'Manned missions to Moon, Mars may face medical emergencies'

Astronauts on missions to deep space such as Mars may face severe medical emergencies like heart attacks, say experts who suggest that the crew must prepare to deal with potentially fatal illnesses or injuries.

Experts at the Euroanaesthesia congress in Geneva discussed the unusual and challenging problem of how to perform emergency medical procedures during space missions.

"Space exploration missions to the Moon and Mars are planned in the coming years. During these long duration flights, the estimated risk of severe medical and surgical events, as well as the risk of loss of crew life are significant," said Matthieu Komorowski, from the Charing Cross Hospital in the UK.

In the event of a crew member suffering from an illness or injury, they may have to be treated by personnel with little formal medical training and without the equipment that would be available in a comparable situation on Earth.

"In the worst-case scenario, non-medical personnel may have to care for an injured or ill crewmember. Far from low Earth orbit, real-time telemedicine will not be available and the crew will need to be self-reliant," Komorowski said.

"Duplication of skills will be critical to enhance crew safety, especially if the doctor on board himself becomes ill, injured, incapacitated or dies. As such, extending basic medical training to most crewmembers will be extremely important," he said.

In remote environments, medical and surgical conditions with a low probability of success that also require using vast quantities of consumables are often not attempted.

Similarly, during future space exploration missions, the crew must prepare for non-survivable illnesses or injuries that will exceed their limited treatment capability, researchers said.

Some of the solutions proposed by Komorowski include matching crew members for blood type to enable blood transfusions or making use of 3D printing of medical equipment rather than carrying items that would most likely not be needed during the mission.

In the event of a serious problem such as a cardiac arrest, it may be necessary to perform cardiopulmonary resuscitation (CPR) - an especially difficult procedure to perform in microgravity.

"Since astronauts are selected carefully, are usually young, and are intensively observed before and during their training, relevant medical problems are, fortunately, rare in space," said Jochen Hinkelbein from the University Hospital of Cologne in Germany.

"However, in the context of future long-term missions, for example to Mars, with durations of several years, the risk for severe medical problems is significantly higher," Hinkelbein said.

"Therefore, there is also a substantial risk for a cardiac arrest in space requiring CPR," he said.
The space environment presents a number of unique problems that must be overcome in order to deliver emergency medical care.

In microgravity it is not possible to use one's body weight to perform actions such as CPR as would be done on Earth, and there are strict limits on the amount of medical equipment and consumables that can be taken on a mission.

Hinkelbein outlined different methods of CPR that have been tested in microgravity experiments onboard aircraft and in specialised underwater space simulators.