Abstract
Introduction:Provision of critical care and resuscitation was not practical during early missions into space. Given likely advancements in commercial spaceflight and increased human presence in low Earth orbit (LEO) in the coming decades, development of these capabilities should be considered as the likelihood of emergent medical evacuation increases.Methods:PubMed, Web of Science, Google Scholar, National Aeronautics and Space Administration (NASA) Technical Server, and Defense Technical Information Center were searched from inception to December 2018. Articles specifically addressing critical care and resuscitation during emergency medical evacuation from LEO were selected. Evidence was graded using Oxford Centre for Evidence-Based Medicine guidelines.Results:The search resulted in 109 articles included in the review with a total of 2,177 subjects. There were two Level I systematic reviews, 33 Level II prospective studies with 647 subjects, seven Level III retrospective studies with 1,455 subjects, and two Level IV case series with four subjects. There were two Level V case reports and 63 pertinent review articles.Discussion:The development of a medical evacuation capability is an important consideration for future missions. This review revealed potential hurdles in the design of a dedicated LEO evacuation spacecraft. The ability to provide critical care and resuscitation during transport is likely to be limited by mass, volume, cost, and re-entry forces. Stabilization and treatment of the patient should be performed prior to departure, if possible, and emphasis should be on a rapid and safe return to Earth for definitive care.
| Original language | English (US) |
|---|---|
| Journal | Prehospital and Disaster Medicine |
| DOIs | |
| State | Accepted/In press - Jan 1 2019 |
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Keywords
- Advanced Life Support
- astronaut
- critical care
- emergency medicine
- evacuation
- International Space Station
- low Earth orbit
- resuscitation
- space ambulance
ASJC Scopus subject areas
- Emergency Medicine
- Emergency
Cite this
Resuscitation and Evacuation from Low Earth Orbit : A Systematic Review. / Nowadly, Craig D.; Trapp, Brandon D.; Robinson, Stephen K.; Richards, John R.
In: Prehospital and Disaster Medicine, 01.01.2019.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Resuscitation and Evacuation from Low Earth Orbit
T2 - A Systematic Review
AU - Nowadly, Craig D.
AU - Trapp, Brandon D.
AU - Robinson, Stephen K.
AU - Richards, John R
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Introduction:Provision of critical care and resuscitation was not practical during early missions into space. Given likely advancements in commercial spaceflight and increased human presence in low Earth orbit (LEO) in the coming decades, development of these capabilities should be considered as the likelihood of emergent medical evacuation increases.Methods:PubMed, Web of Science, Google Scholar, National Aeronautics and Space Administration (NASA) Technical Server, and Defense Technical Information Center were searched from inception to December 2018. Articles specifically addressing critical care and resuscitation during emergency medical evacuation from LEO were selected. Evidence was graded using Oxford Centre for Evidence-Based Medicine guidelines.Results:The search resulted in 109 articles included in the review with a total of 2,177 subjects. There were two Level I systematic reviews, 33 Level II prospective studies with 647 subjects, seven Level III retrospective studies with 1,455 subjects, and two Level IV case series with four subjects. There were two Level V case reports and 63 pertinent review articles.Discussion:The development of a medical evacuation capability is an important consideration for future missions. This review revealed potential hurdles in the design of a dedicated LEO evacuation spacecraft. The ability to provide critical care and resuscitation during transport is likely to be limited by mass, volume, cost, and re-entry forces. Stabilization and treatment of the patient should be performed prior to departure, if possible, and emphasis should be on a rapid and safe return to Earth for definitive care.
AB - Introduction:Provision of critical care and resuscitation was not practical during early missions into space. Given likely advancements in commercial spaceflight and increased human presence in low Earth orbit (LEO) in the coming decades, development of these capabilities should be considered as the likelihood of emergent medical evacuation increases.Methods:PubMed, Web of Science, Google Scholar, National Aeronautics and Space Administration (NASA) Technical Server, and Defense Technical Information Center were searched from inception to December 2018. Articles specifically addressing critical care and resuscitation during emergency medical evacuation from LEO were selected. Evidence was graded using Oxford Centre for Evidence-Based Medicine guidelines.Results:The search resulted in 109 articles included in the review with a total of 2,177 subjects. There were two Level I systematic reviews, 33 Level II prospective studies with 647 subjects, seven Level III retrospective studies with 1,455 subjects, and two Level IV case series with four subjects. There were two Level V case reports and 63 pertinent review articles.Discussion:The development of a medical evacuation capability is an important consideration for future missions. This review revealed potential hurdles in the design of a dedicated LEO evacuation spacecraft. The ability to provide critical care and resuscitation during transport is likely to be limited by mass, volume, cost, and re-entry forces. Stabilization and treatment of the patient should be performed prior to departure, if possible, and emphasis should be on a rapid and safe return to Earth for definitive care.
KW - Advanced Life Support
KW - astronaut
KW - critical care
KW - emergency medicine
KW - evacuation
KW - International Space Station
KW - low Earth orbit
KW - resuscitation
KW - space ambulance
UR - http://www.scopus.com/inward/record.url?scp=85072083446&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85072083446&partnerID=8YFLogxK
U2 - 10.1017/S1049023X19004734
DO - 10.1017/S1049023X19004734
M3 - Review article
AN - SCOPUS:85072083446
JO - Prehospital and Disaster Medicine
JF - Prehospital and Disaster Medicine
SN - 1049-023X
ER -