Here’s What Emergency Medicine Will Look Like for Astronauts in Space4 min read

Komorowski has direct experience working in isolated environments. In 2014, he served as the on-site doctor for a two-week mission to the Mars Desert Research Station (MDRS), a Mars Society facility in Utah where mock astronaut teams simulate procedures and experiments for the Red Planet. (Komorowski and I were crewmates on the project.)

Komorowski did a medical study on site where untrained crew members were taught to insert tubes in a mannequin, simulating a common medical procedure. A study based in part on this work was published in 2014 in Extreme Physiology & Medicine.

It’s possible that on such a long voyage to Mars, even the doctor could get ill on the trip. Komorowski advocates for a few ways to deal with such a situation.

The first is to have duplicated skills among the crew, which means requiring that everyone have at least basic medical training. The second — although less accessible on a trip to Mars — would be telemedicine. Given the minutes-long time lag between Earth and Mars communications, there would be little opportunity for a conference call in an emergency.

There also are preventative steps that can be taken, such as having on-demand 3D printing of medical equipment, or matching crew members by blood type — an easier solution for transfusions, since the right blood type would be available for everyone.

Komorowski also cautioned that in some cases it may be best not to make an attempted medical intervention, especially if a lot of consumables would be used on a medical procedure where the person is not likely to survive.

“During future space exploration missions, the crew must prepare for non-survivable illnesses or injuries that will exceed their limited treatment capability,” he said.

Even common procedures, such as cardiopulmonary resuscitation (CPR), may require a rethink in space. After all, you can’t use your body weight in microgravity, and there are restrictions on how much medical equipment you can take on board.

After testing CPR techniques aboard aircraft and underwater space simulators, a team led by Jochen Hinkelbein suggests that the “hand-stand technique” is the most effective method for CPR in space. Alternatively, especially in a microgravity environment, wrapping the legs around the patient (called the Evetts-Russomano method) while performing compressions will stop them from floating away.

“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 Hinkelbein, executive senior physician of anesthesiology and intensive care at the University Hospital of Cologne in Germany, in a statement.

“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,” added Hinkelbein, who is also president of the German Society for Aerospace Medicine. “Therefore, there is also a substantial risk for a cardiac arrest in space requiring CPR.”

Emergency medicine in space was recently discussed at this year’s Euroanaesthesia congress, which was held in Geneva, Switzerland, from June 3 to June 5.