From Space to Earth: adapting astronaut medical strategies for emergency and disaster management

Contributed by Dr. Ekaterina Kostioukhina

The same medical innovations that keep astronauts alive in space are revolutionizing emergency medicine, telemedicine, trauma care, and psychological resilience on Earth. In space, survival hinges on adaptability, resourcefulness, and advanced technology, qualities just as crucial in disaster zones, remote areas, and conflict regions. Space Medicine for Earthlings, a virtual series by Australia in Space, convened top experts to discuss how these breakthroughs are shaping crisis and disaster response on our planet.

Dr. Josef Schmid: Telemedicine, Holoportation, and AI for Crisis Response

NASA Flight Surgeon and Orion Medical Operations Lead Dr. Schmid emphasized how telemedicine and AI-assisted diagnostics are transforming both space and terrestrial medicine. Astronauts must function autonomously with limited medical support, mirroring the constraints in remote or conflict settings where immediate healthcare is scarce.

Communication delays present a major obstacle in space medicine, making real-time specialist consultations difficult. This challenge parallels field hospitals in war zones or isolated disaster sites, where connectivity may be limited. To overcome these barriers, AI-driven decision support systems can guide non-medical personnel through complex procedures when experts are unreachable. Originally designed for deep-space missions, AI-assisted triage can also speed up data processing to prioritize patient care in mass casualty events. Building on telemedicine, holoportation using augmented reality can place medical experts virtually in crisis situations. Specialists could offer real-time guidance to field medics as though physically present, extending high-level care into challenging environments.

Dr. Ekaterina Kostioukhina: Human Hibernation for Trauma and Survival

Physician and human hibernation researcher Dr. Kostioukhina explored how inducing hypometabolic states could transform trauma care. Though once the domain of science fiction, hibernation research is rapidly advancing with potential for disaster response and survival in extreme scenarios.

One promising approach is extending the “golden hour,” the brief period after severe injury that can determine survival. By lowering metabolic demands, teams buy time for transport and definitive care, even when oxygen or advanced treatment is delayed by environmental challenges. Another emerging application is “suspended animation” for organ failure or severe infections, allowing patients to remain stable until higher-level care is available and reducing mortality in large-scale emergencies. In parallel, emerging organ preservation techniques employ similar methods to keep donor organs viable longer, boosting transplant success rates when supply is limited and time is critical.

Dr. Shawna Pandya: Women’s Health and Space Medicine in Disaster Response

Commercial astronaut candidate and Space Medicine Group Director Dr. Pandya highlighted the importance of gender-specific research. Historically, space medicine data has focused on male astronauts, leaving knowledge gaps in how female physiology reacts to radiation, microgravity, and prolonged isolation, gaps mirrored in many disaster protocols.

Menstrual health is a key concern. Female astronauts often choose menstrual suppression during missions, but more research is needed to understand how hormonal changes affect resilience and medication efficacy in stressful, isolated conditions. Pharmacological stability is another issue: on extended space missions, 60–98% of medications could degrade due to radiation and microgravity. These findings are directly relevant to disaster medicine, where disrupted supply chains and extreme temperatures can compromise drug quality.

Dr. Vladimir Ivkovic: Physiological Monitoring and Psychological Resilience

Dr. Ivkovic from Massachusetts General Hospital and Harvard Medical School focused on space-developed physiological monitoring, originally for astronauts, now aiding high-risk professionals like firefighters, soldiers, and first responders. Wearable brain imaging and physiological monitors track stress, cognitive function, and autonomic responses in real time, helping teams maintain optimal performance under extreme pressure.

By detecting early signs of cognitive fatigue or psychological distress, these tools enable timely interventions that improve decision-making. Beyond emergency operations, such monitoring can benefit disaster survivors with limited access to mental health services. Adapted from astronaut well-being programs, portable systems can measure stress levels in displaced individuals, informing targeted support and aiding long-term recovery.

Translating Space Medicine to Crisis and Disaster Management

In space, the hostile environment itself demands crisis management. Every aspect of care must account for isolation, limited resources, and delayed support. This expertise is now reshaping emergency response on Earth, with experts highlighting these priorities:

• Expand Telemedicine Networks: AI-enhanced diagnostics and holoportation can bring expert guidance to disaster teams wherever needed.

• Develop Hypometabolic Protocols for Trauma: Research on metabolic suspension could extend survival during transport and in resource-scarce zones.

• Implement Physiological Monitoring for First Responders: Wearable devices tracking cognitive and stress indicators help optimize performance and safety.

• Improve Medication Storage and Stability: Insights on drug degradation in space can inform best practices for crisis settings with harsh conditions.

• Enhance Psychological Resilience: Mental health protocols for astronaut isolation can be adapted for survivors and frontline workers in disasters.

Space medicine is no longer confined to orbit, it is shaping the future of crisis response on Earth. The lessons learned from safeguarding astronauts are fueling innovations that improve survival, healthcare access, and overall crisis management in some of the most challenging places on our planet.

Disclaimer: Each panelist's views are their own and do not represent the institutions or organizations they are affiliated with.