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Arctic simulations prepare scientists for space medical emergencies

Haughton MArs Project

It's isolated and barren, accessible by plane for only a short window of time each summer. But for scientists exploring the frontiers of space-based telemedicine, Nunavut's Devon Island is about as ideal a spot as any on Earth.

That's why researchers from McMaster University are spending the next 10 days or so on the Arctic island, running a series of simulated medical emergencies and testing telecommunications systems that will link them up with doctors thousands of kilometres away.

At the heart of the project is a robotic patient used by McMaster's Centre for Simulation-Based Learning to teach medical grads and nursing students how to deal with emergency medical conditions without putting real patients at risk.

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"They look like department store mannequins, but they breathe and they talk," said program director Dave Musson, who is conducting the study with two grad students on Devon Island.

"We can speak to them, you can do CPR on these guys, you can defibrillate them, they produce heart rhythms, they have pulses. So they basically are a model of somebody lying in bed who's extremely sick."

The plan is to have other scientists with basic medical training also working at the site - the Haughton-Mars Project Research Base - to respond to simulated medical emergencies under the guidance of physicians at McMaster in Hamilton, in Toronto and at other points around the globe, he said.

"We'll do a series of these simulations and we'll beam them back down to several sites," Dr. Musson said. "We've done some of this stuff at McMaster, going from room to room or building to building and we recognize certain limitations in what you can and can't do."

On Wednesday, the team did its first run-through with "Sim Man" - a severe trauma involving a multiple limb amputation after a simulated polar bear attack, "in keeping with the spirit of the environment," Dr. Musson said from Devon Island.

"And we resuscitated him by intubating him and doing CPR and filling him full of fluids again. And we defibrillated his heart after it stopped, and we tried to stop his bleeding and we ran some blood products in," he said.

"Miraculously we managed to save him."

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Dr. Musson said in the next couple of days they will do another simulation, but this time linked electronically to doctors down south.

Dealing with blood-and-guts emergency scenarios with the robot as a stand-in will allow the team to test the setup in-situ - basically a bunch of tents, where geologists and other scientists from NASA, the European Space Agency and universities carry out studies for about six weeks each summer.

"Because if you don't do it through simulation, you have to wait until somebody actually gets attacked by a polar bear or has a heart attack," he said.

The immediate goal of the project, funded by the Canadian Space Agency, is to prove the concept can work in isolated locales, such as northern communities. But it is also setting the groundwork for the longer-term goal of providing medical help for space mission crews.

"We know you do a lot of telemedicine on the space station, we know that telemedicine is going to be a big deal on the moon and we know in Canada we have a huge need for telemedicine through all the northern communities that are fairly remote," Dr. Musson said.

"So if somebody has a major medical event on the space station … [the idea is to be]in full contact with Earth and resources on the ground, to hope the system supports you through the event."

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Alain Berinstain of the Canadian Space Agency said Devon Island is ideal for a dry run of the system. In many ways, it even resembles the moon's surface because of a massive, well-preserved crater likely left when a meteorite punched into the surface an estimated 20 million to 30 million years ago, he said.

It simulates some aspects of the space environment, said the CSA's Montreal-based director of planetary exploration and space astronomy.

"Because there's already a group there doing work and they need medical support to be able to do their work - and there are techniques being developed for supporting medical attention to astronauts in space - you can start to test in remote locations here on Earth," he said.

"So this is a remote location where there are some space scientists … and they can be used a little bit as guinea pigs for being able to work out ways you could support crew or astronauts eventually in a remote way."

Dr. Musson said residents of northern communities need telemedicine capabilities for such emergencies as severe frostbite, heart attacks, motor vehicle trauma, gunshot wounds and life-threatening allergic reactions from foods and insect bites.

"In space you would worry about some of these things. You do worry about anaphylaxis in space, although it's less likely. You do worry about smoke inhalation (from on-board fires) and the resulting asthmatic-type attack."

Other hazards include a puncture in a space suit or spacecraft that could cause decompression sickness, similar to that experienced by deep-sea divers.

There is also the chance of serious crush injuries from heavy equipment.

"You don't have gravity and you don't have vehicles and you don't have guns, which are the cause of a lot of trauma on Earth. But you do have micrometeorites and meteorites, so you do have rocks hurling past the space station at several thousand miles an hour. You do have large pieces of equipment docking, so you do worry about people getting small crush injuries."

Depending on the severity of the condition, that could mean a hasty retreat to Earth. But with the time needed for travel - the International Space Station is about eight hours away and the moon four to five days - crew would need telemedical support to care for an ill or injured astronaut until touchdown at home.

Preparing for that is what the next 10 to 14 days will be all about, Dr. Musson said, with the $35,000 Sim Man being put through his paces. (The robot can become Sim Woman by swapping genitals, which doctors have dubbed Sim Bits.) "Our main objective for this summer is just to see that we can do it, make sure the equipment works, make sure the simulator can handle the conditions and see if we can do what we think we can do," Dr. Musson said.

It will also let researchers assess the skills of people on both ends of the linkup, to see how long in real time it takes to manage a particular emergency and to evaluate whether the telemedicine connection being tested has the right stuff, he said.

"Otherwise, it's completely theoretical."

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