Telecommunications systems in support of disaster medicine: applications of basic information pathways.

Disaster events have always been a fact of life. Success or failure of a disaster response is often determined by timely access to communication and reliable information. The rapid progress and future course in telecommunications indicate that lack of communications need no longer be the paralyzing factor in a disaster scenario. This is especially important for medical response where time is of essence to save lives. This article explores various telecommunications tools that can enhance medical response in a disaster and includes those associated with telemedicine (providing medical care from a distance through telecommunications). Disaster telemedicine systems need not be special or sophisticated-the challenge is to match the right systems with a given disaster plan or scenario. A brief history of telemedicine use for disaster relief and humanitarian assistance is presented together with a discussion of advantages, disadvantages, and near-future potential of telecommunication systems to gain a better perspective of which tools might best fit disaster medicine needs today and into the new millennium.

Applications of telemedicine and telecommunications to disaster medicine: historical and future perspectives.

Disaster management utilizes diverse technologies to accomplish a complex set of tasks. Despite a decade of experience, few published reports have reviewed application of telemedicine (clinical care at a distance enabled by telecommunication) in disaster situations. Appropriate new telemedicine applications can improve future disaster medicine outcomes, based on lessons learned from a decade of civilian and military disaster (wide-area) telemedicine deployments. This manuscript reviews the history of telemedicine activities in actual disasters and similar scenarios as well as ongoing telemedicine innovations that may be applicable to disaster situations. Emergency care providers must begin to plan effectively to utilize disaster-specific telemedicine applications to improve future outcomes.

A preliminary comparison of two perennially ice-covered lakes in Antarctica: analogs of past Martian lacustrine environments.

Perennially ice-covered lakes in the Antarctic have been suggested as analogs to lakes which may have existed on the surface of Mars 3.5 billion years ago. During the 1991-1992 austral summer, a joint Russian/American research effort was directed at studies of ice-covered lakes in the Bunger Hills Oasis, Antarctica (66 degrees S, 100 degrees E). The primary objective of the expedition was to investigate this ice-free area for features analogous to ancient martian environments that may have been capable of supporting life and to compare the ice-covered lakes of the Bunger Hills with those in the McMurdo Dry Valleys of southern Victoria Land (77 degrees S, 166 degrees E) as part of the continuing studies of Antarctic-Mars analogs.

The lunar environment as a fractional-gravity biological laboratory.

A quarter of a century ago men stepped upon the lunar surface and established the possibility of human expansion beyond Earth. When humans return to the moon to occupy it with greater permanency, an applied lunar biological laboratory would provide a means of conducting experiments on the long-term effects of fractional gravity in animals and plants and provide necessary data to enhance the health, safety and well-being of lunar workers and inhabitants. In-depth studies can go beyond zero-g observations, on-orbit centrifuge studies, and ground-based research providing important insight into continuous 1/6-g effects on biological systems. Studies concentrating on development, gravity sensing, and adaptation/readaptation would provide preliminary data on whether long-term fractional gravity is detrimental or compromising to fundamental biological function. Food production research in 1/6-g would provide important information for on site application to improve the yield and quality of food (animal and plant) produced in the unique lunar environment. The purpose of this paper is to discuss some examples of the major gravitational biology areas that could be studied on the moon and applied to lunar population needs utilizing lunar biological facilities and continuous fractional gravity.

Applications of space communications technology to critical human needs: rescue, disaster relief, and remote medical assistance.

The applications of space communications technology to various critical human needs are discussed. Satellite communications, telemetry, and biotelemetry have provided timely and crucial communications capabilities over remote distances. The use of satellite/beacon systems have been used for disaster relief as well as search and rescue operations. The combination of telemetry and electronic medical systems (telemedicine) have augmented existing health care delivery and have provided consultation links between remotely located health care specialists working with patients and physicians at a central location. This has been expanded into networks to respond to victims of disasters in need of critical medical assistance with the hope that with further work, telemedicine may become available to all nations through an international network.

Earth benefits from space life sciences.

Contributions of space exploration which are widely recognized are those dealing with the impact of space technology on public health and medical services in both urban and remote rural areas. Telecommunications, image enhancement, 3-dimensional image reconstructions, miniaturization, automation, and data analysis, have transformed the delivery of medical care and have brought about a new impetus to the field of biomedicine. Many areas of medical care and biological research have been affected. These include technological breakthroughs in such areas as: (1) diagnosis, treatment, and prevention of cardiovascular diseases, (2) new approaches to the understanding of osteoporosis, (3) early detection of genetic birth defects, (4) emergency medical care, and (5) treatment of chronic metabolic disorders. These are but a few examples where technology originally developed to support space medicine or space research has been applied to solving medical and health care delivery problems on Earth.

Space medicine comes down to Earth.

Over the years innovative technologies developed for space flight have found their way into a variety of useful terrestrial applications. Significant examples can be found in the area of space medicine, which has greatly influenced human health care delivery on Earth. This report discusses several US applications of space medicine to terrestrial health needs and services, stressing the importance of a 'space applications mentality' as a valuable national asset.

Crucial factor: human. Safely extending the human presence in space.

The concept of advanced manned space missions has captured the interest and imagination of spacefaring nations. However, the physiological and psychological effects of space flight increase in magnitude and significance in the 'extended time-in-space' context. The unencumbered weightless condition enjoyed during short flights might compromise crew productivity upon return to a gravity field and extremely effective countermeasures may be essential. Missions remote from Earth require careful consideration of the medical facilities, psychological support and life support needed. The author discusses pressing issues that must be resolved before the visions of bolder human missions can be realistically fulfilled.

Soviet space flight: the human element.

Building on past experience and knowledge, the Soviet manned space flight effort has become broad, comprehensive, and forward-looking. Their long-running space station program has provided the capabilities to investigate long-term effects of microgravity on human physiology and behavior, and test various countermeasures against microgravity-induced physiological deconditioning. Since the beginning of Soviet manned space flight, the biomedical training and preparation of cosmonauts has evolved from a process that increased human tolerance to space flight factors, to a system of interrelated measures to prepare cosmonauts physically and psychologically to live and work in space. Currently, the Soviet Union is constructing a multimodular space station, the Mir. With the emergence of dedicated laboratory modules, the Soviets have begun the transition from small-scale experimental research to large-scale production activities and specialized scientific work in space. In the future, additional laboratory modules will be added, including one dedicated to biomedical research, called the "Medilab." The longest manned space flight to date (326 d) has been completed by the Soviets. The biomedical effects of previous long-duration flights, and perhaps those of still greater length, may contribute important insight into the possibility of extended missions beyond Earth, such as a voyage to Mars.

Soviet space flight: the human element.

Building on past experience and knowledge, the Soviet manned space flight effort has become broad, comprehensive, and forward-looking. Their long-running space station program has provided the capabilities to investigate long-term effects of microgravity on human physiology and behavior and test various countermeasures against microgravity-induced physiological deconditioning. Since the beginning of Soviet manned space flight, the biomedical training and preparation of cosmonauts has evolved from a process that increased human tolerance to space flight factors, to a system of interrelated measures to prepare cosmonauts physically and psychologically to live and work in space. Currently, the Soviet Union is constructing a multimodular space station, the Mir. With the emergence of dedicated laboratory modules, the Soviets have begun the transition from small-scale experimental research to large-scale production activities and specialized scientific work in space. In the future, additional laboratory modules will be added, including one dedicated to biomedical research, called the "Medilab." The longest manned space flight to date (326 days) has been completed by the Soviets. The biomedical effects of previous long-duration flights, and perhaps those of still greater length, may contribute important insight ito the possibility of extended missions beyond Earth, such as a voyage to Mars.