Resuscitation and Evacuation from Low Earth Orbit: A Systematic Review

Craig D. Nowadly, Brandon D. Trapp, Stephen K. Robinson, John R Richards

Research output: Contribution to journalReview article

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 languageEnglish (US)
JournalPrehospital and Disaster Medicine
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Orbit
Critical Care
Resuscitation
Spacecraft
United States National Aeronautics and Space Administration
Information Centers
Space Flight
Evidence-Based Medicine
PubMed
Emergencies
Retrospective Studies
Prospective Studies
Guidelines
Costs and Cost Analysis
Therapeutics

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 journalReview article

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