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    Developing safe space exploration requires understanding medical evacuation (MEDEVAC) risks. This study identifies key risk factors from experts in space and extreme environments to improve future mission planning.

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    Area of Science:

    • Space Medicine
    • Human Factors Engineering
    • Risk Management

    Background:

    • Deep space missions necessitate advanced medical support due to limited evacuation options.
    • Assessing medical evacuation (MEDEVAC) risks is crucial for crew, mission, and astronaut safety.
    • Current risk assessment models require enhancement for exploration beyond low Earth orbit.

    Purpose of the Study:

    • To identify common medical evacuation (MEDEVAC) risk assessment principles from spaceflight and analogous extreme environments.
    • To inform the development of improved risk assessment tools for future exploration missions.
    • To analyze the unique challenges of MEDEVAC in deep space contexts.

    Main Methods:

    • Qualitative study employing semistructured interviews with subject matter experts.
    • Experts from spaceflight, polar, undersea, combat medicine, and mountaineering domains participated.
    • Thematic Analysis, using consensus, co-occurrence, and comparison techniques, was applied to interview transcripts.

    Main Results:

    • Eighteen themes were identified, categorized into Primary Risk Considerations (crew, mission, resources, time) and Contributing Factors (psychological, medical preparation, politics).
    • Contributing Factors were found to modulate risks identified in Primary Risk Considerations.
    • Medical support, psychological, and political considerations, alongside decision-making, emerged as highly impactful factors, especially for exploration missions.

    Conclusions:

    • Established risk assessment principles can be adapted for space exploration MEDEVAC planning.
    • Contributing Factors offer critical pre-mission adjustments to mitigate identified risks.
    • Findings provide essential inputs for developing robust MEDEVAC Concepts of Operations for future exploration missions.