Experiment Objectives
Statistically, every 2.4 years there will be a medical emergency onboard a space vehicle requiring the use of the onboard medical equipment, and, extrapolating crew time on the fully operational International Space Station, an astronaut will need to be evacuated back to Earth for a medical reason every 5 years. Although so far only two incidents have been reported, as flight times are extended, the chances increase that an emergency that necessitates appropriate airway management will occur, e.g. during a cardiac arrest, decompression events involving decompression sickness or others.
Some experiments have been carried out with respect to Cardio Pulmonary Resuscitation (CPR) under microgravity conditions using animals or CPR manikins, both on parabolic flights and neutral buoyancy conditions. Opposed to classical endotracheal intubation, the laryngeal mask (LMA) is a relatively new tool for securing airways to patients in emergency medical environments. This method, compared to the laryngoscopically guided endotracheal intubation, is relatively easy to use and, in addition, allows for a better ergonomic positioning of the patient. This easiness of use is especially relevant when taking into account that due to crew size constraints, medical doctors are not always available for on-site interventions, therefore, trained personnel will have to carry out the first treatment under strict procedural guidelines.
The experiment is designed to validate this intubation method (LMA) compared to other airway management strategies (endotracheal intubation). The reason for using a partially inexperienced team is that also most astronauts undergo a basic medical training similar to the training foreseen for the test subjects.
The ADAMA team training on the manikin
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We propose a series of airway-management experiments to be carried out during a parabolic flight campaign. Four experimenters without anaesthesiological background are to be trained in airway management and shall test the laryngeal mask airway management under neutral buoyancy and microgravity conditions on a modified cardio-pulmonary resuscitation manikin. As during extended space missions, patient treatment will also be provided by healthcare non-professionals, the equipment and procedures have to be as fail-safe as possible, especially when it comes to airway management which is both time critical and requires substantial training.
The proposed experiment will provide new insights into the training of medical personnel with varying degrees of medical backgrounds for extreme environments. We expect that it will also provide new insights into the usage of LMA's on a real patient (handling/procedures and airway management in general). The field of applications is wide, as it will benefit advanced medical safety onboard long-term space sojourns (e.g. the ISS or a crewed expedition to Mars...).
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