CPR in space is possible, maybe

Last summer I wrote about the many problems associated with performing surgery in outer space. [Link here.]  Not surprisingly, I was highly skeptical about such issues as training astronauts to operate on each other and the difficulties in taking along enough supplies to deal with unexpected trauma and surgical diseases.

At least one commentor on that post felt that NASA had all the answers. But another said, “What NASA never wants to discuss publicly is the scenario: If X happens then you die.”

Not to be outdone, the European Space Agency recently released a YouTube video illustrating how cardiopulmonary resuscitation could be carried out in a weightless environment.



You can see that the technique is rather awkward and questionably effective. To my knowledge, the rescuer falling on the victim is not currently recommended in the latest CPR guidelines.

Assuming that by some miracle the victim survives CPR, what would happen to him? Would he be transferred to the intensive care unit on the spaceship? Would there be a ventilator? What about an endotracheal tube and someone to insert it? Who would monitor the patient? Would that person be subject to work hours limits?

Here’s what I think.

If you have a cardiac arrest on the way to Mars, you’re not only in deep space, you’re in deep doodoo.

Surgery in space: I foresee problems.

The astronauts are halfway to Mars when suddenly one of them develops abdominal pain and requires surgery. What will they do?

According to NASA, a miniature robot capable of assisting in surgery has been developed, tested in pigs, and is soon to be trialed in a weightless environment. The robot, which weighs less than 1 pound, can be inserted into the abdomen via the umbilicus and controlled remotely.

The press release from NASA said types of operations that the robot would be capable of performing were "emergency appendectomies, emergency cholecystectomies, emergency perforation of gastric ulcers [sic], and intra-abdominal bleeding due to trauma." NASA meant to say "repair of perforated gastric ulcers." Not surprisingly, many science reporters for media outlets, for example, SFGate and WiredUK, did not notice the error. New Scientist also missed it, but at least published a later correction.

However, even the famous da Vinci robot is incapable of performing surgery on its own.

The original idea was that a surgeon on the ground would direct the robot's movements, but that will not be possible for two reasons. In deep space, the time lag between the earthbound surgeon's actions and the robot's response would be too long, and a recent article about remote-controlled drone crashes highlighted the problems that can occur when links are lost or computers malfunction.

The plan is to train the astronauts to perform minimally invasive robotic surgery on each other. What could go wrong?

A lot.