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Section 02Clinical
NASA-STD-3001 and space medicine research, translated into practical, plain-language guidance for general practitioners, emergency physicians, nurses, flight and aviation medicine doctors, and anyone seeing a patient before or after spaceflight — including commercial spaceflight participants. Every article opens with a Bottom line for clinicians, then What to do checklists, red flags and terrestrial parallels; deeper physiology is tucked into collapsible “Deeper dive” sections.
Clinician Quick-Start: Seeing a Patient Who Flew — or Will Fly — to Space
A one-page orientation for GPs, emergency physicians, nurses and flight/aviation doctors: what to ask, what to check, the red flags, and where to find the details — before and after spaceflight.
ReferenceNASA-STD-3001 Standards Quick Reference
How the two volumes are organized, the requirement IDs clinicians meet most often, and official links (NASA, OCHMO, FAA).
| Tier | Distance to hospital care | Communication | Medical model |
|---|---|---|---|
| Suborbital / parabolic | Minutes (lands where it launched) | Real time | Screening + landing-site care |
| LEO (ISS, commercial) | Hours–about a day pending verification | Near real time | Ground-guided crew medical officers; evacuate if beyond capability |
| Lunar (Artemis) | About 3 days | ~1.3 s one-way | Stabilize and return |
| Mars | Months; usually no return on demand | Up to ~20–22 min one-way; blackouts | Earth-independent care, palliative capability |
Sources: NASA-STD-3001 Vol. 1 [V1 3007]; NASA HRP “Distance from Earth” hazard page; NASA Mars communications fact sheet. Details in Emergencies & evacuation.
A Medical Standards & Selection
How NASA-STD-3001 and OCHMO-STD-100.1A set the medical bar for crews, and how that differs for commercial flyers.
Medical standards overview
What NASA's crew health standard actually requires, how astronauts are medically selected and recertified, and what that means for a clinician who sees space travelers.
◆◆◆◆ High · E F
SMF-C-0002 · protocol · draftSFP screening
How to approach a patient who wants to fly as a paying passenger: what the FAA does and does not require, what published guidance recommends, and which conditions deserve a closer look.
◆◆◇◇ Low · E A F
SMF-C-0003 · countermeasure · draftRadiation limits & monitoring
NASA's radiation limits in plain clinical terms, how crew dose is monitored, what shielding can and cannot do, and what it means for a patient's lifetime cancer screening.
◆◆◆◇ Moderate · E C F M
SMF-C-0006 · countermeasure · draftExercise countermeasures
What spaceflight does to aerobic capacity and muscle, NASA's fitness standards in plain numbers, how in-flight exercise works, and how to prescribe reconditioning after return.
◆◆◆◇ Moderate · F A E
SMF-C-0010 · topic · draftEmergencies & evacuation
What medical care is actually available on a spacecraft, who provides it, how evacuation works from orbit, and why the model changes completely for lunar and Mars missions.
◆◆◆◇ Moderate · F E C
SMF-C-0014 · protocol · draftDCS & EVA
Why spacewalks carry decompression risk, how prebreathe protocols prevent it, how DCS is recognized and treated without a hyperbaric chamber, and other EVA hazards (CO2, water in the helmet, hand injuries) — with links to dive and altitude medicine.
◆◆◆◇ Moderate · E A F
B Preflight Screening
Screening professional astronauts and commercial spaceflight participants (SFPs); health stabilization before launch.
Medical standards overview
What NASA's crew health standard actually requires, how astronauts are medically selected and recertified, and what that means for a clinician who sees space travelers.
◆◆◆◆ High · E F
SMF-C-0002 · protocol · draftSFP screening
How to approach a patient who wants to fly as a paying passenger: what the FAA does and does not require, what published guidance recommends, and which conditions deserve a closer look.
◆◆◇◇ Low · E A F
SMF-C-0012 · protocol · draftBehavioral health monitoring
What psychological problems have occurred in spaceflight, how agencies select, train, monitor and support crews, what isolation analogs teach us, and how to help with reintegration after return.
◆◆◇◇ Low · F A E
C In-flight Medical Care & Capabilities
What can be diagnosed and treated on board, and how that changes from LEO to the Moon to Mars.
SANS management
How space agencies screen for and manage optic disc edema, globe flattening, choroidal folds and hyperopic shift in long-duration flyers — and how to evaluate a returning astronaut's eyes.
◆◆◆◇ Moderate · F A E
SMF-C-0007 · protocol · draftSpace motion sickness
Who gets space motion sickness, how it is graded, why promethazine is NASA's treatment of choice, what else is used, and how to manage the same symptoms after landing.
◆◆◆◇ Moderate · F E
SMF-C-0009 · topic · draftSpace pharmacy & drug stability
What astronauts actually take, whether drugs still work in space, what happens to medications stored for months to years, and how to plan a formulary for missions far from resupply.
◆◆◇◇ Low · F E M
SMF-C-0010 · topic · draftEmergencies & evacuation
What medical care is actually available on a spacecraft, who provides it, how evacuation works from orbit, and why the model changes completely for lunar and Mars missions.
◆◆◆◇ Moderate · F E C
SMF-C-0011 · topic · draftPOCUS in space
How ultrasound became the main imaging tool in space — remote-guided FAST, echo, eye and kidney scans, and routine screening of the jugular veins for thrombosis — and what that means for clinicians on the ground.
◆◆◆◇ Moderate · F E
SMF-C-0012 · protocol · draftBehavioral health monitoring
What psychological problems have occurred in spaceflight, how agencies select, train, monitor and support crews, what isolation analogs teach us, and how to help with reintegration after return.
◆◆◇◇ Low · F A E
SMF-C-0013 · topic · draftKidney stones
Why spaceflight raises stone-forming risk (bone calcium loss, low urine volume), what prevents it, how a stone would be recognized in flight, and what to watch for in the year after return.
◆◆◆◇ Moderate · F C E
D Countermeasures
Exercise, nutrition, radiation shielding & dosimetry, fluid loading and pharmacologic protection.
Radiation limits & monitoring
NASA's radiation limits in plain clinical terms, how crew dose is monitored, what shielding can and cannot do, and what it means for a patient's lifetime cancer screening.
◆◆◆◇ Moderate · E C F M
SMF-C-0005 · countermeasure · draftBone loss countermeasures
How much bone astronauts lose, what prevents it (resistance exercise, nutrition, and in research, bisphosphonates), how NASA monitors BMD with DXA, T-scores and FRAX, and what a primary care clinician should do after a long flight.
◆◆◆◇ Moderate · F A E
SMF-C-0006 · countermeasure · draftExercise countermeasures
What spaceflight does to aerobic capacity and muscle, NASA's fitness standards in plain numbers, how in-flight exercise works, and how to prescribe reconditioning after return.
◆◆◆◇ Moderate · F A E
SMF-C-0008 · protocol · draftOrthostatic intolerance on landing
Why returning space travelers get lightheaded or faint when they stand, how agencies prevent it (fluid/salt loading, compression garments, recumbent seating), and how to assess and treat it in the ED or clinic.
◆◆◆◇ Moderate · F A E
SMF-C-0013 · topic · draftKidney stones
Why spaceflight raises stone-forming risk (bone calcium loss, low urine volume), what prevents it, how a stone would be recognized in flight, and what to watch for in the year after return.
◆◆◆◇ Moderate · F C E
SMF-C-0014 · protocol · draftDCS & EVA
Why spacewalks carry decompression risk, how prebreathe protocols prevent it, how DCS is recognized and treated without a hyperbaric chamber, and other EVA hazards (CO2, water in the helmet, hand injuries) — with links to dive and altitude medicine.
◆◆◆◇ Moderate · E A F
E Space Pharmacology
Medical kits, drug stability and shelf life, and medicines commonly used in flight.
Space motion sickness
Who gets space motion sickness, how it is graded, why promethazine is NASA's treatment of choice, what else is used, and how to manage the same symptoms after landing.
◆◆◆◇ Moderate · F E
SMF-C-0009 · topic · draftSpace pharmacy & drug stability
What astronauts actually take, whether drugs still work in space, what happens to medications stored for months to years, and how to plan a formulary for missions far from resupply.
◆◆◇◇ Low · F E M
F Emergency Care & Evacuation
In-flight emergencies, decompression sickness, and when (and whether) evacuation is possible.
Orthostatic intolerance on landing
Why returning space travelers get lightheaded or faint when they stand, how agencies prevent it (fluid/salt loading, compression garments, recumbent seating), and how to assess and treat it in the ED or clinic.
◆◆◆◇ Moderate · F A E
SMF-C-0010 · topic · draftEmergencies & evacuation
What medical care is actually available on a spacecraft, who provides it, how evacuation works from orbit, and why the model changes completely for lunar and Mars missions.
◆◆◆◇ Moderate · F E C
SMF-C-0011 · topic · draftPOCUS in space
How ultrasound became the main imaging tool in space — remote-guided FAST, echo, eye and kidney scans, and routine screening of the jugular veins for thrombosis — and what that means for clinicians on the ground.
◆◆◆◇ Moderate · F E
SMF-C-0014 · protocol · draftDCS & EVA
Why spacewalks carry decompression risk, how prebreathe protocols prevent it, how DCS is recognized and treated without a hyperbaric chamber, and other EVA hazards (CO2, water in the helmet, hand injuries) — with links to dive and altitude medicine.
◆◆◆◇ Moderate · E A F
G Diagnostics
Point-of-care ultrasound, eye imaging (OCT, fundoscopy) and monitoring in flight.
SANS management
How space agencies screen for and manage optic disc edema, globe flattening, choroidal folds and hyperopic shift in long-duration flyers — and how to evaluate a returning astronaut's eyes.
◆◆◆◇ Moderate · F A E
SMF-C-0011 · topic · draftPOCUS in space
How ultrasound became the main imaging tool in space — remote-guided FAST, echo, eye and kidney scans, and routine screening of the jugular veins for thrombosis — and what that means for clinicians on the ground.
◆◆◆◇ Moderate · F E
H Postflight Recovery & Rehabilitation
Landing-day care, orthostatic intolerance, reconditioning and return to normal activity.
Bone loss countermeasures
How much bone astronauts lose, what prevents it (resistance exercise, nutrition, and in research, bisphosphonates), how NASA monitors BMD with DXA, T-scores and FRAX, and what a primary care clinician should do after a long flight.
◆◆◆◇ Moderate · F A E
SMF-C-0006 · countermeasure · draftExercise countermeasures
What spaceflight does to aerobic capacity and muscle, NASA's fitness standards in plain numbers, how in-flight exercise works, and how to prescribe reconditioning after return.
◆◆◆◇ Moderate · F A E
SMF-C-0007 · protocol · draftSpace motion sickness
Who gets space motion sickness, how it is graded, why promethazine is NASA's treatment of choice, what else is used, and how to manage the same symptoms after landing.
◆◆◆◇ Moderate · F E
SMF-C-0008 · protocol · draftOrthostatic intolerance on landing
Why returning space travelers get lightheaded or faint when they stand, how agencies prevent it (fluid/salt loading, compression garments, recumbent seating), and how to assess and treat it in the ED or clinic.
◆◆◆◇ Moderate · F A E
SMF-C-0013 · topic · draftKidney stones
Why spaceflight raises stone-forming risk (bone calcium loss, low urine volume), what prevents it, how a stone would be recognized in flight, and what to watch for in the year after return.
◆◆◆◇ Moderate · F C E
SMF-C-0015 · guide · draftPostflight recovery & surveillance
A timeline of what to expect after landing — day 0 to day 45 and beyond — what NASA measures and when, which problems can persist for months or years, and how lifelong occupational surveillance works.
◆◆◆◇ Moderate · F E
I Long-term Surveillance
Lifetime health monitoring of people who have flown, including radiation and eye follow-up.
Radiation limits & monitoring
NASA's radiation limits in plain clinical terms, how crew dose is monitored, what shielding can and cannot do, and what it means for a patient's lifetime cancer screening.
◆◆◆◇ Moderate · E C F M
SMF-C-0004 · protocol · draftSANS management
How space agencies screen for and manage optic disc edema, globe flattening, choroidal folds and hyperopic shift in long-duration flyers — and how to evaluate a returning astronaut's eyes.
◆◆◆◇ Moderate · F A E
SMF-C-0005 · countermeasure · draftBone loss countermeasures
How much bone astronauts lose, what prevents it (resistance exercise, nutrition, and in research, bisphosphonates), how NASA monitors BMD with DXA, T-scores and FRAX, and what a primary care clinician should do after a long flight.
◆◆◆◇ Moderate · F A E
SMF-C-0012 · protocol · draftBehavioral health monitoring
What psychological problems have occurred in spaceflight, how agencies select, train, monitor and support crews, what isolation analogs teach us, and how to help with reintegration after return.
◆◆◇◇ Low · F A E
SMF-C-0013 · topic · draftKidney stones
Why spaceflight raises stone-forming risk (bone calcium loss, low urine volume), what prevents it, how a stone would be recognized in flight, and what to watch for in the year after return.
◆◆◆◇ Moderate · F C E
SMF-C-0015 · guide · draftPostflight recovery & surveillance
A timeline of what to expect after landing — day 0 to day 45 and beyond — what NASA measures and when, which problems can persist for months or years, and how lifelong occupational surveillance works.
◆◆◆◇ Moderate · F E
- NASA-STD-3001 Vol. 1 Rev C (2023-09-15) (PDF) · NASA Technical Standards System page
- NASA-STD-3001 Vol. 2 Rev F (2026-07-14) (NASA Technical Standards System)
- OCHMO technical briefs · OCHMO standards home
- NASA Human Research Program evidence reports · Human Research Roadmap
- 14 CFR Part 460 (FAA human spaceflight requirements) · FAA guidance for medical screening of commercial aerospace passengers (AM-06/1)
NASA documents are U.S. Government works (public domain), summarized with attribution. SMF is independent and not affiliated with NASA or the FAA.
All pages: Reviewer — Pending review · AI-assisted · Educational use only (disclaimer).