Since 1968, Kennedy Space Center (KSC) has been home to America's manned spaceflight program. The record breaking feats of the Mercury and Redstone missions from the nearby Cape Canaveral Air Station sent astronauts into orbit and returned them safely to earth. Shortly thereafter in the 1960s and early '70s, history was again made during the Apollo program when the U.S. sent astronauts to the moon. Kennedy Space Center is now tasked with sending Astronauts into low Earth orbit via the Space Transportation System (STS), also known as the space shuttle program.
KSC with cooperation of international partners launch from KSC in one of three operational space shuttles Atlantis, Discovery and Endeavor to assemble and maintain the International Space Station (ISS).
KSC is home to some of the largest and most technologically advanced facilities in the world. The Vehicle Assembly Building (VAB) stands 526 feet tall, and has a volume of over 129 million cubic feet. Under the right conditions; clouds have been known to form within its large access bays. The size and complexity of the facility provide additional challenges to EMS personal responding to a medical emergency and evacuating the patient from the building.
Although space exploration has advanced throughout history, KSC remains as the nation’s premier spaceport for manned space missions. Located on the east coast of central Florida, the Kennedy Space Center covers an area of 219 square miles. KSC is a secure and gated federal installation, which operates quite like any other city of its size.
The daily population can vary from several hundred personnel on a weekend or holiday, to over 15,000 employees and visitors on launch days. Space Gateway Support provides contracted Fire support and Emergency Medical Services for NASA at Kennedy Space Center.
KSC is divided into three major areas, the Industrial Area, the Launch Complex 39 area and the Shuttle Landing Facility (SLF). The industrial complex contains many of the facilities essential for the running of the launch preparation, the Space Station Processing Facility, the operations and checkout building and NASA administrative ofices.
The Launch Complex 39 area houses many facilities essential to launch operations such as the VAB, Launch Pads A&B, and the press site which from where much of the world has viewed launches of spacecraft from KSC since 1969.
NASA Protective Services maintains the daily operations of emergency responders as well as several specialty teams. Kennedy Space Center Fire Rescue Services (KSCFRS) is responsible for providing Advance Life Support (ALS) EMS for the Space Center and manning four transport ambulances. In addition paramedics participate on the departments’ Technical Rescue Team, Launchpad Rescue (PAD) team, Shuttle Astronaut Rescue (SAR) team and Hazardous Materials Team.
HazMat Preparedness & Response Teams
As with many industrial facilities, concerns for toxic substances and life safety are top priority. KSC contains many very dangerous chemicals for use in the exploration of space it does not contain any chemicals that cannot be found in many communities and chemical manufacturing facilities.
Chief Glen Witt says, “KSC does not manufacture any products, each of the chemicals found here are manufactured elsewhere and then transported to the Space Center.” Hypergolic chemicals are commonly used as propellants by spacecraft. Nitrogen tetroxide, monomethylhydrazine, and solid rocket propellants are held in sizable quantities at launch facilities and present a constant need for vigilance on behalf of the workers.
Such coolants as anhydrous ammonia are stored in large quantity on the Space Center for cooling industrial complexes on site, and for use in space. The overwhelming culture of safety instilled upon the employees at KSC makes accidents rare and quickly mitigated by the Hazardous Materials Team.
The Hazardous Materials Team is comprised of members of NASA Fire Rescue Services trained to the level of hazardous materials technician with some operational level, and EMS personnel. Paramedics on the team operate under specialized hazardous materials treatment protocols, which include specific treatment modalities for hazardous substances in use at KSC.
The following medications are used for the treatment of hazardous materials exposure:
Tecnical Rescue Teams
The technical rescue team maintains high angle, trench, and confined space rescue capabilities. KSC is home to structures, towers and launch pads hundreds of feet tall, requiring specialized rescue capabilities on site at all times.
The Pad team consists of members of Fire Rescue services specially trained to rescue astronauts and closeout crewmembers (Technicians who assist the astronaut into the Space Shuttle Orbiter) during the space shuttle launch sequence while the space shuttle is in the vertical position on the pad prior to liftoff.
Once the shuttle leaves the launch pad but is still within 25 nautical miles the rescue and emergency medical treatment of the astronauts becomes the responsibility of the Shuttle Astronaut Rescue (SAR) team. The SAR yeam members consist of Fire Services personnel specifically trained in the rescue of astronauts during any landing attempt, whether during a planned or alternate landing. SAR team personal utilize a very specialized set of techniques and equipment specifically designed for rescue of the astronauts from the Space Shuttle Orbiter during a during an evacuation and subsequent treatment.
SAR and PAD team members train both at KSC and Johnson Space Center (JSC) located in Houston biannually and at KSC quarterly or when mission circumstances dictate.
Launch and landing contingency responses are categorized into “Modes” as part of NASA's plan to tailor responses according to the type of contingency presented. Training at KSC involves full-scale drills to test the Emergency Action Plan (EAP) with all hands on deck, including Launch Control, KSC Medical Personal, USAF Pararescue personnel, and NASA Fire Rescue personnel designated as MOD Exercises. MODE exercises vary depending upon the personal involved and the emergency scenario being reviewed. Participants can involve only a few organizations or encompass all KSC emergency responders as well as area hospitals. Once the exercise is complete the actions are reviewed and emergency managers as needed alter the Incident Action Plan (IAP).
Modes of rescue are divided into the following eight different categories:
MODE I: Unaided Egress/Escape from the orbiter on the launch pad.
MODE II: Aided Egress/Escape from the orbiter by the Closeout Crew MODE III: Aided Egress/Escape from the orbiter by the Pad Rescue Team
MODE IV: Aided Egress/Escape from the orbiter by the Pad Rescue Team with Closeout Crew on station
MODE V: Unaided Egress/Escape from orbiter after landing
MODE VI: Aided Egress/Escape from orbiter after a landing mishap on or near the SLF Runway by SAR team
MODE VII: Aided Egress/Escape from orbiter in a remote area by SAR team
MODE VIII: Self bailout of flight crew from orbiter while in flight
The launch and landing of a Space Shuttle is comparable to an organized Mass Causality Incident (MCI). A “Medical Launch Package” is a NASA Incident Action Plan (IAP) created prior to each mission, which choreographs the entire medical plan from several days prior to launch and then landing of the Space Shuttle Orbiter. This plan outlines mission information, staffing, launch countdown charts which detail positioning and deployment of medical personnel specific to each launch, medical staging maps, a NASA wide communications directory, up to date local hospital capabilities, a notification flow chart, pre-established triage area maps, and information specific to the flight crew. This level of planning is essential to the safe and efficient operations of the EMS system at KSC during a launch or landing. The thoroughness of the IAP would undoubtedly impress the most meticulous Emergency Manager.
Medical personal are comprised of Emergency Physicians, Surgeons, Anesthesiologist and Nurses augmented by EMS personal from KSCFRS and are equipped to handle an emergency involving an orbiter during launch or landing. In the event of a Mode being declared, Launch Control assigns triage locations, and pre-arranged teams assigned to each member of the flight crew when they arrive at the triage area. Flight crewmembers after being evacuated from the incident site are evaluated for the presence of hazardous materials and decontaminated if necessary.
EMS personal deemed “advance paramedics” are assigned to the corridor zone assisting in decontamination of flight crew and others working in the hot zone. Paramedics assigned to the decontamination corridor results in more efficient triage of the injured in the hot/warm zone. The triage area medical staff then evaluates astronauts, and condition information is relayed to Launch Control EMS. Launch Control EMS then orders air evacuation of the astronauts in order of need for transport to the closest appropriate trauma or burn center by KSCFRS Flight Paramedics in one of two UH-1 Huey II’s.
KSC has quickly become one of many popular tourist attractions in Central Florida and is host to thousands of visitors annually. Located within easy driving distance of Walt Disney World and other Orlando area attractions, it regularly attracts thousands of tourists daily from the U.S. and around the world. These visitors comprise a large portion of the EMS call volume. EMS personal routinely encounter patients with a wide variety of languages and cultural differences that pose additional challenges to patient care. Many foreign visitors are not accustomed to the beautiful weather of the Sunshine State and fall victim to a mixture of heat, humidity, and fatigue. The KSC Visitor's center maintains a first aid station manned by OHF nurses, and when patients require hospital transport or care outside of the first aid station, NASA Fire Rescue EMS is notified to respond.
During the launch of a Space Shuttle, KSC routinely sees a surge of thousands of additional visitors and employees to the Space Center. This additional visitor traffic clogs the already limited roadways leading to and from the Space Center. Traffic affects all of the surrounding municipalities, prolonging already long transport times, and turn- around time from area hospitals. All of these situations strain EMS resources.
To overcome this situation, additional resources are used during the launch of a space shuttle. Additional ALS ambulances and BLS engine crews are placed in service and nursing stations are located at viewing areas throughout the Space Center to provide efficient minor care and facilitate early medical treatment during a lift-threatening emergency. To reduce turn-around time NASA Fire Rescue paramedics may transport employees with a minor illness and injuries to one of several Occupational Health Facilities (OHF) located at KSC. The clinics treat minor work related injuries, provide mental health facilities to KSC employees and maintain annual wellness evaluations for all employees at KSC. The OHF provides NASA Fire Rescue paramedics with medical direction while on center, and during launches and landings of spacecraft. NASA Fire Rescue paramedics follow local Brevard County EMS protocols, and receive medical direction from OHF physicians.
End of an Era
With the retiring of the space shuttle fleet, the role of KSCFRS is again in the process of evolving. New technologies are being taken from the drawing board, and pushed from theory to reality. New heavy launch vehicle is being developed, and estimated to be launched by 2015. Entire generations of employees have labored on the Apollo and Space Shuttle programs in the past and the next generation is looking forward to a bright future. As always the men and women of KSCRS will continue to provide the highest level of service while witnessing history in the making, and adapting to its ever changing mission as NASA begins the next phase of space exploration.
James Mills, EMT-P, RN, CEN is a 19-year veteran of EMS and the fire service, currently serving as a firefighter/paramedic with Kennedy Space Center Fire Rescue Services. You can contact him via email at firstname.lastname@example.org.
Brian Hills, EMT-P, is a 22-year veteran of EMS and the fire service, currently serving as a firefighter/paramedic assigned to the Shuttle Astronaut Rescue Team with KSCFRS. You can contact via email at email@example.com.