Just-in-time Training with Remote Guidance for Ultrasound-Guided Percutaneous Intervention

Area of Science:

• Aerospace Medicine
• Medical Simulation
• Interventional Radiology

Background:

• Surgical emergency management in spaceflight presents challenges due to limited resources and crew autonomy.
• Ultrasound-guided percutaneous interventions offer a versatile solution for various pathologies using shared equipment.
• Exploration-class missions necessitate autonomous crew capabilities for medical procedures.

Purpose of the Study:

• To assess the feasibility of remote, just-in-time teaching and guidance for ultrasound-guided percutaneous intervention.
• To evaluate the effectiveness of audiovisual communication in training inexperienced personnel for spaceflight medical procedures.
• To establish proof-of-concept for remote surgical guidance in simulated spaceflight emergencies.

Main Methods:

• Inexperienced subjects received brief training and remote audiovisual guidance for percutaneous drain placement in a simulated abscess.
• Technical success was defined by fluid aspiration post-drainage.
• Procedure completion time and needle redirections were compared between inexperienced and experienced personnel.

Main Results:

• All participants, regardless of prior experience, achieved technical success in drain placement.
• Inexperienced subjects took longer (5.8 min) than experienced staff (2 min) to complete the procedure.
• No significant difference was observed in the number of needle redirections between groups.

Conclusions:

• Percutaneous ultrasound-guided interventions can be successfully performed by inexperienced individuals with just-in-time training and remote audiovisual guidance.
• This approach demonstrates high technical success rates, crucial for autonomous medical care during space missions.
• Remote guidance is a viable strategy for enabling complex medical procedures in resource-limited environments like spaceflight.