e dt o s u s t a i n the medical needs of a twoman crew f o r up t o 7 days.The t o t a l system includes two medicalk i t s (Med ic ine and Bandage Kit p l u sEmergency Medical K i t ) , th e MedicalChecklist and the o c c a s i o n a l use o fo t h e r Orbiter s y s t e m s s u c h a s theP or t a b l e Oxygen Sys t em ( P O S ) . T h eEmergency Medical Ki t ( E M K ) c o n t a i n sp a l l e t s A , B , and C w i t h items stowed onboth sides of each pal le t . All i n j e c t -ab le m ed ica t ions , th e IV supplies, mostd iagnos t i c equipment and al l su tur ingequipment are stowed i n t h e EMk (SeeT a b l e 8-1 f o r d e t a i l e d l i s t i n g of

contents) . The Medicine and Bandage K i t( M B K ) a1 so con ta in s three pal lets C , 0 ,and E , w i t h items stowed on both sideso f e a c h p a l l e t . The MBK i n c l u d e s a l lo r a l , r e c t a l , a n d t o p i c a l m e d i c a t i o n s ;most bandage items an d some d i a g n o s t i cequipment.

Oisc ussionThe S h u t t l e Crews A an d B r ece ived bas i cmedical and physio logic al t ra in in g fo l -lowing the i r i n i t i a l s e l e c t i o n . Inaddit ion, astronauts Young and Engle hadreceived specific t r a i n i n g i n prepara-t i o n f o r p r i o r m i s s io n s. To preparesp ec i f i ca l ly f o r STS-1, medical t r a i n i n gwas provided t o the fou r c rem em bers i nthree sessions. T h e t h i r d session,given i n March 1981, d e a l t s p e c i f i c a l l yw i t h the organ iza t ion and use o f t h eSOMS-A .The prescribed medical t ra in ing i n t h eperformance of emergency procedures, theuse of d i agnos t i c equipment, th e per fo r -mance of therapeutic modal i ties, and theknow1 ed ge o f the medical kits c o n t e n t swas saccessfully completed by Crews Aand B.T h e e v a l u a t i o n o f an i n d i v i d u a la s t r o n a u t ' s s e n s i t i v i t y t o any of thedrugs present i n the medical k i t hasbeen a par t o f premiss ion preparat iont h r o u g h o u t t h e h i s t o r y o f the s p a c eprogra m. Know1 ed ge o f an y a11e r g 1 cr e a c t i o n o r u n d e s i r a b l e side effects t oth e medical k i t con ten t s i s imperativef o r e f f e c t i v e h e a l t h c a r e by t h e MissionOperations Control Room (MOCR 1 Surgeonsand Crew Surgeons.As was done i n t h e p a s t , a d r u gsens i t i v i ty e v a l u a t i o n w a s c o n d u c t e dp r i o r t o t h e STS-1 f l i g h t . T h i se v a l u a t i o n was c a r r i e d o u t i n twosegments. First , th e hea l th r eco rd o f

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Tabte8-1WARNING

* Indicates item to be usedonly after Surgeon wprov-al or as directed in C/L

Ace handage, 3 in. wide, 1(MBK 2-5)"Actified, 30 -(MBK 01-11

Adapzic bandage, 3x3 in., 3(MBK EZ3)

"Afrin nasal spray 15-ml bottle, 2(MBK F1-1.2)(EMK Bl-51(MBK D2-9)(MBK D1-6)(MBK F1-6)(EMK A1-2,3!(MBK 02-14](EMK A1-7,8,9)

Alcohol wipe, 8 (MBK El -7); 5"Aminophylline suppository 500 mg 8+Ampicillin. 250 mg, 30 capsAnusol-HC cream, 28-gm tube. 1*Armnine 10 mg/cc, 1-cc unit, 2Aspirin, 5 grain, 30 tabs*Atropine, 0.4 mglcc 2-cc unit, 3

Bandaid 1x3 in., 10+Benadryl, 25 mg, 20 caps+Benadryl. 50 mg/cc, 1-ccunit, 2Benzoin swab, 5Betadine (Povidonelodine) ointment1 0 2 . tube, 1Betadine wipe, 4 (MBK El-7); 4Binocular LoupeBlistex lip balm, 2Blue filter for penlight, 1BP cuff and sphygmomanometer, 1

(MBK El-18)(MBK D2-11(EMK Al-1, AZ-6)(MBK 1-91

(MBK E l - 5 )(EMK el-5)(MBK F2-2)(MBK F1-11)(EMK (22-81(EMK C l -11

Calgitwab, 6'Comparine, 5 mg/cc, 2 . c ~ nit, 3'Compatine suppository, 25 rng, 8

(MBK E l - 1 )(EMK A t -1 .14.15)(MBK 02-7)

"Cortisporin otic suspension, 10-mlbotde, 1

Cotton Ball, 6Cricothyrotomy setup, 1

(MBK F1-12)(EMK C1-2)/EMK C1-4)

"Dalmane, 15 mg. 12 caps*hadron. 4 mg/cc. l-cc unit, 3+Dernerol, 25 mg/cc, 2-ec unit, 2Dermicel tape, 1 n. wide, 1 roll'Dexedrine. 5 mg, 0 tabs*Digoxin, 0.25 mg, 20 tabs*Donnatal, 30 absDrape, sterile, 1*Dulcolax 5 mg, 10 tabs

(MBK D1-5)(EMK A23,4,5)(EMK A2-14,15)(MBK E 1 4 1(MBK 01-21(MBK 02-10)(MBK 01-31(EMK 82-31(M6K D2-12)

*Epinephrine, 1:1000, l-cc unit, 3*Erythromycin, 250 rng, 30 capsEy e Pad. 3

(EMK A14.5.6)(MBK D1-7)(MBK 2-2)

Finger splint. 1Fuorescein strip, 4Foley catheter, No. 12 Fr., with30.a. balloon, 1

(MBK El-9)(EMK C2-8)

(MBK F2-3)Gauze, 3 in. wida, 1 rollrdoves, sterile, 1pair(MBK 1-5)

(EMK C2-61Halotex cream, 30-gm tube, 1(MBK F1-71

Iv butterfly. 21 g, 3/4 in., 2(EMK 81-81'Keflex, 250 mg, 30 cdpsKendog cream, 15-gm tube, 1/MBK D Z - 8 )(MBK F1-6)

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Table8-1 (Continued)Kerlix dressing. 4.5 in. wide 1rollKling, 3 in. wide,3 rolls(MBK F1-41

(MBK El-2, E2-3, F2-1)"Lidocaine, 20 mg/cc, 2 - c ~ nit, 4"Lomotil, 75 tabs(EMK A2-7.8.9.16)

(MBK D1-4)Methylcellulose eyedrops(Absorbtear). 15ml bottle. 1"Morphine Sulfate, 10 mg/cc, 1-ccUnit, 2M y d o g cream, 15-gm tube, 1Mylanta, 24 tab

(MBK F1-3)

(EMK A2-1.2)(MBK F1-8)(MBK El-3)

Needle, 21 g. butterfly IV. 2Needle, 22 g, 1.5 in., 1+Neocortef ointment, 3.5gm tube, 1

(EMK B1-8)(EMK 81-11

"Phenergan suppository, 25 mg, 8"Pontocaine eye drnoa, 15 mibottle, 1Povidone-Iodine (Betadine ointment,1-02. tube, 1'Pronestyl, 500 mg/cc, 2- c~ nit 2'Pyr 'dium, 200 mg, 20 capsRobituuin Cough Calmen, 6

(MBK D2-11)

(MBK F1-10)

(MBK F1-5)(EMK A1-16,171(MBK 01-12)

(MBK El-6)Saline 100 cc, 1Scalpels no. 11and no. 10, 1ea.*Scopolamine/Dexedrine, 0.4/5 mg,54 caps(MBK 01-10. 11)Sponge. 2x3 in., 22(MBK 2-1.2)st8th0,cope. 1(EMK C l - l i

(EMK 81-71

(EMK 82-41

(MBK F1-91(MBK F1-7)(MBX 02-2) "Sulfacetamide ophthalmic ointment,

Steri-Strip skin dosure, 2+Sudafed. 30 mg. 30 tabs

Neooporin cream, 1-02 tube, 1 (MBK El-9)+Nitroglycerin,0.4 mg, 20 tabsNormal saline, 100 oc, 1

(MBK 02-4)1/8 02 . tube, 1

(EMK 81-71 (MBK F1-9)Cphthalmotcope head, 1Oral airway, 1O t O ~ p e ,Otoscope speculum, 1

(EMK C2-7)(EMK C1-3)(EMK C24)(EMK C2-31

*Parofon Forte, 20 tabs*Pen VK. 250 rng, 40 tabsPenlight, 1Veriactin, 4 mg, 20 tabs+?henergan,25 mglcc, 2 i x unit, 3*Pheergm/Dexedrine, 26/5 mg.24 tabs

(MBK 02-13](MBK 02-5)(EMK C2-5)(MBK 02-31(EMK A1-10.11.121

(MBK D2-6)

Surgical Instrument Assembly(EMK 82-3)Fomps (small point)Needle HolderSmab HemostatTweezers (fine point)Scissors b n e d )Surgical mask,1

Suture, 4-0 exon, with C-4 needle.Suture, 4-0 Ethilon, with FS-2ceedle, 2 (EMK 82-1)Syringe, 10 cc, 1

(EMK C2-6)(EMK 82-11

(EMK Bl-6 )Taw, Dermicel, 1 in. wide, 1 roll"Tetraeyeline, 260 mg. 30 capsThermometer, disposable, 10

\MBK E l 4(MBK Dl-8 )(EMK C2-1)

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i &le 8-1 {Con$ruedlThroat lorengrs, Cepacol, 12Tongue depressor, 5

Urine T is t Package, i(MBK 01-91 (EMK 82-21C h r m t r i p - 7 (13 strips totel)iEMK C2-21 Color Chart

Toohache Ki t , 1(MBK E 2 4Eugenol dental anesthetic dropsTweetersCotto n pel letsCavit tube (temporary dentalfi l l ing)Tournitpa:, 1

Triangular bandaae, 1Tubex injector, 1Tubing, IV, wi thout drip chamber, 1*Tylenol No. 3, 20 tabs

(EMK C1-2)(NIB# F2-3)(EMK 81-21(EMK 61-81(MBK D1-14)

*Valium, 5 mg, 20 t a bV a l i u m , 5 mglcc, 2-cc unit. 2*Vistaril, 50 mg/cc, 2-cc unit, 1

(M6K D1-13)(EMK A2-12.13)(EMK A2-17)

*Xylocaine, 296 wi th Epinephr ine1:lOO.WO. ?a nit, 1*Xylocaine, 2% witho ut Epmapli rine,2-c~ nit. 1

(EMK A2-10)

(EMK A2-11)

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PRECEDING PAGE BUNK NOT FILMED N82-15719 3 8Validation of Predictive Tests andCountermeasures for Space Motion SicknessJ e r r y L. Homick, Ph.D.Exp erience from pr ev io us manned spacef l i g h t i n d i c a t e s t h a t t h e space s ic k ne s ssyndrme represents a p o t e n t i a l t h r e a tt o t he ope ra ti ona l e f f i ca cy and phys i ca lwe l l be ing of f u tu re space f l i g h t crew-members . A1 though none o f the Mercuryo r G em ini f l i g h t c re w s r e p o r t e d anyspace sickness, 33% o f t he Apo l l o c rew-men experienced symptoms and 54% o f t h eSkylab crewnen had sylnptoms. Re po rtsfrom th e USSR i n d i c a t e t h a t a b ou t 40% o fthe Soviet cosmonauts have experiencedspace mo tio n sic kn ess . These combinedd a t a s u g g e s t t h a t i f n o c o r r e c t i v eact ions are taken up t o 4Gb o f Shu t t l ecrewnembers could experience some degreeof space sickness du rin g th e f i r s t f e wdays o f f l i g h t .Because of i t s comp lexity and uniquenesst h i s b i o m e d i c a l p r o b le m c a n n o t b er e s o l v e d s o l e l y w i t h g r o u n d b a s e dresearch . To ob ta in f i n a l and v a l i dso lu t i ons i t i s e s s e nt ia l t h a t d ata beco l l ec ted sys tema t i ca l l y on i nd i v idua l swho f l y Space S h u t t l e m i s s i o n s .De tai l ed Supplemental Objec t ive ; D S O )S141 was implemented i n order t o com-mence th is da ta co l ec t io n process wi ththe STS-I mission.A p r i m a r y o b j x t i v e o f t h i s DS O was t occjnduct i n f l g h t observa tions , supportedby a se r ies o f p re and pos t f l i gh t da taco l ie c t io n procedurss, on S T S - 1 crew-members i n an e f f o r t t o v a l id a te g roundbased tes ts whic i. may be p re di ct iv e o fs u s c e p t i b i l i t y t o t h e space n o t i o n s i c k -ness syndrome. An a d d i t i o n a l o b j e c t i v ewas t o implement crew procedures w hichwould enh le ac qu is i t io n o f data t o beused in va l ida t ing mot ion s ickness coun-termeasures.

Resuits an d Oiscussi0 nP a r t o f t he r e q u i r e d crew p r e f l i g h ta c t i v i t y w a s based on g u i d e l i n e s s e tf o r t h i r i NASAs Med ica l Opera t ionsPo l i cy f o r t f ,e prop hyl ax is and treatm ent

37

o f spa ce m o t i o n s i c k n e s s w i t h a n t i -m o t i on s i c kn e s s d ru gs . T h i s p o l i c ys ta tes i n p a r t t h a t a s t r o n a u t s w i t h ap o s i t i v e h i s t o r y o f space s ic k ne s s o rw i th no space f l i g h t exper ience w i l l bep remedica ted w i t h a p rope r l y se lec tedan t i -m ot i on s ickness drug. Tine p o l i c yfu r th e r s ta tes t h a t as t r onau ts who havef lown i n space w i t h no symptoms o f spaces ickness are n o t re qu i re d t o be premed-i ca ted . Any i n d i v i d u a l who exper iencesspace mot ion s ickness w i l l be admin-i s t e r e d a p pr op r ia te i n f l g h t t re a tm e ntw i t h ant i - mo t ion s ickness drugs. Thepo l c y r eq u ir es p r e f l i g h t s id e e f f e c t ssc ree r ; i ag and e f f i cacy tes t i ng with opeo r m ore a n t i - m o t i o n s i c k n e s s m e d i ca -t i o n s .D u r i n g t h e p r e f l i g h t p e r i o d ( a ta p p r o x i m a t e l y F -120 d a y s ) e a c hc rewmember comp le ted a ques t i onna i r ed es ign ed t o e l i c i t p e r t i n e n t in f o r m a t io nregard ing past exper iences w i h v a r i o u st y p e s o f m o t i o n e n v ir o n m e n ts a n dresponses t o those cw i romne nts .A lso, a t about F-120 d a y s t h e P i l o t(PLT) c o n f e r r e d K i t h t h e F i i gh t Surgeont o s e l e c t a p r e f e r r e d a n t i - m o t i o n s i c k -ness medication. The se lec ted med iza t ionwas adm inistered t o h im t o determine anyadverse react ions . The drug screeningwas done under op er at io na l co nd it i on s(e.g., Shu t t l e s imu la to r t r a i n i ng ) andby verba l repor t ing . Because o f th ec o m p l e t e a b se n ce o f s p ac e s i c k n e s sd u r in g h i s f o u r p r i o r space f l i g h t s t h eCommander (CCF,) was n o t r eq u i r ed t o pa r -t i c i p a t e i n any o f t h e d r ug s c re e n in ga c ti i y .Dur ing approximately the F-90 t o F-60per iod o f time the crewmen were testedf o r s u s c e p t i b i 1i y t o e x p e r i m en t al yi nd uc ed m o t i o n s i c k ne s s i n t h e JSCNeurop hysiology Lab oratory . The stand-a r d C o r i o l i s S ic kn es s S u s c e p t i b i l i t yI ndex ( C S S I ) t e s t was u s ed . T h i sprocedure re qu ires the performance o fhe ad movem ents w h i l e r o t a t i n g a t a


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Crew Cardiovascular ProfileMichael W. Bungo, M.D.

Sect ion I Heart Rate and Blood Pressure ResponsesTine Or b it al F l i g h t Tes t (OFT) programwas designed t o v e r i f y t he ope ra t i on o ft h e Space S h u tt le systems. Cremembersa r e an i n t e r g a l p a r t o f t h i s system .They a re respons ib le f o r niuch o f ther e a l - t i m e i f l g h t p r o c ed u re s , a n dduring OFT-1 were direct p a r t i c i p a n t s i nth e landin g o f Colrmrbia. The hardwareo r i e n t e d t i m e l i n e o f STS-1 l e f t l i t t l eoppo r tun i t y f o r medica l r esea rch so t h a tca rd iovascu la r da ta was acqu i r ed i n apurely operat ional mode.

Results and DiscussionThe two man crew o f Colunbia co nsi ste dof a p i l o t (PLT) and copnlander ( CDR ) .Data co l l e c t i o n was i d en t i c a l f o r both.Twelve days pr io r to launch (F-12) ag raded -t readm il 1 exe rc i se te s t (GTETT)was performed t o 80% o f a p r e v io u s l ypre dic ted maximum he ar t rat e. He ar trat e, b lood pre r sure, and e l e c t r o c a r d i o-gram were recorded. Re sp ira to ry par -ameters were not recorded due t o equ ip-m e nt m al f u n c t i o n . A ' ' s t a n d " t e s t(de scri bed below) was a lso performed a tt h a t tim e .Upon en te r i ng the spacec ra f c p r i o r t o1 aunch, th e crewmembers were i s t r u -mented with a t h r e e l e a d e l e c t r o c a r d i o -g r a p h i c I E C G ) ca ble . One l e a d wasp laced a t the manubrium, a second leadwas placed below the l e f t n ipp le nea rthe apex o f t he hea r t , and the th i r dl e a d , f u n c t i o n i n g a s a g r ou n d , wasp la c ed on t h e r i g h t c h e st . E l e c t r o -card iogr aph ic data was mo nitor ed con-t inuous ly dur ing the launch phase andt h r o u g h o r b i a l i n s e r t i o n ex ceD t f o rthose t imes when ground system trackingwas n o t a v a i l b l e , ( l o s s o f s i g n a l -LOS) . No EC G moni towin g was done duringt h e r o u t in e , o n - o r b i t , " s h i r t s le e ve "e nv ir on m en t o f t h e S h u t t l e m i s s i o n .P r io r t o re -e n t ry , the crew once aga ind o n n e d t h e b i o m e d i c a l h a r n e s s ( E C Gc a b l e ) and t h e e l e c t r o c a r d i o g r a p h f cs igna l was moni to red th rough the en t ry

10and land ing phases o f the miss ion .A f t e r Or b i te r egress , th e crew was metby a phys ic ian who performed a p h y s i c a le x a m i n a ti o n w h ic h i n c l u d e d a " s t a n d"te s t as a means o f o r t ho s ta t i c p rovoca-t io n . The he ar t ra te was mon i to redc o n t i n u o u s l y b y E C G a n d t h e b l o o dp r e s s u r e o b t a i n e d b y t h e s t a n d a r dcu f f / auscu l t a t o r y me thod each m inu te f o ra t o t a l o f t e n m in ute s. D u r i ng t h ef i r s t f i v e m in ut es t h e c r e m a n was a ts up in e r e s t and d u ri n g t h e l a s t f i v eminutes he was requ i red t o s tand up r ig h tw i tho u t o the r wwement. Th i s s tand te s tp ro to co l was repeated th ree days a f t e rt h e f l i

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STS-1 Medical Report