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