Challenges include: � 12 pulse points � oral and naso-intubation � tongue swells � laryngospasm � Cricothyrotomy � bilateral chest tube placement with simulated fluid discharge � bilateral pneumothorax relief � stomach distention � IV arm therapy � defibrillation � arrhythmia training. Skill areas include: � pulses � CPR � multiple injection sites � advanced IV arm � intubation � 4-lead monitoring � chest tubes.