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.
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