This article was taken from the September 2013 issue of Wired magazine. Be the first to read Wired's articles in print before they're posted online, and get your hands on loads of additional content by <span class="s1">subscribing online.

In his latest book, Extremes: Life, Death and the Limits of the Human Body, space physician Kevin Fong, who is also cofounder of the Centre for Altitude, Space and Extreme Environment Medicine at UCL, describes how modern medicine can "take things that are routinely fatal and make them routinely survivable". Things such as a heart attack in outer space. Fong explains how to perform life-saving cardiopulmonary resuscitation in a space shuttle.

Strap yourself in


"Imagine, for a moment, trying to deliver cardiac compressions while floating weightlessly in orbit," Fong writes in his book.

Because you're in a zero-gravity environment, the trick is to strap the patient down to the floor to keep him or her still. You will need to stop floating too, so fasten yourself on top of them with Velcro straps. Alternatively, jump up with your feet on the ceiling so you're hanging upside down, and push down on to the patient's chest, starting your compressions. "That's actually a good way to do it because your legs won't tire as quickly," Fong says.

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Defibrillate with care

When a shock is being applied in a regular operating theatre, no one can touch the patient because of the powerful electromagnetic current. But in space, Fong reminds us, other crew members are floating around and astronaut chairs could be conductive. "If you need to defibrillate [or shock] the patient, the question is how do you do it without shocking everybody else around you?" asks Fong. "Special defibrillators have to be used, so they don't interfere with the electronics of the space station or make sparks."

Make syringes bubble-free

You need to account for how liquids move in space. While monitoring the patient's electrical heart activity, space physicians have to adapt the way they insert and deliver drips with drugs and adrenaline into their patient's vein, to help in the resuscitation. "The thing you need to have is bubble filters for your syringe," says Fong. On Earth, bubbles float to the surface, but in space they spread themselves through the liquid, because of lack of gravity. "Without filters, you end up with an emulsion of bubbles suspended in the solution, and you'd just be injecting air."


Come back to Earth

Once you've got the patient's circulation going, he or she is still going to need intensive care, including ventilators and drugs that promote circulation. According to Fong, the International Space Station has less medical equipment and expertise than an average London ambulance. "So you need to get them home as quickly as possible, which is tricky," Fong says. The Soyuz capsule can taxi you back, but it's no Hailo. "When you start sending up space tourists or astronauts on longer missions, we will have to start thinking about these things," Fong says.

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