Original Publication
Open Access

Shortness of Breath/PEA

Published: August 29, 2008 | 10.15766/mep_2374-8265.1071

Included in this publication:

  • PEA.doc
  • PEA.ppt
  • METI Scenario.txt

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


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.

Educational Objectives

By the end of this simulation case, participants will be able to:

  1. Demonstrate understanding and general management of shortness of breath and respiratory distress.
  2. Demonstrate understanding and management of pulseless electrical activity.
  3. Perform intubation.
  4. Perform needle thoracostomy.
  5. Describe the differential diagnosis for pulseless electrical activity.

Author Information

  • Cullen Hegarty, MD: University of Minnesota Medical School
  • Jessie Nelson, MD: HealthPartners Simulation Center

None to report.

None to report.


Hegarty C, Nelson J. Shortness of breath/PEA. MedEdPORTAL. 2008;4:1071. https://doi.org/10.15766/mep_2374-8265.1071