SIM Scenario Exchange

EMS: Securing a Difficult Airway (VRE)

Contributed on October 30, 2023, last updated November 17, 2023.



Mike Gamble, Northern Alberta Institute of Technology

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A young man is sitting on the floor in a mechanical room. He has second-degree burns to his face, obvious signs of respiratory distress and appears disoriented. He works for a local heating and air conditioning company and received a service call for a faulty boiler. For the past two hours, he was attempting to pinpoint the problem and was working on a valve when he was violently struck in the face and neck by superheated water vapour. He also sustained injuries to his airway. Paramedics are on the way, the nearest hospital is 30 minutes away, and aeromedical services are not available.

Learning Objectives:

  1. Recall the need for basic airway management and oxygenation prior to advanced airway management.
  2. Choose to secure airway patency in a timely manner.
  3. Recognize proper equipment setup.
  4. Appreciate the difficulty of intubating an airway burn.
  5. Recall the correct procedure for intubation.
  6. Summarize the steps for confirming successful intubation and performing ongoing reassessment.
  7. Discuss troubleshooting options for post-intubation problems such as inadequate ventilation, unimproved oxygenation, or loss of airway patency.

Simulation Modality:

Extended reality (virtual reality, augmented reality, mixed reality)




EMS: Securing a Difficult Airway (VRE). Simulation resource published by Simulation Canada; 2023. Available from

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Target Learners






Undergraduate / post-secondary

Fields / Disciplines:

Clinical Procedures

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