medical treatment during spaceflight medical treatment during spaceflight it is inevitable that medical conditions of varying complexity, severity and emergency will occur during spaceflight missions with human participants. different levels of care are required depending on the problem, available resources and time required to return to earth. all medical problems have the potential to affect the mission, but significant illnesses or trauma will result in a high probability of mission failure or loss of crew. as the distance that missions travel from earth increases, more possible medical conditions and types of trauma need to be evaluated. return to earth will be highly unlikely or very difficult depending on the distance traveled. emergency health care will, and psychological support may, have to be self-administered and could possibly be completely autonomous. the most effective way to provide adequate support is to establish a thorough pre-flight health status assessment and develop a systematic approach to autonomous health care in space. for nasa, specific provisions and requirements for medical services during space missions are outlined in npd 8900.5b nasa health and medical policy for human space exploration, npd 8900.1g medical operations responsibilities in support of human space flight programs and nasa-std-3001 nasa spaceflight human systems standard - volume 1, crew health. in flight in-flight medical events for u.s. astronauts during the space shuttle program (sts-1 through sts-89, april 1981 to january 1998) medical event or system by icd9* category number percent of total space adaptation syndrome 788 42.2 nervous system and sense organs 318 17.0 digestive system 163 8.7 skin and subcutaneous tissue 151 8.1 injuries or trauma 141 7.6 musculoskeletal system and connective tissue 132 7.1 respiratory system 83 4.4 behavioral signs and symptoms 34 1.8 infectious diseases 26 1.4 genitourinary system 23 1.2 circulatory system 6 0.3 endocrine, nutritional, metabolic, and immunity disorders 2 0.1 *international classification of diseases, 9th ed. non-emergencies most medical conditions that occur while in flight do not constitute a medical emergency and can be treated with medication, if available. some documented non-emergency conditions that have occurred while in space include, space adaptation sickness, motion sickness, headache, sleeplessness, back pain, trauma, burns, dermatological conditions, musculoskeletal conditions, respiratory illness and genitourinary problems. skylab 2 commander charles conrad is seen undergoing a dental examination by the medical officer, joseph kerwin in the skylab medical facility. emergencies potential medical emergencies during space flight arrhythmias, heart attack, stroke, embolism, massive hemorrhage, emergencies related to renal stone formation, infection and thrombotic complications. to date, arrhythmias, renal colic, venous thrombosis, and infections have been documented during space flights. the documented arrhythmias were mostly mild abnormalities, but potentially serious arrhythmias have been reported. cosmonaut sergei k. krikalev, expedition 11 commander representing russia's federal space agency, participates in medical training at johnson space center (jsc). space medicine instructor tyler n. carruth with wyle life sciences assisted krikalev. the manifestation of coronary artery disease has not been registered during any human space flight, but considering the risk of coronary events in older people and the increasing age of crew members, the possibility of complications during long-duration missions should not be ignored. other medical emergencies that have been observed in space include rare but real cases of urological and dental emergencies. additional consideration substantiates the risk of the inability to treat crew members on long-duration missions. radiation