Sickbay Considerations - No Bones About It

Palomar · 2002-08-28 11:43:31

*No Bones About It [double pun].

I've been thinking what the astronauts going to Mars MIGHT need in their sickbay [I'm not a nurse, btw; I'm a medical transcriptionist]:

A blood pressure cuff.

An ENT probe [can check eyes, ears, and oral temperature].

Splinting material [casting would be too difficult].

Knowledge of how to palpate for fractures.

Sharps [blood-drawing needles], tubes, a small centrifuge, and machine to read [at the very least] complete blood counts [including white count], hemoglobin and hematocrit, platelet count, etc.

Each astronaut will be trained to chart their medical care, according to accredited medical record standards [any pill of whatever kind taken from the pharmacy must be logged, every blood pressure reading must be logged, etc., in an orderly fashion, most-recent-date-last in order]. Each astronaut will have access to the medical chart of every other astronaut, in the event of an emergency [i.e. what is Astronaut L allergic to? What medicine has s/he recently taken, if any?, etc.]. However, it will be understood that the charts of others will ONLY be read in the event of a medical emergency/sickness/incapacitation of said crewmember.

Any and all items taken from the pharmacy store must be logged, dated, and signed for. A witness MUST accompany the person signing out meds, and must initial as well.

Besides prescribed [if any] medications for crew members, the pharmacy should contain: Anti-diarrheals, anti-constipation, and anti-emetic [vomiting] over-the-counter medications; fever-reducing/muscle-relaxing over-the-counter medications [such as Tylenol, Aleve, ibuprofen]. Prescription-strength pain killers should be included, including morphine and Tylenol with codeine. However, it will be understood that the morphine and like heavy-duty, addictive pain killers can only be accessed upon permission from a medical authority on Earth [if feasible], and all astronauts must sign/witness for the person to receive it [as it is a habit-forming drug, obviously]. If communications with Earth is thwarted for whatever reason [solar flare, whatever], proceed with all astronauts signing and witnessing for receipt of morphine [and the like] for an astronaut, and then relay this occurrence to Earth-based medical authority.

Just some ideas...I'll keep thinking...

--Cindy

turbo · 2002-08-28 12:39:02

Might I suggest an item for the Medical Section? It is referred to as "pink-eye powder". Composed of an antibiotic, an antiseptic, and an anesthetic (spell?) the powder comes inexpensively in large quanities. It is normally used to treat eye infections in cows, but has been known to be used on humans in emergency field conditions. With humans, a little bit of the stuff goes a very long way. I understand it also has a long shelf-life.

turbo, who remembers DMSO was made for horses

Josh Cryer · 2002-08-28 14:30:34

Cindy, bones wouldn't heal in space quickly, would they? You could break a bone and it wouldn't heal for a long time. You're screwed if you break a bone in zero G, as far as I know. I did a Google search (gotta love Google! ) and found this little bit from a Q&A about the ISS:

Bursch said that he didn't know for sure, but that his best guess was that bones heal differently in microgravity, and that the stress of gravity led to quicker healing for fractured bones. Bursch speculated that if one of the crew [of the ISS] should suffer a fracture, the doctors on the ground would prescribe some sort of stress on the bone to aid healing.

Seems logical, since bone density shrinks in zero G. I suspect it'd be hard to break a bone anyway.

But the rest of your ideas seem fine. One thing I would want is a remote doctor, to take my blood and have it completely analyzable by doctors on Earth.

turbo, problem number one, fine powders aren't good. They can get lose and scattered everywhere, breaking components. I suspect liquid eyedrops would be good, they aren't very difficult to apply, and the ventilation systems would take care of it if it got lose.

Adrian · 2002-08-28 18:02:28

I wonder what the data is for things like viral and bacterial infections in extended spaceflight. On the one hand, astronauts are kept in a clean and antiseptic environment before launch so they don't catch anything*, but on the other, you can only sterilise the inside of a rocket so much - bacteria is bound to stay there. So my real question is, on the ISS, Mir, Spacelab and other space stations, did colds, coughs and similar ailments occur more or less frequently than on Earth? And what implications does this have for stocking the sickbay?

*At least, this is what I used to think. I still believe that NASA practices this clean-astronaut policy, but I remember seeing that Russian cosmonauts will regularly stroll around without their helmets on right up until launch so that they could catch a cold or worse from random passers-by.

Palomar · 2002-08-29 10:08:35

Cindy, bones wouldn't heal in space quickly, would they? You could break a bone and it wouldn't heal for a long time. You're screwed if you break a bone in zero G, as far as I know. I did a Google search (gotta love Google! ) and found this little bit from a Q&A about the ISS:
Bursch said that he didn't know for sure, but that his best guess was that bones heal differently in microgravity, and that the stress of gravity led to quicker healing for fractured bones. Bursch speculated that if one of the crew [of the ISS] should suffer a fracture, the doctors on the ground would prescribe some sort of stress on the bone to aid healing.
Seems logical, since bone density shrinks in zero G. I suspect it'd be hard to break a bone anyway.
But the rest of your ideas seem fine. One thing I would want is a remote doctor, to take my blood and have it completely analyzable by doctors on Earth.
turbo, problem number one, fine powders aren't good. They can get lose and scattered everywhere, breaking components. I suspect liquid eyedrops would be good, they aren't very difficult to apply, and the ventilation systems would take care of it if it got lose.

*Josh: I doubt bones would heal quickly in space; however, I agree that it'd probably be hard to break one anyway -- the probability of this occurring is higher on Mars itself [where there's some gravity].

The astronauts will probably never encounter a fracture [I hope], but it'd be wise for them to learn how to recognize signs of it, including palpable signs.

Turbo: I'm not familiar with the powder you've mentioned. Do you have the brand name for it?

--Cindy

Palomar · 2002-08-29 10:20:29

*In the event of dehydration [say, induced by severe vomiting which anti-emetics won't relieve], an electrolyte-rich powdered drink mix should be included. I don't think the other alternative to rapid rehydration -- intravenous saline solution -- is a good idea because intravenous lines can be difficult to start [blood gets backed up into the needle and/or line, a good vein may be difficult to access] and saline solution, being water-based, is heavy.

If a separate sickbay area is not created in the hab [yes, I realize space is at a premium in it], one of the astronaut's quarters should be designated as Sickbay in the event someone becomes delirious or psychotic, and needs to be restrained [the astronaut put out of his/her own room, now Sickbay, would move to the ailing member's quarters], or if a minor surgery needs to be performed [I can only imagine that port procedures could be carried out, i.e. supposing an astronaut develops a fluid-filled cyst beneath the abdominal muscles, and requires local anesthesia and drainage via a small incision with a probe and suction].

A Gigli saw, tourniquet, and antibiotics should be included, in the event [I hope NOT] that an astronaut requires amputation of a limb or digit, in the event of some terrible injury [severe burn, crush injury, etc.].

Anesthetics will need to be provided; however, it'd be best to avoid total anesthesia as anytime a person is put "completely under" there is a very real chance they will not come out of the anesthesia -- and in operating rooms, an anesthesiologist [M.D.] is *always* present during the procedure. Any anesthesia use should be limited to local, if possible.

Sorry to sound so morbid, but when you're that far away from home...

--Cindy

turbo · 2002-08-29 12:08:42

I don't recall ever hearing any brand names for the pink-eye powder. The stuff is so common. Anybody heading near a grain & feed store soon?

Uh, Gigli saw, is that the diamond-tipped whirly-gig used during autopsies?

turbo, who will eventually find a signature quote I like.

Palomar · 2002-08-29 12:17:16

I don't recall ever hearing any brand names for the pink-eye powder. The stuff is so common. Anybody heading near a grain & feed store soon?
Uh, Gigli saw, is that the diamond-tipped whirly-gig used during autopsies?
turbo, who will eventually find a signature quote I like.

*I haven't been in a grain and feed store in years. Sorry.

A Gigli saw is a hand-held saw which is sharp as a scalpel. It can very quickly cut through bones.

--Cindy

Palomar · 2003-07-19 11:12:56

*I thought I'd revive this old thread, as medical-related topics have surfaced again at these boards. Take from it what you will. We had some really great discussions in the summer and autumn of 2002...digging around in the old threads might yield up unexpected treasures from many members!

--Cindy

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#1 2002-08-28 11:43:31

Re: Sickbay Considerations - No Bones About It

#2 2002-08-28 12:39:02

Re: Sickbay Considerations - No Bones About It

#3 2002-08-28 14:30:34

Re: Sickbay Considerations - No Bones About It

#4 2002-08-28 18:02:28

Re: Sickbay Considerations - No Bones About It

#5 2002-08-29 10:08:35

Re: Sickbay Considerations - No Bones About It

#6 2002-08-29 10:20:29

Re: Sickbay Considerations - No Bones About It

#7 2002-08-29 12:08:42

Re: Sickbay Considerations - No Bones About It

#8 2002-08-29 12:17:16

Re: Sickbay Considerations - No Bones About It

#9 2003-07-19 11:12:56

Re: Sickbay Considerations - No Bones About It

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