| Spaceflight Decompression Sickness (DCS) related to ExtraVehicular Activity (EVA) is a real and potentially serious threat to astronaut health, performance, and mission success. With the dramatic increases in EVA time and complexity required for construction and maintenance of the International Space Station, priorities have been raised for assessing DCS likelihood, prevention, and potentially, for intervention and treatment. This paper is the result of efforts to comprehensively review current understanding of the risk of spaceflight DCS, assess current treatment options and plans, and develop strategies to prevent its occurrence. The salient clinical features of spaceflight DCS are discussed, along with methodologies to quantitatively assess its likelihood during EVA operations. Particular focus is placed on the unique considerations of ISS EVA operations, the development of strategies to manage DCS risk, and the implementation of a reduced prebreathe protocol for use during EVA preparation to safely and more effectively utilize mission timelines. |
