title: Explosive Decompression with Resultant Air Gas Embolism in a Fourth Generation Fighter at Ground Level.
abstract: BACKGROUND
  Arterial gas embolism (AGE) is a rare condition in the flying community most often only ever seen in flight while operating at high altitude or incidents involving hypobaric chambers. This article describes a severe case of AGE that occurred in a pilot of a fourth generation fighter aircraft at ground level. The environmental control system (ECS) malfunctioned, causing an overpressurized cockpit and a subsequent explosive decompression when the pilot opened the canopy to egress.
  
  
  METHODS
  The ECS onboard fourth generation fighter aircraft is composed of many computer-controlled subsystems. When these components fail, the system can potentially overpressurize the cockpit. Combined with opening the canopy without prior venting, this overpressurization can lead to a situation akin to a diver surfacing too quickly. A pilot experienced this scenario and subsequently developed symptoms of arterial gas embolization-one form of decompression illness (DCI). We reviewed the design of the environmental control system and recommend that the cockpit must be slowly depressurized to decrease risk of injury from rapid decompression.
  
  
  CONCLUSIONS
  Literature review showed three similar cases of ground-based overpressurization causing AGE symptoms, although these cases were maintenance personnel intentionally testing aircraft cabin integrity and not associated with aircraft intending flight.7The lessons learned from this case can be used to identify and hopefully prevent severe DCI from ground level cockpit overpressurization and to further general understanding of aircraft ECS. Zhang JX, Berry JR, Beckstrand DP. Explosive decompression with resultant air gas embolism in a fourth generation fighter at ground level. Aerosp Med Hum Perform. 2016; 87(11):963-967.
authors: 51st Medical Group, U.S. Air Force, Oan Air Base, South Korea.
authors: Joe X
authors: JX
authors: Zhang
authors: Jacob R
authors: JR
authors: Berry
authors: Devin P
authors: DP
authors: Beckstrand
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D000401:Aircraft; D019646:Decompression, Explosive; D004618:Embolism, Air; D004868:Equipment Failure; D006801:Humans; D008297:Male; D000070356:Pilots