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2015 ; 4
(ä): 19
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Intubation after rapid sequence induction performed by non-medical personnel
during space exploration missions: a simulation pilot study in a Mars analogue
environment
#MMPMID26527252
Komorowski M
; Fleming S
Extrem Physiol Med
2015[]; 4
(ä): 19
PMID26527252
show ga
BACKGROUND: The question of the safety of anaesthetic procedures performed by non
anaesthetists or even by non physicians has long been debated. We explore here
this question in the hypothetical context of an exploration mission to Mars.
During future interplanetary space missions, the risk of medical conditions
requiring surgery and anaesthetic techniques will be significant. On Earth,
anaesthesia is generally performed by well accustomed personnel. During
exploration missions, onboard medical expertise might be lacking, or the crew
doctor could become ill or injured. Telemedical assistance will not be available.
In these conditions and as a last resort, personnel with limited medical training
may have to perform lifesaving procedures, which could include anaesthesia and
surgery. The objective of this pilot study was to test the ability for unassisted
personnel with no medical training to perform oro-tracheal intubation after a
rapid sequence induction on a simulated deconditioned astronaut in a Mars
analogue environment. The experiment made use of a hybrid simulation model, in
which the injured astronaut was represented by a torso manikin, whose vital signs
and hemodynamic status were emulated using a patient simulator software. Only
assisted by an interactive computer tool (PowerPoint(®) presentation), five
participants with no previous medical training completed a simplified induction
of general anaesthesia with intubation. RESULTS: No major complication occurred
during the simulated trials, namely no cardiac arrest, no hypoxia, no
cardiovascular collapse and no failure to intubate. The study design was able to
reproduce many of the constraints of a space exploration mission. CONCLUSIONS:
Unassisted personnel with minimal medical training and familiarization with the
equipment may be able to perform advanced medical care in a safe and efficient
manner. Further studies integrating this protocol into a complete anaesthetic and
surgical scenario will provide valuable input in designing health support systems
for space exploration missions.