24 Aug How do you perform CPR in Space?
I met this guy the other day and he told me that he made movies for a living and I told him that I taught First Aid for my living.
We chatted about the oldies, lighting and the cinema in general and then he asked me an interesting question;
‘’How do you perform CPR (Cardiopulmonary Resuscitation) in Space’’?
I thought ‘WOW, how would you do that?’
He suggested that the casualty would be on the Space Shuttle’s ceiling, facing downward, while the First Aider would have to essentially float under the victim, whilst manually pushing his/her chest, in order to keep the heart pumping blood around the body.
Of course, back down on earth, in modern day medicine, we take things, which are routinely fatal, and we make them routinely survivable.
Things, such as a Cardiac Arrest (damaged electrics) or Heart Attack (blocked plumbing), when CPR is performed on earth, the patient lays on their back, while the First Aider kneels next to them, with both of their hands placed on the victims chest as they push 5-6cm down at a rate of 100 compressions per minute, to enable the heart to beat again by itself. (See diagram below).
Imagine for a moment trying to deliver your 30 Chest Compressions to the casualty, whilst floating weightlessly in orbit! This would mean that the person performing CPR would have to use a lot of strength and force on his/her arms, to push far enough on the chest cavity, in order to reach the lifeless heart.
Bear in mind that the environment is at Zero Gravity, which means that the casualty will be floating around (because his/her body weighs nothing), so therefore, you would have to pin him/her down, so to speak.
Basically in this environment, everybody floats, most importantly you and the casualty, who is in need of your life saving First Aid skills!
Now, you are in space and you try to put pressure on the chest as you would do in the earths atmosphere, the force you apply will generate a reaction force in the opposite direction (known as Newton’s Law of motion), in essence, if you do this in space, you will float away from the very person you are trying to save!
That is how I would imagine being the goal in trying to perform valuable CPR on the casualty, which is strapping them in the chair with their seat belt attached, which a Velcro fastening.
One way to actually achieve this is for the First Aider to hang upside down with their feet on the ceiling, in order to force their weight onto the victim, whilst you are strapping them in a chair.
Another way would be to wrap your legs around the victim, to ensure that they are in situ to enable you to use your arms to compress the chest.
This way would be less effort or strain for the First Aider, especially for their legs, as opposed to floating below the victim and doing Chest Compressions upside down.
However, time is always a big factor once the heart stops beating blood around the body, delivering all that lovely essential oxygen, keeping cells, organs and the whole person alive.
Another big consideration when saving a life in the space atmosphere is the use of an AED Machine (Automated External defibrillator), which is often used these days to restart the fibrillating (wobbling) heart. (See pictures below of an AED and where to place pads to defibrillate the heart)
I imagine that using this life saving device, would need a lot of Health & Safety considerations, i.e. carrying out a Risk Assessment before actual set up and use.
Let’s face it; using an AED on earth is pretty straight forward, not because you have to do it differently, because the voice prompt tells you exactly what to do after switching it on, namely;
- Apply the two pads, one to the right shoulder and the other to the left side of the chest over the rib cage.
- Next, plug in the connector into the AED and follow instruction.
- Next, the machine will say ‘stand clear’, which is your cue to shout out ‘everybody move clear’, at which point you press the button and a shock is sent through the heart, in order to restart it again normally (known as Defibrillation).
- Follow instructions and carry on CPR
In space, however, you will have other crewmembers, and probably passengers too, not so far in the not so distant future. Notably Virgin Atlantic passengers, because they just received their FAA operating licence to fly passengers into space, which will make them the first non-commercial operating airline to fly to space in the world.
So the big question I ask of you all is;
‘How do you defibrillate the patient, without electrocuting everyone on-board the space shuttle?’
Another issue with using an AED in space is that one spark from the machine could blow the entire ship up and there is nowhere to go but ‘Black Matter’ or be saved by an alien, which is doubtful, but of course possible, if you like Sci-Fi movies.
I would imagine that NASA or people who work in the field of space or Extreme Environmental Medicine, will have to come up with a 100% safe AED, which can be used in space on crew or passengers alike, giving them equal chances of surviving (20% more chance with AED use!).
I am sure that all my thoughts have been considered and researched, but there is not much information relating to this subject out there is cyberspace, but I am sure it will be on the agenda, once we can use our air miles to buy a trip around the moon and back, to ensure everyone’s safety in space.
Writing this Blog has made me realise that First Aid is important anywhere on earth as it is in space, because all the same principles are the same wherever you are, but how you perform it differs.