Navy expeditionary medics share lessons from historic Artemis II recovery

SAN DIEGO, California — Navy medical officers who supported April’s Artemis II recovery detailed how exhaustive preparation and tightly integrated teams shaped their approach to caring for astronauts and Sailors at sea.

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 coordinating across 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.

They outlined how staffing constraints shape expeditionary medicine and why precise role definition matters. Parra called personnel the scarcest resource and said aligning skills across units can amplify results. “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.”

A central challenge was the Orion Crew Survival System, a custom-fitted suit that provides oxygen, cooling, communication and protection and carries a multimillion-dollar price tag. Because the suit is threaded with electrical wiring, oxygen tubing and coolant lines, traditional trauma steps like cutting away clothing don’t apply. The Navy team trained directly with a NASA suit technician, reviewed diagrams marking safe cut points and rehearsed controlled removal on a mock patient. Parra said the team concluded that in many scenarios a deliberate removal could be faster and safer than cutting, with the approach tailored to the injury pattern.

Preparation also included observing full-mission drills, from recovering the capsule through air 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.” She added that her team treats every assignment as a no-fail mission, leaning on past lessons and early coordination with logistics to map risks before operations begin.

Ryan drew parallels between space recovery and combat medical evacuation. “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.”

When asked about critical care equipment used during the mission, Ryan highlighted the Mobile Oxygen Venting and Environmental System – Suction, Life-Support and Circulation. “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.”

Ryan said she plans to reinforce 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.”

Naval Medical Forces Pacific oversees 10 Navy Medicine Readiness and Training Commands across the West Coast and Pacific Rim that train, man and equip medical forces, primarily in military treatment facilities. Globally, it directs eight research laboratories focused on warfighter health and readiness and manages the Naval Expeditionary Medicine Warfighter Development Center, which prepares medical teams for expeditionary and operational settings.