Field Hazards and Remote Operations -...
Transcript of Field Hazards and Remote Operations -...
Aerospace Medical Association 84th Annual Scientific MeetingMay 13, 2013
Red Bull Stratos Medical Operations
Field Hazards and Remote Operations:
Providing Medical Care for the Red Bull Stratos Project
James Pattarini, MD Alejandro Garbino, MD, PhD Jennifer Law, MD, MPH Sean Norton, EMT-PRebecca Blue, MD, MPH Matthew Turney, MDSharmila Watkins, MD, MPH Jonathan Clark, MD, MPHErik Antonsen, MD, PhD
Disclosure InformationJames Pattarini, MD
I have no financial relationships to disclose.
I will not discuss off-label use and/or investigational use in my presentation
Introduction
• Red Bull Stratos:• Remote field operations• Hundreds of support personnel
• Unique environment (Roswell, New Mexico)• Limited level of medical care
• Remote location
• Desert environment
• Identification of risks• Steep learning curve from MBF1 - MBF3• Significant obstacles for the medical team to overcome.
Flight Line Hazards: Nighttime Operations
• Nighttime operations
• Reflective gear while on the flight line at all times
• Trip hazards: power lines and data cables
• Heavy machinery
Flight Line Hazards:Balloon Awareness
• Balloon Awareness
• Gloves for handling
• Fragility – • No stepping over
train
• Only balloon team members to handle the balloon
• Helium Truck Hazards
Field Hazards: Capsule Awareness
• Capsule Awareness
• Falling objects (capsule suspended by crane until launch)
• Rapid crane acceleration
• Power umbilicals
• LOX, pressurized
nitrogen, batteries
Field Hazards
• Manmade Obstacles– Barbed wire fencing– Few inroads to remote territory – Private land with few, widely-
separated gates
• Automobile Hazards– Divided attention
• Balloon tracking, situational awareness
– Gravel/dirt roads the norm– Off-road driving– Geographic familiarity, or lack
thereof
Field Hazards
• Desert terrain• Field personnel hydration
requirements• Areas inaccessible by car
• Possibility of prolonged exposure
• Heat exposure• Distance to Level 1 Trauma
Center
• Indigenous wildlife• Rattlesnakes• Scorpions• Black Widows
Remote Operations
• Communication
• Primary method of communication by text message
• Loss of coverage – Dependent on location,
cellular network• Group text useful• Coordination
– Medical back room trailer
• Radios primary while on site
Remote Operations
• Limited Resources• Field clinic: minor care to field personnel• Situation awareness and medical preparations
• Major obstacles during MBF1• No video feeds of MCC, flight line • Crew often unaware of medical capabilities, clinic
locations
• Limited clinical capabilities
Final Clinic Capabilities
• Clinic– Stethoscope– Sphygmomanometer– Thermometer– Oto/ophthalmoscope
• MCC– AED
– O2 single bottle with NRB mask
OTC medications• Analgesics, antihistamines,
decongestants, PPIs• Sunblock, insect repellants
Rx medications:• Ondansetron,
prochlorperazine, prednisone, lidocaine, epinephrine
Basic wound care: • Dressings, gauze, splints• NS IVF 3-5 Liters• Suture supplies
Results
• Clinic Utilization• Encounters related to hazards outline previously
• Soft tissue injuries
• Medical illness• Upper respiratory infections
• Gastroenteritis
• Headache
• Exhaustion
Summary
• MBF 1 - 21 total encounters • MBF 2 - 14 total encounters• MBF 3 - 25 total encounters• Most common: URI complaints• Most avoidable: Headache from dehydration• Most serious:
– Lightheadedness in 75 yo M with atrial fibrillation • s/p cardioversion x3 prior to event
– Referred to local emergency department
Lessons Learned
• URI cases expected – Weather, stress, close quarters, night operations with sleep
shifting
• Multiple headache complaints– Dehydration, caffeine consumption
• Most undocumented health issues: exhaustion from prolonged nighttime operations– 15+ hour days for most crew– 10PM briefing, reset following scrubbed launch by noon.– Rest days built into schedule a necessity– Clinic requested as a nap site by crew, utilized most during
MBF2
Discussion
• Medical providers face unique challenges in a remote environment.
• Nighttime operations introduce further risk in reduced visibility and circadian disruption
• Despite resource limitations, the medical support team for the Stratos project was able to respond well to all field medical concerns
Acknowledgements
• The authors acknowledge the invaluable contribution to the spaceflight scientific community that Felix Baumgartner is making by releasing his data obtained throughout the Red Bull Stratos Project.
• The authors also acknowledge the invaluable support of the following:
– Red Bull N.A.– The Red Bull Stratos team– Col. Joe Kittinger, USAF (ret)– Art Thompson and the Sage Cheshire Aerospace Team– Jim Bagian, MD– University of Texas Medical Branch– Baylor College of Medicine– Jeffrey Sutton, MD, PhD– National Space Biomedical Research Institute through the NASA cooperative
agreement NCC 9-58– Space Medicine Clinical Research Training Program