CaseData[53] = {
    "title": "Case 112 - 54 year old female for craniotomy", 
    "badDrugs": ["Dantrolene"], 
    "coMin": 1, 
    "debriefMsg": "left heart failure basedon case 13", 
    "depthCarina": 25, 
    "depthCords": 18, 
    "depthTubeInitial": 22, 
    "durationPrep": 60, 
    "durationSurgery": 1200, 
    "fsmFlag": false, 
    "helpFlag": false, 
    "imageSet": 5, 
    "initialSat": 96, 
    "leanBodyMass": 60, 
    "learningObj": "", 
    "possiblePoints": 1000, 
    "preopMsg": "\n54 year old female for craniotomy\n\nHistory of Present Illness\nThis patient underwent modified radical mastectomy 3 years prior for breast cancer. She was treated with cytoxan, adriamycin, and 5-FU, and radiation therapy. She now has seizures and 7 cm right brain space-occupying lesion.\n\n\nPast Medical History\nIllnesses - as above\nSurgeries - modified radical mastectomy under general anesthesia without problem\nMeds - dilantin, phenobarbital, decadron\nNo known drug allergies\nHabits - Smoker 30 pack-years\n\nFamily History\nNo anesthetic complications\n\nPhysical Exam\nAnxious female, short of breath  \nWeight: 66 Kg\nHR 92,  BP 136/80,  RR 22\nAirway - normal\nLungs - occasional crackles\nHeart - S3, jugulovenous distention, pretibial pitting edema\n\nLabs\nHematocrit 33\nK 4.7,  Glucose, Bun, Cr - normal\nEKG - sinus rhythm, non-specific T-wave changes\nCXR - cardiomegaly, increased lung markings\n\nNPO Status\nLast ate 10 hours ago. \n\nPatient and Surgeon Requests\nRequires a general anesthetic. The surgeon requests mannitol administration to lower the intracranial pressure. \n\n\n\n", 
    "volAnDsp": 80,  
    "states": [
        {
            "name": "AWAKE", 
            "whatNextMsg": "Sedate, preoxygenate and induce anesthesia.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 86, 
            "baseAbpM": 100, 
            "baseAbpS": 132, 
            "baseBicarb": 23.8, 
            "baseHr": 88, 
            "basePot": 4.8, 
            "breathSoundsMsg": "The breath sounds are clear bilaterally.", 
            "cardiacOutput": 4.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 8, 
            "finalState": 0, 
            "glucose": 120, 
            "hct": 48, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 0, 
            "lidReflexMsg": "The lid reflex is present.", 
            "lmaSuccessFlag": false, 
            "mentalStatusMsg": "The patient is awake and responds to voice commands. The patient is moving spontaneously.", 
            "papD": 10, 
            "papM": 14, 
            "papS": 22, 
            "papW": 8, 
            "pulseMsg": "The pulse is weak and rapid.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Awake, alert, and anxiously awaiting induction.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry but has slow capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 144, 
            "sat20": 93, 
            "sat40": 95, 
            "sat100": 98, 
            "spSignal": 2, 
            "spontRr": 16, 
            "spontTv": 320, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": 0.1, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "SEDATED", 
                    "comment": "You administered a sedative agent. (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.2
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "AWAKECOUGH", 
                    "comment": "You should not have tried to place the LMA in an unsedated patient. (Lost points)", 
                    "conditions": [
                        {
                            "type": "tryLma", 
                            "value": true
                        }
                    ], 
                    "points": -200
                }, 
                {
                    "nextState": "AWAKECOUGH", 
                    "comment": "You should not have tried to place the endotracheal tube in an unsedated patient. (-500 points)", 
                    "conditions": [
                        {
                            "type": "tryLaryTube", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "AWAKEHURT", 
                    "comment": "You should not have allowed the surgeon to make an incision in an unsedated patient. (-500 points)", 
                    "conditions": [
                        {
                            "type": "makeIncision", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "AWAKEPARA", 
                    "comment": "You should not have paralyzed an unsedated patient. (-500 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "nmb", 
                            "value": 0.6
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "AWAKECOUGH", 
            "whatNextMsg": "Wait for the patient to settle down and induce anesthesia.", 
			"airwayStr": "obstructed",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 90, 
            "baseAbpM": 104, 
            "baseAbpS": 160, 
            "baseBicarb": 24, 
            "baseHr": 104, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The patient is coughing.", 
            "cardiacOutput": 4.6, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 14, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 0, 
            "lidReflexMsg": "The lid reflex is present.", 
            "lmaSuccessFlag": false, 
            "mentalStatusMsg": "The patient is upset and uncooperative. The patient is coughing.", 
            "papD": 12, 
            "papM": 16, 
            "papS": 28, 
            "papW": 12, 
            "pulseMsg": "The pulse is strong and fast.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Upset and coughing.", 
            "rhythm": "St1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 3, 
            "spontRr": 18, 
            "spontTv": 300, 
            "sputumAmount": 0, 
            "stSegII": -0.1, 
            "stSegV5": 0.2, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "AWAKE", 
                    "comment": "The patient stopped coughing.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "AWAKEHURT", 
            "whatNextMsg": "Wait for the patient to settle down and induce anesthesia.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 100, 
            "baseAbpM": 132, 
            "baseAbpS": 200, 
            "baseBicarb": 24, 
            "baseHr": 124, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The patient is screaming but the breath sounds seem to be clear bilaterally.", 
            "cardiacOutput": 4, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 18, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 0, 
            "lidReflexMsg": "The lid reflex is present.", 
            "lmaSuccessFlag": false, 
            "mentalStatusMsg": "The patient is screaming and writhing in pain.", 
            "papD": 20, 
            "papM": 26, 
            "papS": 38, 
            "papW": 18, 
            "pulseMsg": "The pulse is bounding.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Screaming and writhing in pain.", 
            "rhythm": "St1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 3, 
            "spontRr": 10, 
            "spontTv": 320, 
            "sputumAmount": 0, 
            "stSegII": 0.3, 
            "stSegV5": 0.2, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "AWAKE", 
                    "comment": "The patient stopped screaming.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "AWAKEPARA", 
            "whatNextMsg": "Call your lawyer.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 100, 
            "baseAbpM": 124, 
            "baseAbpS": 180, 
            "baseBicarb": 24, 
            "baseHr": 114, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are clear bilaterally.", 
            "cardiacOutput": 4.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 16, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 0, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": false, 
            "mentalStatusMsg": "The patient is not moving, but is thinking about calling his lawyer.", 
            "papD": 14, 
            "papM": 20, 
            "papS": 32, 
            "papW": 12, 
            "pulseMsg": "The pulse is strong.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Awake but paralyzed.", 
            "rhythm": "St1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 3, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": 0.2, 
            "stSegV5": 0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "AWAKE", 
                    "comment": "The muscle relaxant is wearing off.", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "nmb", 
                            "value": 0.6
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "SEDATEDPARA", 
                    "comment": "You sedated this patient after you administered muscle relaxant. (+25 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.1
                        }
                    ], 
                    "points": 25
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "SEDATED", 
            "whatNextMsg": "Continue induction.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 80, 
            "baseAbpM": 92, 
            "baseAbpS": 126, 
            "baseBicarb": 24, 
            "baseHr": 82, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are clear.", 
            "cardiacOutput": 4, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 14, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 0, 
            "lidReflexMsg": "There is mild ptosis. The lid reflex is present.", 
            "lmaSuccessFlag": false, 
            "mentalStatusMsg": "The patient has a lethargic response to voice. The patient is moving spontaneously.", 
            "papD": 12, 
            "papM": 16, 
            "papS": 28, 
            "papW": 12, 
            "pulseMsg": "The pulse is strong.", 
            "pupilsMsg": "The eyes are glazed. The pupils are equal, round, and react to light.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Sedated.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "sat20": 80, 
            "sat40": 90, 
            "sat100": 92, 
            "spSignal": 3, 
            "spontRr": 14, 
            "spontTv": 300, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": 0.1, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "ASLEEPAPNEA", 
                    "comment": "You administered an appropriate dose of propofol. (+200 points)", 
                    "conditions": [
                        {
                            "drug": "Propofol", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 89
                        }, 
                        {
                            "drug": "Propofol", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 141
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "XSINDUCTION", 
                    "comment": "You administered an excessive dose of propofol. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Propofol", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 140
                        }
                    ], 
                    "points": -400
                }, 
                {
                    "nextState": "ASLEEPAPNEA", 
                    "comment": "Etomidate is no longer recommended. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Etomidate", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 8
                        }, 
                        {
                            "drug": "Etomidate", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 21
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "XSINDUCTION", 
                    "comment": "Etomidate is no longer recommended. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Etomidate", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 20
                        }
                    ], 
                    "points": -200
                }, 
                {
                    "nextState": "ASLEEPAPNEA", 
                    "comment": "You administered enough intravenous agent to induce anesthesia. (+200 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.8
                        }, 
                        {
                            "op": "LT", 
                            "type": "mac", 
                            "value": 0.4
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "ASLEEPBREATHE", 
                    "comment": "You administered enough inhalation agent to induce anesthesia. (+200 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.8
                        }, 
                        {
                            "op": "LT", 
                            "type": "mic", 
                            "value": 0.4
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "SEDATEDCOUGH", 
                    "comment": "You should not have tried to place the LMA in a lightly sedated patient. (Lost points)", 
                    "conditions": [
                        {
                            "type": "tryLma", 
                            "value": true
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "SEDATEDCOUGH", 
                    "comment": "You should not have tried to place the endotracheal tube in a lightly sedated patient. (Lost points)", 
                    "conditions": [
                        {
                            "type": "tryLaryTube", 
                            "value": true
                        }
                    ], 
                    "points": -200
                }, 
                {
                    "nextState": "SEDATEDHURT", 
                    "comment": "You should not have allowed the surgeon to make an incision in a lightly sedated patient. (-500 points)", 
                    "conditions": [
                        {
                            "type": "makeIncision", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "SEDATEDPARA", 
                    "comment": "", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "nmb", 
                            "value": 0.8
                        }
                    ], 
                    "points": -500
                }
            ]
        }, 
        {
            "name": "SEDATEDCOUGH", 
            "whatNextMsg": "Wait for the patient to settle down and induce anesthesia.", 
			"airwayStr": "obstructed",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 84, 
            "baseAbpM": 102, 
            "baseAbpS": 154, 
            "baseBicarb": 24, 
            "baseHr": 104, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The patient is coughing.", 
            "cardiacOutput": 4.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 18, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 0, 
            "lidReflexMsg": "There is mild ptosis. The lid reflex is present.", 
            "lmaSuccessFlag": false, 
            "mentalStatusMsg": "The patient has a lethargic response to voice, but is coughing.", 
            "papD": 20, 
            "papM": 26, 
            "papS": 38, 
            "papW": 18, 
            "pulseMsg": "The pulse is strong.", 
            "pupilsMsg": "The eyes are glazed. The pupils are equal, round, and react to light.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Lightly sedated and coughing.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 3, 
            "spontRr": 16, 
            "spontTv": 260, 
            "sputumAmount": 0, 
            "stSegII": -0.1, 
            "stSegV5": 0.2, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "SEDATED", 
                    "comment": "The patient stopped coughing.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "SEDATEDHURT", 
            "whatNextMsg": "Induce anesthesia immediately.", 
 			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 90, 
            "baseAbpM": 126, 
            "baseAbpS": 196, 
            "baseBicarb": 24, 
            "baseHr": 118, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The patient is moaning, but the breath sounds are equal bilaterally.", 
            "cardiacOutput": 4.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 18, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 0, 
            "lidReflexMsg": "There is mild ptosis. The lid reflex is present.", 
            "lmaSuccessFlag": false, 
            "mentalStatusMsg": "The patient is moaning in pain.", 
            "papD": 20, 
            "papM": 26, 
            "papS": 38, 
            "papW": 18, 
            "pulseMsg": "The pulse is strong.", 
            "pupilsMsg": "The eyes are glazed. The pupils are equal, round, and react to light.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Moaning in pain.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 3, 
            "spontRr": 24, 
            "spontTv": 220, 
            "sputumAmount": 0, 
            "stSegII": 0.3, 
            "stSegV5": 0.2, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "SEDATED", 
                    "comment": "The patient stopped moaning.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "SEDATEDPARA", 
            "whatNextMsg": "Induce anesthesia immediately.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 96, 
            "baseAbpM": 116, 
            "baseAbpS": 176, 
            "baseBicarb": 24, 
            "baseHr": 108, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are clear bilaterally.", 
            "cardiacOutput": 4.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 16, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 0, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": false, 
            "mentalStatusMsg": "The patient is dreaming about calling his lawyer.", 
            "papD": 18, 
            "papM": 26, 
            "papS": 34, 
            "papW": 16, 
            "pulseMsg": "The pulse is strong.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Lightly sedated but paralyzed.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 3, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": 0.2, 
            "stSegV5": 0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "SEDATED", 
                    "comment": "The neuromuscular blocker started wearing off.", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "nmb", 
                            "value": 0.5
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "ASLEEPAPNEA", 
                    "comment": "You administered sedative agent to this paralyzed patient.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.6
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "ASLEEPAPNEA", 
            "whatNextMsg": "Secure the airway, ensure adequate anesthesia and instruct the surgeon to operate.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 76, 
            "baseAbpM": 90, 
            "baseAbpS": 118, 
            "baseBicarb": 24, 
            "baseHr": 78, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 3.8, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 14, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 10, 
            "papM": 16, 
            "papS": 26, 
            "papW": 10, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Anesthetized mainly with intravenous agents.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 3, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "AWAPNEA", 
                    "comment": "You secured the airway with an endotracheal tube. (+100 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "AWAPNEA", 
                    "comment": "You should have secured the airway with an endotracheal tube for this operation. (Lost points)", 
                    "conditions": [
                        {
                            "type": "airwayLma", 
                            "value": true
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "ASLEEPBREATHE", 
            "whatNextMsg": "Secure the airway, ensure adequate anesthesia and instruct the surgeon to operate.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 56, 
            "baseAbpM": 68, 
            "baseAbpS": 88, 
            "baseBicarb": 24, 
            "baseHr": 92, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 4, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 14, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 12, 
            "papM": 16, 
            "papS": 28, 
            "papW": 12, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Anesthetized mainly with inhalation agents.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 3, 
            "spontRr": 16, 
            "spontTv": 200, 
            "sputumAmount": 0, 
            "stSegII": -0.3, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "AWBREATHE", 
                    "comment": "You secured the airway with an endotracheal tube. (+100 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "AWBREATHE", 
                    "comment": "You should have secured the airway with an endotracheal tube for this operation. (Lost points)", 
                    "conditions": [
                        {
                            "type": "airwayLma", 
                            "value": true
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "ASLEEPAPNEA", 
                    "comment": "Intravenous agent(s) caused respiratory depression.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "mic", 
                            "value": 0.55
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "ASLEEPAPNEA", 
                    "comment": "The patient is paralyzed.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "nmb", 
                            "value": 0.8
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "XSINDUCTION", 
            "whatNextMsg": "Secure the airway and administer pressors.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 56, 
            "baseAbpM": 64, 
            "baseAbpS": 76, 
            "baseBicarb": 23.8, 
            "baseHr": 98, 
            "basePot": 4.8, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 3.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 5, 
            "finalState": 0, 
            "glucose": 120, 
            "hct": 46, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 6, 
            "papM": 9, 
            "papS": 15, 
            "papW": 5, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Excessive induction agent administered.", 
            "rhythm": "St1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 144, 
            "sat20": 93, 
            "sat40": 95, 
            "sat100": 99, 
            "spSignal": 2, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.3, 
            "stSegV5": -0.2, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "AWDEEP", 
                    "comment": "You secured the airway with an endotracheal tube. (+100 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "AWDEEP", 
                    "comment": "You should have secured the airway with an endotracheal tube for this operation. (Lost points)", 
                    "conditions": [
                        {
                            "type": "airwayLma", 
                            "value": true
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "AWAPNEA", 
            "whatNextMsg": "Provide adequate anesthesia and inform the surgeon when the patient is ready for surgery.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 78, 
            "baseAbpM": 90, 
            "baseAbpS": 122, 
            "baseBicarb": 24, 
            "baseHr": 76, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 3.8, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 14, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 10, 
            "papM": 16, 
            "papS": 26, 
            "papW": 10, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Anesthetized, airway secured, no spontaneous breathing.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 3, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "OPAPNEA", 
                    "comment": "You anesthetized the patient adequately for surgery. (+200 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 1.3
                        }, 
                        {
                            "type": "doingSurgery", 
                            "value": true
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "OPLITEAPNEA", 
                    "comment": "You did not provide adequate anesthesia for incision. (Lost points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "doa", 
                            "value": 1.4
                        }, 
                        {
                            "type": "doingSurgery", 
                            "value": true
                        }
                    ], 
                    "points": -200
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "AWBREATHE", 
            "whatNextMsg": "Provide adequate anesthesia and inform the surgeon when the patient is ready for surgery.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 58, 
            "baseAbpM": 68, 
            "baseAbpS": 90, 
            "baseBicarb": 24, 
            "baseHr": 90, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 4, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 14, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 12, 
            "papM": 16, 
            "papS": 28, 
            "papW": 12, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Anesthetized, airway secured, breathing spontaneously.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 3, 
            "spontRr": 16, 
            "spontTv": 180, 
            "sputumAmount": 0, 
            "stSegII": -0.3, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "OPBREATHE", 
                    "comment": "You anesthetized the patient adequately for surgery. (+200 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 1.3
                        }, 
                        {
                            "type": "doingSurgery", 
                            "value": true
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "OPLITEBREATHE", 
                    "comment": "You did not provide adequate anesthesia for incision. (Lost points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "doa", 
                            "value": 1.4
                        }, 
                        {
                            "type": "doingSurgery", 
                            "value": true
                        }
                    ], 
                    "points": -200
                }, 
                {
                    "nextState": "AWAPNEA", 
                    "comment": "Intravenous agent(s) caused respiratory depression.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "mic", 
                            "value": 0.55
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "AWAPNEA", 
                    "comment": "The patient is paralyzed.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "nmb", 
                            "value": 0.8
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "AWDEEP", 
            "whatNextMsg": "Inform the surgeon when the patient is ready for surgery.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 58, 
            "baseAbpM": 66, 
            "baseAbpS": 78, 
            "baseBicarb": 24, 
            "baseHr": 96, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 3.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 4, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 6, 
            "papM": 10, 
            "papS": 16, 
            "papW": 6, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Deeply anesthetized, airway secured.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 2, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "OPDEEP", 
                    "comment": "You anesthetized the patient for surgery. (+100 points)", 
                    "conditions": [
                        {
                            "type": "doingSurgery", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "OPLITEAPNEA", 
            "whatNextMsg": "Deepen the level of anesthesia and monitor closely.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 80, 
            "baseAbpM": 98, 
            "baseAbpS": 136, 
            "baseBicarb": 24, 
            "baseHr": 132, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 3.8, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 14, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 12, 
            "papM": 16, 
            "papS": 28, 
            "papW": 12, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "Operation underway, light anesthesia, no spontaneous breathing.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 3, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "GA2", 
                    "comment": "You deepened the anesthetic for surgery. (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 2
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "OPAPNEA", 
            "whatNextMsg": "Maintain appropriate level of anesthesia and monitor closely.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 80, 
            "baseAbpM": 92, 
            "baseAbpS": 126, 
            "baseBicarb": 24, 
            "baseHr": 122, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 3.8, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 14, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 12, 
            "papM": 16, 
            "papS": 28, 
            "papW": 12, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "Operation underway, no spontaneous breathing.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 3, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "GA2", 
                    "comment": "You provided adequate anesthesia for surgery. (+200 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 2
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "OPLITEBREATHE", 
            "whatNextMsg": "Deepen the level of anesthesia and monitor closely.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 60, 
            "baseAbpM": 78, 
            "baseAbpS": 104, 
            "baseBicarb": 24, 
            "baseHr": 134, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 4, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 14, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is grimmacing.", 
            "papD": 14, 
            "papM": 20, 
            "papS": 30, 
            "papW": 12, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "Operation underway, light anesthesia, breathing spontaneously.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 3, 
            "spontRr": 22, 
            "spontTv": 170, 
            "sputumAmount": 0, 
            "stSegII": -0.3, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "GA2", 
                    "comment": "You deepened the anesthesia for surgery. (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 2
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "OPAPNEA", 
                    "comment": "Intravenous agent(s) caused respiratory depression.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "mic", 
                            "value": 0.55
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "OPAPNEA", 
                    "comment": "The patient is paralyzed.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "nmb", 
                            "value": 0.8
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "OPBREATHE", 
            "whatNextMsg": "Maintain appropriate level of anesthesia and monitor closely.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 60, 
            "baseAbpM": 72, 
            "baseAbpS": 94, 
            "baseBicarb": 24, 
            "baseHr": 124, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 4, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 14, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 14, 
            "papM": 20, 
            "papS": 30, 
            "papW": 12, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "Operation underway, breathing spontaneously.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 3, 
            "spontRr": 14, 
            "spontTv": 180, 
            "sputumAmount": 0, 
            "stSegII": -0.3, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "GA2", 
                    "comment": "You provided adequate anesthesia for surgery. (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 2
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "OPAPNEA", 
                    "comment": "Intravenous agent(s) caused respiratory depression.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "mic", 
                            "value": 0.55
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "OPAPNEA", 
                    "comment": "The patient is paralyzed.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "nmb", 
                            "value": 0.8
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "OPDEEP", 
            "whatNextMsg": "Add inotropic support with dopamine or dobutamine.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 60, 
            "baseAbpM": 68, 
            "baseAbpS": 80, 
            "baseBicarb": 24, 
            "baseHr": 98, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 3.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 6, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 6, 
            "papM": 10, 
            "papS": 18, 
            "papW": 6, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "Operation underway, deeply anesthetized", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 2, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "GA2", 
                    "comment": "You administered ephedrine as an inotropic agent. (+50 points)", 
                    "conditions": [
                        {
                            "drug": "Ephedrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 9
                        }
                    ], 
                    "points": 50
                }, 
                {
                    "nextState": "GA2", 
                    "comment": "You administered a bolus of epinephrine as an inotropic agent. (+50 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 19
                        }
                    ], 
                    "points": 50
                }, 
                {
                    "nextState": "GA2", 
                    "comment": "You administered an infusion of dopamine as an inotropic agent. (+100 points)", 
                    "conditions": [
                        {
                            "drug": "Dopamine", 
                            "op": "GT", 
                            "type": "iDrug", 
                            "value": 4
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "GA2", 
                    "comment": "You administered an infusion of dobutamine as an inotropic agent. (+100 points)", 
                    "conditions": [
                        {
                            "drug": "Dobutamine", 
                            "op": "GT", 
                            "type": "iDrug", 
                            "value": 4
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "GA2", 
                    "comment": "You administered an infusion of epinephrine as an inotropic agent. (+50 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "iDrug", 
                            "value": 0.1
                        }
                    ], 
                    "points": 50
                }, 
                {
                    "nextState": "GA2", 
                    "comment": "You administered an infusion of norepinephrine as an inotropic agent. (+50 points)", 
                    "conditions": [
                        {
                            "drug": "Norepinephrine", 
                            "op": "GT", 
                            "type": "iDrug", 
                            "value": 0.1
                        }
                    ], 
                    "points": 50
                }, 
                {
                    "nextState": "OPHYPO1", 
                    "comment": "You administered a bolus of phenylephrine to this patient with heart failure. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Phenylephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 40
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "OPHYPO1", 
                    "comment": "You administered an infusion of phenylephrine to this patient with heart failure. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Phenylephrine", 
                            "op": "GT", 
                            "type": "iDrug", 
                            "value": 0.9
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "OPHYPO1", 
                    "comment": "You waited too long to treat hypotension in this patient with heart failure. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 120
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "GA2", 
            "whatNextMsg": "Maintain appropriate level of anesthesia and monitor closely.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 64, 
            "baseAbpM": 70, 
            "baseAbpS": 84, 
            "baseBicarb": 24, 
            "baseHr": 102, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 3, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 6, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 8, 
            "papM": 12, 
            "papS": 20, 
            "papW": 8, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Adequate anesthesia", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 3, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "STABLE", 
                    "comment": "You provided appropriate anesthetic to this patient. (+200 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 180
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "OPDEEP", 
                    "comment": "You provided excessive anesthetic to this patient. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 3.3
                        },
                        {
                            "drug": "Dopamine", 
                            "op": "LT", 
                            "type": "iDrug", 
                            "value": 0.9
                        },
                        {
                            "drug": "Dobutamine", 
                            "op": "LT", 
                            "type": "iDrug", 
                            "value": 0.9
                        }
                    ], 
                    "points": -200
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "STABLE", 
            "whatNextMsg": "You satisfied the learning objectives for this case. End of simulation.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 62, 
            "baseAbpM": 70, 
            "baseAbpS": 88, 
            "baseBicarb": 24, 
            "baseHr": 96, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 3.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 6, 
            "finalState": 1, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 6, 
            "papM": 10, 
            "papS": 18, 
            "papW": 6, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Adequately anesthetized.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 3, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "OPHYPO1", 
            "whatNextMsg": "Add inotropic support with dopamine or dobutamine.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 54, 
            "baseAbpM": 60, 
            "baseAbpS": 74, 
            "baseBicarb": 24, 
            "baseHr": 114, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 2.6, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 8, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 10, 
            "papM": 14, 
            "papS": 22, 
            "papW": 10, 
            "pulseMsg": "The pulse is weak.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "Hypotensive", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is cool with slow capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 2, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "GA2", 
                    "comment": "You administered ephedrine as an inotropic agent. (+50 points)", 
                    "conditions": [
                        {
                            "drug": "Ephedrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 9
                        }
                    ], 
                    "points": 50
                }, 
                {
                    "nextState": "GA2", 
                    "comment": "You administered a bolus of epinephrine as an inotropic agent. (+50 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 19
                        }
                    ], 
                    "points": 50
                }, 
                {
                    "nextState": "GA2", 
                    "comment": "You administered an infusion of dopamine as an inotropic agent. (+100 points)", 
                    "conditions": [
                        {
                            "drug": "Dopamine", 
                            "op": "GT", 
                            "type": "iDrug", 
                            "value": 4
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "GA2", 
                    "comment": "You administered an infusion of dobutamine as an inotropic agent. (+100 points)", 
                    "conditions": [
                        {
                            "drug": "Dobutamine", 
                            "op": "GT", 
                            "type": "iDrug", 
                            "value": 4
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "GA2", 
                    "comment": "You administered an infusion of epinephrine as an inotropic agent. (+50 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "iDrug", 
                            "value": 0.1
                        }
                    ], 
                    "points": 50
                }, 
                {
                    "nextState": "GA2", 
                    "comment": "You administered an infusion of norepinephrine as an inotropic agent. (+50 points)", 
                    "conditions": [
                        {
                            "drug": "Norepinephrine", 
                            "op": "GT", 
                            "type": "iDrug", 
                            "value": 0.1
                        }
                    ], 
                    "points": 50
                }, 
                {
                    "nextState": "OPHYPO2", 
                    "comment": "You administered a bolus of phenylephrine to this patient with heart failure. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Phenylephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 40
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "OPHYPO2", 
                    "comment": "You administered an infusion of phenylephrine to this patient with heart failure. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Phenylephrine", 
                            "op": "GT", 
                            "type": "iDrug", 
                            "value": 1.9
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "OPHYPO2", 
                    "comment": "You waited too long to treat hypotension in this patient with heart failure. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 120
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "OPHYPO2", 
            "whatNextMsg": "Add inotropic support with dopamine or dobutamine.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 50, 
            "baseAbpM": 56, 
            "baseAbpS": 66, 
            "baseBicarb": 24, 
            "baseHr": 128, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 2.4, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 8, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 12, 
            "papM": 16, 
            "papS": 24, 
            "papW": 12, 
            "pulseMsg": "The pulse is absent", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "Severely hypotensive.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is cool with slow capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 1, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "GA2", 
                    "comment": "You administered ephedrine as an inotropic agent. (+50 points)", 
                    "conditions": [
                        {
                            "drug": "Ephedrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 9
                        }
                    ], 
                    "points": 50
                }, 
                {
                    "nextState": "GA2", 
                    "comment": "You administered a bolus of epinephrine as an inotropic agent. (+50 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 19
                        }
                    ], 
                    "points": 50
                }, 
                {
                    "nextState": "GA2", 
                    "comment": "You administered an infusion of dopamine as an inotropic agent. (+100 points)", 
                    "conditions": [
                        {
                            "drug": "Dopamine", 
                            "op": "GT", 
                            "type": "iDrug", 
                            "value": 4
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "GA2", 
                    "comment": "You administered an infusion of dobutamine as an inotropic agent. (+100 points)", 
                    "conditions": [
                        {
                            "drug": "Dobutamine", 
                            "op": "GT", 
                            "type": "iDrug", 
                            "value": 4
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "GA2", 
                    "comment": "You administered an infusion of epinephrine as an inotropic agent. (+50 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "iDrug", 
                            "value": 0.1
                        }
                    ], 
                    "points": 50
                }, 
                {
                    "nextState": "GA2", 
                    "comment": "You administered an infusion of norepinephrine as an inotropic agent. (+50 points)", 
                    "conditions": [
                        {
                            "drug": "Norepinephrine", 
                            "op": "GT", 
                            "type": "iDrug", 
                            "value": 0.1
                        }
                    ], 
                    "points": 50
                }, 
                {
                    "nextState": "DESATASYST", 
                    "comment": "You waited too long to treat hypotension in this patient with heart failure. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 120
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "DESATBRADY1", 
            "whatNextMsg": "Must reverse hypoxia immediately and treat bradycardia.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 48, 
            "baseAbpM": 62, 
            "baseAbpS": 92, 
            "baseBicarb": 24, 
            "baseHr": 32, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 0.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 12, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Slow, regular rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 8, 
            "papM": 12, 
            "papS": 18, 
            "papW": 8, 
            "pulseMsg": "The pulse is weak and slow.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Hypoxic and bradycardic.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is cyanotic with poor capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 60, 
            "sat40": 61, 
            "sat100": 62, 
            "spSignal": 1, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": 0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "DESATBRADY2", 
                    "comment": "", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 0
                }
            ]
        }, 
        {
            "name": "DESATBRADY2", 
            "whatNextMsg": "Must reverse hypoxia immediately and treat bradycardia.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 38, 
            "baseAbpM": 50, 
            "baseAbpS": 72, 
            "baseBicarb": 24, 
            "baseHr": 22, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 0.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 12, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Very slow, regular rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 8, 
            "papM": 12, 
            "papS": 18, 
            "papW": 8, 
            "pulseMsg": "The pulse is weak and very slow.", 
            "pupilsMsg": "The pupils are large.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Hypoxic and severely bradycardic.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is cyanotic with poor capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 60, 
            "sat40": 61, 
            "sat100": 62, 
            "spSignal": 1, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": 0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "DESATASYST", 
                    "comment": "", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 20
                        }
                    ], 
                    "points": 0
                }
            ]
        }, 
        {
            "name": "DESATASYST", 
            "whatNextMsg": "CPR, epinephrine, atropine.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 18, 
            "baseAbpM": 18, 
            "baseAbpS": 18, 
            "baseBicarb": 24, 
            "baseHr": 0, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 0.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 18, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Heart sounds are absent.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
			"overdoseFlag": false,
            "papD": 18, 
            "papM": 18, 
            "papS": 18, 
            "papW": 18, 
            "pulseMsg": "The pulse is absent.", 
            "pupilsMsg": "The pupils are large.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Hypoxic and asystolic.", 
            "rhythm": "Asystole1", 
            "skinMsg": "The skin is cyanotic with poor capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 60, 
            "sat40": 61, 
            "sat100": 62, 
            "spSignal": 0, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": 0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "DEAD", 
                    "comment": "", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 0
                }
            ]
        }, 
        {
            "name": "DEAD", 
            "whatNextMsg": "Notify the family.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 18, 
            "baseAbpM": 18, 
            "baseAbpS": 18, 
            "baseBicarb": 24, 
            "baseHr": 0, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 0.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 18, 
            "finalState": -2, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Heart sounds are absent.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
			"overdoseFlag": false,
            "papD": 18, 
            "papM": 18, 
            "papS": 18, 
            "papW": 18, 
            "pulseMsg": "The pulse is absent.", 
            "pupilsMsg": "The pupils are fixed and dilated.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "The patient cannot be resuscitated. End of case simulation.", 
            "rhythm": "Asystole1", 
            "skinMsg": "The skin is cyanotic.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 60, 
            "sat40": 61, 
            "sat100": 62, 
            "spSignal": 0, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": 0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9
        }
    ]
}