Navy EXMED teams reveal lessons from historic Artemis II recovery

SAN DIEGO, California — Navy medical personnel who supported the historic Artemis II recovery mission in April detailed the exhaustive preparation and teamwork behind the operation, highlighting lessons they say carry directly into day-to-day military readiness.

Lt. Cmdr. Kristine Tolentino Parra, a general surgeon and platform lead for Expeditionary Resuscitative Surgical System 14 at Navy Medicine Readiness and Training Command Camp Pendleton, and Lt. Stephanie Ryan, a Navy nurse with En Route Care System 11 at NMRTC San Diego, described their roles providing care for both the Artemis II astronauts and the Navy recovery team during a recent presentation to Naval Medical Forces Pacific personnel.

They stressed that success hinged on tight coordination among NASA crew surgeons, dive teams, helicopter squadrons and waterfront medical staff. “Although you may be wearing a different patch on your chest, at the end of the day, true integration allows everyone to serve a role and a purpose,” Parra said.

With personnel at a premium on any expeditionary medicine mission, Parra underscored the importance of knowing each team’s capabilities and gaps to maximize patient care. “Each team has different composition of members and trains differently,” Parra said. “Familiarizing yourself with each team’s strengths and weaknesses allows you to utilize each member to create an integrated team where the sum of the parts are greater than the whole.”

One of the most complex challenges was the astronauts’ gear. The Orion Crew Survival System, a custom-fitted life-support suit that provides oxygen, cooling, communications and protection, is integrated with electrical wiring, oxygen tubes and coolants—and is valued in the millions of dollars. That complexity meant standard trauma protocols, such as cutting away clothing, could not be applied in the same way.

To adapt, the team trained directly with a NASA suit technician, studied detailed diagrams identifying safe cut points for emergencies, and ensured every clinician practiced controlled removal on a patient. Parra said they determined that a slow, methodical removal might be faster and safer than cutting in some scenarios, with the approach tailored to a patient’s specific injuries.

Their preparation extended across the mission’s integrated drills, from capsule recovery through patient transport to the ship. “We familiarized ourselves with moments in the operation that posed a particularly high risk, not only to the NASA astronauts but also to the crew on board the ship,” Parra said. “By identifying the likely injury patterns for both astronauts and Sailors, we were able to prepare to address those injuries and verify we had the appropriate equipment to do so.”

Parra noted her team treats every assignment as a no-fail mission, applying lessons learned and coordinating early with logistics staff to understand medical risks before operations begin.

Ryan said those practices mirror the approach to medical evacuation in combat, where anticipating likely injuries drives planning and training. “We always try to plan for the type of injury that is most likely to occur,” Ryan said. “For Artemis, the most critical injuries would have come from high impact on landing, such as crush injuries, pelvic injuries and burns. This is not much different from how we train and plan for combat-related injuries.”

During a question-and-answer session, attendees asked about the time needed to move a critically injured patient from the recovery ship to higher-level care and the critical care equipment used underway. Ryan pointed to the Mobile Oxygen Venting and Environmental System – Suction, Life-Support and Circulation (MOVES SLC), a 45-pound portable life-support platform used by emergency medical teams. “This machine is able to hold battery life for roughly eight hours,” Ryan said. “It also produces its own oxygen via a concentrator. It is an amazing piece of equipment and allows us to fly without needing to carry supplemental oxygen cylinders.”

To ensure equipment, protocols and personnel mesh under pressure, Ryan said she plans to double down on fundamentals in standard En Route Care System training. “I would continue to emphasize how important walk-throughs and rehearsals are, especially when various medical teams are working together for the first time,” Ryan said. “It is crucial to rehearse patient movement, emergency responses, roles and responsibilities, and communication chains.”

The briefing underscored how Navy Expeditionary Medicine projects its capabilities on a global stage and reinforced the role of Naval Medical Forces Pacific in organizing that effort. NMFP provides oversight for 10 Navy Medicine Readiness and Training Commands on the West Coast and Pacific Rim that train, man and equip medical forces, primarily in military treatment facilities. Globally, it oversees eight research laboratories that deliver research expertise in support of warfighter health and readiness, and it manages the Naval Expeditionary Medicine Warfighter Development Center, which prepares medical teams for expeditionary and operational environments.