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1. Extraterrestrial Telemedicine
Kolkata India
September 2014
Ronald Merrell, MD, FACS
Emeritus Professor of Surgery
Virginia Commonwealth University
Richmond, Virginia
6. Human Space Flight
• 536 people. 38 countries. Kalpana Chawla
2003, Rakesh Sharma 1984 from India
• First Yuri Gagarin 4/12/61 0ne hour 48
minutes
• Valery Polyokov MIR 437 days 18 hours
• 2015 routine stays of one year.
7. International Space Station
• Continuous human occupation since 2000
• 419,455kg. Habitable volume 388 meter
sq. pressurized volume same as Boeing
777
• Solar array 73 meter sq. 84 kilowatts
• Orbit about every 93 minutes. Velocity
27,600 km/h
• Usual gas tensions, one atmosphere
pressure
12. Health Risks for Exploration
• Radiation. Low earth orbit as opposed to deep
space beyond the van Allen Belt
• Bone mineral loss
• Visual problems
• Deconditioning
• Pharmacokinetics
• Neurovestibular and autonomic adaptation
• Behavioral issues
• INJURY. Work related and MMOD
• INTERCURRENT ILLNESS
17. Health Maintenance
• Monitor
• Daily Health Interview
• Countermeasures
• Return to earth. Not really
• Early intervention. No crew physician!
• Semiautonomous telemedicine
18.
19. A Problem of Time: long
distance travel
• Mars apogee 54,000,000 km. perigee
401,000,000km
• Therefore telcom at speed of light average
28 minutes round trip. Max 44 minutes.
• Travel time 150 to 300 days each way.
• No possibility to return or even for robotic
intervention.
20. Imhotep
Designed Step pyramid at Saqqara
2630-2611 BCE
Author of the Edwin Smith Papyrus
"Thou should say concerning him [the
patient] . . ."
1. An ailment which I will treat.
2. An ailment with which I will contend.
3. An ailment not to be treated.
21.
22. Semiautonomous Medical Care
In long distance space travel real time
or synchronous health management is
not feasible. Return to earth for health
issues is not feasible either. The
inspiring safety record of space
medicine is about to be challenged and
cannot be sustained with optimism and
anecdote.
23. Tools
• Physiologic Sensors
• Software for data including analysis and
prompts
• Video
• Ultrasound
• Evolving surgical capability
24.
25. Conclusions
•Telemedicine as telemetry was defined in the needs for space travel
•Extraterrestrial medicine has been evolving for over 50 years
•Space medicine has been remarkably successful win identifying and
mitigating risk
•The challenges of medicine in space offers many opportunities to
solve probl4emjs of patients in remote and isolated areas. And for
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