Managing Select Medical Emergencies During Long-Duration Space Missions

Area of Science:

• Space Medicine
• Aerospace Medicine
• Medical Emergencies

Background:

• Long-duration space missions present significant medical challenges due to increased distances, communication delays, and isolation.
• Current medical preparedness for space exploration must account for a wide range of potential emergencies.
• This study addresses the critical need to review existing knowledge on managing medical emergencies in space.

Purpose of the Study:

• To systematically review the literature on managing medical emergencies relevant to long-duration space missions.
• To identify existing knowledge gaps in the medical preparedness for space exploration.
• To inform future research priorities for enhancing medical autonomy in space.

Main Methods:

• A comprehensive scoping review was conducted using PRISMA guidelines.
• Searches were performed across multiple electronic databases (ARC, Embase, IEEE Xplore, Medline Ovid, PsycINFO, Web of Science) up to June 1, 2023.
• Included studies focused on the management of 10 prioritized, potentially mission-critical medical conditions during space missions.

Main Results:

• Ninety-nine studies were included after assessing 484 full-text articles.
• Most represented conditions included spaceflight-associated neuro-ocular syndrome (23 studies), herniated disk (22 studies), and nephrolithiasis (22 studies).
• Limited evidence exists for cerebrovascular accidents (4 studies), eye penetration (3 studies), and retinal detachment (2 studies), particularly concerning prolonged deep-space exposure.

Conclusions:

• Medical autonomy is crucial for the success of long-duration space missions where support and communication are limited.
• Significant knowledge gaps persist, necessitating targeted research to improve astronaut medical preparedness.
• Prioritizing research in identified gaps will enhance medical capabilities for future space exploration endeavors.