Red Bull Stratos Medical Operations Field Hazards and Remote Operations: Providing Medical Care for the Red Bull Stratos Project James Pattarini, MD Jennifer Law, MD, MPH Rebecca Blue, MD, MPH Sharmila Watkins, MD, MPH Erik Antonsen, MD, PhD Alejandro Garbino, MD, PhD Sean Norton, EMT-P Matthew Turney, MD Jonathan Clark, MD, MPH Aerospace Medical Association 84th Annual Scientific Meeting May 13, 2013
Disclosure Information James 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.
Overview Flight Line Hazards Field Hazards Remote Operations
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, widelyseparated 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
Field Hazards
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
Field Clinic Evolution MBF1 MBF3
Final Clinic Capabilities Clinic Stethoscope Sphygmomanometer Thermometer Oto/ophthalmoscope OTC medications Rx medications: MCC AED O2 single bottle with NRB mask Analgesics, antihistamines, decongestants, PPIs Sunblock, insect repellants 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
Encounter Summary
Encounter Summary
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