Cermack M
International Space University, Central Campus, 67400 Illkirch-Strasbourg, France.
Br J Anaesth. 2006 Jul;97(1):107-14. doi: 10.1093/bja/ael132. Epub 2006 May 26.
The common features of remote environments are geographical separation, logistic problems with health care delivery and with patient retrieval, extreme natural conditions, artificial environment, or combination of all. The exposure can have adverse effects on patients' physiology, on care providers' performance and on hardware functionality. The time to definite treatment may vary between hours as in orbital space flight, days for remote exploratory camp, weeks for polar bases and months to years for interplanetary exploration. The generic system architecture, used in any telematic support, consists of data acquisition, data-processing and storage, telecommunications links, decision-making facilities and the means of command execution. At the present level of technology, a simple data transfer and two-way voice communication could be established from any place on the earth, but the current use of mobile communication technologies for telemedicine applications is still low, either for logistic, economic and political reasons, or because of limited knowledge about the available technology and procedures. Criteria for selection of portable telemedicine terminals in remote terrestrial places, characteristics of currently available mobile telecommunication systems, and the concept of integrated monitoring of physiological and environmental parameters are mentioned in the first section of this paper. The second part describes some aspects of emergency medical support in human orbital spaceflight, the limits of telemedicine support in near-Earth space environment and mentions some open issues related to long-term exploratory missions beyond the low Earth orbit.
偏远环境的共同特点是地理隔离、医疗服务和患者转运方面的后勤问题、极端自然条件、人工环境或上述所有因素的组合。这种暴露可能会对患者的生理状况、医护人员的表现以及硬件功能产生不利影响。明确治疗的时间在不同情况下有所不同，如在轨道太空飞行中为数小时，在偏远勘探营地为数天，在极地基地为数周，而在星际探索中则为数月至数年。任何远程信息支持中使用的通用系统架构包括数据采集、数据处理与存储、电信链路、决策设施以及命令执行手段。在当前技术水平下，可以从地球上的任何地方建立简单的数据传输和双向语音通信，但由于后勤、经济和政治原因，或者由于对可用技术和程序的了解有限，目前移动通信技术在远程医疗应用中的使用率仍然较低。本文第一部分提到了在偏远陆地地区选择便携式远程医疗终端的标准、当前可用移动通信系统的特点以及生理和环境参数综合监测的概念。第二部分描述了人类轨道太空飞行中紧急医疗支持的一些方面、近地空间环境中远程医疗支持的局限性，并提及了与低地球轨道以外的长期探索任务相关的一些未解决问题。
