{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:12:44Z","timestamp":1792512764478,"version":"4.5.0"},"reference-count":11,"publisher":"Aerospace Medical Association","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:p><jats:bold>BACKGROUND:<\/jats:bold> Arterial gas embolism (AGE) may occur while breathing compressed air and failing to exhale during ascent to compensate for gas expansion as pressure decreases. Trauma to the lungs from over-pressurization may result in air bubbles entering the pulmonary veins and subsequently the systemic circulation, causing obstructed blood flow and inflammatory cascades. AGEs are known to always manifest within 10\u2009min of surfacing from depth. In underwater egress training (UET), which is mandatory for U.S. Marines, service members learn to escape from a tilt-wing or rotor aircraft after it submerges and inverts in water.<\/jats:p>\n<jats:p><jats:bold>CASE REPORT:<\/jats:bold> We report a case of cerebral AGE in which the victim experienced neurological symptoms more than 1\u2009h after completing UET at a depth between only 3.28\u20136.56\u2009ft (1\u20132\u2009m). The patient was treated with a U.S. Navy Treatment Table 6 and experienced complete resolution of symptoms.<\/jats:p>\n<jats:p><jats:bold>DISCUSSION:<\/jats:bold> This case is one of only two AGEs reported with symptom onset occurring after 10\u2009min of surfacing from depth to be published. AGE at depths between 1\u20132\u2009m has only been reported on three other occasions, and dysbarism injuries during UET are also exceedingly rare. This case demonstrates a situation in which all three events occurred, highlighting the need for increased awareness and clinical consideration of delayed AGE in similar scenarios despite the commonly held belief that AGEs do not occur outside of 10\u2009min of surfacing.<\/jats:p>\n<jats:p><jats:bold>Harvey SE, Reynolds RP, Fisher JF. <jats:italic>Delayed-onset arterial gas embolism after underwater egress training<\/jats:italic>. Aerosp Med Hum Perform. 2024; 95(11):867\u2013870.<\/jats:bold><\/jats:p>","DOI":"10.3357\/amhp.6492.2024","type":"journal-article","created":{"date-parts":[[2024,11,16]],"date-time":"2024-11-16T00:30:17Z","timestamp":1731717017000},"page":"867-870","source":"Crossref","is-referenced-by-count":1,"title":["Delayed-Onset Arterial Gas Embolism After Underwater Egress Training"],"prefix":"10.3357","volume":"95","author":[{"given":"Seth E.","family":"Harvey","sequence":"first","affiliation":[{"name":"From Submarine Readiness Squadron 33, Pearl Harbor, HI, United States; the Pearl Harbor Naval Shipyard Dive Locker, Pearl Harbor, HI, United States; and the 3rd Medical Battalion, Bravo Company, U.S. Marine Corps, Oahu, HI, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert P.","family":"Reynolds","sequence":"additional","affiliation":[{"name":"From Submarine Readiness Squadron 33, Pearl Harbor, HI, United States; the Pearl Harbor Naval Shipyard Dive Locker, Pearl Harbor, HI, United States; and the 3rd Medical Battalion, Bravo Company, U.S. Marine Corps, Oahu, HI, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason F.","family":"Fisher","sequence":"additional","affiliation":[{"name":"From Submarine Readiness Squadron 33, Pearl Harbor, HI, United States; the Pearl Harbor Naval Shipyard Dive Locker, Pearl Harbor, HI, United States; and the 3rd Medical Battalion, Bravo Company, U.S. Marine Corps, Oahu, HI, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1911","reference":[{"key":"B1","unstructured":"Naval Air Systems Command. Modular egress training simulator (METS) trainer. Navair. [Accessed Sept. 24, 2024]. Available from https:\/\/www.navair.navy.mil\/product\/Modular-Egress-Training-Simulator-METS-Trainer."},{"key":"B2","series-title":"Diving medicine & recompression chamber operations, Chapter 17-3.1.","volume":"vol. 5","year":"2016","unstructured":"Naval Sea Systems Command US. Navy dive manual, Rev 7, vol. 5: Diving medicine & recompression chamber operations, Chapter 17-3.1. Washington (DC): GPO; 2016."},{"key":"B3","series-title":"Diving and subaquatic medicine.","first-page":"65","article-title":"Pulmonary barotrauma","author":"Edmonds C","year":"2016","unstructured":"Edmonds C, Bennett M, Lippmann J, Mitchell S. Pulmonary barotrauma. In: Edmonds C, Bennett M, Lipmann J, Mitchell S. Diving and subaquatic medicine. 5th ed. Boca Raton (FL): CRC Press; 2016:65\u201381."},{"issue":"11","key":"B4","series-title":"Aviat Space Environ Med.","first-page":"1040","article-title":"Delayed onset arterial gas embolism","volume":"64","author":"Moloff A.","year":"1993","unstructured":"Moloff A. Delayed onset arterial gas embolism. Aviat Space Environ Med. 1993; 64(11):1040\u20131043."},{"key":"B5","series-title":"The physician\u2019s guide to diving medicine.","first-page":"333","article-title":"Diagnosis and treatment of gas embolism","author":"Pearson R.","year":"1984","unstructured":"Pearson R. Diagnosis and treatment of gas embolism. In: Schilling C, Carlston C, Mathias R, editors. The physician\u2019s guide to diving medicine. New York: Plenum Press; 1984:333\u2013367. 10.1007\/978-1-4613-2671-7_7"},{"key":"B6","series-title":"Aviat Space Environ Med.","first-page":"931","article-title":"Pulmonary barotrauma in divers and the treatment of cerebral arterial gas embolism","volume":"57","author":"Leitch DR","year":"1986","unstructured":"Leitch DR, Green RD. Pulmonary barotrauma in divers and the treatment of cerebral arterial gas embolism. Aviat Space Environ Med. 1986; 57:931\u2013938."},{"issue":"4","key":"B7","series-title":"Undersea Biomed Res.","first-page":"283","article-title":"Delayed cerebral edema complicating cerebral arterial gas embolism: case histories","volume":"9","author":"Pearson RR","year":"1982","unstructured":"Pearson RR, Goad RF. Delayed cerebral edema complicating cerebral arterial gas embolism: case histories. Undersea Biomed Res. 1982; 9(4):283\u2013296."},{"issue":"8","key":"B8","series-title":"Aviat Space Environ Med.","first-page":"857","article-title":"Injury rate in a helicopter underwater escape trainer (HUET) from 2005\u20132012","volume":"85","author":"Brooks CJ","year":"2014","unstructured":"Brooks CJ, MacDonald CV, Gibbs PNA. Injury rate in a helicopter underwater escape trainer (HUET) from 2005\u20132012. Aviat Space Environ Med. 2014; 85(8):857\u2013862. 10.3357\/ASEM.3624.2014"},{"issue":"1","key":"B9","series-title":"Aviat Space Environ Med.","first-page":"63","article-title":"Arterial gas embolism following a 1-meter ascent during helicopter escape training: a case report","volume":"67","author":"Benton PJ","year":"1996","unstructured":"Benton PJ, Woodfine JD, Westwood PR. Arterial gas embolism following a 1-meter ascent during helicopter escape training: a case report. Aviat Space Environ Med. 1996; 67(1):63\u201364."},{"issue":"3","key":"B10","series-title":"Diving Hyperb Med.","first-page":"292","article-title":"Arterial gas embolism breathing compressed air in 1.2 metres of water","volume":"50","author":"Hampson NB","year":"2020","unstructured":"Hampson NB, Moon RE. Arterial gas embolism breathing compressed air in 1.2 metres of water. Diving Hyperb Med. 2020; 50(3):292\u2013294. 10.28920\/dhm50.3.292-294"},{"issue":"2","key":"B11","series-title":"Diving Hyperb Med.","first-page":"224","article-title":"Pulmonary barotrauma with cerebral arterial gas embolism from a depth of 0.75-1.2 metres of fresh water or less: a case report","volume":"51","author":"Lindblom U","year":"2021","unstructured":"Lindblom U, Tosterud C. Pulmonary barotrauma with cerebral arterial gas embolism from a depth of 0.75-1.2 metres of fresh water or less: a case report. Diving Hyperb Med. 2021; 51(2):224\u2013226. 10.28920\/dhm51.2.224-226"}],"container-title":["Aerospace Medicine and Human Performance"],"original-title":[],"link":[{"URL":"https:\/\/asma.kglmeridian.com\/view\/journals\/amhp\/95\/11\/article-p867.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/asma.kglmeridian.com\/downloadpdf\/journals\/amhp\/95\/11\/article-p867.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/asma.kglmeridian.com\/downloadpdf\/journals\/amhp\/95\/11\/article-p867.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T00:01:57Z","timestamp":1740614517000},"score":1,"resource":{"primary":{"URL":"https:\/\/asma.kglmeridian.com\/view\/journals\/amhp\/95\/11\/article-p867.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11]]},"references-count":11,"journal-issue":{"issue":"11"},"URL":"https:\/\/doi.org\/10.3357\/amhp.6492.2024","relation":{},"ISSN":["2375-6314","2375-6322"],"issn-type":[{"value":"2375-6314","type":"print"},{"value":"2375-6322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11]]}}}