FALLING ill a boat ride from the nearest hospital is daunting enough - but what if the symptoms hit in outer space?
Injuries and ailments can pose serious threats to astronauts floating hundreds of kilometers above earth.
Now a new medical training regime has been designed for staff travelling to the international space station and beyond. The details will be revealed for the first time at the World Extreme Medicine Conference in Edinburgh and could even be adapted to help residents living in the remotest islands of Scotland.
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Dr John Cherry, who created the blueprint for the medical training given to European Space Agency astronauts, will describe the project at the event in Dynamic Earth.
He said: "We cannot turn astronauts into doctors in a few days but we can give them the skills to deal with emergencies in space."
Previously the medical training astronauts received was based on experience during past missions, he said, rather than an "evidence base".
He researched before drawing up a new curriculum which involves the astronauts spending time treating real patients in a major teaching hospital in Germany.
As the number of people who have been into space is small, Dr Cherry said they also looked at the medical problems which presented in places on earth that are "similar to space" when deciding what the astronauts needed to know. He explained: "There actually are fairly extreme environments (on earth) - places dependent on technology, small groups of people and isolated. The ones we looked at most closely were the national Antarctic programmes which are based in Antarctica."
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Drawing on this larger pool of potential patients, they focused on preparing the astronauts to deal with a range of conditions including heart attacks, clots on the lung, problems with the digestive system and common infections.
Ultrasound equipment is already on board missions to allow the astronauts to conduct experiments on themselves in space. Dr Cherry, whose previous jobs have included helping assess the feasibility of a mission to Mars, said they realised the crew could also be trained to use it in a medical emergency. Noting that it would hopefully never happen, he said: "If there is a situation where they would have to work out if there is internal bleeding, that (the ultrasound) would help them work it out."
The astronauts are also trained to implant intravenous lines so fluid and drugs can be administered urgently. Medication used to aid resuscitation are among the treatments they are trained to give.
Dr Cherry, who is qualified in astrophysics as well as medicine and works in a remote Australian hospital, said the new programme was introduced after British astronaut Tim Peake left for the International Space Station. He could not reveal medical incidents which have taken place in space due to patient confidentiality, but said: "The skills that we have taught have come in very useful and have been used."
European astronauts are in communication with doctors and surgeons based on earth when they are away.
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Dr Cherry said he was excited to share the work with doctors working in a range of extreme situations at the Edinburgh conference, which is taking place in mid November.
He said: "Hopefully people will see use for it in a range of environments.
The event is bringing together experts who have worked in conflict and disasters zones as well as leaders in the field of sports medicine.
Kate Rubins, one of three astronauts aboard the International Space Station, has already transmitted a message of support to the organisers. She said: “The concept of extreme medicine resonates with so many corners of human health, such as disaster and humanitarian medicine, pre-hospital care, wilderness medicine, and in isolated villages in the developing world.
“The breaking down of traditional silos between these disciplines is leading to more effective treatments and devices, and of course the sharing of knowledge and best practices on a wider stage.”
World Extreme Medicine Founder Mark Hannaford said: “In today’s world, more than ever before, the human race is determined to access remote areas, whether it be for science, exploration, business or a myriad of other reasons. People going into these areas need medical support, and the skillsets of the medical professionals required are very different to those needed in a traditional clinical environment."
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