Increasingly, ICUs are implementing protocols for the initiation of mechanical ventilation that require clinicians to determine how support is applied to patients presenting with varying pathophysiologies.

External collaborator: Eric Kriner
Intended Learners: Critical Care Clinicians

These ten RespiSim® clinical simulations give learners in-depth experience with the entire process of initiating mechanical ventilation and adjusting after a change in patient conditions. Learners assess clinical data provided by hands-on examination of the RespiPatient® manikin (e.g. chest rise, lung and heart sounds) and the patient monitor (e.g. vital signs, ABG results, chest x-rays). They intubate the RespiPatient manikin if indicated; and recommend and install initial ventilator and alarm settings. Students learn correct documentation by recording the settings on a ventilator flowsheet. See example.

Then the simulation fast-forwards four hours, the patient’s condition has changed and the ventilator is alarming. The student must perform a new patient-ventilator assessment, adjust alarm settings, and record them on the flowsheet.

Read an interview with Amanda Dexter about critical issues around initiation of mechanical ventilation here.


  • CHF exacerbation
  • COPD exacerbation
  • Cardiac arrest
  • Drug overdose
  • Sepsis & ARDS
  • Post-op coronary artery bypass
  • Post-op exploratory laparotomy
  • Chest trauma
  • Head injury trauma
  • Morbidly obese

There are no clinical practice guidelines for ventilator alarm settings. Patient parameters as well as initial ventilator and alarm settings for theses modules are based on major textbooks.