The unique environment of the Kennedy Space Center includes a wide variety of industrial processes culminating in launch and spaceflight. Many are potentially hazardous to the work force and the astronauts. Technology, planning, training, and quality control are utilized to prevent contingencies and expedite response should a contingency occur

Long, Irene D.

Myers, K. Jeffrey

Tipton, David A.

Woodard, Daniel

English

NASA Technical Reports Server

_(_( NASA-TM-I12512
SCIENTIFIC
Emergency Medical Operations
at Kennedy Space Center
in Support of Space Shuttle
K. Jeffrey Myers, M.D., David A. Tipton, M.D., Daniel Woodard, M.D., and Irene D. Long, M.D.
ABSTRACT: The unique environment of the Kennedy
Space Center includes a wide variety of industrial pro-
cesses culminating in launch and spaceflight. Many are
potentially hazardous to the work force and the
astronauts. Technology, planning, tra/ning, and quality
control are utilized to prevent contingencies and expedite
response should a contingency occur.
The Authors
K. JEFFREY MYERS, M.D., DAVID A. TIPTON, M.D., DANIEL
WOODARD, M.D., AND IRENE D. LONG, M.D.
Dr. Myers is Manager of Medical Operations and Dr.
Woodard is Manager of Future Projects for the Bionetics
Corporation under the NASA Life Sciences Support Con-
tract. Dr. Tipton is the NASA Medical Officer for the
Medical and Environmental Health Office and Dr. Long
is Chief These physicians are assigned to Medical Opera-
tions under the direction of the Biomedical Operations and
Research Office at the Kennedy Space Center.
Emergency Medical Support at the Kennedy Space
Center {KSC) requires a complex multffaceted ap-
proach involving several disciplines. This type of sup-
port has developed due to a variety of factors:
1. The unique environment at KSC predisposes
to potential contingencies because of the variety of
hazardous substances and operations necessary to
support launch vehicle processing and payload
functions.
2. An increasing awareness of environmental,
toxicologic, and occupational safety and health con-
ceres has elevated the roles of these considerations.
3. Technological improvements in medicine
(many spinoffs from the Space Program itself) have
modified the medical approach.
4. Expectations have gradually risen throughout
the country regarding rescue, emergency or disaster
response and medical support capabilities within any
given locality or community. These expectations in-
clude the rescue of individuals while providing them
state-of-the-art medical care and protection of the
environment during the perilous conditions of a
disaster.
Launch contingencies may be viewed as an all or
none phenomenon; either everyone is uninjured or
the accident is catastrophically fatal. We know,
however, that there is considerable potential for many
disasters that lie in between and, as we all are aware,
if we do not prepare we will not perform well. There
is an innate psychological need to have a fighting
chance in any event. Further, others besides the crew
may directly or indirectly receive injury and require
attention.
The potential hazards include chemical (e.g., am-
monia, freon, hydrazine and nitrogen tetroxide), fire,
explosion, decceleration]impact, hypoxia, and decom-
pression. Our approach is development of a written
plan to define roles and responsibilities, maintain
Vol. 79, No. 8 / J. FLORIDAM.A / August 1992 / 557
https://ntrs.nasa.gov/search.jsp?R=19980006836 2020-06-16T00:39:59+00:00Z
RTLS- 33SLF-ROAD B
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MEDICAL FORCES
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Fig. 1.--Medical forces prelaunch deployment.
558/J, FLORIDA M A./August 1992/Vol. 79, No. 8
organization, and serve as a blueprint for progress. It
is equally important to practice this plan through
rescue simulations coordinated by the Emergency
Egress and Rescue Working Group.
Emergency services • Those at risk at KSC include
not only the flightcrew but also 20,000 other workers
and up to 80,000 spectators. We have found that a
coordinated team approach involving several
disciplines is best. These include fire/rescue, securi-
ty, medical, DOD, environmental health, safety,
Shuttle operations, and the astronaut office. Medical
care provision has been established along parallel
lines for two groups: those in close proximity to the
orbiter such as astronauts, closeout crew and landing
crew, and those at greater distance such as other
workers and spectators. Both lines of care are super-
vised by the Emergency Medical Services Coordinator
{EMSI, a physician, operating with real time radio
communications in the Launch Control Center. The
triage team headed up by the Triage Physician is stag-
ed at the Launch Area Clinic to respond to contingen-
cies involving the Space Shuttle by establishing a
predesignated triage site. A medical command post
with a physician in charge is set up at the
Occupational Health Facility {OHF} to handle
on-going medical problems of other KSC workers
and to coordinate the care of spectators. Medical
forces are deployed during prelaunch staging
(Fig. 1).
The EMS is assisted by the Biomedical Office
Physician {KMD} located in the Operations and
Checkout Building. This individual maintains a
dynamic inventory of area hospital resources and
facilitates hospital communications.
Search and rescue • The EMS is also in communica-
tion with the DOD Support Operations Center (DOD
SOC} at Cape Canaveral Air Force Station {CCAFS}.
The DOD SOC performs search and rescue for ocean
bailouts, rescue team deployment for off-runway con-
tingencies at KSC, and Medevac in addition to their
global rescue operations responsibilities.
When Medevac is required, the EMS requests this
through the NASA Landing Recovery Director for
DOD HH-3 lolly Green Giant helicopters or for
NASA UH-1 helicopters.
The DOD helicopters can carry four litter pa-
tients with a medical crew of one flight surgeon and
three pararescue specialists. The NASA helicopters
can carry one to two patients and are staffed by two
paramedics with a physician option.
Communications are maintained with Johnson
Space Center (ISC} flight medicine through a variety
of means: The mission's crew surgeon is a member
of the deployed triage team. The deputy crew surgeon
is located with the EMS at the Biomedical Com-
munications Console in the Launch Control Center.
The surgeon's communications loop {private
telephone line) is used between the EMS, DOD SOC,
and JSC Flight Operations Control Room Surgeon (in
Houston}.
In a contingency the basic response sequence of
rescue events is the following:
1. Prior to launch, a probable triage site is an-
nounced, chosen from a variety of locations based on
the functioning launch pad, wind direction, and other
conditions.
2. Declaration of an emergency, corLfirmation of
triage site designation, and dispatch of forces.
3. Rescue and delivery of injured to the triage
site {Fig. 2}.
4. Decontamination, triage, and treatment/
stabilization.
5. Medevac to definitive care.
Each triage site consists of a decontamination
area and a treatment area. A washdown fire truck
with attendants for decontamination, an Environmen-
tal Health Team IEH} with equipment to detect con-
tamination, and a paramedic to monitor the Airway/
Breathing/Circulatory Status {ABCs) of the injured,
deploy to the decontamination area. Should a patient
require immediate lifesaving treatment, the para-
medic may request that decontamination be sus-
pended and the patient be moved to the treatment
area, or that a treatment team deploy to the decon-
tamination area. Following such a procedure, all par-
ties and areas are evaluated and decontaminated as
indicated by EH. The personnel in this area wear pro-
tective gear.
The triage physician, two to four trauma physi-
cians, the lSC Crew Surgeon, six paramedics, a
medical communicator {radio operator}, and a
logistics coordinator {to dispense medical supplies}
deploy to the treatment area.
The patients may arrive by a variety of vehicles
depending upon the contingency. In prelaunch con-
tingencies they are transported along the crawlerway
by armored personnel carriers. For runway mishaps
a rescue van is utilized. When the crash site is off the
runway by some distance, DOD helicopter transport
is required both to deploy the rescue team and retrieve
the injured. The DOD Flight Surgeon, in consultation
with the EMS, may then elect to go directly to the
designated hospital rather than return to a triage
site.
The rescue scenarios have been divided into eight
modes:
I. PRELAUNCH: Unaided egress of the
flightcrew
11. PRELAUNCH: Egress with or aided by the
closeout crew
PRELAUNCH: Egress aided by fire/rescue,
closeout crew no longer on
station
Vol. 79, NO. 8/J. FLORIDA M.A./Augost 1992/559
Fig. 2.--A simulated patient Is delivered to a triage site by the rescue team at Kennedy space Center.
Fig. 3.--Space Shuttle launch.
IV. PRELAUNCH: Egress aided by fire/rescue
with closeout crew on
station
V. POSTLANDING: Unaided egress by flightcrew
5601J. FLORIDA M.A./August 1992/Vol. 79, NO. 8
I=lg. 4.--Space Shuttle Landing at the Kennedy Space Center.
VI. POSTLANDING: Aided egress following a
mishap on or near the
shuttle landing facility
VII. POSTLANDING: Aided egress following a
mishap in a remote area on
KSC
VIII. Unaided egress (bailout} in flight
In modes I-IV, the subjects proceed or are carried
by rescuers from the Orbiter to slidewire baskets
located at the 195-foot level on the launch pad {Fig.
2). If there is risk of fire or contamination, a deluge
system will be spraying water over the entire launch
complex. Astronauts who are fully suited activate
theirEmergencyBreathingAir {10-minutesupply} as
soon as a contingency is declared while others don
emergency breathing devices prior to proceeding to
the slidewires. After a rapid trip down the wires, they
arrive near a bunker where they contact the NASA
Test Director on a direct line to determine whether
to stay or proceed via armored personnel carrier to the
triage site. Decontamination showers, breathing air,
and first aid equipment are available at the bunker.
In modes V-VI, a triage site is established 1250
feet upwind of the orbiter on the runway. In the event
of an overrun or landing too short, the triage site is
set up at the end of the runway closest to the crash
site. The astronauts and/or rescuers egress through the
side hatch with an airline type slide or climb out an
emergency opening on top and rappel down the side.
They are transported to the triage site by rescue vans.
For mode VII, the rescue team is deployed from
DOD helicopters by landing, hoist, or rope. One
pararescue specialist deploys with the rescue team to
perform initial care and decontamination. The
helicopter then returns to the Shuttle Landing Facility
to pick up its full complement of medical personnel
for patient loading. Both the rope and hoist
deployments may require hoisting of the patients up
into the hovering helicopter. After patient loading, the
helicopter may land at the triage site for further
patient stabilization or proceed with direct Medevac
to a hospital.
In mode VIII, C-130 fixed wing aircraft search and
rescue teams deploy with pararescue specialists who
parachute into the ocean with zodiac rafts to rescue
and stabilize the injured. This is followed by Medevac
on HH-3 helicopters equipped with medical teams
who hoist the injured on board. In-flight refueling is
used as needed.
We also provide emergency medical coverage for
the other workers at KSC as well as large crowds of
spectators. A medical command post operates from
the Occupational Health Facility {OHF} utilizing a
complement of ambulances and other staff vehicles
manned by paramedics, nurses, and EMTs stationed
at various viewing sites in the field {Fig. 1}. This
allocation of resources for astronauts and spectators
helps ensure that medical support is not interrupted
to either group.
This is a brief description of current KSC
emergency medical operations for Space Shuttle
launch {Fig. 3} and landing {Fig. 4}. As long as this
spaceport is charged with the signal responsibilities
of space vehicle processing, launching, and landing,
it will be necessary to support these potentially hazar-
dous activities with prudent emergency medical ser-
vices. Further developments are anticipated in the
future as the needs, capabilities, and visions expand
in this area.
Reference Documents
Medical Operations Requirements Document [SC-13956 July 1988.
Medical Operations Support Implementation Plan, KBM-PL-1.1, August 1988.
Emergency Medical Services Plan, KBM-PL-I.2B, January 1992.
Dr. Myers, Bionetics Corp., Mail Code BIO-1, John
F. Kennedy Space Center, FL 32899.
VOI. 79, No. 8/J. FLORIDA M.A./August 1992/561



Emergency Medical Operations at Kennedy Space Center in Support of Space Shuttle

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