mars travel medical emergencies

[YPOD]

Whenever I see a movie or hear of plans for a manned mission to Mars, I always wonder how they would handle an in flight medical emergency - like appendicitis? Will every trip have a surgeon? what happens if he or she is the victim? Any ever hear how this would be handled?

[GusNSpot]

They remove them before they go, likewise with other known problems of the individual menbers of the flight crew.

Solo sailers have done since dirt got wet.

[I_forgot_my_username]

Well, before an astronaut goes into space they are checked for any diseases, and are kept in isolation for a certain amount of time before launch, but, if anyone ever got sick on a manned mission to mars despite all of the prevention of disease, I guess that they could be shot into space.

[MEBuckner]

Any viable proposal for a manned Mars mission is going to have to include crew members with medical training and putting medical supplies including surgical equipment on board the ship. (I’m assuming no really big technological breakthroughs, like a “space drive” that allows you to get there and back in 36 hours, or “This is the Emergency Medical Hologram. Please state the nature of the medical emergency”.)

This proposal, for example, includes a total expedition crew of eight: six planetary scientists and two medical scientists. (I would think there could be some doubling up of roles, especially between medical personnel for the crew and researchers for biological sciences.)

[drachillix]

*Originally posted by MEBuckner *
**Any viable proposal for a manned Mars mission is going to have to include crew members with medical training and putting medical supplies including surgical equipment on board the ship.

…six planetary scientists and two medical scientists.**

Please tell me they will take someone emergency medical experience. Considering the average US astronaut is about as heathy as can be imagined, these guys are probably far more likely to be seriously injured than suddenly come up with Type II Diabetes or some form of cancer.

The thought of medical research types who may not have touched a life threatening medical crisis since they were an intern kinda frightens me. Especially since we are looking at probably weeks of travel time… if need be a space shuttle can be on the ground in a few hours to deal with a critcally injured or ill crewmember. Mars runs will have to have at a minimum the facilities of a present day hospital emergency department. Which is alot of stuff even crammed in tight.

[Duck_Duck_Goose]

Looking for that Antarctic researcher who diagnosed her own breast cancer…

Okay, here she is. Jerri Nielsen.
http://more.abcnews.go.com/sections/primetime/2020/primetime_nielsen_010719_feature.html

In March 1999, a month after the station closed for the Antarctic winter, Nielsen discovered a lump in her breast.

…She e-mailed doctors in the United States, who replied that she needed a biopsy right away…Using apples, potatoes and yams for practice, Nielsen trained a welder who helped her perform a biopsy on herself. Since she was both the doctor and the patient, she had to stay conscious; her only anesthetics were ice and a local painkiller.

A maintenance specialist on the team learned from the Internet how to make pathology slides, and a computer wizard hooked up a camera to an old microscope and then to a computer. They were able to send results to doctors in the United States via satellite.

…A month later…an airdrop brought the drugs Nielsen would need for chemotherapy. She worked with her fellow “Polies” to learn how to mix the chemo.

So okay, she was airlifted back to the States for the actual surgery, but if they’d had to, I have no doubt that her fellow “Polies” could have figured out how to do a mastectomy.

And I came across this.
http://www.nsf.gov/od/lpa/news/02/pr0261.htm

July 17, 2002

Telemedicine Link With South Pole Allows Remote Knee Surgery

In a groundbreaking telemedicine development, doctors in Massachusetts earlier this month helped a physician at Amundsen-Scott South Pole Station to surgically repair the damaged knee of a meteorologist spending the winter in Antarctica.

Using a “telemedicine” connection operated by Raytheon Polar Services Co. (RPSC) of Centennial, Colo., orthopedic surgeon Bertram Zarins and anesthesiologist Vicki Modest, both of Massachusetts General Hospital in Boston, helped South Pole physician Dr. Timothy Pollard to suture a damaged tendon in the left knee of RPSC employee Dar Gibson in a two-hour operation July 5 (EDT). Gibson injured his knee in a fall.

[MEBuckner]

Well, there are going to be pretty severe limits on telemedicine on a Mars mission (or any other deep space mission) because of the speed-of-light communications lag. You can’t have the doctor saying “Clamp that!” and then, 40 minutes later, it gets clamped.

I would imagine that any surgeons on a Mars mission would be trained especially for emergencies (even if they’re also doubling as exobiologists). I would also imagine that even the guy who runs the ship’s nuclear reactor will have basic medical training of the setting bones level. “Telemedicine” could also be used, not to actually carry out the operation, but to allow the reactor guy to consult with real doctors back on Earth in some really dire emergency where the ship’s fully trained doctor(s) are already dead or are the ones requiring surgery, to allow him to figure out what he’s going to do before he does it.

Of course, a Mars mission will likely take years, not just weeks. Certainly something may come up which even the best-equipped ship’s doctor can’t handle, but which a fully equipped hospital or some specialist back on Earth could have taken care of. This is the Final Frontier we’re talking about here; if they wanted to be totally safe, they should have stayed home in bed. It’s not like you won’t get far more volunteers than you have slots, despite the inherent dangers of such an undertaking.

[partly_warmer]

Amazing story Duck Duck Goose…

---

Here are a couple interesting quotes from “The MIR Space Station: A Precursor to Space Colonization”.

(On Soyuz-T 14) “…over a period of several days, Vasyutin had progressively succumbed to illness…Although initially the cosmonauts had kept this to themselves, as soon as it became apparent that this was a serious illness they reported it…The medics at Kaliningrad told him to relay the output from the biomedical test kit…to prepare to return to Earth…although his condition was “satisfactory”, he “required hospital treatment” and was flown to Moscow…This was the first time that a mission had been cut short by illness…”

“It was suspected that he was suffering from appendicitis, but he had a prostate infection.”

So, apparently the Russians didn’t remove appendicies, even in anticipation of long flights. They didn’t include a doctor, and didn’t send one up to handle the problem, or try to talk them through a resolution. On can conclude the examinations and remedies in space, in 1985, were limited and dangerous.

[scr4]

There’s a big difference between interplanetary trips and low-earth orbit space stations. On the Mir, the Soyuz capsule that took the cosmonauts up to the station stayed with them, and could be used for a return trip any time. If an emergency occured, they could be back on the ground within an hour or so. So I guess they didn’t worry too much about having to do on-site medical treatments. It’s the same situation on the International Space Station. They keep Soyuz capsules up there as lifeboats since the Shuttles can’t stay there.

[Duck_Duck_Goose]

I can’t find anything that says that NASA flight crews have all had their appendixes out before they fly. As a matter of fact, it sounds like they don’t.

Interview with Dan Goldin, head of NASA in 1997.
http://www.floridatoday.com/space/explore/stories/1997b/122197c.htm

By doing the things I talked about, we are developing virtual surgery at NASA so that when the astronauts are on the space station or another planet we can, in three-dimensional space, look at a patient. The doctor can have on cyber-gloves on the ground, and a cyber-mask and the patient could be an astronaut on the space station and they determine if they have an appendectomy. And then we could train the astronauts in cyberspace how to do that appendectomy with some advanced devices we’re developing at NASA.

http://www4.medical.philips.com/newsandevents/studies.asp

In addition to studies, the ultrasound system is a key tool for evaluating the physical condition of the astronauts. Tightly scheduled medical experiments and other important activities make the stakes too high for astronauts to be hobbled or disabled. “The ATL ATL HDI 5000 ultrasound system will be the only medical imaging device on the station,” said Martin. “The stakes are extremely high if there is an injury on board. So, anything that could contribute to an accurate diagnosis is very important. In addition to the standard applications, we are prepared for looking into hip fractures, pneumothorax, abdominal trauma, eye trauma, musculoskeletal injuries, and appendicitis,” he said.

http://www.vanderbilt.edu/News/register/Current/story7.html

Seddon and DeHart can rattle off lists of crucial unanswered questions regarding medical care and long-duration space travel. What are the effects of long-term exposure to solar radiation? Bone loss from spending three years in low-gravity conditions may be so severe that the reentry maneuver would entail a fractured back, but no one knows for sure. What would be the effect on performance from long-term use of the drugs astronauts rely on to assist regular sleep during space travel? For trips of long duration, would it be a good idea to enforce pre-flight prophylactic removal of the appendix? (A Mir Space Station crew was nearly forced to make an unscheduled return because of a suspected case of appendicitis; it turned out to be a kidney stone.)

So.

[partly_warmer]

*Originally posted by scr4 *
**There’s a big difference between interplanetary trips and low-earth orbit space stations. On the Mir, the Soyuz capsule that took the cosmonauts up to the station stayed with them, and could be used for a return trip any time. If an emergency occured, they could be back on the ground within an hour or so. So I guess they didn’t worry too much about having to do on-site medical treatments. It’s the same situation on the International Space Station. They keep Soyuz capsules up there as lifeboats since the Shuttles can’t stay there. **

Yeah, I realized the situation wasn’t very similar, but it was about the closest space-related situation I had to go on. (Duck Duck Goose’s is actually more to the point in a couple respects.)

Actually, the Russians felt they couldn’t bring them back immediately, due to “less than ideal weather conditions”, and kept the sick cosmonaut up 3 weeks. It was interesting there was no thought of performing surgery during that time.

Antarctic bases are used to hazard a number of guesses about long-term space voyages, among them the quite severe discipline, and the considerable mental problems with being confined. I’d suspect personality conflicts / mental disorders would be as hazardous as physical problems. Wonder what plans they’re making for that? (Bearing in mind the Mars mission, as far as I know is in a very tentative and preliminary state.)

[drachillix]

*Originally posted by Duck Duck Goose *
**So okay, she was airlifted back to the States for the actual surgery, but if they’d had to, I have no doubt that her fellow “Polies” could have figured out how to do a mastectomy.
**

One tough woman, hadn’t heard the story. A mastectomy is something where you have time to plan and learn before you need to do it. While a mastectomy is no cake walk, its still pretty “superficial” compared to an appendicitis for example. Screwing up the mastectomy would me more likely to leave her disfigured than dead (infections aside). To perform an appendectomy they will have to be cutting through a bunch of muscle, into the abdominal cavity, and searching for the structure they wish to remove, then repairing the hole it leaves behind. There are tons of relatively common procedures I saw in my EMT days that ER MD’s and RN’s made look easy but it looks that way because they have done it hundreds of times. how many people without guidance would even think about doing cut-down IV insertions, chest tube placements.

[Broomstick]

There have been instances of people being “talked through” an appendectomy or other emergency surgery/procedure, although usually it’s under the most dire of circumstances where there is NO opportunity for rescue and the patient is in iminent danger of death. Since in our modern world travel is so readily available it’s hard for anyone (short of the Antartic base in winter) to be out of range of medical transport. That wasn’t the case 50 or 75 years ago, when you might get someone on a radio but they won’t be able to get to you for days or weeks.

It wouldn’t surprise me to have at least two doctor-level medical people on a Mars mission, and train the others to paramedic level, maybe with some surgery basics thrown in. But, let’s face it, going to space at all is dangerous, much less to Mars. They’re definitely taking a risk that they won’t come back.