SITREP Report, Hermes II Station, mission day 283…

Dr. Douglas Wayne Talk began the “Medical Emergencies in Space: There is NO ‘Space 911’!” on Saturday in the Hilton with a terse situation report. Dr. Martin, the station medical specialist, needs her gallbladder removed immediately. Her condition is deteriorating rapidly. Specialists on earth can give advice and may even be able to perform the operation remotely, but there’s a time delay in communication from Mars to earth—24 minutes at Zenith. To make matter worse, blood vessel damage occurs during surgery, and the patient has lost 24% of her blood during the time delay. The imaginary scenario depicted only a few of the many problems of dealing with medical emergencies in space.

From past statistics, we should expect at least one emergency if we send a crew to Mars. The limited weight allowance for medical equipment is the biggest problem in trying to prepare possible medical emergencies. On the Mercury missions, the only medical equipment was a set of four auto-injectors. Gemini had 10 injectors, plus vision drops–not a good idea in space. How do you get the drops into your eye in zero gravity? So a mist replaced the drops. Gemini also added bandages and glue, which are standard emergency room supplies these days, plus a compact biophysical monitoring set.

Apollo included a medical bag, gauze, dressings, and blood and urine testing kits. The STS missions had a trained medical specialist at the level of a paramedic. The ISS has 90 medicines, a reference book of medical conditions, and a defibrillator. There’s also another medical kit on the Russian side, but we don’t know what it contains. We assume it’s mainly vodka.

Other difficulties include things as simple as how to administer oxygen. NASA specialists have come up with a tube placed into the trachea that seals when inflated so air can only flow through the tube, not around it.

Think about trying to administer CPR in zero gravity. If you push against another person’s chest in zero-g, what happens? The two of you just fly in opposite directions. An impedance device called a rescue pump has been developed to form suction against the chest, which allows a rescuer to pull the patient’s chest up and push it down.

Dr. Talk and his two sons demonstrated another form of CPR called the Hinkelbein technique. While Dr. Talk laid on the ground, one son did a handstand on his chest while the other grabbed his brother’s ankles to support his pushes. In a second technique, one son straddled the patient’s middle, legs wrapped tightly around, and used that leverage to push against Dr. Talk’s chest.

Bleeding in space is another big problem. Rather than spurting out and falling due to gravity, blood in zero-g forms a cloud of tiny droplets that expands from the wound as the patient bleeds. Eventually, a big clot pools on the skin, obscuring the wound. Scientists have developed a pressurized, transparent dome to place over and around the affect area, with access via glove ports.

NASA has also been working on a version of the Da Vinci surgical robot on the ISS. Called Robonaut 2, the robot can be remote-controlled and could be used as a robot surgeon in space. Unfortunately, it malfunctioned and was removed from the ISS in April.

Lastly, Dr. Talk regaled the audience with a promised and eagerly anticipated discussion of how to survive being sucked out of an airlock. Contrary to what most people think, you wouldn’t freeze solid in a short time. Without any atmosphere, it’s difficult to your body to radiate heat. You would freeze eventually, but you’d be dead way before that. You wouldn’t boil, either, because your skin would hold most of your water-content in place. And you wouldn’t explode, either. The human body is mostly liquid, but since you have skin, there wouldn’t be any huge shift of liquid.

So how long could you survive? Your organs would begin to die once they are deprived of oxygen for two minutes. You would be in extreme pain during that interval, since you’d get the bends as nitrogen was released in your bloodstream. You’d also get a horrific sunburn because you’d have no protection from radiation. You’d eventually get cancer from that. But you wouldn’t last long enough to worry about cancer, unless you got back inside FAST. Altogether, you’d have 15 seconds to react.

Here’s what you’d need to do:

• Take a deep breath, but don’t hold it or your lungs will explode.
• Blow out as hard as you can.
• Meanwhile, curl up slightly with your knees bent.
• Use your expelling breath to propel yourself back inside.
• Use your “reserve” propulsion unit located…um…in the rear to add extra propulsion.

Then all you can do is hope that your crewmates get you back inside in time.

During the Q&A that followed, Dr. Talk discussed using spin for artificial gravity, noting that the problem here is the long moment-arm needed to avoid dizziness and nausea. He also pointed out that at least one-third gravity—equal to the force on Mars—is required for reproduction and development of a normal fetus. Mice born in space are never able to stand when brought back to earth. Bone density loss is another problem, but placing astronauts in hibernation would decrease that loss.

Then there is a moral conundrum to consider. Do you use your entire medical supply to save one person? Or do you let that person die to make sure you have enough supplies for the rest?

On the positive side, at least toothaches in space are easy to cure. You simply pull the tooth. All it takes is a pair of pliers and some of that potent Russian Vodka. A dead body? Put it in the freezer. Unless you’re on Mars, in which case you might want to pack it in poo. Loaded with bacteria, it would cause rapid decay. Problem solved. As for the rest, we’ll have to wait and see what our scientists and engineers can develop.