Respiratory Simulation Specialists


Initiation of Mechanical Ventilation

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.

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