Since the year 2000, not all living humans have resided on Earth — the International Space Station, or ISS, has been continually occupied since then. At any given time, there are six to seven crew members aboard the ISS.

Supporting astronauts in orbit can be a real challenge, especially when it comes to space medicine. It’s not like there’s a hospital in orbit, and there certainly aren’t doctors on every mission. What happens when an astronaut finds themselves getting sick in space? How does NASA manage the medical care of its astronauts?

How Are Astronauts Trained for Space-Based Medicine?

For the most part, NASA uses telemedicine to handle an astronaut’s health and sickness. But astronauts also have to do their part. Before launch, as a routine part of training, astronauts learn about all the medical devices aboard the ISS. Because there’s neither room nor bandwidth to keep a medical doctor in space at all times, crews will have a designated medical officer. That person undergoes 40 hours of paramedic-level training to ensure they’re ready to deal with any emergencies that may come up.

Extended exposure to microgravity can have serious health consequences, especially once astronauts return to Earth. Alongside their mission training, astronauts undergo demanding physical training to ensure their bodies can endure the harsh conditions they’ll face. In essence, they need to be built up enough to have room to deteriorate during long duration missions. Astronauts also perform rigorous fitness routines during their missions, spending around two hours a day exercising so they’re healthy enough to handle anything that may come their way. By focusing on preventative care, NASA avoids many medical emergencies in space that could occur.

How Does NASA Monitor Astronauts’ Health?

NASA keeps close track on astronauts’ health on the ground, thanks to the flight surgeon. This specialist in aerospace medicine is assigned to each crew while they’re still on the ground. They oversee their exercise regimen and medical training, and build trust with the astronauts that’s crucial to managing their health when they’re finally in flight.

Dealing with getting sick in space requires open, honest communication between the astronauts and flight surgeon. Each week, the astronauts have a private medical conference with the flight surgeon. This information is held in confidence unless it’s something that could affect the mission. NASA also collects biometric data, results of ultrasounds and more to gain a full understanding of an astronaut’s health during a mission.

Have There Ever Been Medical Emergencies in Space?

Of course, all of the preventative care in the world can’t prevent every single medical emergency. Thankfully, there have been few true medical emergencies in space so far. But they have occurred on occasion.

A recent scare involved an astronaut who found a blood clot in their neck — called deep vein thrombosis. The identity of the astronaut and when, precisely, the incident occurred haven’t been released to maintain medical privacy, but we do know they were two months into a six-month mission when it happened.

The clot was identified thanks to the routine ultrasounds the crew give each other to monitor health. There were no external symptoms. NASA had no procedure at the time for treating a blood clot in space.

A 2020 article in The New England Journal of Medicine dives into the issue. NASA brought in a blood clot expert to talk through options for treatment. The doctor prescribed a blood thinner, but there was a limited amount available on the ISS. They worked with the astronauts to determine how to ration the drug until more could be sent on a resupply mission. It worked — the astronaut didn’t require any further treatment for the clot once they returned to Earth.

Astronaut healthcare is a huge concern, and will become even more important as missions get longer and further away from Earth. That’s probably why one of the most recent astronaut candidates, Anil Menon, is a former NASA flight surgeon — having a doctor on a mission to Mars to care for the crew seems like a smart idea.

Interested in all things in outer space and exploration? We are, too. Take a look at open positions at Northrop Grumman and consider joining our team.