Acute Respiratory Distress Syndrome is an inflammatory response resulting from injury to the alveolar-‐capillary membrane. This injury is caused by a systemic inflammatory response that involves either direct trauma to the lung cells, such as a pneumonia, or indirect, such as sepsis. The inflammatory response that is triggered results in leaky alveolar-‐capillary beds and infiltration of the lungs (Villar, 2011). This is very common with approximately 150,000 cases annually in the United States and a very high mortality rate of 60,000 deaths per year (Pipeling & Fan, 2010). Despite the high mortality rate, 15-‐35%, there is no set of guidelines for treatment of this condition, and methods of mechanical ventilation are only supportive (Zaglam, Jouvet, Flechelles, Emeriaud & Cheriet, 2014). The most severe form of ARDS is refractory hypoxemia, a life threatening condition, in which there is not an adequate amount of oxygen delivered to the tissues (Villar & Kacmarek, 2013). With more than 60 causes of ARDS, it is essential for nursing staff working directly with these patients to be aware of signs and early detection allowing more rapid initiation of treatment modalities in the hope of decreasing patient mortality (Taylor, 2005)