CaseData[43] = {
    "title": "Case 102 - 22 year old for appendectomy", 
    "badDrugs": ["Dantrolene"], 
    "coMin": 1.2, 
    "debriefMsg": "based on anaphylaxis case 6", 
    "depthCarina": 25, 
    "depthCords": 18, 
    "depthTubeInitial": 22, 
    "durationPrep": 60, 
    "durationSurgery": 1200, 
    "helpFlag": false, 
    "imageSet": 3, 
    "initialSat": 98, 
    "leanBodyMass": 70, 
    "learningObj": "", 
    "possiblePoints": 1800, 
    "preopMsg": "\n22 year old healthy female for appendectomy\n\nHistory of Present Illness\nThe patient complains of lower abdominal pain for the last 12 hours.\n\nPast Medical History\nIllnesses - seasonal allergies\nSurgeries - none\nMeds - none, except occasional antihistamines\nMed allergies - none\nHabits - denies smoking and drinking. Denies intravenous drugs.\n\nFamily History\nNo anesthetic complications\n\nPhysical Exam\nThin, fit appearing female, anxious and in mild distress\nWeight: 64 kg\nHR 108,  BP 126/60,  RR 20,  T 37.2\nAirway - normal\nLungs - clear\nHeart - normal\n\nLabs\nHematocrit 42,  White blood cell count 12.2\nElectrolytes, Glucose, Blood Urea Nitrogen, creatinine - normal\n\nNPO Status\nLast ate 13 hours ago. \n\nPatient and Surgeon Requests\nThe patient requests general anesthesia. The procedure is scheduled for 60 minutes.\n\n", 
    "volAnDsp": 80, 
    "states": [
        {
            "name": "AWAKE", 
            "whatNextMsg": "Administer oxygen by mask and a sedative agent.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 80, 
            "baseAbpM": 92, 
            "baseAbpS": 140, 
            "baseBicarb": 23.8, 
            "baseHr": 88, 
            "basePot": 4.8, 
            "breathSoundsMsg": "The breath sounds are clear bilaterally.", 
            "cardiacOutput": 5.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 14, 
            "finalState": 0, 
            "glucose": 120, 
            "hct": 39, 
            "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": 12, 
            "papM": 16, 
            "papS": 28, 
            "papW": 12, 
            "pulseMsg": "The pulse is strong and regular.", 
            "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 with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 144, 
            "sat20": 98, 
            "sat40": 99, 
            "sat100": 100, 
            "spSignal": 3, 
            "spontRr": 16, 
            "spontTv": 320, 
            "sputumAmount": 0, 
            "stSegII": 0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "SEDATEDIV1", 
                    "comment": "You administered an intravenous sedative agent. (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.1
                        }, 
                        {
                            "op": "GT", 
                            "type": "mic", 
                            "value": 0.05
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "SEDATEDINH", 
                    "comment": "You administered an inhalational anesthetic. (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.1
                        }, 
                        {
                            "op": "LT", 
                            "type": "mic", 
                            "value": 0.05
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "COUGH5", 
                    "comment": "You tried to insert a laryngeal mask airway in an unanesthetized patient. (Lost points)", 
                    "conditions": [
                        {
                            "type": "tryLma", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "COUGH5", 
                    "comment": "You tried to insert the endotracheal tube in an unanesthetized patient. (Lost points)", 
                    "conditions": [
                        {
                            "type": "tryLaryTube", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "AWAKEPARA", 
                    "comment": "You paralyzed an unanesthetized patient. (-500 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "nmb", 
                            "value": 0.8
                        }, 
                        {
                            "op": "LT", 
                            "type": "doa", 
                            "value": 0.4
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "HURT5", 
                    "comment": "You should not have allowed the surgeon to make an incision in an unanesthetized patient. (-1000 points)", 
                    "conditions": [
                        {
                            "type": "makeIncision", 
                            "value": true
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "SEDATEDIV1", 
            "whatNextMsg": "Continue induction.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 80, 
            "baseAbpM": 92, 
            "baseAbpS": 135, 
            "baseBicarb": 24, 
            "baseHr": 84, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are clear.", 
            "cardiacOutput": 5.2, 
            "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 reduced.", 
            "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": "Lightly sedated with intravenous agents.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 98, 
            "sat40": 99, 
            "sat100": 100, 
            "spSignal": 3, 
            "spontRr": 12, 
            "spontTv": 300, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "AWAKE", 
                    "comment": "The patient recovered from the sedative. (Lost points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "doa", 
                            "value": 0.05
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "SEDATEDIV2", 
                    "comment": "You administered enough intravenous agent to heavily sedate the patient. (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.5
                        }, 
                        {
                            "op": "GT", 
                            "type": "mic", 
                            "value": 0.25
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "SEDATEDINH", 
                    "comment": "", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "mic", 
                            "value": 0.1
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "COUGH4", 
                    "comment": "You should not have tried to place the LMA in a lightly sedated patient. (Lost points)", 
                    "conditions": [
                        {
                            "type": "tryLma", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "COUGH4", 
                    "comment": "You should not have tried to place the endotracheal tube in a lightly sedated patient. (Lost points)", 
                    "conditions": [
                        {
                            "type": "tryLaryTube", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "HURT4", 
                    "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": "You should not have paralyzed a lightly sedated patient. (-500 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "nmb", 
                            "value": 0.8
                        }
                    ], 
                    "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": "SEDATEDIV2", 
            "whatNextMsg": "Continue induction.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 80, 
            "baseAbpM": 92, 
            "baseAbpS": 135, 
            "baseBicarb": 24, 
            "baseHr": 84, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are clear.", 
            "cardiacOutput": 5.2, 
            "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 reduced.", 
            "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": "Deeply sedated with intravenous agents.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 98, 
            "sat40": 99, 
            "sat100": 100, 
            "spSignal": 3, 
            "spontRr": 4, 
            "spontTv": 200, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "SEDATEDIV1", 
                    "comment": "The patient recovered from the sedative. (Lost points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "doa", 
                            "value": 0.4
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "SEDATEDINH", 
                    "comment": "", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "mic", 
                            "value": 0.25
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "ASLEEPIV", 
                    "comment": "You administered enough intravenous agent to lightly anesthetize the patient. (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.8
                        }, 
                        {
                            "op": "GT", 
                            "type": "mic", 
                            "value": 0.4
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "ASLEEPINH", 
                    "comment": "You administered enough inhalation agent to lightly anesthetize the patient. (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.8
                        }, 
                        {
                            "op": "LT", 
                            "type": "mic", 
                            "value": 0.3
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "COUGH4", 
                    "comment": "You should not have tried to place the LMA in a sedated patient. (Lost points)", 
                    "conditions": [
                        {
                            "type": "tryLma", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "COUGH4", 
                    "comment": "You should not have tried to place the endotracheal tube in an unanesthetized patient. (Lost points)", 
                    "conditions": [
                        {
                            "type": "tryLaryTube", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "HURT4", 
                    "comment": "You should not have allowed the surgeon to make an incision in an unanesthetized patient. (-500 points)", 
                    "conditions": [
                        {
                            "type": "makeIncision", 
                            "value": true
                        }
                    ], 
                    "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": "ASLEEPIV", 
            "whatNextMsg": "Place the endotracheal tube.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 68, 
            "baseAbpM": 86, 
            "baseAbpS": 122, 
            "baseBicarb": 24, 
            "baseHr": 76, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 5.2, 
            "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": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Anesthetized with intravenous agents.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 98, 
            "sat40": 99, 
            "sat100": 100, 
            "spSignal": 2, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "SEDATEDIV2", 
                    "comment": "You decreased the anesthetic depth. (Lost points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "doa", 
                            "value": 0.6
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "ASLEEPINH", 
                    "comment": "You continued to administer inhalation agent.", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "mic", 
                            "value": 0.3
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "AWIV", 
                    "comment": "You should place an endotracheal tube due to the meal four hours ago. (Lost points)", 
                    "conditions": [
                        {
                            "type": "tryLma", 
                            "value": true
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "AWIV", 
                    "comment": "You successfully placed the endotracheal tube. (+100 points)", 
                    "conditions": [
                        {
                            "type": "tryLaryTube", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "AWIV", 
                    "comment": "An endotracheal tube was successfully placed. (+100 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "HURT3", 
                    "comment": "You should not have allowed the surgeon to make an incision in a lightly anesthetized patient. (-500 points)", 
                    "conditions": [
                        {
                            "type": "makeIncision", 
                            "value": true
                        }
                    ], 
                    "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": "AWIV", 
            "whatNextMsg": "Deepen the level of anesthesia.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 78, 
            "baseAbpM": 96, 
            "baseAbpS": 132, 
            "baseBicarb": 24, 
            "baseHr": 82, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 5.2, 
            "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": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Anesthetized and airway secured.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 98, 
            "sat40": 99, 
            "sat100": 100, 
            "spSignal": 2, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "GA2IV", 
                    "comment": "You deepened the level of anesthesia. (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 2.2
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "AWINH", 
                    "comment": "", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "mic", 
                            "value": 0.7
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "HURT1", 
                    "comment": "You should not have allowed the surgeon to make an incision in a lightly anesthetized patient. (Lost points)", 
                    "conditions": [
                        {
                            "type": "makeIncision", 
                            "value": true
                        }
                    ], 
                    "points": -300
                }, 
                {
                    "nextState": "HURT1", 
                    "comment": "You should not have allowed the surgeon to operate on a lightly anesthetized patient. (Lost points)", 
                    "conditions": [
                        {
                            "type": "doingSurgery", 
                            "value": true
                        }
                    ], 
                    "points": -300
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "GA2IV", 
            "whatNextMsg": "Inform the surgeon when the patient is ready.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 68, 
            "baseAbpM": 88, 
            "baseAbpS": 122, 
            "baseBicarb": 24, 
            "baseHr": 80, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 5.2, 
            "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": 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": 96, 
            "sat40": 98, 
            "sat100": 99, 
            "spSignal": 2, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "OPIV", 
                    "comment": "You instructed the surgeon to make the incision at the appropriate time. (+100 points)", 
                    "conditions": [
                        {
                            "type": "makeIncision", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "OPIV", 
                    "comment": "You instructed the surgeon to operate.", 
                    "conditions": [
                        {
                            "type": "doingSurgery", 
                            "value": true
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "GA2INH", 
                    "comment": "", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "mic", 
                            "value": 0.7
                        }
                    ], 
                    "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": "SEDATEDINH", 
            "whatNextMsg": "Continue induction.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 80, 
            "baseAbpM": 92, 
            "baseAbpS": 135, 
            "baseBicarb": 24, 
            "baseHr": 82, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are clear.", 
            "cardiacOutput": 5.2, 
            "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 slowed.", 
            "lmaSuccessFlag": false, 
            "mentalStatusMsg": "The patient has a lethargic response to voice.", 
            "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": "Lightly sedated with inhalation agents.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 94, 
            "sat40": 96, 
            "sat100": 99, 
            "spSignal": 3, 
            "spontRr": 18, 
            "spontTv": 270, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "AWAKE", 
                    "comment": "The patient recovered from the sedative. (Lost points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "doa", 
                            "value": 0.05
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "ASLEEPIV", 
                    "comment": "You administered enough intravenous agent to lightly anesthetize the patient. (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.8
                        }, 
                        {
                            "op": "GT", 
                            "type": "mic", 
                            "value": 0.4
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "ASLEEPINH", 
                    "comment": "You administered enough inhalation agent to lightly anesthetize the patient. (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.8
                        }, 
                        {
                            "op": "LT", 
                            "type": "mic", 
                            "value": 0.4
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "COUGH4", 
                    "comment": "You should not have tried to place the LMA in a lightly sedated patient. (Lost points)", 
                    "conditions": [
                        {
                            "type": "tryLma", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "COUGH4", 
                    "comment": "You should not have tried to place the endotracheal tube in a lightly sedated patient. (Lost points)", 
                    "conditions": [
                        {
                            "type": "tryLaryTube", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "HURT4", 
                    "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": "You should not have paralyzed a lightly sedated patient. (-500 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "nmb", 
                            "value": 0.8
                        }
                    ], 
                    "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": "ASLEEPINH", 
            "whatNextMsg": "Place the endotracheal tube.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 68, 
            "baseAbpM": 86, 
            "baseAbpS": 122, 
            "baseBicarb": 24, 
            "baseHr": 86, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 5.2, 
            "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": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Adequately anesthetized with intravenous agents.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 94, 
            "sat40": 96, 
            "sat100": 99, 
            "spSignal": 2, 
            "spontRr": 20, 
            "spontTv": 300, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "SEDATEDINH", 
                    "comment": "You decreased the anesthetic depth. (Lost points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "doa", 
                            "value": 0.6
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "ASLEEPIV", 
                    "comment": "You administered intravenous anesthetic agent.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "mic", 
                            "value": 0.4
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "AWINH", 
                    "comment": "You should place an endotracheal tube due to the meal four hours ago. (Lost points)", 
                    "conditions": [
                        {
                            "type": "tryLma", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "AWINH", 
                    "comment": "You successfully placed the endotracheal tube. (+100 points)", 
                    "conditions": [
                        {
                            "type": "tryLaryTube", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "AWINH", 
                    "comment": "An endotracheal tube was successfully placed. (+100 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "HURT3", 
                    "comment": "You should not have allowed the surgeon to make an incision in a lightly anesthetized patient. (Lost points)", 
                    "conditions": [
                        {
                            "type": "makeIncision", 
                            "value": true
                        }
                    ], 
                    "points": -300
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "AWINH", 
            "whatNextMsg": "Deepen the level of anesthesia.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 78, 
            "baseAbpM": 96, 
            "baseAbpS": 132, 
            "baseBicarb": 24, 
            "baseHr": 88, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 5.2, 
            "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": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Anesthetized and airway secured.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 94, 
            "sat40": 96, 
            "sat100": 100, 
            "spSignal": 2, 
            "spontRr": 22, 
            "spontTv": 250, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "GA2INH", 
                    "comment": "You deepened the level of anesthesia. (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 2.2
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "AWIV", 
                    "comment": "", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "mic", 
                            "value": 0.8
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "HURT1", 
                    "comment": "You should not have allowed the surgeon to make an incision in a lightly anesthetized patient. (Lost points)", 
                    "conditions": [
                        {
                            "type": "makeIncision", 
                            "value": true
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "HURT1", 
                    "comment": "You should not have allowed the surgeon to operate on a lightly anesthetized patient. (Lost 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": "GA2INH", 
            "whatNextMsg": "Inform the surgeon when the patient is ready.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 68, 
            "baseAbpM": 88, 
            "baseAbpS": 122, 
            "baseBicarb": 24, 
            "baseHr": 84, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 5.2, 
            "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": 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": 93, 
            "sat40": 94, 
            "sat100": 98, 
            "spSignal": 2, 
            "spontRr": 20, 
            "spontTv": 240, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "OPINH", 
                    "comment": "You instructed the surgeon to make the incision at the appropriate time. (+100 points)", 
                    "conditions": [
                        {
                            "type": "makeIncision", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "OPINH", 
                    "comment": "You instructed the surgeon to operate.", 
                    "conditions": [
                        {
                            "type": "doingSurgery", 
                            "value": true
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "GA2IV", 
                    "comment": "", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "mic", 
                            "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": "OPINH", 
            "whatNextMsg": "Monitor closely and adjust anesthetic as needed.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 78, 
            "baseAbpM": 98, 
            "baseAbpS": 134, 
            "baseBicarb": 24, 
            "baseHr": 88, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 5.2, 
            "contPip": 30, 
            "contPlateau": 28, 
            "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": "Maintenance anesthesia.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 93, 
            "sat40": 94, 
            "sat100": 99, 
            "spSignal": 2, 
            "spontRr": 18, 
            "spontTv": 230, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "TACHYINH", 
                    "comment": "The simulation forced the patient to develop anaphylaxis.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 180
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "OPIV", 
                    "comment": "", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "mic", 
                            "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": "OPIV", 
            "whatNextMsg": "Monitor closely and adjust anesthetic as needed.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 78, 
            "baseAbpM": 98, 
            "baseAbpS": 134, 
            "baseBicarb": 24, 
            "baseHr": 88, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 5.2, 
            "contPip": 30, 
            "contPlateau": 28, 
            "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": "Maintenance anesthesia.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 93, 
            "sat40": 94, 
            "sat100": 98, 
            "spSignal": 2, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "TACHYIV", 
                    "comment": "The simulation forced the patient to develop anaphylaxis.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 180
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "OPINH", 
                    "comment": "", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "mic", 
                            "value": 0.7
                        }
                    ], 
                    "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": "TACHYIV", 
            "whatNextMsg": "Recheck the blood pressure before treating tachycardia.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 68, 
            "baseAbpM": 88, 
            "baseAbpS": 114, 
            "baseBicarb": 24, 
            "baseHr": 106, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 5.2, 
            "contPip": 32, 
            "contPlateau": 30, 
            "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": "The patient has become markedly tachycardic.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 90, 
            "sat40": 93, 
            "sat100": 99, 
            "spSignal": 2, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "ANAPH1", 
                    "comment": "The simulation forced the patient to become more tachycardic and hypotensive.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 40
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "TACHYINH", 
                    "comment": "", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "mic", 
                            "value": 0.7
                        }
                    ], 
                    "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": "TACHYINH", 
            "whatNextMsg": "Recheck the blood pressure before treating tachycardia.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 68, 
            "baseAbpM": 88, 
            "baseAbpS": 114, 
            "baseBicarb": 24, 
            "baseHr": 106, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 5.2, 
            "contPip": 32, 
            "contPlateau": 30, 
            "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.", 
			"overdoseFlag": false,
            "papD": 12, 
            "papM": 16, 
            "papS": 28, 
            "papW": 12, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "The patient has become markedly tachycardic.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 92, 
            "sat100": 97, 
            "spSignal": 2, 
            "spontRr": 22, 
            "spontTv": 230, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "ANAPH1", 
                    "comment": "The simulation forced the patient to develop anaphylaxis.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 40
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "TACHYIV", 
                    "comment": "", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "mic", 
                            "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": "ANAPH1", 
            "whatNextMsg": "Examine the patient and make the diagnosis.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 62, 
            "baseAbpM": 72, 
            "baseAbpS": 88, 
            "baseBicarb": 24, 
            "baseHr": 118, 
            "basePot": 4.2, 
            "breathSoundsMsg": "There are a few scattered wheezes present.", 
            "cardiacOutput": 3, 
            "contPip": 34, 
            "contPlateau": 32, 
            "cvp": 7, 
            "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.", 
			"overdoseFlag": false,
            "papD": 6, 
            "papM": 8, 
            "papS": 14, 
            "papW": 6, 
            "pulseMsg": "The pulse is rapid and weak.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "The patient has become markedly tachycardic and hypotensive.", 
            "rhythm": "Sinus1", 
            "skinMsg": "There is a red rash spreading up the arm from the IV site.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 86, 
            "sat40": 90, 
            "sat100": 94, 
            "spSignal": 2, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "ANAPH2", 
                    "comment": "The simulation forced the patient to become more tachycardic and hypotensive.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 40
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "EP1", 
                    "comment": "You administered an appropriate bolus of epinephrine. (+200 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 4
                        }, 
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 11
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "ANAPH1", 
                    "comment": "You administered an inadequate bolus of epinephrine. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 5
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "VTACH1", 
                    "comment": "You administered an excessive bolus of epinephrine. (-500 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 199
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "EP1", 
                    "comment": "Recommended bolus of epinephrine for anaphylaxis is 5-10 mcg. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 10
                        }
                    ], 
                    "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": "ANAPH2", 
            "whatNextMsg": "The physical exam reveals hints.", 
			"airwayStr": "restricted",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 45, 
            "baseAbpM": 52, 
            "baseAbpS": 62, 
            "baseBicarb": 24, 
            "baseHr": 134, 
            "basePot": 4.2, 
            "breathSoundsMsg": "There are scattered wheezes present.", 
            "cardiacOutput": 2.4, 
            "contPip": 36, 
            "contPlateau": 34, 
            "cvp": 5, 
            "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.", 
			"overdoseFlag": false,
            "papD": 4, 
            "papM": 7, 
            "papS": 12, 
            "papW": 4, 
            "pulseMsg": "The pulse is rapid and thready.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "The patient has become increasingly tachycardic and hypotensive.", 
            "rhythm": "Sinus1", 
            "skinMsg": "There is a red rash spreading up the arm from the IV site.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 85, 
            "sat40": 89, 
            "sat100": 92, 
            "spSignal": 1, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "ANAPH3", 
                    "comment": "The simulation forced the patient to become pulseless.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "EP1", 
                    "comment": "You administered an appropriate bolus of epinephrine. (+200 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 4
                        }, 
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 11
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "ANAPH2", 
                    "comment": "You administered an inadequate bolus of epinephrine. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 5
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "VTACH1", 
                    "comment": "You administered an excessive bolus of epinephrine. (-500 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 199
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "EP1", 
                    "comment": "Recommended bolus of epinephrine for anaphylaxis is 5-10 mcg. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 10
                        }
                    ], 
                    "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": "ANAPH3", 
            "whatNextMsg": "Resuscitate!", 
			"airwayStr": "restricted",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 36, 
            "baseAbpM": 42, 
            "baseAbpS": 52, 
            "baseBicarb": 24, 
            "baseHr": 128, 
            "basePot": 4.2, 
            "breathSoundsMsg": "There is severe wheezing throughout.", 
            "cardiacOutput": 2.2, 
            "contPip": 48, 
            "contPlateau": 46, 
            "cvp": 4, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Heart sounds are distant.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent. There is periorbital edema.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
			"overdoseFlag": false,
            "papD": 2, 
            "papM": 5, 
            "papS": 10, 
            "papW": 2, 
            "pulseMsg": "The pulse is not palpable.", 
            "pupilsMsg": "The pupils are small. There is periorbital edema.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "The patient has become pulseless.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The red rash is now mottled and purple.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 80, 
            "sat40": 84, 
            "sat100": 86, 
            "spSignal": 0, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "HARDVENT", 
                    "comment": "You should have placed an endotracheal tube in this unstable patient. (-500 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "value": false
                        }, 
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "AWSECURED", 
                    "comment": "The airway is secured with an endotracheal tube. (+200 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "value": true
                        }, 
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "EP1", 
                    "comment": "You administered an appropriate bolus of epinephrine. (+200 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 4
                        }, 
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 11
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "ANAPH3", 
                    "comment": "You administered an inadequate bolus of epinephrine. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 5
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "VTACH1", 
                    "comment": "You administered an excessive bolus of epinephrine. (-500 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 199
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "EP1", 
                    "comment": "Recommended bolus of epinephrine for anaphylaxis is 5-10 mcg. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 10
                        }
                    ], 
                    "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": "HARDVENT", 
            "whatNextMsg": "Examine the patient and make the diagnosis.", 
			"airwayStr": "obstructed",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 26, 
            "baseAbpM": 32, 
            "baseAbpS": 48, 
            "baseBicarb": 24, 
            "baseHr": 132, 
            "basePot": 4.2, 
            "breathSoundsMsg": "There is severe wheezing throughout.", 
            "cardiacOutput": 2.2, 
            "contPip": 68, 
            "contPlateau": 66, 
            "cvp": 4, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Heart sounds are distant.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 0, 
            "lidReflexMsg": "The lid reflex is absent. There is periorbital edema.", 
            "lmaSuccessFlag": false, 
            "mentalStatusMsg": "The patient is unresponsive.", 
			"overdoseFlag": false,
            "papD": 2, 
            "papM": 5, 
            "papS": 10, 
            "papW": 2, 
            "pulseMsg": "The pulse is not palpable.", 
            "pupilsMsg": "The pupils are small. There is periorbital edema.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "The patient has become pulseless and difficult to ventilate.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The red rash is now ashen gray", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 68, 
            "sat40": 72, 
            "sat100": 76, 
            "spSignal": 0, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "The patient became severely hypoxic.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 120
                        }
                    ], 
                    "points": 0
                }
            ]
        }, 
        {
            "name": "AWSECURED", 
            "whatNextMsg": "Examine the patient and make the diagnosis.", 
			"airwayStr": "restricted",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 36, 
            "baseAbpM": 42, 
            "baseAbpS": 52, 
            "baseBicarb": 24, 
            "baseHr": 128, 
            "basePot": 4.2, 
            "breathSoundsMsg": "There is severe wheezing throughout.", 
            "cardiacOutput": 2.2, 
            "contPip": 48, 
            "contPlateau": 46, 
            "cvp": 4, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Heart sounds are distant.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent. There is periorbital edema.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
			"overdoseFlag": false,
            "papD": 2, 
            "papM": 5, 
            "papS": 10, 
            "papW": 2, 
            "pulseMsg": "The pulse is not palpable.", 
            "pupilsMsg": "The pupils are small. There is periorbital edema.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "The airway is secured but the patient has become pulseless.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The red rash is now mottled and purple.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 78, 
            "sat40": 84, 
            "sat100": 86, 
            "spSignal": 0, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "HARDVENT", 
                    "comment": "You need to administer epinephrine and fluids faster. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 360
                        }
                    ], 
                    "points": -300
                }, 
                {
                    "nextState": "FLUID1", 
                    "comment": "You administered a bolus of intravenous fluid appropriately. (+200 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "tFluid", 
                            "value": 1799
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "EP1", 
                    "comment": "You administered an appropriate bolus of epinephrine. (+200 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 4
                        }, 
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 11
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "AWSECURED", 
                    "comment": "You administered an inadequate bolus of epinephrine. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 5
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "VTACH1", 
                    "comment": "You administered an excessive bolus of epinephrine. (-500 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 199
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "EP1", 
                    "comment": "Recommended bolus of epinephrine for anaphylaxis is 5-10 mcg. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 10
                        }
                    ], 
                    "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": "EP1", 
            "whatNextMsg": "Now administer a 25-50 mL/kg bolus of intravenous fluids.", 
			"airwayStr": "restricted",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 46, 
            "baseAbpM": 52, 
            "baseAbpS": 62, 
            "baseBicarb": 24, 
            "baseHr": 126, 
            "basePot": 4.2, 
            "breathSoundsMsg": "There is moderate wheezing throughout.", 
            "cardiacOutput": 2.2, 
            "contPip": 38, 
            "contPlateau": 36, 
            "cvp": 4, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Heart sounds are distant.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent. There is periorbital edema.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
			"overdoseFlag": false,
            "papD": 2, 
            "papM": 5, 
            "papS": 10, 
            "papW": 2, 
            "pulseMsg": "The pulse is thready.", 
            "pupilsMsg": "The pupils are small. There is periorbital edema.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "One dose of epinephrine administered.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The red rash is now mottled.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 80, 
            "sat40": 87, 
            "sat100": 90, 
            "spSignal": 1, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "HARDVENT", 
                    "comment": "You need to administer epinephrine and fluids faster. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 360
                        }
                    ], 
                    "points": -300
                }, 
                {
                    "nextState": "EP1FLUID1", 
                    "comment": "You administered a bolus of intravenous fluid appropriately. (+200 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "tFluid", 
                            "value": 1799
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "EP2", 
                    "comment": "You administered a second bolus of epinephrine appropriately. (+200 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 4
                        }, 
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 21
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "EP1", 
                    "comment": "You administered an inadequate bolus of epinephrine. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 5
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "VTACH2", 
                    "comment": "You administered an excessive bolus of epinephrine. (-500 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 199
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "EP2", 
                    "comment": "Recommended bolus of epinephrine for anaphylaxis is 5-10 mcg. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 10
                        }
                    ], 
                    "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": "EP2", 
            "whatNextMsg": "Now administer a 25-50 mL/kg mL bolus of intravenous fluids.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 48, 
            "baseAbpM": 56, 
            "baseAbpS": 72, 
            "baseBicarb": 24, 
            "baseHr": 124, 
            "basePot": 4.2, 
            "breathSoundsMsg": "There is mild wheezing throughout.", 
            "cardiacOutput": 2.2, 
            "contPip": 34, 
            "contPlateau": 32, 
            "cvp": 4, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Heart sounds are present.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent. There is periorbital edema.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
			"overdoseFlag": false,
            "papD": 2, 
            "papM": 5, 
            "papS": 10, 
            "papW": 2, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are small. There is periorbital edema.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "Second dose of epinephrine administered.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The red rash is now mottled.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 85, 
            "sat40": 89, 
            "sat100": 91, 
            "spSignal": 1, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "HARDVENT", 
                    "comment": "You need to administer intravenous fluids faster. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 360
                        }
                    ], 
                    "points": -300
                }, 
                {
                    "nextState": "EP2FLUID1", 
                    "comment": "You administered a bolus of intravenous fluid appropriately. (+200 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "tFluid", 
                            "value": 1799
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "EP2", 
                    "comment": "You administered an inadequate bolus of epinephrine. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 5
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "VTACH2", 
                    "comment": "You administered an excessive bolus of epinephrine. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 199
                        }
                    ], 
                    "points": -200
                }, 
                 {
                    "nextState": "EP2", 
                    "comment": "Recommended bolus of epinephrine for anaphylaxis is 5-10 mcg. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 10
                        }
                    ], 
                    "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": "FLUID1", 
            "whatNextMsg": "Now give an epinephrine bolus.", 
			"airwayStr": "restricted",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 46, 
            "baseAbpM": 52, 
            "baseAbpS": 62, 
            "baseBicarb": 24, 
            "baseHr": 120, 
            "basePot": 4.2, 
            "breathSoundsMsg": "There is severe wheezing throughout.", 
            "cardiacOutput": 3, 
            "contPip": 48, 
            "contPlateau": 46, 
            "cvp": 6, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Heart sounds are distant.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent. There is periorbital edema.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
			"overdoseFlag": false,
            "papD": 4, 
            "papM": 8, 
            "papS": 14, 
            "papW": 4, 
            "pulseMsg": "The pulse is thready.", 
            "pupilsMsg": "The pupils are small. There is periorbital edema.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "The first fluid bolus was administered.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The red rash is now mottled.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 80, 
            "sat40": 83, 
            "sat100": 86, 
            "spSignal": 1, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "HARDVENT", 
                    "comment": "You need to administer epinephrine and fluids faster. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 360
                        }
                    ], 
                    "points": -300
                }, 
                {
                    "nextState": "FLUID2", 
                    "comment": "You administered a second bolus of intravenous fluid appropriately. (+200 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "tFluid", 
                            "value": 3599
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "EP1FLUID1", 
                    "comment": "You administered an appropriate bolus of epinephrine. (+200 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 4
                        }, 
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 11
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "FLUID1", 
                    "comment": "You administered an inadequate bolus of epinephrine. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 5
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "VTACH1", 
                    "comment": "You administered an excessive bolus of epinephrine. (-500 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 199
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "EP1FLUID1", 
                    "comment": "Recommended bolus of epinephrine for anaphylaxis is 5-10 mcg. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 10
                        }
                    ], 
                    "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": "EP1FLUID1", 
            "whatNextMsg": "Now administer a second bolus of epinephrine and fluids.", 
			"airwayStr": "restricted",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 50, 
            "baseAbpM": 58, 
            "baseAbpS": 72, 
            "baseBicarb": 24, 
            "baseHr": 122, 
            "basePot": 4.2, 
            "breathSoundsMsg": "There is moderate wheezing throughout.", 
            "cardiacOutput": 2.2, 
            "contPip": 38, 
            "contPlateau": 36, 
            "cvp": 4, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Heart sounds are present.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent. There is periorbital edema.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
			"overdoseFlag": false,
            "papD": 2, 
            "papM": 5, 
            "papS": 10, 
            "papW": 2, 
            "pulseMsg": "The pulse is thready.", 
            "pupilsMsg": "The pupils are small. There is periorbital edema.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "First dose of epinephrine and fluid administered.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The red rash is now mottled.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 84, 
            "sat40": 88, 
            "sat100": 90, 
            "spSignal": 1, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "HARDVENT", 
                    "comment": "You need to administer epinephrine and fluids faster. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 360
                        }
                    ], 
                    "points": -300
                }, 
                {
                    "nextState": "EP1FLUID2", 
                    "comment": "You administered a second bolus of intravenous fluid appropriately. (+200 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "tFluid", 
                            "value": 3599
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "EP2FLUID1", 
                    "comment": "You administered a second bolus of epinephrine appropriately. (+200 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 4
                        }, 
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 11
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "EP1FLUID1", 
                    "comment": "You administered an inadequate bolus of epinephrine. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 5
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "VTACH2", 
                    "comment": "You administered an excessive bolus of epinephrine. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 199
                        }
                    ], 
                    "points": -200
                }, 
                {
                    "nextState": "EP2FLUID1", 
                    "comment": "Recommended bolus of epinephrine for anaphylaxis is 5-10 mcg. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 10
                        }
                    ], 
                    "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": "EP2FLUID1", 
            "whatNextMsg": "Now administer a second 1000 mL bolus of intravenous fluids.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 54, 
            "baseAbpM": 62, 
            "baseAbpS": 82, 
            "baseBicarb": 24, 
            "baseHr": 118, 
            "basePot": 4.2, 
            "breathSoundsMsg": "There is mild wheezing throughout.", 
            "cardiacOutput": 2.2, 
            "contPip": 34, 
            "contPlateau": 32, 
            "cvp": 4, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Heart sounds are present.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent. There is periorbital edema.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
			"overdoseFlag": false,
            "papD": 2, 
            "papM": 5, 
            "papS": 10, 
            "papW": 2, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are small. There is periorbital edema.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "Second dose of epinephrine and first bolus of intravenous fluid administered.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The red rash is now mottled.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 85, 
            "sat40": 89, 
            "sat100": 91, 
            "spSignal": 1, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "HARDVENT", 
                    "comment": "You need to administer intravenous fluids faster. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 360
                        }
                    ], 
                    "points": -300
                }, 
                {
                    "nextState": "EP2FLUID2", 
                    "comment": "You administered a second bolus of intravenous fluid appropriately. (+200 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "tFluid", 
                            "value": 3599
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "EP2FLUID1", 
                    "comment": "You administered an inadequate bolus of epinephrine. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 5
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "VTACH2", 
                    "comment": "You administered an excessive bolus of epinephrine. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 199
                        }
                    ], 
                    "points": -200
                }, 
                {
                    "nextState": "EP2FLUID1", 
                    "comment": "Recommended bolus of epinephrine for anaphylaxis is 5-10 mcg. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 10
                        }
                    ], 
                    "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": "FLUID2", 
            "whatNextMsg": "Now give an epinephrine bolus.", 
			"airwayStr": "restricted",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 54, 
            "baseAbpM": 62, 
            "baseAbpS": 72, 
            "baseBicarb": 24, 
            "baseHr": 118, 
            "basePot": 4.2, 
            "breathSoundsMsg": "There is severe wheezing throughout.", 
            "cardiacOutput": 4, 
            "contPip": 48, 
            "contPlateau": 46, 
            "cvp": 8, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Heart sounds are present.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 0, 
            "lidReflexMsg": "The lid reflex is absent. There is periorbital edema.", 
            "lmaSuccessFlag": false, 
            "mentalStatusMsg": "The patient is unresponsive.", 
			"overdoseFlag": false,
            "papD": 6, 
            "papM": 9, 
            "papS": 16, 
            "papW": 6, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are small. There is periorbital edema.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "The second fluid bolus was administered.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The red rash is now mottled.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 80, 
            "sat40": 84, 
            "sat100": 86, 
            "spSignal": 1, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "HARDVENT", 
                    "comment": "You need to administer epinephrine and fluids faster. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 360
                        }
                    ], 
                    "points": -300
                }, 
                {
                    "nextState": "EP1FLUID2", 
                    "comment": "You administered an appropriate bolus of epinephrine. (+200 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 4
                        }, 
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 11
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "FLUID2", 
                    "comment": "You administered an inadequate bolus of epinephrine. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 5
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "VTACH1", 
                    "comment": "You administered an excessive bolus of epinephrine. (-500 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 199
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "EP1FLUID2", 
                    "comment": "Recommended bolus of epinephrine for anaphylaxis is 5-10 mcg. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 10
                        }
                    ], 
                    "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": "EP1FLUID2", 
            "whatNextMsg": "Now administer a second bolus of epinephrine.", 
			"airwayStr": "restricted",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 58, 
            "baseAbpM": 68, 
            "baseAbpS": 82, 
            "baseBicarb": 24, 
            "baseHr": 116, 
            "basePot": 4.2, 
            "breathSoundsMsg": "There is moderate wheezing throughout.", 
            "cardiacOutput": 3.2, 
            "contPip": 38, 
            "contPlateau": 36, 
            "cvp": 8, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Heart sounds are present.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent. There is periorbital edema.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
			"overdoseFlag": false,
            "papD": 6, 
            "papM": 10, 
            "papS": 16, 
            "papW": 5, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are small. There is periorbital edema.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "First dose of epinephrine and second bolus of fluid administered.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The red rash is now mottled.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 85, 
            "sat40": 89, 
            "sat100": 91, 
            "spSignal": 1, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "HARDVENT", 
                    "comment": "You need to administer epinephrine and fluids faster. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 360
                        }
                    ], 
                    "points": -300
                }, 
                {
                    "nextState": "EP2FLUID2", 
                    "comment": "You administered a second bolus of epinephrine appropriately. (+200 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 4
                        }, 
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 11
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "EP1FLUID2", 
                    "comment": "You administered an inadequate bolus of epinephrine. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 5
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "VTACH2", 
                    "comment": "You administered an excessive bolus of epinephrine. (-500 points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 199
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "EP2FLUID2", 
                    "comment": "Recommended bolus of epinephrine for anaphylaxis is 5-10 mcg. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 10
                        }
                    ], 
                    "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": "EP2FLUID2", 
            "whatNextMsg": "Administer diphenhydramine and albuterol.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 64, 
            "baseAbpM": 74, 
            "baseAbpS": 92, 
            "baseBicarb": 24, 
            "baseHr": 114, 
            "basePot": 4.2, 
            "breathSoundsMsg": "There is mild wheezing throughout.", 
            "cardiacOutput": 4, 
            "contPip": 34, 
            "contPlateau": 32, 
            "cvp": 8, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Heart sounds are present.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent. There is periorbital edema.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
			"overdoseFlag": false,
            "papD": 6, 
            "papM": 10, 
            "papS": 16, 
            "papW": 6, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are small. There is periorbital edema.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "Second bolus of epinephrine and intravenous fluid administered.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The red rash is now mottled.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 92, 
            "sat100": 96, 
            "spSignal": 1, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "STABLE", 
                    "comment": "You need to administer diphenhydramine and albuterol faster. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 360
                        }
                    ], 
                    "points": -400
                }, 
                {
                    "nextState": "STABLE", 
                    "comment": "You administered diphenhydramine and albuterol appropriately. (+200 points)", 
                    "conditions": [
                        {
                            "drug": "Diphenhydramine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 49
                        }, 
                        {
                            "drug": "Albuterol", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 1
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "EP2FLUID2", 
                    "comment": "You administered an inadequate dose of diphenhydramine. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Diphenhydramine", 
                            "op": "LT", 
                            "type": "bDrug", 
                            "value": 50
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "VTACH2", 
                    "comment": "You administered an excessive bolus of epinephrine. (Lost points)", 
                    "conditions": [
                        {
                            "drug": "Epinephrine", 
                            "op": "GT", 
                            "type": "bDrug", 
                            "value": 199
                        }
                    ], 
                    "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 successfully resuscitated from anaphylaxis.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 64, 
            "baseAbpM": 74, 
            "baseAbpS": 92, 
            "baseBicarb": 24, 
            "baseHr": 114, 
            "basePot": 4.2, 
            "breathSoundsMsg": "There is mild wheezing throughout.", 
            "cardiacOutput": 4, 
            "contPip": 34, 
            "contPlateau": 32, 
            "cvp": 8, 
            "finalState": 1, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Heart sounds are present.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent. There is periorbital edema.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
			"overdoseFlag": false,
            "papD": 6, 
            "papM": 10, 
            "papS": 16, 
            "papW": 6, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are small. There is periorbital edema.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "The patient is stable.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The red rash is now mottled.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 85, 
            "sat40": 93, 
            "sat100": 96, 
            "spSignal": 1, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9
        }, 
        {
            "name": "VTACH1", 
            "whatNextMsg": "Pulseless ventricular tachycardia should be treated the same as V Fib - defibrillate.", 
			"airwayStr": "restricted",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 36, 
            "baseAbpM": 42, 
            "baseAbpS": 52, 
            "baseBicarb": 24, 
            "baseHr": 142, 
            "basePot": 4.2, 
            "breathSoundsMsg": "There is severe wheezing throughout.", 
            "cardiacOutput": 2.2, 
            "contPip": 48, 
            "contPlateau": 46, 
            "cvp": 4, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Heart sounds are distant.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent. There is periorbital edema.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
			"overdoseFlag": false,
            "papD": 2, 
            "papM": 5, 
            "papS": 10, 
            "papW": 2, 
            "pulseMsg": "The pulse is absent.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "Excessive dose of epinephrine administered.", 
            "rhythm": "Vtach3", 
            "skinMsg": "The red rash is now mottled and purple.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 78, 
            "sat40": 82, 
            "sat100": 86, 
            "spSignal": 1, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "EP1", 
                    "comment": "", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "EP1", 
                    "comment": "You defibrillated for pulseless v tach appropriately. (+50 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "defib", 
                            "value": 199
                        }
                    ], 
                    "points": 50
                }
            ]
        }, 
        {
            "name": "VTACH2", 
            "whatNextMsg": "Pulseless ventricular tachycardia should be treated the same as V Fib - defibrillate.", 
			"airwayStr": "restricted",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 36, 
            "baseAbpM": 42, 
            "baseAbpS": 52, 
            "baseBicarb": 24, 
            "baseHr": 142, 
            "basePot": 4.2, 
            "breathSoundsMsg": "There is severe wheezing throughout.", 
            "cardiacOutput": 2.2, 
            "contPip": 48, 
            "contPlateau": 46, 
            "cvp": 4, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Heart sounds are distant.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent. There is periorbital edema.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
 			"overdoseFlag": false,
           "papD": 2, 
            "papM": 5, 
            "papS": 10, 
            "papW": 2, 
            "pulseMsg": "The pulse is absent.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "Excessive dose of epinephrine administered.", 
            "rhythm": "Vtach3", 
            "skinMsg": "The red rash is now mottled and purple.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 78, 
            "sat40": 82, 
            "sat100": 86, 
            "spSignal": 1, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "EP2", 
                    "comment": "", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "EP2", 
                    "comment": "You defibrillated for pulseless v tach appropriately. (+50 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "defib", 
                            "value": 199
                        }
                    ], 
                    "points": 50
                }
            ]
        }, 
        {
            "name": "COUGH5", 
            "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": 100, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The patient is coughing but the breath sounds are clear bilaterally.", 
            "cardiacOutput": 5.2, 
            "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": 7, 
            "rateUo": 1.5, 
            "recordMsg": "Upset and coughing.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 86, 
            "sat40": 90, 
            "sat100": 98, 
            "spSignal": 3, 
            "spontRr": 18, 
            "spontTv": 320, 
            "sputumAmount": 0, 
            "stSegII": 0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "AWAKE", 
                    "comment": "The patient stopped coughing.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "ASLEEPIV", 
                    "comment": "The sedative agent is starting to take effect.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.6
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "HURT5", 
                    "comment": "You should not have allowed the surgeon to make an incision in an unanesthetized patient. (-500 points)", 
                    "conditions": [
                        {
                            "type": "makeIncision", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "AWAKEPARA", 
                    "comment": "You paralyzed an unanesthetized patient. (-500 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "nmb", 
                            "value": 0.8
                        }, 
                        {
                            "op": "LT", 
                            "type": "doa", 
                            "value": 0.4
                        }
                    ], 
                    "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": "HURT5", 
            "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": 120, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The patient is screaming but the breath sounds seem to be clear bilaterally.", 
            "cardiacOutput": 5.2, 
            "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 screaming and writhing in pain.", 
            "papD": 12, 
            "papM": 16, 
            "papS": 28, 
            "papW": 18, 
            "pulseMsg": "The pulse is bounding.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "Screaming and writhing in pain.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 84, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 3, 
            "spontRr": 10, 
            "spontTv": 320, 
            "sputumAmount": 0, 
            "stSegII": 0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "AWAKE", 
                    "comment": "The patient stopped screaming.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "ASLEEPIV", 
                    "comment": "The sedative agent is starting to take effect. (+25 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.6
                        }
                    ], 
                    "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": "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": 110, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are clear bilaterally.", 
            "cardiacOutput": 5.2, 
            "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 not moving, but is thinking about calling his lawyer.", 
            "papD": 12, 
            "papM": 16, 
            "papS": 28, 
            "papW": 18, 
            "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": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 84, 
            "sat40": 90, 
            "sat100": 96, 
            "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": "COUGH4", 
            "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": 100, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The patient is coughing.", 
            "cardiacOutput": 5.2, 
            "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": 18, 
            "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": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 84, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 3, 
            "spontRr": 18, 
            "spontTv": 320, 
            "sputumAmount": 0, 
            "stSegII": 0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "SEDATEDIV1", 
                    "comment": "The patient stopped coughing.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "ASLEEPIV", 
                    "comment": "The sedative agent is starting to take effect.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.6
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "HURT5", 
                    "comment": "You should not have allowed the surgeon to make an incision in an unanesthetized patient. (-500 points)", 
                    "conditions": [
                        {
                            "type": "makeIncision", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "AWAKEPARA", 
                    "comment": "You paralyzed an unanesthetized patient. (-500 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "nmb", 
                            "value": 0.8
                        }, 
                        {
                            "op": "LT", 
                            "type": "doa", 
                            "value": 0.4
                        }
                    ], 
                    "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": "HURT4", 
            "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": 120, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The patient is screaming but the breath sounds seem to be clear bilaterally.", 
            "cardiacOutput": 5.2, 
            "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 screaming and writhing in pain.", 
            "papD": 12, 
            "papM": 16, 
            "papS": 28, 
            "papW": 12, 
            "pulseMsg": "The pulse is bounding.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 10, 
            "rateUo": 1.5, 
            "recordMsg": "Screaming and writhing in pain.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 84, 
            "sat40": 91, 
            "sat100": 97, 
            "spSignal": 3, 
            "spontRr": 10, 
            "spontTv": 320, 
            "sputumAmount": 0, 
            "stSegII": 0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "SEDATEDIV1", 
                    "comment": "The patient stopped screaming.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "ASLEEPIV", 
                    "comment": "The sedative agent is starting to take effect. (+25 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.6
                        }
                    ], 
                    "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": "SEDATEDPARA", 
            "whatNextMsg": "Now perform laryngoscopy and place the endotracheal intubation.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 60, 
            "baseAbpM": 74, 
            "baseAbpS": 108, 
            "baseBicarb": 24, 
            "baseHr": 66, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 5.2, 
            "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 pinpoint.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Asleep and paralyzed.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 96, 
            "spSignal": 2, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": 0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You took too long to intubate and the patient aspirated massive quantities of acidic fluids. (-500 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 180
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "SEDATEDIV1", 
                    "comment": "You placed the endotracheal tube in a timely fashion. (+100 points)", 
                    "conditions": [
                        {
                            "type": "tryLaryTube", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "SEDATEDIV1", 
                    "comment": "You placed the endotracheal tube in a timely fashion. (+100 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }
            ]
        }, 
        {
            "name": "HURT3", 
            "whatNextMsg": "Deepen the anesthetic.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 84, 
            "baseAbpM": 112, 
            "baseAbpS": 182, 
            "baseBicarb": 24, 
            "baseHr": 106, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 5.2, 
            "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 reduced.", 
            "lmaSuccessFlag": false, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 12, 
            "papM": 16, 
            "papS": 28, 
            "papW": 12, 
            "pulseMsg": "The pulse is strong.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "Lightly anesthetized but autonomic response to painful stimulus.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 86, 
            "sat40": 91, 
            "sat100": 98, 
            "spSignal": 2, 
            "spontRr": 18, 
            "spontTv": 240, 
            "sputumAmount": 0, 
            "stSegII": 0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "ASLEEPIV", 
                    "comment": "The autonomic response is abating.", 
                    "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": "HURT1", 
            "whatNextMsg": "Deepen the anesthetic.", 
			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 84, 
            "baseAbpM": 112, 
            "baseAbpS": 182, 
            "baseBicarb": 24, 
            "baseHr": 106, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 5.2, 
            "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 reduced.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 12, 
            "papM": 16, 
            "papS": 28, 
            "papW": 12, 
            "pulseMsg": "The pulse is strong.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 8, 
            "rateUo": 1.5, 
            "recordMsg": "Lightly anesthetized but autonomic response to painful stimulus.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 96, 
            "spSignal": 2, 
            "spontRr": 18, 
            "spontTv": 240, 
            "sputumAmount": 0, 
            "stSegII": 0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "OPIV", 
                    "comment": "The autonomic response is abating.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 60
                        }
                    ], 
                    "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": "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.", 
			"overdoseFlag": false,
            "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.", 
			"overdoseFlag": false,
            "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": "DESATDEAD", 
                    "comment": "", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 0
                }
            ]
        }, 
        {
            "name": "DESATDEAD", 
            "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, 
            "spontRr": 0, 
            "spSignal": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": 0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9
        }
    ] 
}