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Human spaceflight is inherently dangerous and may be one of the riskiest modes of transportation. 28 Despite the obvious risks, fatal incidents have occurred primarily from vehicle malfunctions, with only three medical evacuations (MEDEVACs) conducted from space, all by the Soviet space program. 29 Proximity to Earth and to a terrestrial definitive medical care facility (DMCF) while in low Earth orbit (LEO) provides important backstops for spaceflight medical care. Even if an astronaut becomes seriously ill or injured (which happens rarely), they can

Historically, medical resources for space missions were selected heuristically as part of a highly successful risk mitigation strategy with an impressive safety record. 1 , 2 However, every mission to date, with the exception of the Apollo program, benefited from access to readily available resupply and evacuation, which helped mitigate the consequences of manifesting inadequate or excessive medical supplies. 3 With missions farther from Earth, resupply, evacuation, and real-time communication become far more challenging or impossible, substantially

Aero-otitis media (AOM) is a kind of acute pressure injury that occurs when the external pressure suddenly changes and the pressure in the middle ear cavity is out of balance with the surrounding pressure. AOM has a high incidence in all types of aircraft and pilots. It ranks fifth in the total hospitalized disease spectrum of a fighter pilot, fourth in the grounding disease spectrum, and first in the otorhinolaryngology hospitalized disease and grounding disease spectrums. 11 According to Professor Xu Xianrong, as for the pathogenesis of aviation otitis

this rotary wing crew chief has not flown in 2 yr due to complications from a centipede envenomation. During the appointment, the patient describes how his medical evacuation unit was supporting a medical readiness training exercise in the South Caribbean. After retiring to an open shack after the duty day, he accidentally laid down on what the locals called an Amazonian centipede. He immediately felt a stabbing pain in his right popliteal fossa. After seeing the centipede scuttle off, the service member inspected his leg to find a red and swollen area surrounding