165:
hazards of their own. A high concentration of oxygen in the breathing gas reduces the severity of decompression sickness complications and may increase the duration of useful consciousness, but at the same time increases fire hazard. A low initial pressure reduces decompression rate and severity in a catastrophic decompression, which reduces the risk of barotrauma but gives a lower margin of safety in a slow decompression, and can increase the risk of decompression sickness. Outside of a pressurised cabin environment, a pressure suit is the usual protective measure, and is the definitive protection in decompression to vacuum, but they are expensive, heavy, bulky, restrict mobility, cause thermal regulatory problems, and reduce comfort.
144:
are most conducive to vapourisation of water and outgassing of nitrogen. Factors include temperature, hydrostatic pressure, tissue elasticity, solute concentration, and the presence of gas bubble nuclei, and which can cause vapour bubbles to form at pressures slightly above the theoretical ambient pressure of 47 millimetres of mercury (63 mbar) in some places such as the pleural cavity, where the pressure can drop below ambient, and large central veins where hydrostatic pressure is minimum and blood temperature is at a maximum.
48:. Ebullism will expand the volume of the tissues, but the vapour pressure of water at temperatures in which a human can survive is not sufficient to rupture skin or most other tissues encased in skin. Ebullism produces predictable injuries, which may be survivable if treated soon enough, and is often accompanied by complications caused by rapid decompression, such as
100:. Death results unless recompression is rapid enough to restore oxygenation and reduce the bubbles before excessive tissue damage occurs. Head exposure may result in freezing of the corneal surface of the eye, impairing vision. Other signs and symptoms of rapid decompression injury may also be present.
249:
The term "space ebullism" was introduced by
Captain Julian E. Ward in his paper "The True Nature of the Boiling of Body Fluids in Space", published in Aviation Medicine in October 1956. It was suggested "because the word ebullism does not connote the addition of heat to produce vapor." It comes from
173:
Ebullism produces secondary tissue damage which, when extensive, has generally been considered fatal due to limited availability of treatment options on site. Immediate recompression to a pressure at minimum pressure for effective oxygenation is necessary for survival in whole-body exposure, along
143:
Pathophysiology of ebullism has mostly been studied in animals, including large primates, but no reasons have been found to suggest that the results should not be reasonably extrapolated to predict effects on humans. The experiments show that ebullism occurs non-uniformly at sites where conditions
191:
Initial field evaluation would be similar to trauma assessment. It may be necessary to remove a pressure suit to give access for primary and secondary surveys. Airway, breathing, and circulation are immediate priorities, followed by assessment of level of consciousness. Intubation is indicated if
44:. It occurs because a system of liquid and gas at equilibrium will see a net conversion of liquid to gas as pressure lowers; for example, liquids reach their boiling points at lower temperatures when the pressure on them is lowered. The injuries and disorder caused by ebullism is also known as
164:
An effective strategy for preventing ebullism would include multiple redundant levels of protection against decompression, and systems allowing non-catastrophic failure with sufficient time of useful consciousness to take effective countermeasures. Several mitigating strategies have associated
135:
Ebullism occurs when unprotected humans are exposed to altitudes above the
Armstrong limit where the vapor pressure of tissues is less than the ambient pressure. In practice bodily fluids do not boil off continuously at this altitude because the skin and outer organs have enough strength to
192:
unconscious and deteriorating. If a pulse cannot be distinguished, and the person is unresponsive, cardiopulmonary resuscitation should be started immediately, with advanced cardiac life support and cardiovascular monitoring as soon as possible.
152:
Ebullism occurs as a consequence of exposure to ambient pressures below about 47 millimetres of mercury (63 mbar). At higher pressures similar symptoms are likely to be caused by decompression sickness and some forms of barotrauma.
206:
The time needed for recovery will depend on the severity of injury, which is largely dependent on severity and duration of exposure. The main predictor of survival is the establishment of sufficient circulation and breathing.
231:-supported gondola. His right-hand glove failed to pressurise and his hand expanded to roughly twice its normal volume accompanied by disabling pain. His hand took about three hours to recover after his return to the ground.
339:
Murray, Daniel H.; Pilmanis, Andrew A.; Blue, Rebecca S.; Pattarini, James M; Law, Jennifer; Bayne, C Gresham; Turney, Matthew W.; Clark, Jonathan B (2013). "Pathophysiology, prevention, and treatment of ebullism".
829:
814:
203:, for injuries due to ebullism. Spontaneous recovery has occurred in cases where recompression was applied with minimal delay, or the damage was restricted to parts of the limbs. Other examples were fatal.
1038:
215:
Ebullism risk is associated with spaceflight, particularly EVA accidents, rapid decompression of aircraft at very high altitudes, and pressure suit failure during flight and training exercises.
136:
withstand the internal pressure, so the pressure inside the tissues would increase to match vapour pressure. Nitrogen dissolved in the tissues may also accumulate in the vapour bubbles causing
161:
To prevent ebullism, the tissues must be kept under sufficient pressure that vaporisation of the aqueous constituents is not possible in the range of temperature those tissues may experience.
1053:
375:
Norfleet, W.T. (2008). "Decompression-Related
Disorders: Decompression Sickness, Arterial Gas Embolism, and Ebullism Syndrome". In Barratt, M.R.; Pool, S.L. (eds.).
1088:
1103:
1078:
743:
1083:
1028:
124:, water boils at 100 °C (212 °F). At an altitude of 63,000 feet (19,000 m), it boils at only 37 °C (99 °F), the normal
1108:
678:
112:
and is likely to cause other decompression injuries such as decompression sickness and possibly one or more forms of decompression barotrauma.
241:
revealed evidence of ebullism. Given the level of tissue damage, the crew could not have regained consciousness even with re-pressurization.
1073:
1002:
174:
with re-oxygenation. Continued or additional pressurisation where necessary to prevent or treat decompression sickness is also indicated.
1033:
76:
with possible bruising, and bubbles in the blood. Blood circulation and breathing may be impaired or stopped by cardiac vapourlock. The
1068:
416:
872:
480:. 5th Annual Workshop on Space Operations Applications and Research (SOAR 1991), Volume 2. NASA. Johnson Space Center. 19920013110.
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961:
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137:
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293:
823:
971:
667:
1134:
858:
981:
263:
49:
1012:
910:
900:
72:
Symptoms of ebullism include bubbles in the membranes of the mouth and eyes, swelling of the
412:
8:
61:
195:
Little information is available on the effectiveness of conventional treatment, such as
1007:
976:
895:
782:
672:
636:
200:
623:
573:
774:
628:
507:
388:
357:
196:
81:
708:
786:
640:
618:
499:
380:
349:
224:
125:
765:
Ward, Julian E. (1956). "The True Nature of the
Boiling of Body Fluids in Space".
290: – Garment worn to keep a human alive in the harsh environment of outer space
16:
Formation of vapour bubbles in bodily fluids due to reduced environmental pressure
905:
384:
299:
130:
503:
1058:
935:
915:
881:
227:
experienced localised ebullism during a 31 kilometres (19 mi) ascent in a
109:
838:
475:
474:
Stegmann, Barbara J.; Pilmanis, Andrew A.; Derion, Toniann (1 February 1992).
439:
1123:
951:
930:
925:
571:
281:
37:
33:
547:
778:
632:
361:
353:
73:
30:
1039:
Central nervous system effects from radiation exposure during spaceflight
185:
806:
920:
287:
278: – Equipment which allows the user to breathe at hypoxic altitudes
97:
57:
53:
266: – Disorder caused by dissolved gases forming bubbles in tissues
121:
606:
41:
20:
850:
579:. Lyndon B. Johnson Space Center, Houston, Texas. pp. 3–83.
284: – Type of protective suit worn in low pressure environments
833:
818:
228:
89:
85:
40:
due to reduced environmental pressure, usually at extreme high
574:"Columbia Crew Survival Investigation Report NASA/SP-2008-565"
93:
77:
415:. Harvard University Graduate School of Arts and Sciences.
413:"The human body in space: Distinguishing fact from fiction"
338:
1054:
Epidemiology data for low-linear energy transfer radiation
527:
Davis, Jeffrey R.; Johnson, Robert; Stepanek, Jan (2008).
296: – Unplanned drop in the pressure of a sealed system
732:"The Annual Awards of the Aerospace Medical Association"
477:
Improving survival after tissue vaporization (Ebullism)
1089:
Reduced muscle mass, strength and performance in space
572:
473:
302: – Altitude where water boils at body temperature
1104:
Team composition and cohesion in spaceflight missions
1079:
Psychological and sociological effects of spaceflight
730:
Mohler, Stanley R.; Day, Pamela C. (September 2006).
108:
A decompression event leading to ebullism will cause
796:
526:
469:
467:
465:
463:
461:
723:
334:
332:
330:
328:
326:
324:
322:
320:
318:
316:
607:"Physiological hazards of flight at high altitude"
605:Pilmanis, Andrew; Sears, William (December 2003).
272: – Medical issues associated with spaceflight
92:resulting in rapid loss of consciousness, and the
458:
1121:
1084:Radiobiology evidence for protons and HZE nuclei
659:
377:Principles of Clinical Medicine for Space Flight
313:
1029:Adverse health effects from lunar dust exposure
494:Busby, Douglas E. (1968). "Ebullism Syndrome".
406:
404:
234:Tissue samples from the remains of the crew of
1109:Visual impairment due to intracranial pressure
60:and high altitude aviators, for whom it is an
866:
604:
1074:List of microorganisms tested in outer space
1003:National Space Biomedical Research Institute
598:
489:
487:
401:
379:. Springer, New York, NY. pp. 223–246.
368:
1034:Cardiac rhythm problems during space flight
736:Aviation, Space, and Environmental Medicine
567:
565:
520:
342:Aviation, Space, and Environmental Medicine
1069:Intervertebral disc damage and spaceflight
873:
859:
254:, meaning "to bubble out, or to boil up."
758:
729:
622:
484:
168:
562:
410:
374:
1044:Effect of spaceflight on the human body
962:Illness and injuries during spaceflight
665:
498:. Dordrecht: Springer. pp. 20–30.
270:Effect of spaceflight on the human body
120:In the atmospheric pressure present at
115:
1122:
431:
128:of humans. This altitude is known as
1049:Effects of sleep deprivation in space
854:
586:from the original on 21 December 2019
535:
493:
178:High-frequency percussive ventilation
1099:Spaceflight radiation carcinogenesis
967:Medical treatment during spaceflight
764:
707:(PBS). November 2000. Archived from
668:"20-Year Journey for 15-Minute Fall"
446:from the original on 18 October 2018
746:from the original on 29 August 2014
693:
681:from the original on 29 August 2021
437:
13:
880:
541:
529:Fundamentals of Aerospace Medicine
184:(2013) for respiratory support as
14:
1146:
276:High altitude breathing apparatus
773:(5). Aviation Medicine: 429–39.
767:The Journal of Aviation Medicine
647:from the original on 27 May 2021
419:from the original on 7 June 2023
103:
701:"Skydive from the Stratosphere"
411:Springel, Mark (30 July 2013).
210:
138:altitude decompression sickness
1094:Renal stone formation in space
1064:Health threat from cosmic rays
666:Higgins, Matt (May 24, 2008).
56:injuries. Persons at risk are
1:
998:Aerospace Medical Association
624:10.1016/S0140-6736(03)15059-3
306:
156:
531:(4th ed.). p. 252.
440:"Ebullism at 1 Million Feet"
385:10.1007/978-0-387-68164-1_11
244:
147:
7:
705:Public Broadcasting Service
504:10.1007/978-94-010-3464-7_2
257:
67:
10:
1151:
544:"Human Exposure to Vacuum"
294:Uncontrolled decompression
218:
18:
1021:
990:
972:Space adaptation syndrome
944:
888:
800:
180:is recommended by Murray
19:Not to be confused with
496:Space Clinical Medicine
88:because of blockage of
982:Spaceflight osteopenia
354:10.3357/ASEM.3468.2013
264:Decompression sickness
236:Space Shuttle STS-107
169:Treatment and outcomes
50:decompression sickness
1013:Space Nursing Society
911:Neuroscience in space
901:Astronautical hygiene
945:Illness and injuries
542:Landis, Geoffrey A.
201:adjunctive therapies
116:Causes and mechanism
29:is the formation of
1130:Medical terminology
62:occupational hazard
1008:Rubicon Foundation
977:Space and survival
896:Artificial gravity
673:The New York Times
1117:
1116:
848:
847:
711:on 29 August 2021
513:978-94-010-3466-1
394:978-0-387-98842-9
197:hyperbaric oxygen
52:and a variety of
46:ebullism syndrome
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626:
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569:
560:
559:
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546:. Archived from
539:
533:
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491:
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456:
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453:
451:
435:
429:
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372:
366:
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225:Joseph Kittinger
131:Armstrong's Line
126:body temperature
1150:
1149:
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1141:
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1139:
1120:
1119:
1118:
1113:
1017:
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906:Bioastronautics
884:
879:
849:
844:
843:
809:
795:
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763:
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749:
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728:
724:
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703:. NOVA Online,
699:
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664:
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583:
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550:on 21 July 2009
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300:Armstrong limit
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1059:Sleep in space
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936:Weightlessness
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916:Space exposure
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882:Space medicine
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801:Classification
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438:Czarnik, Tam.
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110:acute anoxemia
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96:may swell and
80:tissue may be
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9:
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2:
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991:Organizations
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952:Asthenization
950:
949:
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931:Space weather
929:
927:
926:Space nursing
924:
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677:. p. 2.
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104:Complications
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38:bodily fluids
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1022:Other topics
956:
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748:. Retrieved
739:
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715:23 September
713:. Retrieved
709:the original
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685:23 September
683:. Retrieved
671:
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651:10 September
649:. Retrieved
614:
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588:. Retrieved
552:. Retrieved
548:the original
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448:. Retrieved
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421:. Retrieved
376:
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348:(2): 89–96.
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211:Epidemiology
205:
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188:is likely.
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74:soft tissues
71:
45:
31:water vapour
26:
25:
750:29 December
617:: s16–s17.
554:16 February
450:16 February
186:atelectasis
1124:Categories
921:Space food
889:Main areas
742:(9): 979.
611:The Lancet
307:References
288:Space suit
250:the Latin
157:Prevention
98:hemorrhage
58:astronauts
54:barotrauma
423:6 October
245:Etymology
223:In 1960,
148:Diagnosis
122:sea level
957:Ebullism
779:13366883
744:Archived
679:Archived
675:(online)
645:Archived
633:14698113
590:11 March
581:Archived
444:Archived
417:Archived
362:23447845
258:See also
252:ebullire
238:Columbia
90:arteries
68:Symptoms
42:altitude
27:Ebullism
21:Embolism
787:6765165
641:8210206
219:History
82:starved
34:bubbles
824:NF04.Y
785:
777:
639:
631:
510:
391:
360:
229:helium
86:oxygen
839:T70.2
783:S2CID
637:S2CID
584:(PDF)
577:(PDF)
199:, or
182:et al
94:lungs
78:brain
775:PMID
752:2018
717:2012
687:2012
653:2019
629:PMID
592:2021
556:2010
508:ISBN
452:2010
425:2023
389:ISBN
358:PMID
830:ICD
815:ICD
619:doi
615:362
500:doi
381:doi
350:doi
84:of
36:in
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837::
834:10
822::
819:11
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771:27
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740:77
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609:.
564:^
506:.
486:^
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403:^
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356:.
346:84
344:.
315:^
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23:.
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