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    ISS construction over New Zealand. Image: NASA

    An Exhaustive Inventory of the International Space Station's Medicine Cabinet

    Written by

    Becky Ferreira


    Life in space is fraught with a dizzying array of potential calamities. With no quick lifeline to an ambulance or hospitals, astronauts aboard the International Space Station (ISS) have to be prepared to tackle medical emergencies, literally on the fly.

    On Monday, fascinating details into these orbital medical protocols were revealed in a document obtained through a Freedom of Information Act (FOIA) request filed by the operators of the website governmentattic.org. The original FOIA request, submitted on December 28, 2015, had outlined interest in the following seven categories:

    According to Jessica Cordero, the Johnson Space Center FOIA officer who responded to the request, a “diligent search” was conducted for all these documents, but “no responsive records exist for items #2, 3, 6 and 7.” Too bad. It would have been interesting to get into the nitty gritty of space burials.

    That said, items 1, 4, and 5 still offer an intriguing look into the space station equivalent of a bathroom medicine cabinet, along with a sobering overview of how to undertake surgical procedures in space. It’s worth taking a spin through 62 pages of the illustrated flowcharts, excruciating dental pictures, and pharmaceutical tables, but here’s the Motherboard tl;dr version of the document’s most memorable highlights.

    Watch out for projectile space needles. In cases of severe respiratory failure or shock in an astronaut, ISS crew members are advised to administer an intraosseous injection directly into the patient’s bone. But conducting this procedure in microgravity comes with certain hazards, like this one:

    So as if space surgery isn’t difficult enough, it may also involve sharp, pointy objects shooting out of their pressurized holding containers. Good to know.

    The Heimlich maneuver is the same in space as on Earth. Abdominal thrusts don’t need validation from gravity to work.

    If lube is what you need, the ISS has you covered. Turns out there are five different kinds of lubrication products on the ISS—surgical, intranasal, and three brands of eyeball lubricant. One of those eye lube products is called “Nature’s Tears,” which, as Motherboard’s Kaleigh Rogers pointed out, is a delightfully odd name for an product meant to artificially simulate nature’s actual tears.

    The ISS medical kits are satisfyingly color-coded. Behold, the apex organizational skills of the ISS.

    There are likely some funky photosets from the ISS shared with support surgeons on Earth. The instructions for almost every medical procedure include a stipulation to use the station’s Nikon D4 camera to document the patient’s condition and progress throughout the treatment process.

    All of these pictures are supposed to be filed in individually labeled folders for each crew member, dated by a GMT timestamp, and downlinked for assessment by medical staff on the ground. While there has never been an invasive surgery in space, odds are there are many pictures of minor injuries, infections, and other symptoms exchanged between the ISS and corresponding ground facilities.

    Antipsychotics, antidepressants, and anti-anxiety pills are well-stocked on the ISS. Space can be as hard on the psyche as it is on the body, so mission doctors have provided the following medications for mood regulation and control.

    Birth control is also available to female astronauts. Norgestrel and Ethinyl Estradiol (Ogestrel) is stocked in 21-tablet packs on the ISS. On Earth, Ogestrel is normally prescribed as a hormone-based contraceptive, which could lend weight to theories surrounding astronauts hooking up in space.

    Boringly, however, the FOIA document only mentions it as a treatment for “elevated blood pressure, headache, dizziness, nervousness, nausea, abdominal cramps, blood clots, appetite changes, bloating, and breast pain.” Of course, millions of women are prescribed birth control medication to treat those very symptoms, so it’s not surprising the ISS comes prepared with them, especially given that some female astronauts are likely already taking hormonal birth control prior to arriving in space.

    ISS medical procedures make for a great survivalist primer. The ISS crews don’t have access to a lot of specialized medical equipment, so their emergency instructions depend on resourcefulness with household items like Ziplock bags, Drink Bags, tape, gauze, and over-the-counter medications like Ibuprofen.

    For instance, astronauts are instructed to use Ziplock bags as sample container bags which can be stored for later study, as well as trash receptacles. The Drink Bags can be used both to hydrate patients, and also decontaminate body parts that have come into contact with toxic substances.

    So if you are concerned about riding out a dystopian future in a bunker somewhere, you might want to take a page or two out of this document as inspiration for how to have your medical basics covered in a remote location.