To the Moon and beyond - pushing boundaries in critical emergency medicine.

Humankind has always been exploring and discovering new worlds. Both space and deep undersea environments have several natural challenges. Explorers have always faced medical challenges, but nowadays, most of the old challenges are preventable and treatable. Both time and gravity issues have led medical scientists to search for new answers and solutions not only for non-critical diseases, but also for critical incidents, which require immediate life-saving action. In this issue of Acta Anaesthesiologica Scandinavica Warnecke et al present a study on airway management in microgravity. The authors concluded that securing the airway was faster with either a laryngeal mask or a laryngeal tube compared to tracheal intubation. Studies conducted in special circumstances are often criticized for the small number of included patients as well as for multiple confounders. These \"limitations\" often represent the overall challenges in working or making research in these circumstances. Confounders are not additional or exceptional but the reality in these environments. If patients are encountered and treated in special circumstances, the procedures and protocols used should not only be adapted from in-hospital ones. Instead, they should be critically evaluated and studied using the environment and methods closest to that special circumstance. Thus, we encourage researchers to raise further questions: Have we evaluated our protocols and procedures in the special circumstances and patient subgroups we encounter in our real-life?