# RMP-ENV-001 Smoke or fire: bring masks, account for crew, video # Version 0.3 (Draft). CONCEPTUAL. NOT FOR CLINICAL USE. # Space Medicine Foundation robot-readable protocol library. Format: https://spacemedicinefoundation.org/robotic-medicine/protocols/schema/ # Every threshold marked must be set by the named owner (see the schema) before any use. schema_version: '0.3' version: '0.3' status: draft conceptual: true not_for_clinical_use: true max_autonomy: 2 missions: - leo - commercial - moon - mars updated: '2026-10-21' review: state: reviewed-ai-assisted requested: '2026-10-21' reviewed: '2026-10-21' human_clinician_review: false text: >- AI-assisted clinical and source review by the Medical Research Assistant, Oct 21, 2026 (batch 5 review, 25 required corrections and 18 optional suggestions); all required corrections, and the low-risk editorial suggestions, are applied in this version (see Corrections). No named human clinician has reviewed it. Not for clinical use. fixed_rules: flight_surgeon_is_medical_authority: true cmo_acts_under_delegated_care: true human_starts_and_restarts_robot: true robot_never_diagnoses: true no_drug_or_fluid_advice_by_robot: true safe_state_on_fault_or_no_response: true lost_link_pause_then_cmo_decides: true robot_lockouts: diagnosis: true drug_or_fluid_advice: true starting_stopping_or_adjusting_oxygen_or_any_medicine: true self_start_or_self_restart: true changing_own_protocol_thresholds_or_limits: true handing_over_a_mismatched_item_as_verified: true id: RMP-ENV-001 slug: rmp-env-001 title: 'Smoke or fire: bring masks, account for crew, video' category: env tier: 1 rung_note: >- Max rung raised from 1 to 2 for supervised fetching of breathing masks / portable breathing apparatus, crew accounting support and video. The robot never fights the fire, never operates extinguishers as the primary responder, and never enters a declared no-go volume unless the crew explicitly send it under the vehicle procedure. result_language: use: - logged, not interpreted - sent to flight surgeon - EMERGENCY FETCH – NOT VERIFIED (CMO or commander command) - crew accounted as stated never: - normal - no problem found - all clear - negative - any diagnosis or cause - fire out - safe to enter - air is safe - all clear - verified - safe - mild - minor - reading is reassuring - oxygen level is good scope: summary: >- When smoke or fire is detected or reported, the robot sends an URGENT alert at once to the CMO, the vehicle commander and the flight surgeon, brings portable breathing masks or portable breathing apparatus on command, helps account for every crewmember by check-in, clears paths, and streams video from a crew-directed viewpoint when the link allows. The crew and vehicle fire-protection system lead under NASA-STD-3001 fire requirements and the vehicle emergency procedure. The robot does not extinguish the fire, does not declare the air safe, and does not enter a smoke-filled volume unless a human explicitly sends it. why: >- NASA-STD-3001 Volume 2 requires a fire protection system with detection, warning and extinguishing [V2 9059], health and status to the crew [V2 9060], failure alerting [V2 9061], manual activation and deactivation [V2 9062] and portable fire extinguishers [V2 9063]. NASA records list 3 smoke-inhalation events among US astronauts through 2006. Protective equipment such as respirators is required for expected hazards [V2 9053]. NASA-STD-3001 also requires real-time monitoring of combustion products including carbon monoxide (CO), hydrogen cyanide (HCN) and acid gases (HCl/HF) [V2 6024, Table 6.2-3], and emergency equipment that is clearly identified, accessible and usable [V2 9064]; the robot never reads monitor values as "air is clear". A robot that fetches masks, accounts for crew and relays video can support the human-led response without becoming a firefighter. The robot hands over sealed mask bags only; size choice and fit are the crew's and CMO's, and the robot never says "verified fit". Default: the robot does not enter a smoke-filled or closed module; a camera scout is allowed only on the commander's explicit authorization after the crew who remain have donned masks, within hard limits. Oxygen in use raises the fire risk, so "oxygen in use" is recorded and told to the commander (RMP-RESP-001). After smoke, carbon monoxide (CO) can make a pulse oximeter read falsely high (Hampson 1998), so the robot never calls a reading reassuring. covers: - Smoke detector alarm, visible smoke, or reported fire or smell of burning in a habitable volume - Crew accounting and mask hand-over until the commander and CMO close the event locked_out: - Operating a fire extinguisher as the primary firefighter - Declaring the fire out or the air safe - >- Entering a no-go or smoke-filled volume unless a human explicitly sends it under the vehicle procedure - Starting life-support or ventilation changes (crew and ground engineers decide) - Any medicine advice for smoke inhalation related: - RMP-ENV-002 - RMP-ENV-003 - RMP-ENV-004 - RMP-ENV-005 - RMP-EYE-001 - RMP-RESP-001 - RMP-CARD-001 - RMP-SKIN-002 - RMP-EGR-001 roles: medical_authority: Flight surgeon (ground). Holds medical authority for every run. onboard_lead: >- Crew medical officer (CMO), acting under delegated care; uses the pre-approved onboard checklist when there is no link. others: - 'Vehicle commander (or equivalent): leads the vehicle emergency procedure' - 'Second trained CMO: receives medical alerts if the CMO is unavailable' - 'All crew: don masks and report location when able' robot_may: - Send an URGENT alert at once - >- Bring sealed mask bags or portable breathing apparatus on command and restrain them at a crew-chosen point - Run a crew-accounting check-in by voice or screen - Hold clear of hatches and extinguisher access - Stream video from a crew-directed position - Fetch medical kits on CMO command using the emergency-fetch pattern robot_may_not: - Fight the fire or declare it out - Say the air is safe - Change ventilation or life-support settings - Enter a no-go volume without an explicit human send - Start without a human command commercial: >- On commercial flights, 'flight surgeon' and 'CMO' mean the operator's designated medical authority and trained onboard responder. If no trained responder is aboard, this protocol is not used. (NASA-STD-3001 requires two CMOs per vehicle for NASA programs [V1 3006]; FAA rules set no medical standards for spaceflight participants.) preconditions: - id: PRE-1 text: >- A crewmember, the commander or the CMO started the protocol by command, or accepted the robot's prompt after a detector alarm (the run still needs a human start). check: human_start == true refs: - V2 10174 - id: PRE-2 text: Robot self-test passed; mask stowage locations known. refs: - V2 10161 - V2 7059 - id: PRE-3 text: Link status known. check: link_state in [live, delayed, down] consent: standard: >- Emergency accounting check-ins; declining a non-urgent question is allowed once everyone is accounted for. emergency: During the event the robot prioritises accounting and mask fetch; medical recording follows the CMO. withdrawal: Crew can stop video; the alert and accounting log stand. inputs: - id: IN-1 name: Detector alarm state and crew report of smoke, fire or burning smell source: Vehicle systems; crew voice required: true if_missing: Log "no response"; keep URGENT alert. - id: IN-2 name: Each crewmember's location and "accounted / not answered", as stated source: Crew check-in required: true if_missing: Any no-answer is URGENT for a search under the vehicle procedure. - id: IN-3 name: Mask bag IDs and seal status when readable without delay source: Kit labels required: false if_missing: Log "not read" if reading would delay hand-over. - id: IN-4 name: Link status and delay source: Communications system required: true if_missing: Treat as link down. - id: IN-5 name: 'Oxygen in use: yes, no or unknown, as stated by the CMO or the commander' source: CMO or commander, by voice; RMP-RESP-001 X10 required: false if_missing: Log "oxygen use unknown" and tell the commander; never treated as "no". steps: - id: S1 actor: robot rung: 2 action: >- On a detector alarm the crew accept, or on a crewmember's word, send an URGENT "smoke or fire" alert to the commander, the CMO and the flight surgeon at once. Every URGENT alert goes to the CMO and the flight surgeon at the same time (queued for the flight surgeon if the link is down). If the CMO is the patient, is busy treating, or does not answer, the alert goes to the second trained CMO, or the crewmember named before flight [V1 3006]. An URGENT alert that is not acknowledged within seconds is repeated and sent to the next named crewmember. success: Alert acknowledged, or escalated. refs: - V2 10174 - V1 6003 - V2 9059 - id: S2 actor: robot rung: 2 action: >- On the commander's or CMO's command, bring sealed portable breathing masks or portable breathing apparatus to the crew-chosen hand-over point and restrain them. This is an emergency fetch on a human command (commander or CMO): no barcode check runs before hand-over and nothing waits for one. The robot reads the kit's own label and seal status only if that adds no delay, says "EMERGENCY FETCH – NOT VERIFIED (commander or CMO command)", and "seal not intact" if so, and hands the kit over anyway. The fetch is logged as an override: time, who asked, the reason as stated, kit ID and seal status. It never says "verified". Announce "EMERGENCY FETCH – NOT VERIFIED". Never say the contents, fit or seal were checked before use. success: Masks within reach, or skipped; override logged. limit: refs: - V2 7046 - V2 9053 - id: S3 actor: crew action: >- The commander leads the vehicle fire procedure (detect, warn, extinguish, isolate as the vehicle provides). The CMO treats smoke inhalation under the medical checklist. Portable extinguishers are crew-operated [V2 9063]. success: Human-led response; robot logs what is stated. refs: - V2 9059 - V2 9063 - id: S4 actor: robot rung: 2 action: >- Run a crew-accounting check-in: call each name once, log "accounted" or "no response". Any no-response is URGENT for the commander's search plan. Keep paths to hatches and extinguishers clear. success: Accounting complete or gaps flagged URGENT. refs: - V1 3006 - id: S5 actor: robot rung: 2 action: >- Default: do not enter a smoke-filled or closed module, and prefer a hatch-side camera view when that is enough. Enter only if the commander explicitly authorizes it, masks are already on the crew who remain, the commander names the path and keep-out, and the visibility and thermal hard limits in the robot controller allow it; return at once when any limit is reached or the commander says return. The robot never declares the volume clear or the fire out. If not authorized, hold clear. success: Hatch-side view or authorized path followed within limits, or hold logged. refs: - V2 10172 - id: S6 actor: robot rung: 2 action: >- After any URGENT alert: After an URGENT alert the robot does not leave on its own: it stays at its rest position in the module, with its screen and voice link available, until a human has taken over or tells it to go. It never follows, blocks or touches anyone. It keeps time-stamping what humans say they did, and repeats the alert if it is not acknowledged. success: Robot at rest in the module until a human releases it; alert acknowledged or escalated. refs: - V2 10173 - V1 3006 - id: S7 actor: ground action: >- The flight surgeon and ground team support the commander and CMO; medical evacuation is a flight-surgeon decision [V1 3007]. The robot logs decisions it is told. success: Decision logged. refs: - V1 3007 - id: S8 actor: robot rung: 2 action: >- When the CMO says the event is over, run RMP-PHARM-001 reconciliation on each kit fetched: record the items the CMO or crew state were used, the remaining contents against the kit list, seal status and expiry, labelled "inventory reconciliation after emergency use – not a check before use". Flag the override to the flight surgeon and the pharmacy lead, and show each kit as "opened – not restocked" until a human restocks and reseals it. Apply to medical kits fetched during the event. success: Reconciliation recorded; opened – not restocked until resealed. refs: - V2 7059 - id: S9 actor: robot rung: 2 action: >- Send one package: alert times, accounting log, mask fetch overrides, video pointer, kit inventory record and decisions. success: Package delivered or queued. refs: - V1 6003 - V1 7001 - V1 7003 decisions: - id: D1 after: S4 decided_by: robot question: >- Checked after every answer and at any point in the run (even mid-question or mid-step): does any answer, reading or observation meet a red flag? branches: - if: 'Yes' then: >- Stop the current question or step at once and apply the action listed for each matching red flag (URGENT alert, flag, or stop), with the answer or reading itself, never a cause. Every URGENT alert goes to the CMO and the flight surgeon at the same time (queued for the flight surgeon if the link is down). If the CMO is the patient, is busy treating, or does not answer, the alert goes to the second trained CMO, or the crewmember named before flight [V1 3006]. An URGENT alert that is not acknowledged within seconds is repeated and sent to the next named crewmember. - if: 'No' then: Continue. The URGENT alert from S1 stands. - id: D2 after: S4 decided_by: robot question: Did each crewmember answer the accounting check-in? branches: - if: 'Yes' then: Continue. - if: Declined explicitly (the crewmember says no to a question) then: Log "declined" for that question only; the alert already sent stands. - if: No response, or the answer does not make sense then: >- URGENT: log "no response" (never "declined"); the CMO, or the second trained CMO if the CMO is the patient, checks the crewmember in person at once. - id: D3 after: S7 decided_by: ground question: What is the plan (fire response, medical care, module isolation, evacuation)? branches: - if: Link live then: Flight surgeon decides; robot logs. - if: Link down or delay too long then: >- The CMO decides under the pre-approved onboard checklist; the flight surgeon reviews the log at the next contact. stop_rules: - id: X1 trigger: The patient (or the crewmember being examined) says stop, or withdraws consent action: >- Robot stops all motion at once, backs away to its rest position and tells the CMO. Recording stops unless the patient agrees to keep it running. level: stop refs: - V2 10165 - id: X2 trigger: Any crewmember presses stop or takes over control action: Protective stop; robot holds its stopped position; only a human may restart it. level: safe-state refs: - V2 10165 - V2 10168 - V2 10174 - id: X3 trigger: Robot fault, sensor fault, or a force, speed or reach limit is reached action: Protective stop and hand control to the CMO; log the fault. level: safe-state refs: - V2 10172 - V2 10168 - id: X4 trigger: CMO is asked to take over and does not respond (for example, the CMO is the patient) action: Robot stays stopped; the next named crewmember is called. level: safe-state refs: - V2 10173 - V2 7045 - id: X5 trigger: Loss of link, or delay longer than the limit for live guidance action: >- Robot pauses its own movement in its stopped position and tells the CMO and the commander. This pauses robot movement only: crew masks, moving away from the smoke and the commander's vehicle procedure continue under the onboard checklist and never wait for the link or the robot. The CMO decides whether the robot continues offline under the pre-approved onboard checklist; the robot resumes only on the commander's confirmation. Everything is logged and sent to the flight surgeon at the next contact. level: pause refs: - V2 10172 - V2 10173 - id: X6 trigger: An URGENT alert is not acknowledged within the set time action: >- Robot repeats the alert and sends it to the next named crewmember (the second trained CMO first if the CMO is the patient), and keeps repeating at the set interval. It stays where it is: it does not leave on its own. level: urgent refs: - V1 3006 - V2 10173 - id: X7 trigger: The crewmember stops responding, or seems confused or drowsy, at any point action: >- URGENT alert at once, even mid-question or mid-step; the robot stops its current task, stays at its rest position and does not continue the run; a crewmember checks in person. level: urgent - id: X8 trigger: A crewmember asks the robot what is wrong, or for medicine, fluid or treatment advice action: >- Robot declines, says it cannot assess or advise, and routes the question to the CMO or flight surgeon. level: stop - id: X9 trigger: The commander declares the robot's module a no-go volume action: >- Robot leaves by the path the commander names, or powers down in place if ordered; it never declares the volume safe. level: safe-state refs: - V2 10172 - V2 9059 - id: X10 trigger: Robot sensors detect its own fault in smoke (visibility or thermal limit) action: Protective stop; hand control to the crew; log the fault. level: safe-state refs: - V2 10172 red_flags: - id: RF1 sign: Visible flame, spreading smoke, or detector alarm, as reported or shown threshold: any action: URGENT alert; vehicle fire procedure leads source: v2 - id: RF2 sign: A crewmember does not answer the accounting check-in threshold: any action: URGENT alert to the commander and CMO; search under the vehicle procedure source: v1 - id: RF3 sign: Cough, voice change, chest pain or breathing difficulty after smoke exposure, as stated threshold: any action: URGENT alert to the CMO and flight surgeon; see RMP-RESP-001 source: ermed - id: RF4 sign: Burns from the fire event threshold: any action: URGENT alert; see RMP-SKIN-002 source: aba - id: RF5 sign: Unresponsive crewmember during the event threshold: any action: URGENT; start RMP-CARD-001 when the scene allows under the commander's direction source: aha2025bls - id: RF6 sign: Fire-protection system failure alert threshold: any action: URGENT alert to the commander and ground; [V2 9061] source: v2 - id: RF7 sign: Eye pain, tearing or vision change after smoke or combustion exposure, as stated threshold: any action: URGENT alert; see RMP-EYE-001 (eye care is crew-led) source: v2 safety_limits: - id: L1 name: Contact with the crewmember value: not allowed enforced: Keep-out zone in the robot controller refs: - V2 10172 - id: L2 name: Operating extinguishers or life-support controls value: not allowed enforced: No extinguisher-discharge or ECLSS-control task is loaded - id: L3 name: Camera-scout distance, time, visibility and thermal limits value: enforced: >- Controller hard limits; entry only on the commander's explicit authorization; return when any limit is reached - id: L4 name: Entering a commander-declared no-go volume value: not allowed enforced: >- Path planner blocks no-go volumes; a human send under the vehicle procedure is logged as an override and is the only exception - id: L5 name: Robot speed near the crewmember value: enforced: Hard limit in the controller refs: - V2 10172 - id: L6 name: Handing over a mismatched or unverified medicine under this protocol value: not allowed enforced: >- RMP-PHARM-001 quarantine is the default; only the CMO's logged two-step override inside RMP-PHARM-001 can release it logs: - id: LOG-1 text: Every input, robot action, decision (with who made it) and hand-off, time-stamped to the second. refs: - V2 10163 - V2 10164 - id: LOG-2 text: Mode changes and safety-limit events are announced to the operator as they happen and logged. refs: - V2 10162 - V2 10172 - id: LOG-3 text: >- Records are stored and sent as private medical data, encrypted, with access limited to the medical team. refs: - V1 6003 - V1 7003 - id: LOG-4 text: Results are kept in a permanent, retrievable format so the flight surgeon can see trends. refs: - V1 7001 - id: LOG-5 text: Alert time, each accounting answer, each mask fetch override, video path and kit reconciliation. - id: LOG-6 text: >- Each URGENT alert, who received it, the time it was acknowledged (or the escalation to the next named crewmember), and the time a human released the robot. refs: - V2 10163 - id: LOG-7 text: >- Each emergency fetch as an override (time, who asked, reason as stated, kit ID, seal status) and the later inventory reconciliation, labelled "not a check before use". refs: - V2 7059 requirements: - id: V1 3004 use: Emergency medical care after smoke exposure; medicines are human decisions. - id: V1 3006 use: >- Two trained CMOs per vehicle for NASA programs; the second trained CMO receives alerts when the CMO is the patient (see the commercial-flight note). - id: V1 3007 use: Evacuation decisions stay with the flight surgeon. - id: V1 6003 use: Logs and alerts sent to the ground are private medical communications. - id: V1 7001 use: Records kept so the flight surgeon can see trends. - id: V1 7003 use: Secure handling of medical records. - id: V2 7045 use: Usable by non-physician crew, including when the CMO is the patient. - id: V2 7046 use: Patient, caregiver and supplies restrained. - id: V2 7059 use: >- Kit inventory and seal status are tracked; after an emergency fetch the robot reconciles the kit through RMP-PHARM-001 as an inventory record (never a check before use) and shows it as "opened – not restocked" until resealed. - id: V2 9053 use: >- Protective equipment (including respirators) for expected hazards; the robot fetches sealed masks, the crew don them. - id: V2 9059 use: Fire protection system with detecting, warning and extinguishing; the crew and vehicle lead. - id: V2 9060 use: >- Fire-protection health and status to the crew; the robot may relay displayed status, not interpret it. - id: V2 9061 use: Alert the crew to fire-protection system failures. - id: V2 9062 use: Manual activation and deactivation of the fire protection system; humans only. - id: V2 9063 use: Portable fire extinguishers; crew-operated. - id: V2 10161 use: Robot shows its status and health. - id: V2 10162 use: Mode changes are announced to the operator. - id: V2 10163 use: Robot records and shares its data. - id: V2 10164 use: Shows whether the human or the robot is expected to act. - id: V2 10165 use: Human can override and shut down the robot. - id: V2 10168 use: Human can take over. - id: V2 10172 use: Protective stop when a limit is exceeded. - id: V2 10173 use: Robot stays stopped if no one takes over. - id: V2 10174 use: Only a human starts or restarts the robot. validation: - stage: simulation what: >- Scripted detector alarms, missing crewmember on accounting, mask fetch, no-go volume, CMO as patient, lost link. pass: >- Zero all-clear statements; zero extinguisher use by the robot; every emergency fetch logged as an override; unaccounted crew escalates. - stage: Earth analog what: Fire-drill training with the robot fetching sealed mask bags. pass: Masks at the hand-over point within seconds. - stage: parabolic or station demonstration what: Mask-bag fetch and restraint in weightlessness without smoke. pass: Bags closed and restrained; hatches kept clear. - stage: flight use under flight surgeon supervision what: First use in vehicle fire drills. pass: No safety events. signoff: protocol: - Clinical lead for the specialty (sets every clinical threshold marked ) - Flight surgeon, as medical authority - Robotics and medical-device safety board - Program approval for the mission restart_after_stop: >- Human only. After any emergency or protective stop, a crewmember must restart the robot; the robot never restarts itself. each_run: >- Started by a crewmember, commander or CMO. Alerts go to commander, CMO and flight surgeon at once; the vehicle procedure leads. change_control: - Every change gets a new version number and a written reason; earlier versions are kept. - >- Any change to steps, thresholds, limits or software that touches the patient repeats validation from the simulation stage before use. - >- Software and learned-skill updates follow a pre-agreed change plan (what may change, how it is tested, how to roll back), modeled on the FDA predetermined change control plan approach. - >- If a new version misbehaves, the robot rolls back to the last validated version and the event is reviewed by the flight surgeon and safety board. - The robot never changes its own protocol, thresholds or limits. comms: live: >- Low Earth orbit: ground flight directors and the flight surgeon receive the alert and video when the link allows. loss_of_signal: - >- The robot pauses non-essential motion and tells the commander and CMO; accounting continues offline on confirmation. - >- Crew masks, moving away from the smoke and the commander's vehicle procedure continue under the onboard checklist and never wait for the link or the robot. - The vehicle procedure never waits for the link. mars_delay: - Fire response cannot wait for the ground; the vehicle procedure and trained crew lead. sources: - key: v2 text: >- NASA. NASA-STD-3001, Volume 2: Human Factors, Habitability, and Environmental Health (Rev F, 2026), including Section 10.6 Automated and Robotic Systems. url: https://standards.nasa.gov/standard/NASA/NASA-STD-3001_VOL_2 supports: >- NASA-STD-3001 Vol 2 Rev F: V2 9053 (protective equipment); V2 9059-9063 (fire protection system, status, failure alerting, manual control, portable extinguishers); V2 9064 (emergency equipment clearly identified, accessible and usable); V2 6024 and Table 6.2-3 (combustion product monitoring: CO 5-1000 ppm, HCN 2-50 ppm, HCl/HF 2-50 ppm). Section 10.6 covers automated and robotic systems. - key: ermed text: >- NASA Human Research Program. Evidence Report: Risk of Adverse Health Outcomes and Decrements in Performance due to Medical Conditions that occur in Flight, as well as Private Medical Conditions, in Exploration Missions (In-Flight Medical Conditions). url: https://humanresearchroadmap.nasa.gov/evidence/reports/Medical.pdf supports: >- Table 2 (US astronauts, Shuttle, Mir and ISS through Expedition 13 / 2006): headache (space adaptation) 233, headache (late) 49, headache (CO2 induced) 20; choking/obstructed airway 3; smoke inhalation 3. Table 1 (ISS through Expedition 40): headache 33. - key: aha2025bls text: >- Kleinman ME, Buick JE, Huber N, et al. Part 7: Adult Basic Life Support: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2025;152(16_suppl_2):S448-S478. url: https://doi.org/10.1161/CIR.0000000000001369 doi: 10.1161/CIR.0000000000001369 pmid: '41122888' supports: >- Adult basic life support: initial recognition of cardiac arrest, activation of the emergency response, high-quality CPR and use of an automated external defibrillator; also respiratory arrest and foreign-body airway obstruction. Earth guidance; the onboard checklist leads. Abstract read via PubMed Oct 21, 2026; full text not read. - key: aba text: >- American Burn Association. Guidelines for Burn Patient Referral: Advice on Transfer and Consultation (2022). url: https://www.ameriburn.org/burn-care-team/resources/guidelines-for-burn-patient-referral supports: >- Immediate consultation with consideration for transfer: full-thickness burns; partial-thickness burns of 10% or more of total body surface area; deep partial or full-thickness burns of the face, hands, genitalia, feet, perineum or over any joint; burns with other illnesses or injuries; poorly controlled pain; all suspected inhalation injury; all chemical injuries; high-voltage electrical injuries. Consultation: partial-thickness burns under 10%; all potentially deep burns of any size; signs of potential inhalation such as facial flash burns, singed facial hair or smoke exposure; low-voltage electrical injuries. The palm of the patient's hand is about 1% of body surface area; full-thickness burns are dry and leathery, white, brown or black, with loss of pin-prick sensation. - key: hampson1998 text: >- Hampson NB. Pulse oximetry in severe carbon monoxide poisoning. Chest. 1998;114(4):1036-41. doi:10.1378/chest.114.4.1036. PMID 9792574. url: https://pubmed.ncbi.nlm.nih.gov/9792574/ supports: >- Abstract: pulse oximeters overestimate arterial oxygenation in severe carbon monoxide (CO) poisoning; an elevated carboxyhaemoglobin level falsely raises the pulse oximeter saturation. Why the robot never calls a reading reassuring during a smoke or fire event. - key: ismpadc text: >- Institute for Safe Medication Practices. Guidelines for the safe use of automated dispensing cabinets (2019). url: https://www.ismp.org/system/files/resources/2019-11/ISMP170-ADC%20Guideline-020719_final.pdf supports: >- Override is limited to medicines needed in emergent circumstances where waiting could harm the patient (3.3b); limit what is available on override (3.4b); require documentation of the override rationale (3.4d); routinely analyze override reports (3.6). Used for the emergency-fetch pattern by analogy (a robot fetching a sealed kit is not a dispensing cabinet). - key: v1 text: 'NASA. NASA-STD-3001, Space Flight Human-System Standard, Volume 1: Crew Health, Revision C (2023).' url: https://www.nasa.gov/wp-content/uploads/2023/11/nasa-std-3001-vol-1-rev-c-with-signature.pdf supports: 'NASA-STD-3001 Vol 1 Rev C: V1 3004, V1 3006, V1 3007.' - key: tb044 text: NASA OCHMO. Medical Operations. Technical Brief OCHMO-TB-044 (2025). url: https://www.nasa.gov/wp-content/uploads/2025/08/ochmo-tb-044-medical-operations.pdf supports: >- The crew surgeon keeps medical authority when care is delegated; crew medical officers train on the JSC 48522 medical checklist. - key: marsdelay text: >- NASA. Mars communications disruption and delay (fact sheet, 2023 Moon to Mars Architecture Concept Review). url: https://www.nasa.gov/wp-content/uploads/2024/01/mars-communications-disruption-and-delay.pdf supports: >- One-way Earth-Mars delay up to about 21-23 minutes, plus blackouts of about 2-3 weeks near solar conjunction. - key: pccp text: >- U.S. Food and Drug Administration. Marketing submission recommendations for a predetermined change control plan for artificial intelligence-enabled device software functions (guidance). url: >- https://www.fda.gov/regulatory-information/search-fda-guidance-documents/marketing-submission-recommendations-predetermined-change-control-plan-artificial-intelligence supports: A model for planning, validating and rolling back software updates. - key: faa460 text: 'U.S. Code of Federal Regulations, Title 14, Part 460: Human space flight requirements.' url: https://www.ecfr.gov/current/title-14/chapter-III/subchapter-C/part-460 supports: >- Federal rules for crew and spaceflight participants on licensed commercial flights; they set no medical standards for spaceflight participants. corrections: - date: '2026-10-21' version: '0.2' source: >- AI-assisted clinical and source review by the Medical Research Assistant, Oct 21, 2026 (batch 5 review) items: - >- Requirement set V2 9059-9063 kept; V2 9064 (emergency equipment accessibility) cited in the "why" and sources (item 17). - >- RMP-EYE-001 and RMP-ENV-005 added to related; new RF7: eye pain, tearing or vision change after smoke or combustion exposure → URGENT; see RMP-EYE-001 (item 18). - >- The "why" adds NASA-STD-3001 combustion-product monitoring: CO, HCN and HCl/HF [V2 6024, Table 6.2-3]; the robot never reads monitor values as "air is clear" (item 19; suggestion 42). - >- Typo "have don masks" removed. S5 camera scout: default no entry; prefer a hatch-side view; entry only on the commander's explicit authorization, with masks on the crew who remain, a named path and keep-out, and controller visibility and thermal hard limits (new limit L3); never declares the volume clear or the fire out (item 20). - >- Mask fit question closed: the robot hands over sealed mask bags only; size and fit are the crew's and CMO's; never "verified fit" (suggestion 39). - >- Batch 5 drafts now record the review as AI-assisted (Medical Research Assistant, Oct 21, 2026); no named human clinician. - date: '2026-10-21' version: '0.3' source: Batch 7 editorial (AI-assisted), Oct 21, 2026 items: - >- Citation labels changed to the site's year-only convention: "(approved for public release )" now reads "(YYYY)", and NASA-STD-3001 Volume 2 "Revision F (approved July 14, 2026)" now reads "(Rev F, 2026)" (sources: v2). Editorial; no change to steps, thresholds or limits. - >- X5 and the comms loss-of-signal branch now say only the robot pauses: crew masks, moving away from the smoke and the commander's vehicle procedure never wait for the link or the robot (batch 6 review item 24 / suggestion 40). Editorial; robot behaviour unchanged. - >- New input "Oxygen in use: yes, no or unknown, as stated" (never treated as "no"); the "why" links oxygen in use to fire risk and says carbon monoxide makes a pulse oximeter read falsely high (Hampson 1998, PMID 9792574); never-words "reading is reassuring" and "oxygen level is good" (batch 6 review items 1d and 4).