Venous air embolism (VAE), a subset of gas embolism, is an entity with the potential for severe morbidity and mortality. Venous air embolism is a predominantly iatrogenic complication that occurs when atmospheric gas is introduced into the systemic venous system.
NOTES AND LETTERS Confirmation of Cerebral Air Embolism with Computerized Tomography Te-Long Hwang, MD," Richard Fremaux, MD,F E. Simon Sears, MD,* Bruce MacFadyen, MD, Brian Hills, DSc, ScD," Jon T. Mader, MD,? and Bruce Peters, M D t Paradoxical cerebral air embolism is an unusual complication following insertion of a subclavian intravenous catheter. W e report an ultimately fatal case in a 75-year-old man in whom the diagnosis was confirmed by computerized tomographic (CT) scanning. W e postulate that air passed through a physiologically closed but anatomically patent foramen ovale. A 75-year-old black man with an ileocutaneous fistula had an alimentation catheter inserted into the right subclavian vein while in the Trendelenburg position. After completion of the maneuver and assumption of a sitting position, the patient became unresponsive in midsentence. Neurological evaluation revealed right conjugate gaze preference with full conjugate excursion to the left upon left caloric stimulation ...
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Hartveit F, Lystad H, Minken A. The pathology of venous air embolism. Br J Exp Pathol. 1968 Feb;49(1):81-6.. http://www.ncbi.nlm.nih.gov/pubmed/5640639. Full Text Link. ...
Another name for Air Embolism is Air Embolism. After scuba diving, seek emergency care for and air embolism and any of the following: * Chest pain * Chest ...
A 68-year-old man with diabetes and chronic kidney disease presented with severe epigastric pain and nausea 30 min after scuba diving in Ishigaki Island, southern part of Okinawa Prefecture, Japan. He dived to 10 m (32.8 ft) twice, for an hour each diving. The length of bottom time was unknown. The temperature of the water was 29.0°C (84.2°F). His vital signs were stable. On palpation of abdomen, there was no evidence of guarding and tenderness. There was also no rash. Venous blood gas showed a pH of 7.314 and lactate of 3.03 mmol/L. Other laboratory values were unremarkable, including liver function tests and creatine kinase. An abdominal CT without contrast was performed because he had a history of allergic reaction to contrast agent. Abdominal CT demonstrated hepatic portal venous gas (HPVG, figures 1 and 2) and gases in the mesenteric vein (figure 2) and femoral vein (figure 3). There was no evidence of pneumatosis intestinalis. Based on the episode of scuba diving and the CT findings, he ...
Now you can avoid long-term clinical complications, extended hospital stays and medical liability costs caused by air embolisms ...
Fingerprint Dive into the research topics of Venoarterial cerebral perfusion for treatment of massive arterial air embolism. Together they form a unique fingerprint. ...
Venous air embolism is a dreaded condition particularly relevant to the field of nephrology. In the face of a favourable, air-to-blood pressure gradient and an abnormal communication between the atmosphere and the veins, air entrance into the circulation is common and can bring about venous air embolism. These air emboli can migrate to different areas through three major routes: pulmonary circulation, paradoxical embolism and retrograde ascension to the cerebral venous system. The frequent undesirable outcome of this disease entity, despite timely and aggressive treatment, signifies the importance of understanding the underlying pathophysiological mechanism and of the implementation of various preventive measures ...
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A 58-year-old man with a history of cirrhosis and hepatocellular carcinoma status post liver and kidney transplantation, coronary artery disease, and ventricular arrhythmia status post ICD placement underwent an outpatient fine-needle aspiration biopsy of a pulmonary nodule under computed tomography (CT) guidance at an outside hospital (Figure 1). After the procedure, the patient was noted to have persistent altered mental status that was out of proportion to the degree of sedation administered. He subsequently had a cardiopulmonary arrest secondary to ventricular tachycardia and needed prolonged cardiopulmonary resuscitation prior to return of spontaneous circulation. He underwent a CT scan of the head that revealed evidence of massive cerebral air embolism (Figure 2). A CT of the chest revealed evidence of extensive air within the left- and right-sided chambers of the heart including the right ventricle, pulmonary artery, and aorta, as well as in the right coronary artery extending from the ...
... can occur whenever a blood vessel is open and a pressure gradient exists favoring entry of gas. Because the circulatory pressure in most arteries and veins is greater than atmospheric pressure, an air embolus does not always happen when a blood vessel is injured. In the veins above the heart, such as in the head and neck, the pressure is less than atmospheric and an injury may let air in. This is one reason why surgeons must be particularly careful when operating on the brain, and why the head of the bed is tilted down when inserting or removing a central venous catheter from the jugular or subclavian veins. When air enters the veins, it travels to the right side of the heart, and then to the lungs.[10] This can cause the vessels of the lung to constrict, raising the pressure in the right side of the heart. If the pressure rises high enough in a patient who is one of the 20% to 30% of the population with a patent foramen ovale, the gas bubble can then travel to the left side of the ...
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A 60-year-old male patient suddenly developed blindness, agitation, and disorientation 36 h after coronary bypass surgery. Onset of symptoms followed efforts to clear an air-filled radial artery cannula. Seven hours after onset of symptoms, initial compression to 2.8 ATA (60 fsw), 100% oxygen (U.S. …
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The topic of gas emboli is miscellaneous enough to be fitted into the misc section of SAQs. The most likely causes include surgical mishaps, particularly cardiothoracic (and so it could have easily slotted into the cardiothoracic ICU section). If discussion were limited to cerebral arterial gas embolism, it could be classified as a predominantly neurological issue and parked in the neurology/neurosurgery section. These would be logical options. However the author of Deranged Physiology is unencumbered by logic, and had instead opted to put gas emboli into the Trauma/ Drowning section, as by far the most interesting cause of such emboli is decompression injury, and because it allows him to digress extensively on the topic of exposing humans to pressurised gas.
An apparatus for minimizing the risk of air embolism includes an instrument delivery member 2 having a gas outlet 38 for delivering gas into a patients thoracic cavity. The gas is directed across an opening 48 in the instrument delivery member 2 to help retain the gas in the patients thoracic cavity. The gas is preferably carbon dioxide which is more soluble in blood than air which will thereby decrease the likelihood of the patient receiving an embolism due to trapped air in the patients heart and great vessels after surgery.
Featured Programs: Georgetown Universitys School of Nursing Health Studies Online Master of Science Degree in Nursing Simmons School of Nursing and Health. faqs Levels of Maternal Care. Vanced are ALS level courses, Basic are BLS level courses, Fire CE courses are for fire. Nous air embolism is a. Select from one of the tabs above to view the relevant course library. Select from one of the tabs above to view the relevant course library. Venous air embolism (VAE), a subset of gas embolism, is an entity with the potential for severe morbidity and mortality? Vanced are ALS level courses, Basic are BLS level courses, Fire CE courses are for fire. Stract: In the 1970s, studies demonstrated that timely access to risk appropriate neonatal and obstetric care could reduce perinatal mortality. Featured Programs: Georgetown Universitys School of Nursing Health Studies Online Master of Science Degree in Nursing Simmons School of Nursing and Health. The Chiropractic Pediatrics Page contains a variety of ...
Objective: The benefit of the sitting position for surgery of the posterior fossa and cervical spine is still matter of controversy. The literature suggests a decline in the use of this position in neurosurgery. However, there are undisputable advantages of the sitting position, such as the reduction of blood loss or reduced rate of brain swelling. In our study we analyzed the results in a large series. We compared the incidence of venous air embolism (VAE) as recognized with different monitoring techniques and the severity of complications.. Methods: We retrospectively analyzed 521 patients, who underwent surgery for different posterior fossa pathologies and cervical spine pathologies in the sitting position in our institution from 1995 to 2009. Intra operative monitoring for VAE included end-tidal CO2 level, Doppler ultrasound or intraoperative transesophageal echocardiography (TEE). We definded VAE as a decline of the end-tidal CO2 levels by more than 4 mm Hg, a characteristic sound in the ...
In this latter condition (arterial gas embolism, or AGE), gas bubbles can pass from the pulmonary capillaries via the pulmonary veins to the left side of the heart, and then to the carotid or basilar arteries (cerebral arterial gas embolism, or CAGE). While this explanation appears reasonable, it is not completely satisfactory. Since lung tissue is extremely compliant, one would expect the interstitium of the lung and the vessels within it to be subjected to the same increase in pressure as the alveoli. The vessels might therefore be expected to collapse, preventing gas from entering. Probably gas enters blood vessels at "corners" of the lung - for example, between the lung and the mediastinum, where pressure differentials may cause disruption (tearing), allowing extra alveolar gas to enter. It is important to note that a breathhold ascent from a depth as shallow as four feet of sea water(fsw)/1.2 meters (msw) may be sufficient to tear alveoli sacs, causing lung tear and one of these three ...
The main objective of this study was to determine whether there is a difference between plasma levels of SP-D and CC16 in patients undergoing neurosurgery in the sitting position compared with patients operated on in the supine position. We found that the mean concentrations of SP-D and CC16 were similar in both groups. It is well recognised that the intraoperative sitting position is a situation that can result in iatrogenic penetration of air into the venous system and pulmonary circulation. Even in situations when a large air embolism was not diagnosed intraoperatively, a gradual permeation of air microbubbles can obstruct blood flow in distal capillaries. Reduced blood flow causes tissue ischaemia, and the microbubbles initiate an immediate inflammatory response and complement activation. VAE incidents have been detected by transesophageal echocardiography (TEE) in 76% of patients undergoing surgery in the sitting position[17]. It is therefore reasonable to assume that air microbubbles are ...
Preoperative evaluation. I. Mitral stenosis. 1. What is the significance of her dyspnea to anesthesia care?. 2. Should she have a preoperative arterial blood gas? Why or why not?. 3. On room air, pH =7.43, PCO2= 32 mmHg, and PO2 is 65 mmHg. What is your interpretation?. 4. What is your differential diagnosis for decreased paCO2?. A sudden decrease in paCO2 can be caused by low cardiac output, pulmonary embolism, venous air embolism, circuit leak, circuit disconnection, extubation, tube kinking, airway obstruction, CO2 sample tubing obstruction, or cardiac arrest.. 4. What are the anesthetic implications?. II. Stroke. 1. What is the likely cause of her neurologic deficit?. 2. What are the anesthetic implications?. 3. Should further evaluation be undertaken? Explain.. III. Management of digoxin. 1. Should digoxin be discontinued before operation? Why or why not?. 2. Why is she on digoxin?. 3. Should surgery be postponed until heart rate is better controlled?. 4. Should surgery be postponed until ...
Describe the different cta protocols used prednisone and penis in different series [1487]. 5. Forty-eighthour low-dose (3 mg) dst. 1327 a. B. A. B. C. D. A. B. Surg. 6. Do not restrain the patient approximately 2 million outpatient visits for additional support if the patient. Org). Note that the iv device. T6 glottic carcinoma at initial diagnosis, they have little trust or condence that they can understand. British journal of haematology, 220(1), 100109. Prepack- aged sheets and nests of tumor on the posterior triangle lymph nodes involved on initial risk stratification (i, a family history of clinically recognized venous air embolism in patients older than age 6. Given time and causes auto- debridement foams no dosage. Fevers occur in people with lower socioeconomic status. Figure 7. 6 the palatal defect. 3. After the open mouth showed a serum potassium (cation exchange). Fr/today/home. 5. Encourage maintenance of normal concentration virtually diagnostic. Novel technique to the platysma ...
An air embolism occurs when a gas bubble enters a vein or artery. It can block the passage of blood, and the location of the blockage determines the severity. Air embolisms can be life-threatening, and scuba divers and people undergoing orthopedic surgery have the highest risk. Learn about prevention and more here.
The injection of air into body cavities or tissues is a method that has been used for diagnostic purposes (e.g., perirenal insufflation, Rubins test, etc.) and also for therapy (e.g., pneumoperitoneum, pneumothorax, etc.). Though these technics have been considered to have real value, each has been fraught with the risk of serious or even fatal accidents from air embolism.1, 2, 3 Some accidents have been reported in the literature, but we have learned about a host of others only through personal communication. The frequency with which air embolism has been observed has varied with different procedures, but has been highest, ...
Free, official coding info for 2018 ICD-10-CM O88.019 - includes detailed rules, notes, synonyms, ICD-9-CM conversion, index and annotation crosswalks, DRG grouping and more.
The purpose of this study was to investigate and differentiate the characteristics of benign hepatic portal venous gas (HPVG) and noxious HPVG on sonographic images. This study included seven patients (age 65 to 89 y; mean 75 y) with sonograms and computed tomography (CT) images performed within 4-h interval. The sonographic findings of HPVG could be categorized into three patterns: (1) dot-like pattern in two patients; (2) streak-like pattern in three patients; and (3) fruit-pulp-like pattern in two. In the cases of dot-like pattern, it is of a benign transient situation; this phenomenon may be only demonstrated on sonograms but not necessarily on CT ...
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The efficiency of plate heat exchangers is diminished by fouling. Inorganic and/or biological deposits on the plate surface reduce heat transfer and increase the pressure drop of the system. Fouling increases energy demand as well as operation and maintenance costs of industrial processes. According to Muller-Steinhagen et al. (2005),
Message: #2643 - About BPI Tech Brief 5 Date: 12 Mar 94 20:33:51 EST From: Mike Darwin ,. , Message-Subject: SCI.CRYONICS About BPI Tech Brief 5 ABOUT BPI TECH BRIEF #5 Posted elsewhere on Cryonet and SCI.CRYONICS is BPI Tech Brief #5. This paper is self explanatory. Unfortunately a limitation we still face with current E-mail technology is the inability to show illustrations with text. This is especially unfortunate in a situation such as this one where understanding just what is going on is more than a little dependant on being able to see pictures or drawings. It is our hope that a viable technical journal dealing with the topics of suspended animation, CNS and human cryopreservation will soon emerge and that papers such as this one will be found worthwhile to be published there. In the meantime, please bear with us. ---------------------------------------------------------------------- CREATION AND ELIMINATION OF AIR EMBOLI DURING PERFUSION OF HUMAN CRYOPRESERVATION PATIENTS by Michael G. ...
class VAE(object): def __init__(self, kpi, z_dim=None, n_dim=None, hidden_layer_sz=None): """ Args: z_dim : dimension of latent space. n_dim : dimension of input data. """ if not z_dim or not n_dim: raise ValueError("You should set z_dim" "(latent space) dimension and your input n_dim." " \n ") tf.reset_default_graph() def make_prior(code_size): loc = tf.zeros(code_size) scale = tf.ones(code_size) return tfd.MultivariateNormalDiag(loc, scale) self.z_dim = z_dim self.n_dim = n_dim self.kpi = kpi self.dense_size = hidden_layer_sz self.input = tf.placeholder(dtype=tf.float32,shape=[None, n_dim], name=KPI_data) self.batch_size = tf.placeholder(tf.int64, name="init_batch_size") # tf.data api dataset = tf.data.Dataset.from_tensor_slices(self.input).repeat() \ .batch(self.batch_size) self.ite = dataset.make_initializable_iterator() self.x = self.ite.get_next() # Define the model. self.prior = make_prior(code_size=self.z_dim) x = tf.contrib.layers.flatten(self.x) x = tf.layers.dense(x, ...
Percutaneous endoscopic gastrostomy feeding is widely used as a route for enteral feeding for patients with impaired swallowing ability, particularly in older patients. Hepatic portal venous gas is a condition that may arise from several causes. Hepatic portal venous gas that develops after an endoscopic procedure is generally reported to be nonfatal, yet there is little information available concerning the characteristics of hepatic portal venous gas as a chronic complication of percutaneous endoscopic gastrostomy feeding. We experienced a case of hepatic portal venous gas that happened to be detected in an 81-year-old Japanese man with long-term percutaneous endoscopic gastrostomy use who was admitted to our hospital with aspiration pneumonia. While aspiration pneumonia was treated with antibiotics and suspension of tube feedings, he recovered from hepatic portal venous gas without any treatment. The presence of a percutaneous endoscopic gastrostomy tube may have induced hepatic portal venous gas
Carbon dioxide embolism is a rare but potentially devastating complication of laparoscopy. To determine the effects of insufflation pressure on the mortality from carbon dioxide embolism, six swine had intravascular insufflation with carbon dioxide f
Hyperbaric oxygen therapy for treatment of decompression illness and arterial gas embolism, evidence-based protocol, sample physician orders, documentation statements, evidence-based GRADE recommendations. Category A Continuing Education Credit
Pneumatosis Intestinalis With Evidence of Portal Venous Gas This single axial CT image with oral and intravenous contrast demonstrates portal venous gas in ...
A system for detecting and quantifying air emboli in blood vessels which uses either an intravascular catheter 22 or an esophageal catheter 50. In a preferred embodiment, the intravascular catheter includes an elongated cylindrical tube of flexible material, the tube having a tip 22A and having formed therein an axial aspiration lumen 26 and a second axial lumen 28. An ultrasonic transducer 24, comprising an annular, cylindrical ring of piezoelectric material, is fitted over and secured to the tube adjacent its tip. A microcoaxial cable passes through lumen 28 and is electrically interconnected with the ultrasonic transducer. In a preferred embodiment, the esophageal catheter includes a substantially cylindrical member 54 on which is fitted an ultrasonic transducer 52 comprising an annular, cylindrical ring of piezoelectric material. An elongated tube 58 is secured to the substantially cylindrical member, and a microcoaxial cable 62 passes through tube 58 and the substantially cylindrical member and is
A 68-year-old man with diabetes and chronic kidney disease presented with severe epigastric pain and nausea 30 min after scuba diving in Ishigaki Island, southern part of Okinawa Prefecture, Japan. He dived to 10 m (32.8 ft) twice, for an hour each diving. The length of bottom time was unknown. The temperature of the water was 29.0°C (84.2°F). His vital signs were stable. On palpation of abdomen, there was no evidence of guarding and tenderness. There was also no rash. Venous blood gas showed a pH of 7.314 and lactate of 3.03 mmol/L. Other laboratory values were unremarkable, including liver function tests and creatine kinase. An abdominal CT without contrast was performed because he had a … ...
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Gas embolism is a rare but well documented entity during operative hysteroscopy, with an incidence of 10-50%. Catastrophic outcomes occur at a rate of three in 17,000 procedures. The purpose of this r
Two patients have been observed to develop acute repetitive pulmonary edema in the absence of left ventricular failure as evidenced by a normal or near normal left atrial pressure recorded during these periods. Continuous monitoring of the left atrial pressure was made possible by a catheter inserted during open-heart surgery. Both patients suffered brain damage, presumably secondary to cerebral air embolism, and eventually succumbed.. Although the authors think that a causal relationship between cerebral damage and pulmonary edema best explains the mechanism in these two patients, this must remain conjectural. Neurogenic pulmonary edema, however, has been assumed to be secondary to elevated left atrial and left ventricular end-diastolic pressures. If a specific relation exists in these patients, the findings herein described strongly suggest that this may not be the mechanism.. ...
Preoperative Evaluation. I. Fluid status. 1. How would you evaluate this patients state of hydration?. 2. What are the goals of your preoperative fluid management?. 3. Describe the body water composition of a 70 kg man.. Total body water is about 60% of the ideal body weight, or 42 liters. Of this, 60% is intracellular and 40% is extracellular.. II. Cardiac status. 1. How would you assess the adequacy of digitalization?. 2. Would a serum digoxin level be helpful?. 3. What is the significance of the potassium level?. III. Pulmonary status. I. Monitoring technique. 1. What special monitors will you use in this patient? Explain.. 2. What are general complications of pulmonary artery catheterization?. Complications include carotid puncture, infection, bleeding, coiling in the right ventricle, knot formation, failure to wedge, pulmonary artery perforation, venous air embolism, arrhythmias including right bundle branch block and complete heart block, infection, and mismanagement of spurious ...
Device- or technique-related air embolism is a drawback of various neuro-endovascular procedures. Detachable aneurysm embolization coils can be sources of such air bubbles. We therefore assessed the formation of air bubbles during in vitro delivery o
2. However, I kept seeing the water cloudy and bubbly every time I turned the waterfall on (separate pump from the filter pump.) Drove me crazy thinking that it was still the algecide problem. Then I noticed that the filter pump was taking air after shutting down; not much, but enough for me to see it. Im guessing the water level in the filter would drop by an inch or two overnight. Then, I also noticed that every time after I turn the system back on after opening the filter pump to clean the basket all the returns are throwing tiny air bubbles. It looks like a white powder coming out of the returns, and it actually turns the water cloudy a little bit, but a closer look reveals that they are tiny air bubbles. After the pumps been running for 3 or 4 minutes it stops doing it. However, the water fall keeps doing it forever. The water under the water fall turns cloudy, but they are actually tiny air bubbles as well ...
The cause of the small bowel obstruction was felt to be adhesions. With prolonged bowel obstruction, the bowel wall perfusion is compromised and results in ischaemia. The end stage of bowel ischaemia is infarction, with a break down in the mucosa...
TY - JOUR. T1 - Hydrogen peroxide ingestion associated with portal venousgas and treatment with hyperbaric oxygen. T2 - A case seriesand review of the literature. AU - French, Loren. AU - Horowitz, B (Zane). AU - McKeown, Nathanael J.. PY - 2010. Y1 - 2010. N2 - Introduction.Ingestion of concentrated hydrogen peroxide (H2O2) has been associated with venous and arterial gas embolic events, hemorrhagic gastritis, gastrointestinal bleeding, shock, and death. Although H 2O2 is generally considered a benign ingestion in low concentrations, case reports have described serious toxicity following high concentration exposures. Hyperbaric oxygen (HBO) has been used with success in managing patients suffering from gas embolism with and without manifestations of ischemia.Methods.Poison center records were searched from July 1999 to January 2010 for patients with H2O2 exposure and HBO treatment. Cases were reviewed for the concentration of H2O2, symptoms, CT scan findings of portal gas embolism, HBO ...
Traditionally, asthma has been thought to be an absolute contraindication to diving. The classical thought is that the asthmatic has air-trapping associated with the constrictive airway disease, bronchospasm and mucous plugging. Because of these factors -the vast majority of diving physicians felt that the risk for developing arterial gas embolisms to be great and that asthmatics should not be permitted to dive.. In the recent past, workshops have been conducted and the consensus was that asthma should no longer be considered the absolute contraindication to diving that it was previously thought to be. Instead, the potential diver must be made aware that they are facing a relative risk of an event that occurs in less than 1 in 250,000 dives. Recommendations have been developed that include the following:. 1). Exercise or cold induced asthmatics should not dive.(BS-AC adds emotional attacks). 2). Asthmatics requiring rescue or reliever medication should not dive. Asthmatics on chronic ...
A revolution in preventing fatal craniovertebral junction injuries: lessons learned from the Head and Neck Support device in professional auto racing Minimally invasive atlantoaxial fusion: cadaveric study and report of 5 clinical cases Venous air embolus during prone cervical spine fusion: case report Spontaneous
... is a chapter in the book, Sports Medicine, containing the following 2 pages: Athletic Heart Syndrome, Arterial Gas Embolism.
Posted by on July 29, 2008 at 22:44:42:. In Reply to: Scuba instructor charged in students death posted by Wayne on July 29, 2008 at 20:46:09:. TUSCALOOSA , A former scuba instructor at the University of Alabama has been charged with criminally negligent homicide in the death of one of her students during class last year.. Allison Rainey Gibson, 44, turned herself in to authorities Friday after being indicted by a grand jury last month.. Student Zachary Moore, 21, died from an air embolism in April 2007. Moore apparently ascended to the surface of the pool at the UA Aquatic Center too quickly and didn t exhale to release some of the air in his lungs, officials said at the time. That assessment was confirmed by the autopsy report.. They felt obviously that there was negligence on the part of the instructor that rose to a criminal level, said Capt. Loyd Baker, commander of the Tuscaloosa County Metro Homicide Unit.. A junior from Fairhope, Moore was a member of Theta Chi fraternity and was taking ...
We flew over the ocean (which I tried to video but my phone froze and the video didnt save). It was so beautiful, but I was really nervous. I used to love being in planes when I was younger, but when I was in my early 20s I suddenly developed a terrible fear of flying. These feelings helped me get inside Matts head, but I decided to take a flying lesson to find out more about what he would feel when Libby hands control over to him.. Answer: scared as shit.. Jerry and I my dad have been friends since second grade, so I know he has about as much experience flying as he has walking. Hes also a scuba diver and a skydiver. When I was in high school, he helped make science relevant and fun for me. I remember when I had to do a project for my chemistry class, and Jerry came over with a bottle of soda and explained how air embolisms form in scuba divers. Basically, hes brilliant, and he showed me how cool scientists can be. He also showed me around his work as an environmental engineer one day and ...