Heart attacks happen in space. And space agencies have a panoply of contortionist protocols that astronauts can use when such emergencies occur out there among the stars.
NASA, for example, recommends rescuers in the International Space Station perform what’s called the “handstand method.” This is when the person doing CPR on a space traveler experiencing cardiac arrest does a handstand on their chest and braces their feet against some internal part of the spacecraft to generate sufficiently robust chest compressions. Other methods include the reverse bear hug and the Evetts Russomano, where rescuers wrap either the arms or legs, respectively, around the stricken person’s torso to compress their chest.
But now there may be a better way to treat heart attacks in space under microgravity: It involves a piston.
A team of scientists and clinicians from various French institutions reported on the new method in a study published last year in the journal Resuscitation, and will present their findings at the European Society of Cardiology Congress happening in Spain this weekend. The team tested three automatic chest compression instruments on a CPR dummy during a parabolic airplane flight that simulates microgravity conditions similar to those experienced by space travelers. They found that one in particular, a standard piston device to perform chest compressions, could deliver a force sufficient to reach an optimal depth of about 2 inches into a person’s torso.
The device could be a critical tool to include in first aid kits carried on cosmic journeys. “It will be up to every space agency whether they want to include automatic chest compression devices in their emergency medical kit,” said Nathan Reynette, a cardiologist at the University of Lorraine, in a statement. “We know they have other considerations beyond effectiveness, such as weight and space constraints.”
Although most astronauts are young and fit, and thus the risk of cardiac arrest in space is relatively low, this type of forethought may become increasingly necessary with the rise of space tourism and longer space missions, Reynette says.
Nobody wants their first trip into the cosmos—or their second, or third—to be their last. 
Lead image: intueri / Shutterstock
