RMP-EYE-001 Eye injury, foreign body or chemical splash: eyewash and containment supplies, timing and video, urgent relay (the robot never touches the eye)

1 · Identity and scope

When something gets into a crewmember's eye, or the eye is hit, the robot tells the flight surgeon and CMO at once (URGENT for any chemical, possible penetrating injury or vision change), brings the eyewash and irrigation water, containment towels, gloves and eye protection for helpers, announces the elapsed irrigation time (never an endpoint; only the CMO ends irrigation), records what the crewmember reports, and takes photos or video of the eye only with the crewmember's agreement. For a chemical splash the crew start irrigating at once with what is at hand; nothing waits for the robot. The one exception is a suspected penetrating (open-globe) injury: nobody presses on the eye, and the CMO decides about irrigation.

Why this protocol was chosen. NASA records list 70 eye abrasions from foreign bodies and 6 chemical eye burns among US astronauts through 2006, among the more frequently recorded injuries in that list; floating debris does not settle in weightlessness, and NASA expects eye wash capability for particulate events, especially with lunar and planetary dust, and provides a minimum water quantity for eye irrigation [V2 6109]. For a chemical splash, eye-care guidance is to flush the eye immediately, unless an open-globe injury is known or strongly suspected, and keep irrigating (for context: primary-care eye guidance says at least 20 minutes before seeking care; ophthalmology guidance uses a stable physiologic pH, not elapsed time alone, as the endpoint, and several liters may be needed), and damage is generally worst with alkalis such as ammonia; a possible penetrating injury needs same-day specialist care. A helper that brings water and containment and keeps time lets the crew keep irrigating.

Autonomy: Max rung raised from 1 to 2 for supervised fetching and recording, as in batch 1. Irrigation and any eye care are done by the crewmember or the CMO.

Related: RMP-ENV-005 · RMP-ENV-002 · RMP-NEURO-001 · RMP-EYE-003 · RMP-INF-002 · RMP-PHARM-001

2 · Roles

Medical authority

Flight surgeon (ground). Holds medical authority for every run.

Onboard lead

Crew medical officer (CMO), acting under delegated care; uses the pre-approved onboard checklist when there is no link.

Others

• Crewmember with the eye problem: starts irrigation at once for a chemical splash if able, and can stop the robot at any time
• Second trained CMO: receives alerts if the CMO is the patient and helps with irrigation
• Environmental lead and crew: deal with the source of any chemical (RMP-ENV-005, RMP-ENV-002)

Commercial flights

On commercial flights, 'flight surgeon' and 'CMO' mean the operator's designated medical authority and trained onboard responder. If no trained responder is aboard, this protocol is not used. (NASA-STD-3001 requires two CMOs per vehicle for NASA programs [V1 3006]; FAA rules set no medical standards for spaceflight participants.) [15]

3 · Preconditions and consent

• PRE-1 A crewmember started the protocol by command. For a chemical splash, irrigation has already started with what is at hand (unless a penetrating injury is suspected; then the CMO decides); the robot never asks the crew to wait.human_start == trueV2 10174
• PRE-2 Robot self-test passed; it knows the stowage location of the eyewash kit, irrigation water and containment supplies.V2 10161
• PRE-3 Robot and supplies restrained when not moving.V2 7046
• PRE-4 Helpers near the irrigation wear eye protection; containment towels are in place for floating droplets.V2 9053
• PRE-5 Link status and current delay known.link_state in [live, delayed, down]

Consent

The crewmember agrees to questions and recording by voice. Photos or video of the eye need the crewmember's agreement each time. Any question can be declined; an explicit "no" is logged as declined for that question only.

Emergency consent

If the crewmember cannot answer, the URGENT alert stands, the robot asks nothing more and a crewmember checks in person; no photos are taken without agreement unless the CMO records them for the medical record.

Withdrawal

The crewmember can stop photos, video or questions at any time; an alert already sent is not withdrawn.

4 · Required sensor inputs

5–6 · Steps and decision points

Each step names who acts. Decision points sit after the step they follow and say who decides: Robot Crew Ground. Any stop rule in section 7 can interrupt any step.

1. S1RobotRung 2

   On a crewmember's word, open the log and send an "eye injury" note to the flight surgeon and the CMO at once, with what got into or hit the eye; for any chemical or unknown fluid, a possible penetrating injury or a vision change it is an URGENT alert. Every URGENT alert goes to the CMO and the flight surgeon at the same time (queued for the flight surgeon if the link is down). If the CMO is the patient, is busy treating, or does not answer, the alert goes to the second trained CMO, or the crewmember named before flight [V1 3006]. An URGENT alert that is not acknowledged within <set by validation> seconds is repeated and sent to the next named crewmember.

   Done when: Note or alert acknowledged, or escalated.

   V2 10174V1 6003V1 3006

2. S2Crew

   For a chemical splash, the crewmember or a helper irrigates the eye at once with what is at hand and keeps going; only the CMO ends irrigation, under the onboard checklist (for example using pH paper if it is in the kit). If a penetrating injury is also suspected (RF2), nobody presses on the eye, and the CMO decides about irrigation under the onboard checklist; otherwise irrigation for a chemical is never delayed. For debris, the CMO decides what to do. Nobody waits for the robot.

   Done when: Irrigation started by humans when needed.

   V1 3004V2 6109

3. S3RobotRung 2

   Bring the eyewash kit, more irrigation water including the potable water for medical use, absorbent containment towels and bags, gloves and eye protection for helpers, and restrain them within reach. This is an emergency fetch on a human command (CMO or crewmember): no barcode check runs before hand-over and nothing waits for one. The robot reads the kit's own label and seal status only if that adds no delay, says "EMERGENCY FETCH – NOT VERIFIED (CMO or crewmember command)", and "seal not intact" if so, and hands the kit over anyway. The fetch is logged as an override: time, who asked, the reason as stated, kit ID and seal status. It never says "verified".

   Done when: Supplies restrained within reach; override logged.

   Limit: <set by validation>

   V2 7046V2 9053V2 6109

4. S4RobotRung 2

   Announce the elapsed irrigation time only, every <set by validation> seconds, from the start time the crew give, and record the volume and any pH reading they report. It never says "complete", "done" or that a time has been reached. Only the CMO ends irrigation; the robot never decides when to stop.

   Done when: Times, volumes and readings logged.

5. S5RobotRung 2

   Ask the red-flag questions by voice once the crewmember can answer and log answers word for word. D1 is checked after every answer.

   Done when: Answers logged, or "no response" logged.

   D1DecisionRobot decides

   Checked after every answer and at any point in the run (even mid-question or mid-step): does any answer, reading or observation meet a red flag?

   • Yes → Stop the current question or step at once and apply the action listed for each matching red flag (URGENT alert, flag, or stop), with the answer or reading itself, never a cause. Every URGENT alert goes to the CMO and the flight surgeon at the same time (queued for the flight surgeon if the link is down). If the CMO is the patient, is busy treating, or does not answer, the alert goes to the second trained CMO, or the crewmember named before flight [V1 3006]. An URGENT alert that is not acknowledged within <set by validation> seconds is repeated and sent to the next named crewmember.
   • No → Continue.
   D2DecisionRobot decides

   Did the crewmember answer the question?

   • Yes → Continue.
   • Declined explicitly (the crewmember says no to a question) → Log "declined" for that question only; the alert already sent stands.
   • No response, or the answer does not make sense → URGENT: log "no response" (never "declined"); the CMO, or the second trained CMO if the CMO is the patient, checks the crewmember in person at once.
6. S6RobotRung 2

   With the crewmember's agreement, take photos or video of the eye area for the flight surgeon; take only sealed bags of used towels and stow them. For a contact lens wearer, bring a separate sealed bag for the lens and case; the crew place them in it, and they are kept, not discarded.

   Done when: Photos taken or "not agreed" logged; sealed waste stowed.

   V1 6003V2 7102

7. S7RobotRung 2

   After any URGENT alert: After an URGENT alert the robot does not leave on its own: it stays at its rest position in the module, with its screen and voice link available, until a human has taken over or tells it to go. It never follows, blocks or touches anyone. It keeps time-stamping what humans say they did, and repeats the alert if it is not acknowledged.

   Done when: Robot at rest in the module until a human releases it; alert acknowledged or escalated.

   V2 10173V1 3006

8. S8Ground

   The flight surgeon (or the CMO under the onboard checklist when there is no link) decides further care, medicines, work limits and any evacuation [V1 3007]. The robot logs the decisions.

   Done when: Decision logged.

   V1 3007

   D3DecisionGround decides

   What is the plan?

   • Link live → Flight surgeon decides; robot logs.
   • Link down or delay too long → The CMO decides under the pre-approved onboard checklist; the flight surgeon reviews the log at the next contact.
9. S9RobotRung 2

   Offer a check-in every <set by flight surgeon> hours for <set by flight surgeon> days (the period the flight surgeon sets). At each scheduled time the robot prompts the crewmember on their own screen; it approaches only when the crewmember (or the CMO) accepts, and a prompt never starts the robot. When the CMO says the event is over, run RMP-PHARM-001 reconciliation on each kit fetched: record the items the CMO or crew state were used, the remaining contents against the kit list, seal status and expiry, labelled "inventory reconciliation after emergency use – not a check before use". Flag the override to the flight surgeon and the pharmacy lead, and show each kit as "opened – not restocked" until a human restocks and reseals it.

   Done when: Each prompt accepted, postponed or answered; kits reconciled or shown as opened – not restocked; log closed by a human.

   V2 10174V2 7059

7 · Stop and escalate rules, red flags

Red flags

The robot reports the sign or value only, never what it means. Numeric thresholds are placeholders for the clinical lead.

8 · Safety limits

9 · Logs and audit

• LOG-1 Every input, robot action, decision (with who made it) and hand-off, time-stamped to the second.V2 10163V2 10164
• LOG-2 Mode changes and safety-limit events are announced to the operator as they happen and logged.V2 10162V2 10172
• LOG-3 Records are stored and sent as private medical data, encrypted, with access limited to the medical team.V1 6003V1 7003
• LOG-4 Results are kept in a permanent, retrievable format so the flight surgeon can see trends.V1 7001
• LOG-5 Irrigation start, elapsed time, volume and any pH reading as stated, who ended irrigation, each answer and alert, and each photo with the agreement recorded.
• LOG-6 Each URGENT alert, who received it, the time it was acknowledged (or the escalation to the next named crewmember), and the time a human released the robot.V2 10163
• LOG-7 Each emergency fetch as an override (time, who asked, reason as stated, kit ID, seal status) and the later inventory reconciliation, labelled "not a check before use".V2 7059

10 · Links to NASA-STD-3001

IDs as published in Volume 1 Revision C [11] and Volume 2 Revision F [12]. NASA-STD-3001 binds NASA programs; it is not a regulation for commercial flights. Its robot rules are general automation requirements, not medical-device rules.

11 · Validation

1. Simulation. Scripted eye events of every red-flag type, an unknown fluid, no response, a CMO who is the patient, and lost link. Pass: Every red flag acts as listed; irrigation is never delayed by the robot; the robot never announces an endpoint; zero contact with the face; zero drop or medicine advice.
2. Training model. CMO irrigation training on a manikin head with the robot fetching water and containment and timing. Pass: Supplies delivered within <set by validation> seconds; timing accurate; the CMO is never obstructed.
3. Parabolic or station demonstration. Fetching irrigation water and containment towels, and collecting sealed bags, in weightlessness, without a patient. Pass: Zero escapes of test fluid from the containment towels; sealed waste only.
4. Flight use under flight surgeon supervision. First use as a fetching and timing aid in drills, then real events. Pass: No safety events; the record is complete.

No stage has been run. Pass and fail criteria must be fixed in advance by the clinical lead and safety board.

12 · Human sign-off

Before any use

• Clinical lead for the specialty (sets every clinical threshold marked <set by clinical lead>)
• Flight surgeon, as medical authority
• Robotics and medical-device safety board
• Program approval for the mission

Each run

Started by a crewmember. Chemical splashes are irrigated by the crew at once; alerts go to the CMO and flight surgeon at once; the flight surgeon decides further care.

Restart after a stop

Human only. After any emergency or protective stop, a crewmember must restart the robot; the robot never restarts itself.

None of these sign-offs has happened. This is a Draft v0.4.

13 · Change control for learning

• Every change gets a new version number and a written reason; earlier versions are kept.
• Any change to steps, thresholds, limits or software that touches the patient repeats validation from the simulation stage before use.
• Software and learned-skill updates follow a pre-agreed change plan (what may change, how it is tested, how to roll back), modeled on the FDA predetermined change control plan approach.
• If a new version misbehaves, the robot rolls back to the last validated version and the event is reviewed by the flight surgeon and safety board.
• The robot never changes its own protocol, thresholds or limits.

Change-plan model: FDA guidance [14].

Loss of signal and Mars delay

Live link

Low Earth orbit: the flight surgeon receives the alert at once and can see photos or video if the crewmember agrees.

Loss of signal

• The robot pauses any movement and tells the CMO; on the CMO's confirmation it keeps timing and logging offline.
• Crew eye irrigation continues under the onboard checklist and never waits for the link or the robot.
• Alerts go to the CMO (or the second trained CMO); the CMO decides under the pre-approved onboard checklist; irrigation never waits for the link.
• At the next contact the robot sends one package: timings, answers, photos and alerts.

Mars-class delay

• Replies may take up to about 21-23 minutes each way, with blackouts of about 2-3 weeks; irrigation and first care are done onboard under the checklist, and planetary dust makes eye events more likely.

[13]

Sources

1. American Academy of Ophthalmology. EyeWiki: Chemical (alkali and acid) injury of the conjunctiva and cornea (curated ophthalmology wiki, not a formal guideline). eyewiki.org/Chemical_(Alkali_and_Acid)_Injury_of_the_Conjunc… Supports: Begin irrigation immediately unless an open globe injury is known or strongly suspected; avoid pressure on the eye when an open globe injury is suspected; if pH paper is immediately available, check the ocular surface pH of both eyes without delaying irrigation; use a stable physiologic pH and removal of retained material to guide the endpoint, rather than a fixed volume or elapsed time alone; several liters and prolonged irrigation may be required; a high-pressure or penetrating mechanism, suspected intraocular foreign body or associated orbital injury requires urgent specialist assessment; assess associated skin, inhalational and systemic exposures while decontamination continues.
2. The College of Optometrists. Clinical Management Guidelines: Trauma (chemical) (last updated March 13, 2026) Primary-care optometry guidance (public sections only). www.college-optometrists.org/clinical-guidance/clinical-mana… Supports: Flush the eye immediately with sterile salt solution, or tap water if that is not available, and continue to irrigate for at least 20 minutes before seeking medical attention; damage is generally greatest with alkalis such as ammonia; severe cases need immediate referral to hospital eye services or emergency care. (Only the publicly visible sections were read; the full guideline needs a login.)
3. The College of Optometrists. Clinical Management Guidelines: Trauma (penetrating) (last updated March 13, 2026) Primary-care optometry guidance (public sections only). www.college-optometrists.org/clinical-guidance/clinical-mana… Supports: Penetrating trauma is a full-thickness injury of the cornea or outer coat of the eye; first aid is followed by emergency referral, with an ophthalmologist seeing the patient as soon as possible the same day; foreign bodies are identified but not removed. (Public sections only.)
4. The College of Optometrists. Clinical Management Guidelines: Corneal (or other superficial ocular) foreign body (last updated Dec 9, 2025) Primary-care optometry guidance (public sections only). www.college-optometrists.org/clinical-guidance/clinical-mana… Supports: Small foreign bodies are usually blinked away but can stick to the cornea, especially if they arrive at speed; a stuck foreign body is removed by a clinician after an anaesthetic drop; referral to an ophthalmologist if it has penetrated below the surface or is likely to cause scarring. (Public sections only.)
5. The College of Optometrists. Clinical Management Guidelines: Corneal abrasion (last updated Dec 9, 2025) Primary-care optometry guidance (public sections only). www.college-optometrists.org/clinical-guidance/clinical-mana… Supports: Corneal abrasions are common, often from a minor injury or a speck under the upper lid, are more common in contact lens wearers, and can be very painful; they usually heal quickly, but deeper, contaminated or possibly infected injuries are referred to an ophthalmologist; topical anaesthetics should not be supplied for pain relief. (Public sections only.)
6. The College of Optometrists. Clinical Management Guidelines: Microbial keratitis (bacterial, fungal) (last updated Oct 9, 2026). Primary-care optometry guidance (public sections only). www.college-optometrists.org/clinical-guidance/clinical-mana… Supports: Microbial keratitis is a sight-threatening emergency, with pain, redness, light sensitivity, discharge and blurred vision; the usual cause is contact lens wear; contact lens wearers should be advised not to discard their lenses or lens cases, as these may help identify the cause.
7. National Institute for Health and Care Excellence. Head injury: assessment and early management. NICE guideline NG232 (May 18, 2023). www.nice.org.uk/guidance/ng232/chapter/Recommendations Supports: Recommendation 1.2.4: community services should refer to an emergency department anyone with a head injury and any of: a Glasgow Coma Scale score below 15 on initial assessment; any loss of consciousness; any focal neurological deficit; suspected complex skull fracture or penetrating head injury; amnesia for events before or after the injury; persistent headache; any vomiting since the injury; any seizure; previous brain surgery; a high-energy head injury; a bleeding or clotting disorder; current anticoagulant or antiplatelet treatment (except aspirin alone); intoxication; or continuing concern about the diagnosis. Signs of basal skull fracture include blood behind the eardrum, "panda" eyes, cerebrospinal fluid leaking from the ear or nose and Battle's sign (1.5.8). With a suspected neck injury, paraesthesia in the arms or legs or a focal peripheral deficit is a high-risk factor (1.6.2). CT is the primary investigation, and people who need CT where none is available are transferred (1.5.1, 1.5.5). CT within 1 hour for a GCS score of 12 or less on initial assessment, below 15 at 2 hours after the injury, a suspected open or depressed skull fracture, any sign of basal skull fracture, a post-traumatic seizure, a focal neurological deficit, or more than 1 episode of vomiting (1.5.8); CT within 8 hours after loss of consciousness or amnesia with a bleeding or clotting disorder or a dangerous mechanism (1.5.9); consider CT for anticoagulant or antiplatelet treatment other than aspirin alone (1.5.13). Only assume a depressed conscious level is due to intoxication after an important brain injury has been excluded (1.4.2). Consider referral for irritability or altered behaviour (1.2.5). Signs of deterioration include agitation or abnormal behaviour, a drop in GCS, severe or increasing headache, persistent vomiting, and new neurological signs (1.9.13); a second competent person confirms deterioration if possible, otherwise the supervising doctor is contacted without waiting (1.9.14). With a suspected neck injury, an axial load to the head is a high-risk factor (1.6.2).
8. Institute for Safe Medication Practices. Guidelines for the safe use of automated dispensing cabinets (2019). www.ismp.org/system/files/resources/2019-11/ISMP170-ADC%20Gu… Supports: Override is limited to medicines needed in emergent circumstances where waiting could harm the patient (3.3b); limit what is available on override (3.4b); require documentation of the override rationale (3.4d); routinely analyze override reports (3.6). Used for the emergency-fetch pattern by analogy (a robot fetching a sealed kit is not a dispensing cabinet).
9. NASA Human Research Program. Evidence Report: Risk of Adverse Health Outcomes and Decrements in Performance due to In-Flight Medical Conditions (2017). humanresearchroadmap.nasa.gov/evidence/reports/Medical.pdf Supports: Table 2: 70 eye abrasions from foreign bodies and 6 chemical eye burns among US astronauts (Shuttle, Mir and ISS through 2006); Table 1: eye debris and irritation recorded on the ISS.
10. NASA OCHMO. Medical Operations. Technical Brief OCHMO-TB-044 (2025). www.nasa.gov/wp-content/uploads/2025/08/ochmo-tb-044-medical… Supports: The crew surgeon keeps medical authority when care is delegated; crew medical officers train on the JSC 48522 medical checklist.
11. NASA. NASA-STD-3001, Space Flight Human-System Standard, Volume 1: Crew Health, Revision C (2023). www.nasa.gov/wp-content/uploads/2023/11/nasa-std-3001-vol-1-… Supports: Requirement IDs beginning V1.
12. NASA. NASA-STD-3001, Volume 2: Human Factors, Habitability, and Environmental Health (Rev F, 2026), including Section 10.6 Automated and Robotic Systems. standards.nasa.gov/standard/NASA/NASA-STD-3001_VOL_2 Supports: Requirement IDs beginning V2.
13. NASA. Mars communications disruption and delay (fact sheet, 2023 Moon to Mars Architecture Concept Review). www.nasa.gov/wp-content/uploads/2024/01/mars-communications-… Supports: One-way Earth-Mars delay up to about 21-23 minutes, plus blackouts of about 2-3 weeks near solar conjunction.
14. U.S. Food and Drug Administration. Marketing submission recommendations for a predetermined change control plan for artificial intelligence-enabled device software functions (guidance). www.fda.gov/regulatory-information/search-fda-guidance-docum… Supports: A model for planning, validating and rolling back software updates.
15. U.S. Code of Federal Regulations, Title 14, Part 460: Human space flight requirements. www.ecfr.gov/current/title-14/chapter-III/subchapter-C/part-… Supports: Federal rules for crew and spaceflight participants on licensed commercial flights; they set no medical standards for spaceflight participants.

Checked on 2026-10-20: links opened (HTTP 200 or publisher redirect), DOIs and PubMed IDs matched, NASA documents read in full text. The framework comes from Part 1.