This simulation case features a 70-year-old male patient presenting to the emergency department in moderate respiratory distress. He has a past history of chronic obstructive pulmonary disease, dystrophia myotonica, and renal failure, and is currently on dialysis. During the initial emergency department treatment and stabilization phase, the patient has respiratory failure requiring intubation. Shortly after intubation, the patient goes into cardiac arrest with pulseless electrical activity. This requires advanced cardiovascular life support–type management and diagnosis and treatment of the cause of the pulseless electrical activity, a tension pneumothorax. After the pneumothorax is resolved, the patient stabilizes. This resource is an excellent simulation case to get medical students and first- or second-year residents to diagnose and manage a pulseless electrical activity case. The resource requires a patient simulator such as an HPS Manikin or Laerdal SimMan.
By the end of this simulation case, participants will be able to:
- Demonstrate understanding and general management of shortness of breath and respiratory distress.
- Demonstrate understanding and management of pulseless electrical activity.
- Perform intubation.
- Perform needle thoracostomy.
- Describe the differential diagnosis for pulseless electrical activity.
© 2008 Hegarty and Nelson.
This is an open-access article distributed under the terms of the Creative Commons Attribution license.
Hegarty C, Nelson J. Shortness of breath/PEA. MedEdPORTAL. 2008;4:1071. https:/
doi. org/ 10. 15766/ mep_ 2374- 8265. 1071