Extraterrestrial CPR and its applications in terrestrial medicine

Christina Mackaill, Lucas REHNBERG, Elliot Brown, Thais Russomano

Research output: Contribution to conference typesAbstractpeer-review


BACKGROUND: Cardiopulmonary resuscitation (CPR) is a well-known method used in
cardiac arrest, aiming to achieve the return of spontaneous circulation (ROSC). Several CPR
methods have been trialled in environments simulating microgravity and hypogravity.
Although the chances of a cardiac arrest in space are low, there is a possible increased risk
in longer microgravity exposures, less screening medical criteria for commercial space flight,
and during a trip to Mars. Therefore, a well-defined CPR protocol for both microgravity and
hypogravity is necessary to avoid a potentially fatal incident.
OVERVIEW: There are currently three proposed methods for both CPR in microgravity
(Handstand (HS), Reverse Bear-Hug (RBH) and Evetts-Russomano (ER)) and two for
hypogravity (Terrestrial, SeAL and Mackaill-Russomano (MR)). When comparing these
methods against 2015 Resuscitation Council guidelines, some would appear to be more
effective at achieving ROSC than others, especially when they are applied in microgravity or
hypogravity. These methods are yet to be combined with airway management to establish
an effective extra-terrestrial CPR protocol, as well as be evaluated in environments with
sustained microgravity and hypogravity.
DISCUSSION: The efficacy of extra-terrestrial CPR methods may be influenced by training
and rescuer’s size and weight, which must be taken into account for the establishment of an
efficient protocol. In hypogravity, the MR method may be more applicable to lighter space
travellers, as it adds more stability to the rescuer. In microgravity, the HS method may be
more applicable to taller crewmembers, who can push their legs against the spacecraft
ceiling. By studying extra-terrestrial CPR, we can learn about CPR on Earth in relation to the
impact of size and weight differences between rescuers and patients. If a child or weaker
adult performing CPR on a patient in an out of hospital cardiac arrest adopts the MR
method, it may increase stability of the rescuer, improving the CPR outcome. Similarly, a
lighter or weaker health-care professional performing CPR on a larger patient, especially in
the presence of a lung disease that increases chest diameter, must flex and extend elbows
to compensate for the lack of weight between themselves and the patient. This will improve
the effectiveness of CPR by increasing the depth of chest compressions, as it has been
shown in studies conducted in microgravity and hypogravity simulations.
Original languageEnglish
Publication statusPublished - 5 May 2019
EventAerospace Medical Association Annual Scientific Meeting 2019 - Rio All-Suites Hotel And Casino, Las Vegas, United States
Duration: 5 May 20199 May 2019


ConferenceAerospace Medical Association Annual Scientific Meeting 2019
Abbreviated titleAsMA 2019
Country/TerritoryUnited States
CityLas Vegas


  • extraterrestrial CPR
  • microgravity
  • hypogravity


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