Notes on a talk delivered by Dr Rochelle Velho, Academic Clinical Fellow, with the UK Space Environments Association, at Final Frontiers in Healthcare, organised by ReThinkX at Citylabs, Manchester, 16th February 2017.
Welcome back!
This week, we're going to talk about Dr Rochelle Velho and her Mars Analogue missions.
Tele-Medicine
Tele-medicine is the practice of viewing vital signs, and, if necessary, giving advice and information based on those signs, from a distance. It's what you need to do in space; often, astronauts are working independently, very far away from help, in dangerous conditions.
This also has applications on earth, both in working with patients in dangerous situations, and simply in the fact that studying bodies in space can allow us to better understand patients on earth.
An important question for space travel is...should a doctor go along? Astronauts are some of the strongest, smartest people on the planet, but, even so, there's only so many skills they can carry between them, especially with all the blood pushing on their eyeballs like that. Might basic first aid and emergency procedures from a non-MD be enough?
One problem with taking a doctor along is simply deciding what kind of medical skills are required. An A&E doctor? A general practitioner? A dentist? That last suggestion isn't a joke; toothache is one of the few things which will cause a great deal of pain without actually killing you.
Another problem is that, with medical care available, astronauts might be tempted to take more risks. It's a little like how, once seat-belt laws came into effect, drivers crashed more often. They took more risks because they knew the consequences wouldn't be as severe.
Tele-medicine and tele-monitoring is one way we can provide medical care and emergency aid to astronauts from a distance, which brings us to the Mars Analogue Missions.
We use places like Austria, Morroco, Russia, and Antartica to mimic the solitude of other planets. The European Space Agency's base, Concordia, is located in Antartica. Incidentally, you may be pleased to learn that the European Space Agency, like the Eurovision Song Contest, will not automatically kick us out when we leave the EU. So, you know, there's that.
While tele-monitoring, Dr Velho is sent details of the astronaut's vital signs. Astronauts are also able to view their own vital signs and so take action to keep themselves out of danger. There's a 20 minute delay between signals, which is one of the things we want to figure out. How do we cope with that delay in an emergency? Another issue that we need to figure out is dealing with radiation disrupting signals. Again, enabling astronauts to deal with medical emergencies is one thing we can do here.
We use places like Austria, Morroco, Russia, and Antartica to mimic the solitude of other planets. The European Space Agency's base, Concordia, is located in Antartica. Incidentally, you may be pleased to learn that the European Space Agency, like the Eurovision Song Contest, will not automatically kick us out when we leave the EU. So, you know, there's that.
While tele-monitoring, Dr Velho is sent details of the astronaut's vital signs. Astronauts are also able to view their own vital signs and so take action to keep themselves out of danger. There's a 20 minute delay between signals, which is one of the things we want to figure out. How do we cope with that delay in an emergency? Another issue that we need to figure out is dealing with radiation disrupting signals. Again, enabling astronauts to deal with medical emergencies is one thing we can do here.
Emergency Medicine in Space
Dr Velho's talk also focused on some things astronauts can do if there is an emergency, particularly in low gravity environments. How does CPR work when there's nothing to push against? Well, it's something like a reverse Heimlich manoeuvre.
First, a quick note on breathing works. Breathing is a mechanical operation; the muscles between your ribs pull them up, and your diaphragm flexes downwards, increasing the volume of the space in your chest. Air rushes in to fill this vacuum. When your muscles relax, the ribs go back down and the diaphragm goes back up, decreasing the space and forcing the air out. When you perform CPR you perform this motion for the patient; you force their lungs to increase and decrease in volume, pushing air in and out.
Something neat one of our lecturers told us last semester; when you breathe harder, you use more muscles to increase the capacity of your lungs and pull more air in. One of these muscles is the pectoralis major, which is attached to both the ribs and the humerus, the bone of the upper arm. When people pant, they 'fix' their upper arm, keeping it still, and therefore allowing the pectoralis major to exert a greater pull on the ribs. That's why people will rest their arms on their thighs or another surface when they pant. It's an automatic motion - I bet you've done it.
In microgravity the body isn't 'fixed' in place as it is in earth - hence why something like a Heimlich manoeuvre is used, allowing you to use your own body to pull and push against. The patient is then strapped to a restriction device, and a Lucas device can be used to maintain CPR mechanically.
I do recommend becoming certified in CPR if you can. It's not a difficult technique and training courses don't take too long; you can find them here. An hour-long course was arranged recently by Reslife at the University of Manchester. In that hour, we learned CPR and practised putting someone in the recovery position. If you get that chance, I really recommend going for it.
The video below shows another method for performing CPR in microgravity. However, Dr Velho tells us that it does shake the ship!
Incidentally, I wrote this post just after buying myself the full series' of Quantum Leap, as a reward for doing well in my exams. I'm literally watching the first episode right now. I'd forgotten this!
Don't forget to check back on the 4th of April, when we'll be talking about solar sails!
This post by Kali, on an event attended by Kali and Alice.
First, a quick note on breathing works. Breathing is a mechanical operation; the muscles between your ribs pull them up, and your diaphragm flexes downwards, increasing the volume of the space in your chest. Air rushes in to fill this vacuum. When your muscles relax, the ribs go back down and the diaphragm goes back up, decreasing the space and forcing the air out. When you perform CPR you perform this motion for the patient; you force their lungs to increase and decrease in volume, pushing air in and out.
In microgravity the body isn't 'fixed' in place as it is in earth - hence why something like a Heimlich manoeuvre is used, allowing you to use your own body to pull and push against. The patient is then strapped to a restriction device, and a Lucas device can be used to maintain CPR mechanically.
I do recommend becoming certified in CPR if you can. It's not a difficult technique and training courses don't take too long; you can find them here. An hour-long course was arranged recently by Reslife at the University of Manchester. In that hour, we learned CPR and practised putting someone in the recovery position. If you get that chance, I really recommend going for it.
The video below shows another method for performing CPR in microgravity. However, Dr Velho tells us that it does shake the ship!
Incidentally, I wrote this post just after buying myself the full series' of Quantum Leap, as a reward for doing well in my exams. I'm literally watching the first episode right now. I'd forgotten this!
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| Oh boy! |
Don't forget to check back on the 4th of April, when we'll be talking about solar sails!
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