Aside from the treatment they can provide on the station, itself, they can have someone in a hospital on the ground in a couple of hours, max, if need be. The ISS orbits the Earth every 90 minutes, give or take a minute or two, and an emergency re-entry only takes a half-hour or so. There’s always at least one capsule docked at the station, so worst-case scenario NASA calculates where and when to undock the capsule, orient for re-entry, and the timing and duration of the retro-burn. They’ll then know within a couple of square miles where the capsule is going to come down (they can’t *quite* put it in a swimming pool, but they can certainly drop it in a lake if they have to), and have emergency medical services ready to swoop in and fly the patient to the nearest hospital. Depending on how much fuel the capsule has to burn, they can almost ensure the astronaut goes to any hospital in the world.
They’ve never *had* to do it, but you can bet they’re ready to do so if they need to.
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