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Smart medical devices that help astronauts handle emergencies such as electrical burns will become part of the International Space Station perhaps as early as next month. Further down the road, astronauts in trouble may also rely on “virtual clinics” on earth for in-depth medical assistance.

These technologies, presented at the June meeting of the American Telemedicine Association in Fort Lauderdale, FL, could also be used to help people on the ground in isolated places with no doctor nearby.

Smaller and Smarter

Researchers at Wyle Laboratories in Houston, TX, and NASA’s Johnson Space Center are developing smart versions of mechanical ventilators, IV pumps, vital-signs monitors and other therapeutic and diagnostic devices.

The new devices communicate through wireless connections and are smaller, lighter and more robust than existing ones, says George Beck, engineer and project leader for on-orbit critical care at Wyle.

They’re also smarter, in that they aren’t limited to recording a person’s condition but can also spit out a treatment plan so that the astronaut in space knows exactly what to do next.

As an additional safeguard, medical experts on earth can monitor the machines whenever communication lines to the Space Station are open.

To prepare the devices, researchers reviewed the gamut of medical problems that astronauts could encounter in space and then programmed appropriate medical protocols into the software.

As more people are flown into space for longer durations, the probability of in-flight medical problems increases, says Beck, looking ahead to the first manned mission to Mars, perhaps no more than 10 years away.

Virtual Collaborative Clinics

For serious medical emergencies in space, such as broken bones or even heart failure, researchers at the University of New Mexico have been evaluating telemedicine technologies that could connect experts at relevant medical centers to the Space Station and other locations.

Astronauts on the planned Mars mission, for example, could send medical information to a “virtual collaborative clinic” of experts on earth, says Dr. Dale Alverson, medical director of the Telehealth and Cybermedicine Research Center at the University of New Mexico.

Networked with high-speed broadband and satellite connections, clinic members would interactively review 3-D reconstructions of the data in real time “to determine the best procedural approach to managing that specific problem or injury,” Alverson says. A “virtual guide” to the treatment plan could then be transmitted back to the caregivers in space, providing images and instructions for the desired course of action.

This telemedicine technology should be especially useful when real-time voice communication becomes impractical or unreliable, adds the University of New Mexico’s Dr. Muriel Ross. On Mars, for example, voice signals to earth can take anywhere from four to 40 minutes to arrive, depending on the planet’s position in relation to earth.

CyberScalpel

At Ross’s previous position as director of the NASA Ames Center for Bioinformatics, she was already working to develop virtual-reality tools that could convey precious medical information to astronauts in space, as well as to physically dispersed medical practitioners on earth.

The CyberScalpel is an instrument developed at Ames that can be used to operate on 3-D simulations on a computer screen so that surgeons can test or rehearse procedures virtually “before carrying them out on the patient,” says Ross. The CyberScalpel cuts through images of human tissue “much like a knife cuts through food,” she adds.

If an astronaut were to suffer a fracture, for example, members of a virtual clinic could use the CyberScalpel to reconstruct the area of the fracture and display the remedial steps needed to reset the bone or otherwise repair it. Images from the virtual operation could be transmitted to the caregivers in space, either for rehearsal at the Space Station or for viewing as a guide during the actual procedure.

“The ideal is always to make everything so simple that someone can walk in off the street and use [it],” Ross says.

Earthly Use

The effectiveness of the virtual clinic was signaled in 1999 when five medical experts from places as far away as California and Ohio provided care to Navajo patients at Shiprock, a remote town in the desert of New Mexico. Treatment of an infant’s defective heart was demonstrated, along with other forms of cardiac surgery.

Participating physicians performed their procedures on 3-D reconstructions of a virtual patient while other doctors followed every move on computer screens at their respective locations.

Elsewhere on earth, virtual medicine has been used in the Arctic Circle, but Ross notes that a general lack of medical funding coupled with the high cost of broadband communications could slow its progress toward widespread availability.

Nevertheless, by 2011 or 2012, when astronauts are projected to blast off on the first manned mission to Mars, ultra-sensitive sensors and scanners capable of producing 3-D neuronal and anatomical images should be ready to accompany them. These sensors could be embedded in a T-shirt or perhaps in hand-held devices similar to Palm Pilots.

Moreover, computer tomography scans could be made of every astronaut before launch so that precise data representing the astronaut’s “before” condition could be brought to bear on any injury suffered in space.

It’s even possible, Ross says, that a robotic surgeon might one day assist the caregiver on missions to Mars or elsewhere.

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