Attachment 6 - Scenarios.pdf

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Attachment 6

NASA Employee International Medical Support Scenarios

For each scenario below, offerors are requested to complete the tables in Attachment 6a. The assumption column of the table can be expanded to fit information. Offerors are permitted to include narratives for each scenario to convey approaches and considerations.

SCENARIO 1

Location: Ebeye, Marshall Islands Patient: Previously healthy 53 year old male Situation: Patient complains of chest pain during a meeting and is admitted to the hospital with a diagnosis of acute ST-elevation myocardial infarction. He is treated with their last dose of alteplase and his symptoms and EKG improve. His COVID antigen test is negative. Eight hours later at time of evaluation for medevac, he starts to complain of more chest pain.

SCENARIO 2

Location: Jakarta, Indonesia Patient: Previously healthy 35 year old female Situation: A bomb exploded in the marketplace where she was shopping. The local authorities were able to secure the scene and eventually transported victims to overwhelmed local hospitals.

Her airway is intact, and she appeared oriented before being sedated for pain control. She is thought to have a pelvic fracture which has been stabilized with a pelvic binder, but the local CT machine isn’t working. She appears to be hemodynamically stable and her COVID antigen test is negative. At medevac evaluation 18 hours later, her situation has not changed.

SCENARIO 3

Location: Kazakhstan, Russia Patient: 45 year old female with history of diabetes type 2 Situation: Patient did not show up for work and one day later was found collapsed in her home.

She was transported to a local facility and treated for suspected COVID disease. She continues to worsen requiring intubation and transfer to the ICU. She is being treated with IV fluids and steroids, but no other COVID treatment medications (antivirals, convalescent serum, monoclonal antibody) are available. At time of medevac evaluation, she is requiring 100% O2 and full respiratory support.

SCENARIO 4

Location: Riyadh, Saudi Arabia Patient: Previously healthy 25 year old male Situation: Patient has been involved in a rigorous self-exercise program and collapsed while running. He was transported to the hospital where he was diagnosed with rhabdomyolysis. His COVID PCR test was negative. Fluids and bicarb were started, but at time of medevac evaluation 12 hours later, he remains confused and his creatinine continues to rise.