Original Publication
Open Access

Cystic Fibrosis: Respiratory Failure with Pneumothorax

Published: July 16, 2014 | 10.15766/mep_2374-8265.9851

Included in this publication:

  • Simulation Case Template Respiratory Failure Final Case Write-Up.pdf
  • Appendix A Respiratory Failure Labs.pptx
  • Appendix B Respiratory Failure PPT Debriefing.pptx
  • Appendix C Evalform.pdf

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 educational resource provides the information and materials for a high-fidelity simulation case suitable for resident physicians in emergency medicine. This case is currently in use at our institution for emergency medicine residents completing required educational time in our Emergency Medicine Simulation Program. This case has been used for the past 2 years in our program and has recently been edited and expanded to its existing form. This case was a real patient encounter that followed the exact flow shown in the write-up. This high-fidelity patient simulation case involves a patient with cystic fibrosis who presents to an emergency department in respiratory failure with bilateral pneumothoraces. Evaluation in the emergency department reveals that the patient has bradycardia and respiratory failure that will only briefly improve after rapid sequence intubation. Shortly after successful rapid sequence intubation, the patient develops a tension pneumothorax that must be relieved with either needle thoracostomy or chest tube placement. Appropriate treatment with either approach will allow stabilization of the patient. The patient will also require suctioning to facilitate normal oxygen saturations. Debriefing materials are provided to illustrate and stimulate discussion of the important concepts for diagnosing and treating patients with respiratory failure and tension pneumothorax.

Educational Objectives

By the end of the module, the learner will be able to:

  1. Demonstrate an appropriate initial approach to a patient with respiratory failure and bradycardia.
  2. Identify the need to complete rapid sequence intubation in respiratory failure.
  3. List the diagnostic features of tension pneumothorax.
  4. Understand the treatment options for tension pneumothorax and cardiovascular collapse after intubation.

Author Information

  • James O'Neill, MD: Wake Forest School of Medicine of Wake Forest Baptist Medical Center
  • Megan Docherty, MD: Wake Forest School of Medicine of Wake Forest Baptist Medical Center
  • Michael Fitch, MD, PhD: Wake Forest School of Medicine of Wake Forest Baptist Medical Center

None to report.

None to report.


O'Neill J, Docherty M, Fitch M. Cystic fibrosis: respiratory failure with pneumothorax. MedEdPORTAL. 2014;10:9851. https://doi.org/10.15766/mep_2374-8265.9851