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National Space Biomedical Research Institute
Houston, Texas

Contact:
Kathy Major, 713-798-5893, major{at}bcm.tmc.edu

January 17, 2003

Patient simulator will enhance training
    for medical emergencies in space
=======================================

HOUSTON -- A lifelike mannequin will be teaching astronauts, flight 
surgeons and other mission personnel how to effectively manage medical 
emergencies in space. 

"This patient simulator is no dummy. It breathes, has a heartbeat, 
pupils that react to light and medications, a pulse that can be felt 
at five locations, and lung sounds," said Dr. Hal Doerr, head of the 
Medical Operational Support Team, a joint project of the National 
Space Biomedical Research Institute (NSBRI), NASA Johnson Space Center 
and its support contractor, Wyle Laboratories. "About 200 parameters 
can be changed, so we can create any type of patient and then simulate 
medical events that could happen." 

As mission lengths grow, the possibilities for medical problems in 
space increase. To expand the training of crew medical officers, NASA 
tasked the NSBRI with designing realistic training scenarios for 
astronauts and ground personnel involved in mission operations.

"This simulator will give us an extremely realistic setting to 
validate and integrate medical procedures and medical equipment," said 
Dr. Jim Logan, MOST project administrator from NASA's Medical 
Informatics and Health Care Systems Office. "The project also links 
the medical and operations sides of a mission. In the event of a 
medical emergency, all parts of the mission team -- crew, flight 
surgeons, biomedical engineers and flight operations -- need to be
ready to react at a moment's notice." 

The patient simulator is linked to a sophisticated computer, designed 
along the lines of a flight simulator, that controls the 'patient's' 
reactions and can be programmed to mimic various situations that could 
occur. 

For a session on allergic reactions to medications, participants will 
face a wheezing simulator with a rapid pulse and swollen tongue. In 
some scenarios, the simulator will be programmed to talk.

Doerr's group is ensuring that the simulated patient represents a 
potential astronaut by gathering data on the current astronaut pool. 
Physiologic changes that occur in space as a mission progresses also 
are programmed into the computer, so that realistic space scenarios 
can be created.

"We're developing programmed scenarios for possible emergencies, such 
as crush trauma, inhalation burn, allergic reactions, decompression 
sickness, eye injury, respiratory distress, or myocardial infarction," 
said Doerr, director of the Houston Center for Advanced Patient
Simulation at Baylor College of Medicine. "Each scenario looks at how 
the injury or illness can be treated with the equipment on board and 
for how long." 

NSBRI researchers, who study the health problems associated with 
long-term space flight, will participate in planning for the different 
medical contingencies. Once the scenarios are complete, Doerr says 
training will be most effective if it occurs in a room that mimics the 
size, look and sounds of areas available for medical care on the
International Space Station. 

"When teaching, you must be able to make the participants suspend 
disbelief. It is hard to think clearly in a medical emergency. We're 
trying to create enough stress to make it realistic, so that they will 
fail," he said.  "Once they see how difficult it can be, we explain 
why they failed, work through the problems and do it until they 
succeed." 

Doerr, who trains anesthesiology residents and firefighters on 
simulators, says this type of training will give astronauts the tools 
to work through an emergency medical situation more effectively.

"The practice sessions teach critical thinking and critical
communications. They learn how to communicate clearly to ground crews 
and each other during medical emergencies," Doerr said. "Crews will be 
prepared to provide the best in-flight medical care possible."

The NSBRI, funded by NASA, is a consortium of institutions studying 
the health risks related to long-duration space flight. The 
Institute's 97 research and education projects take place at 75 
institutions in 22 states involving 269 investigators.

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