CASE PRESENTATION: A 63-year-old man presented to a peripheral hospital after a mechanical fall. He has a past medical history of Diabetes Mellitus type II and hypertension. Physical examination revealed a morbidly obese Caucasian male with limited range of motion in his right shoulder and large ecchymosis on his chest. X-ray of the right shoulder showed a comminuted fracture involving the surgical neck of the humerus. Blood work revealed normocytic normochromic anemia with a hemoglobin of 8.7mg/dl and thrombocytopenia with a platelet count of 35,000/mm3. DIC workup was negative. A Bone marrow biopsy was performed from the posterior superior iliac crest approximately forty-eight hours after his presentation. Within hours of the procedure, he became hemodynamically unstable with a BP of 70/50mmHg, HR of 120 beats/min, RR 26 breaths/min and oxygen saturation of 92% on non-rebreather mask. He was volume resuscitated, started on vasopressor support and transferred to our institution. Upon arrival to our ICU, 2D echocardiogram revealed right ventricular strain with no wall motion abnormalities. CT thorax without contrast revealed extensive air embolism within the right atrium, right ventricle, main pulmonary artery and the ascending thoracic aorta. He underwent two sessions of hyperbaric oxygen therapy with complete resolution of air embolism on repeat CT thorax and hemodynamic stability was achieved after the first session of hyperbaric oxygen therapy.