Surgery in Extreme Environments
At the 2015 International World Conference on Extreme Medicine in London, renowned British explorer Sir Renolf Fiennes vividly described his companion's frostbitten foot during an expedition in the Arctic. He described in detail how he cut away the festering skin tissue of his friend's foot and showed photographs of the foot that had exposed the nerve endings. The photos were so "brutal" that even some of the medical professionals in the audience had to look away.
Sir Fiennes has traveled to many of the planet's most extreme regions. Survival in these places involves dealing with cold and other highly dangerous conditions. On several occasions he had come close to death - suffering starvation, disease, and having his fingers amputated by his own hand after frostbite. In fact, treating injuries, illnesses and even performing surgery in this way is one of the essential survival skills of every explorer in extreme isolation.
As mankind gradually heads toward the moon and Mars, astronauts will have to face the same emergency medical situations in space, an equally extreme environment. Does this mean that space astronauts will have to "self-harm" in an emergency?
What happens if you get hurt in space?
Fortunately, none of the medical conditions experienced by ISS astronauts over the years have been life-threatening. Only one Italian astronaut, Luca Palmitano, nearly drowned in space.
Parmitano, who was on a spacewalk in 2013, had a leaking helmet that continued to seep into his helmet, flooding his nose and blurring his vision, and he no longer knew which direction led to the station's hatch. He tried to contact fellow spacewalker American Christopher Cassidy and the control center, but his voice was so faint that no one heard him. Water faded into his ears and he was cut off completely from the outside world.
In a moment of crisis, he had to cut a 'hole' in his spacesuit as a last resort, thinking it was better than drowning in his helmet. That is, until he spots the hatch through the "curtain of water in front of him". As it happens, Cassidy was right behind him, and when the hatch opened, the astronauts inside helped remove his helmet. He thanked his teammates, but couldn't hear their replies because his ears and nose were still soaked with water.
In addition to near-drowning deaths, the unique space environment can cause astronauts to suffer from a host of physical problems: aerospace motion sickness (nausea, disorientation), back pain, blurred vision (caused by changes in the eye's retina and optic nerves), and a decline in the immune system and the ability to regulate bodily fluids ......
Medical worries of astronauts
"Star Trek" is a movie in which McCoy, the space doctor with great medical skills, is a very likable character. In reality, though, we have enough good astronauts and a shortage of specialized space doctors.
Of course, the ISS has medical facilities, but they're certainly not what you'd expect to find in a hospital on Earth: cozy beds, flashing lights, and a wide variety of medical instruments. The medical equipment on the ISS is rather primitive, resembling that of an ordinary public **** swimming pool, and most of the paramedical equipment is "simplified" and compact. Similar to polar expeditions, there is a lot of equipment that we can't take with us into space, and the highest level of human medical care is "abandoned" on a distant planet, with astronauts, the station, and the public on the ground having to accept this level of risk.
Usually, astronauts carry a backpack with life-saving equipment: a defibrillator, a small ventilator and some emergency medication. In the event of a sudden accident, astronauts can temporarily "stabilize" the damage, but this is obviously not a long-term solution.
Thankfully, the ISS is not too far from the ground, only about 400 kilometers above the Earth, and in the case of seriously ill or injured astronauts, the Soyuz spacecraft would return them to Earth as quickly as possible. Within a few hours, the astronauts can reach care centers in Earth hospitals.
But if humans wanted to go farther into space, such as aboard a spacecraft bound for the moon or Mars, on an unfamiliar world, it would be a dangerous situation if an astronaut broke a leg or had an appendicitis attack, which would require us to be equipped with advanced medical equipment and good, dedicated doctors.
How to overcome the heavy challenges?
So how do you solve emergency surgery in deep space?
One of the challenges doctors face in space surgery is the blood problem, because the blood that flows out floats in the air. In addition since other particles don't sink either, all sorts of bacteria float in the air of the space station, greatly increasing the risk of infection. Pain control for space surgery is also a challenge. The use of inhalation anesthesia in space is very difficult because there is no suitable contaminant removal system to deal with the leftover anesthesia, so alternative means need to be developed as well.
Scientists have actually experimented with zero-gravity surgery several times.
Back in 1991, engineers installed a fully equipped ward on the International Space Station and then had surgeons perform operations to anesthetize rabbits in the weightless conditions caused by parabolic-flying aircraft. But the experiment didn't turn out to be very successful at the time.
But in 2006, a French medical team successfully removed a lipoma from a man's forearm in a simulated zero-gravity environment aboard a modified Airbus aircraft. The "space operating room" area of only 4 square meters large, all surgical instruments are fixed with strong magnets on the operating table, while the doctor was fixed by a rope to prevent drift around. They also use special vacuum suction machines to absorb the blood floating in the air.
All along, NASA has also been looking for new types of operating rooms and medical equipment suitable for spaceships, such as a small liquid-filled dome they developed to cover a patient's injured area, where surgeons can maneuver instruments, scalpels and endoscopes. The device not only prevents blood from spewing out, but also helps keep wounds clean. However it may be some time before it is actually put to use.
In addition, NASA is also developing robots that can perform surgical procedures, allowing them to receive instructions from ground-based medical personnel via satellite communications and then treat astronauts who need surgery. Right now, the robots can't perform surgery in weightlessness. Researchers must gain experience before programming them to take the place of doctors.
Michael Barratt, M.D., believes that robotic surgeons are the most viable approach right now, and that space medicine infirmaries will definitely become a reality in the future. The real "Dr. McCoy" is coming, but not anytime soon. ......
This article is from Big Tech*Science Mysteries Issue 1, 2017 ?