SIM Scenario Exchange

ARDS / Pneumothorax

Contributed on July 4, 2016, last updated June 29, 2022.



Heather Epp, RN,BSN, Vancouver Coastal Health – Lion’s Gate Hospital ICU

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Pt has 1 week history of cough/fever, seen in ED yesterday and intubated this morning for worsening SOB and hypoxia. Remains difficult to oxygenate. Hypotensive and on pressure support. Pt taken to CT scan then directly to ICU. More difficult to bag en-route to ICU.
Pt O2 sat decreasing to 82%- 75%. Pt develops decreased breath sounds to left lung : no air entry.
Pt develops tension pneumothorax. Trach deviation to right.
Pt deteriorates to PEA arrest.

Learning Objectives:

Knowledge & Skills:

Rapidly recognize deterioration in patient status
Assist physician with insertion of chest tube – equipment, dressing, pleurevac set-up
Recognize PEA and follow PEA ACLS algorithm

Attitudes and Judgement:

Demonstrate role clarity, delegation of roles and responsibilities early in scenario
Demonstrate effective communication during the scenario: constructing clear messages, closed loop communication, sharing mental model
Exhibit elements of good teamwork
Demonstrate effective resource utilization
Exhibit situational awareness/ global awareness – recognizing limitations, avoiding fixation error


Simulation Modality:



Adult manikin - high sophistication


Tested once/used once and feedback from staff examined.  No significant changes made to scenario.


Epp H. ARDS / Pneumothorax. Simulation resource published by Simulation Canada; 2016. Available from

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Target Learners




Respiratory Therapy


Continuing professional development
Graduate / postgraduate / residency

Fields / Disciplines:

Critical care

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