CaseData[50] = {
    "title": "Case 109 - 79 year old male with open femur fracture", 
    "badDrugs": ["Dantrolene"], 
    "coMin": 1.2, 
    "debriefMsg": "induction of hypovolemic patient based on case 3", 
    "depthCarina": 25, 
    "depthCords": 18, 
    "depthTubeInitial": 22, 
    "durationPrep": 60, 
    "durationSurgery": 1200, 
    "helpFlag": false, 
    "imageSet": 7, 
    "initialSat": 96, 
    "leanBodyMass": 70, 
    "learningObj": "", 
    "possiblePoints": 1000, 
    "preopMsg": "\n79 year old male with fractured hip\n\nHistory of Present Illness\nThe patient suffered an open femur fracture when he crashed his motorcycle.\n\nPast Medical History\nIllnesses - Hard of hearing, poor vision, but otherwise remarkably healthy\nSurgeries - Cataracts, bilateral hernia repairs with no complications\nMeds - Valsartan, simvastatin\nHabits - Smokes, drinks beer, but denies other bad habits\nNo known drug allergies\n\nFamily History\nNo family history of anesthetic problems.\n\nPhysical Exam\nThin, elderly male, in moderate distress, confused and in pain.\nWeight: 74 kg\nHR 112,  BP 102/64,  RR 16\nAirway - normal\nLungs - clear  \nHeart - normal\n\nLabs\nHematocrit 38%\nNa 142,  K 4.0,  Cl 110,  HCO3 22\nBun 36,     Cr 1.8\nRoom air - pH 7.36,  PCO2 38,  PO2 81\nECG - sinus tachycardia\nCXR - no acute disease\n\nNPO Status\nThe patient last ate 8 hours ago. \n\nPatient and Surgeon Requests\nThe patient requests general anesthesia.  The surgeon states the procedure will take about two hours.\n\n", 
    "volAnDsp": 80, 
    "states": [
        {
            "name": "DRY", 
            "whatNextMsg": "Rehydrate prior to induction.", 
 			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 60, 
            "baseAbpM": 74, 
            "baseAbpS": 96, 
            "baseBicarb": 23.8, 
            "baseHr": 118, 
            "basePot": 4.8, 
            "breathSoundsMsg": "The breath sounds are clear bilaterally.", 
            "cardiacOutput": 2.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 3, 
            "finalState": 0, 
            "glucose": 120, 
            "hct": 48, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 0, 
            "lidReflexMsg": "The lid reflex is present.", 
            "lmaSuccessFlag": false, 
            "mentalStatusMsg": "The patient is awake and responds to voice commands. The patient is moving spontaneously.", 
            "papD": 4, 
            "papM": 7, 
            "papS": 12, 
            "papW": 3, 
            "pulseMsg": "The pulse is weak and rapid.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Awake, alert, and anxiously awaiting induction.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry but has slow capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 144, 
            "sat20": 90, 
            "sat40": 95, 
            "sat100": 96, 
            "spSignal": 2, 
            "spontRr": 16, 
            "spontTv": 220, 
            "sputumAmount": 0, 
            "stSegII": -0.1, 
            "stSegV5": -0.2, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "FLUIDS1", 
                    "comment": "You partially rehydrated the patient. (+200 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "tFluid", 
                            "value": 299
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "SEDATEDRY", 
                    "comment": "You administered a sedative agent before rehydrating. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.2
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "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": "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
                }, 
                {
                    "nextState": "PARA5", 
                    "comment": "You paralyzed an unanesthetized patient. (-500 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "nmb", 
                            "value": 0.8
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "GA1SECURE", 
                    "comment": "You placed the endotracheal tube before induction of anesthesia. (-500 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }
            ]
        }, 
        {
            "name": "FLUIDS1", 
            "whatNextMsg": "Continue to administer fluids until vital signs stabilize.", 
 			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 64, 
            "baseAbpM": 78, 
            "baseAbpS": 106, 
            "baseBicarb": 23.8, 
            "baseHr": 108, 
            "basePot": 4.8, 
            "breathSoundsMsg": "The breath sounds are clear bilaterally.", 
            "cardiacOutput": 3.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 5, 
            "finalState": 0, 
            "glucose": 120, 
            "hct": 44, 
            "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": 6, 
            "papM": 9, 
            "papS": 15, 
            "papW": 5, 
            "pulseMsg": "The pulse is stronger but still fast.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Partially rehydrated.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 144, 
            "sat20": 90, 
            "sat40": 95, 
            "sat100": 96, 
            "spSignal": 3, 
            "spontRr": 16, 
            "spontTv": 220, 
            "sputumAmount": 0, 
            "stSegII": -0.1, 
            "stSegV5": -0.2, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "FLUIDS2", 
                    "comment": "You adequately rehydrated the patient. (+200 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "tFluid", 
                            "value": 799
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "SEDATEFLUIDS1", 
                    "comment": "You administered a sedative agent. (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.2
                        }
                    ], 
                    "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": "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
                }, 
                {
                    "nextState": "PARA5", 
                    "comment": "You paralyzed an unanesthetized  patient. (-500 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "nmb", 
                            "value": 0.8
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "GA1SECURE", 
                    "comment": "You placed the endotracheal tube before induction of anesthesia. (-500 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }
            ]
        }, 
        {
            "name": "FLUIDS2", 
            "whatNextMsg": "Preoxygenate, induce general anesthesia and intubate.", 
 			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 72, 
            "baseAbpM": 86, 
            "baseAbpS": 116, 
            "baseBicarb": 23.8, 
            "baseHr": 96, 
            "basePot": 4.8, 
            "breathSoundsMsg": "The breath sounds are clear bilaterally.", 
            "cardiacOutput": 4.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 8, 
            "finalState": 0, 
            "glucose": 120, 
            "hct": 42, 
            "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": 9, 
            "papM": 12, 
            "papS": 18, 
            "papW": 8, 
            "pulseMsg": "The pulse is strong and regular.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Adequately rehydrated.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 144, 
            "sat20": 90, 
            "sat40": 95, 
            "sat100": 96, 
            "spSignal": 3, 
            "spontRr": 16, 
            "spontTv": 220, 
            "sputumAmount": 0, 
            "stSegII": -0.1, 
            "stSegV5": -0.2, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "SEDATEFLUIDS2", 
                    "comment": "You administered a sedative agent. (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.2
                        }
                    ], 
                    "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": "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
                }, 
                {
                    "nextState": "PARA5", 
                    "comment": "You paralyzed an unanesthetized  patient. (-500 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "nmb", 
                            "value": 0.8
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "GA1SECURE", 
                    "comment": "You placed the endotracheal tube before induction of anesthesia. (-500 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }
            ]
        }, 
        {
            "name": "SEDATEDRY", 
            "whatNextMsg": "Rehydrate this patient prior to induction of anesthesia.", 
 			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 58, 
            "baseAbpM": 68, 
            "baseAbpS": 88, 
            "baseBicarb": 23.8, 
            "baseHr": 128, 
            "basePot": 4.8, 
            "breathSoundsMsg": "The breath sounds are clear bilaterally.", 
            "cardiacOutput": 1.8, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 2, 
            "finalState": 0, 
            "glucose": 120, 
            "hct": 46, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 0, 
            "lidReflexMsg": "The lid reflex is present.", 
            "lmaSuccessFlag": false, 
            "mentalStatusMsg": "The patient is sedated but responsive.", 
            "papD": 2, 
            "papM": 5, 
            "papS": 10, 
            "papW": 2, 
            "pulseMsg": "The pulse is fast but weak.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Sedated but not rehydrated.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with poor capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 144, 
            "sat20": 90, 
            "sat40": 95, 
            "sat100": 96, 
            "spSignal": 2, 
            "spontRr": 8, 
            "spontTv": 200, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "ASLEEPVERYDRY", 
                    "comment": "You induced anesthesia before replacing volume. (-500 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.6
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "SEDATEFLUIDS1", 
                    "comment": "You partially rehydrated the patient. (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "tFluid", 
                            "value": 299
                        }
                    ], 
                    "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": "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
                }, 
                {
                    "nextState": "PARA5", 
                    "comment": "You paralyzed an unanesthetized patient. (-500 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "nmb", 
                            "value": 0.8
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "GA1SECURE", 
                    "comment": "You placed the endotracheal tube before induction of anesthesia. (-500 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }
            ]
        }, 
        {
            "name": "SEDATEFLUIDS1", 
            "whatNextMsg": "Administer additional intravenous fluids.", 
 			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 58, 
            "baseAbpM": 78, 
            "baseAbpS": 102, 
            "baseBicarb": 23.8, 
            "baseHr": 120, 
            "basePot": 4.8, 
            "breathSoundsMsg": "The breath sounds are clear bilaterally.", 
            "cardiacOutput": 3.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 5, 
            "finalState": 0, 
            "glucose": 120, 
            "hct": 46, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 0, 
            "lidReflexMsg": "The lid reflex is present.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is sedated but responsive.", 
            "papD": 6, 
            "papM": 9, 
            "papS": 15, 
            "papW": 5, 
            "pulseMsg": "The pulse is fast and weak.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Partially rehydrated and sedated.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with slow capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 144, 
            "sat20": 90, 
            "sat40": 95, 
            "sat100": 96, 
            "spSignal": 3, 
            "spontRr": 8, 
            "spontTv": 200, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "SEDATEFLUIDS2", 
                    "comment": "You administered adequate volume replacement. (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "tFluid", 
                            "value": 799
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "ASLEEPDRY", 
                    "comment": "You induced anesthesia prior to adequately replacing volume. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.6
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "COUGH5", 
                    "comment": "You tried to insert the endotracheal tube in an under anesthetized patient. (Lost points)", 
                    "conditions": [
                        {
                            "type": "tryLaryTube", 
                            "value": true
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "PARA5", 
                    "comment": "You administered muscle relaxant before completely inducing unconsciousness. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "nmb", 
                            "value": 0.8
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "HURT5", 
                    "comment": "You should not have allowed the surgeon to make an incision in an under anesthetized patient. (-500 points)", 
                    "conditions": [
                        {
                            "type": "makeIncision", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "GA1SECURE", 
                    "comment": "You placed the endotracheal tube before induction of anesthesia. (-500 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }
            ]
        }, 
        {
            "name": "SEDATEFLUIDS2", 
            "whatNextMsg": "Preoxygenate, induce anesthesia and intubate.", 
 			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 70, 
            "baseAbpM": 84, 
            "baseAbpS": 114, 
            "baseBicarb": 24, 
            "baseHr": 98, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are clear bilaterally.", 
            "cardiacOutput": 4.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 8, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 42, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 0, 
            "lidReflexMsg": "The lid reflex is present.", 
            "lmaSuccessFlag": false, 
            "mentalStatusMsg": "The patient is sedated but responsive.", 
            "papD": 9, 
            "papM": 12, 
            "papS": 18, 
            "papW": 8, 
            "pulseMsg": "The pulse is strong.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Adequately rehydrated.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 90, 
            "sat40": 95, 
            "sat100": 96, 
            "spSignal": 3, 
            "spontRr": 8, 
            "spontTv": 200, 
            "sputumAmount": 0, 
            "stSegII": -0.1, 
            "stSegV5": -0.2, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "GA1", 
                    "comment": "You induced anesthesia after adequately treating hypovolemia.  (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.6
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }, 
                {
                    "nextState": "GA1SECURE", 
                    "comment": "You placed the endotracheal tube before induction of anesthesia. (-500 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }
            ]
        }, 
        {
            "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": 64, 
            "baseAbpM": 88, 
            "baseAbpS": 116, 
            "baseBicarb": 23.8, 
            "baseHr": 122, 
            "basePot": 4.8, 
            "breathSoundsMsg": "The patient is coughing.", 
            "cardiacOutput": 2.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 3, 
            "finalState": 0, 
            "glucose": 120, 
            "hct": 48, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 0, 
            "lidReflexMsg": "The lid reflex is present.", 
            "lmaSuccessFlag": false, 
            "mentalStatusMsg": "The patient is upset and uncooperative. The patient is coughing.", 
            "papD": 4, 
            "papM": 7, 
            "papS": 12, 
            "papW": 3, 
            "pulseMsg": "The pulse is fast.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Upset and coughing. ST depression is present.", 
            "rhythm": "St3", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 144, 
            "sat20": 90, 
            "sat40": 95, 
            "sat100": 96, 
            "spSignal": 2, 
            "spontRr": 16, 
            "spontTv": 240, 
            "sputumAmount": 0, 
            "stSegII": -2.2, 
            "stSegV5": -2.8, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "DRY", 
                    "comment": "The patient stopped coughing.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "ASLEEPVERYDRY", 
                    "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. (-1000 points)", 
                    "conditions": [
                        {
                            "type": "makeIncision", 
                            "value": true
                        }
                    ], 
                    "points": -1000
                }, 
                {
                    "nextState": "PARA5", 
                    "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
                }, 
                {
                    "nextState": "GA1SECURE", 
                    "comment": "You placed the endotracheal tube before induction of anesthesia. (-500 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }
            ]
        }, 
        {
            "name": "HURT5", 
            "whatNextMsg": "Administer narcotic.", 
 			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 64, 
            "baseAbpM": 88, 
            "baseAbpS": 116, 
            "baseBicarb": 23.8, 
            "baseHr": 120, 
            "basePot": 4.8, 
            "breathSoundsMsg": "The patient is screaming but the breath sounds seem to be clear bilaterally.", 
            "cardiacOutput": 2.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 3, 
            "finalState": 0, 
            "glucose": 120, 
            "hct": 48, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 0, 
            "lidReflexMsg": "The lid reflex is present.", 
            "lmaSuccessFlag": false, 
            "mentalStatusMsg": "The patient is screaming and writhing in pain.", 
            "papD": 4, 
            "papM": 7, 
            "papS": 12, 
            "papW": 3, 
            "pulseMsg": "The pulse is fast.", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 5, 
            "rateUo": 1.5, 
            "recordMsg": "Screaming and writhing in pain. ST depression is present.", 
            "rhythm": "St3", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 144, 
            "sat20": 90, 
            "sat40": 95, 
            "sat100": 96, 
            "spSignal": 2, 
            "spontRr": 16, 
            "spontTv": 240, 
            "sputumAmount": 0, 
            "stSegII": -2.2, 
            "stSegV5": -2.8, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "DRY", 
                    "comment": "The patient stopped screaming.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "ASLEEPVERYDRY", 
                    "comment": "You induced anesthesia before adequately replacing volume. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.6
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }, 
                {
                    "nextState": "GA1SECURE", 
                    "comment": "You placed the endotracheal tube before induction of anesthesia. (-500 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }
            ]
        }, 
        {
            "name": "PARA5", 
            "whatNextMsg": "Call your lawyer.", 
 			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 64, 
            "baseAbpM": 88, 
            "baseAbpS": 116, 
            "baseBicarb": 23.8, 
            "baseHr": 120, 
            "basePot": 4.8, 
            "breathSoundsMsg": "The breath sounds are clear bilaterally.", 
            "cardiacOutput": 2.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 3, 
            "finalState": 0, 
            "glucose": 120, 
            "hct": 48, 
            "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": 4, 
            "papM": 7, 
            "papS": 12, 
            "papW": 3, 
            "pulseMsg": "The pulse is fast", 
            "pupilsMsg": "The pupils are equal, round, and react to light.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Awake but paralyzed.", 
            "rhythm": "St3", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 144, 
            "sat20": 90, 
            "sat40": 95, 
            "sat100": 96, 
            "spSignal": 2, 
            "spontTv": 0, 
            "spontRr": 0, 
            "sputumAmount": 0, 
            "stSegII": 0.4, 
            "stSegV5": 0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "DRY", 
                    "comment": "The muscle relaxant is wearing off.", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "nmb", 
                            "value": 0.6
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "ASLEEPVERYDRY", 
                    "comment": "You induced anesthesia without adequately replacing volume. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 0.6
                        }
                    ], 
                    "points": -500
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }, 
                {
                    "nextState": "GA1SECURE", 
                    "comment": "You placed the endotracheal tube before induction of anesthesia. (-500 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "value": true
                        }
                    ], 
                    "points": -500
                }
            ]
        }, 
        {
            "name": "ASLEEPDRY", 
            "whatNextMsg": "Administer fluids and pressors to resuscitate.", 
 			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 58, 
            "baseAbpM": 68, 
            "baseAbpS": 88, 
            "baseBicarb": 24, 
            "baseHr": 128, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 1.8, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 2, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 46, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 2, 
            "papM": 5, 
            "papS": 10, 
            "papW": 2, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are pinpoint.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Anesthetized but only partially rehydrated.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with slow capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 90, 
            "sat40": 95, 
            "sat100": 96, 
            "spSignal": 2, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.2, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "GA1SECURE", 
                    "comment": "You successfully intubated the patient. (+100 points)", 
                    "conditions": [
                        {
                            "type": "tryLaryTube", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "GA1SECURE", 
                    "comment": "You successfully placed a laryngeal mask airway. (+100 points)", 
                    "conditions": [
                        {
                            "type": "tryLma", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "GA1SECURE", 
                    "comment": "A laryngeal mask airway was placed. (+100 points)", 
                    "conditions": [
                        {
                            "type": "airwayLma", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "GA1SECURE", 
                    "comment": "An endotracheal tube was placed. (+100 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "GA1", 
                    "comment": "You delayed securing the airway for too long. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 180
                        }
                    ], 
                    "points": -50
                }
            ]
        }, 
        {
            "name": "ASLEEPVERYDRY", 
            "whatNextMsg": "Resuscitate with volume replacement and pressors.", 
 			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 38, 
            "baseAbpM": 48, 
            "baseAbpS": 68, 
            "baseBicarb": 24, 
            "baseHr": 138, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 1.8, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 2, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 48, 
            "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": 2, 
            "papM": 5, 
            "papS": 10, 
            "papW": 2, 
            "pulseMsg": "The pulse is weak.", 
            "pupilsMsg": "The pupils are pinpoint.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Anesthetized without fluid replacement. The patient is now hypotensive and has ST depression.", 
            "rhythm": "St3", 
            "skinMsg": "The skin is warm and dry with poor capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 90, 
            "sat40": 95, 
            "sat100": 96, 
            "spSignal": 1, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -3.2, 
            "stSegV5": -3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "SEDATEFLUIDS1", 
                    "comment": "You partially rehydrated the patient, but only after induction of anesthesia. (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "tFluid", 
                            "value": 299
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "VFIB", 
                    "comment": "The rhythm degenerated to ventricular fibrillation. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 60
                        }
                    ], 
                    "points": -500
                }
            ]
        }, 
        {
            "name": "VFIB", 
            "whatNextMsg": "Call for help and call your lawyer.", 
 			"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": 14, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 46, 
            "heartSoundsMsg": "Heart sounds are absent.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 18, 
            "papM": 18, 
            "papS": 18, 
            "papW": 18, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are pinpoint.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Cardiac arrest!", 
            "rhythm": "Vfib2", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88,
            "sat40": 92, 
            "sat100": 94, 
            "spSignal": 0, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": 0, 
            "stSegV5": 0, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "DEAD", 
                    "comment": "The rhythm degenerated to asystole. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 60
                        }
                    ], 
                    "points": -500
                }
            ]
        }, 
        {
            "name": "GA1", 
            "whatNextMsg": "Secure the airway with an LMA or endotracheal tube.", 
 			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 68, 
            "baseAbpM": 86, 
            "baseAbpS": 108, 
            "baseBicarb": 24, 
            "baseHr": 99, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 5.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 12, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 46, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 14, 
            "papM": 18, 
            "papS": 28, 
            "papW": 12, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Anesthesia induced, ready for intubation.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 90, 
            "sat40": 95, 
            "sat100": 96, 
            "spSignal": 2, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.5, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "GA1SECURE", 
                    "comment": "You successfully intubated the patient. (+100 points)", 
                    "conditions": [
                        {
                            "type": "tryLaryTube", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "GA1SECURE", 
                    "comment": "You successfully placed a laryngeal mask airway. (+100 points)", 
                    "conditions": [
                        {
                            "type": "tryLma", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "GA1SECURE", 
                    "comment": "A laryngeal mask airway was placed. (+100 points)", 
                    "conditions": [
                        {
                            "type": "airwayLma", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "GA1SECURE", 
                    "comment": "An endotracheal tube was placed. (+100 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "GA1DEEP", 
                    "comment": "You administered deep anesthetic for this patient. (Lost points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 2.2
                        }
                    ], 
                    "points": -100
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "GA1DEEP", 
            "whatNextMsg": "Secure the airway with an LMA or endotracheal tube.", 
 			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 50, 
            "baseAbpM": 62, 
            "baseAbpS": 78, 
            "baseBicarb": 24, 
            "baseHr": 109, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 5.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 12, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 46, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 14, 
            "papM": 18, 
            "papS": 28, 
            "papW": 12, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Anesthesia induced, ready for intubation.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 90, 
            "sat40": 95, 
            "sat100": 96, 
            "spSignal": 2, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.5, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "GA2", 
                    "comment": "You successfully intubated the patient. (+100 points)", 
                    "conditions": [
                        {
                            "type": "tryLaryTube", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "GA2", 
                    "comment": "You successfully placed a laryngeal mask airway. (+100 points)", 
                    "conditions": [
                        {
                            "type": "tryLma", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "GA2", 
                    "comment": "A laryngeal mask airway was placed. (+100 points)", 
                    "conditions": [
                        {
                            "type": "airwayLma", 
                            "value": true
                        }
                    ], 
                    "points": 100
                }, 
                {
                    "nextState": "GA2", 
                    "comment": "An endotracheal tube was placed. (+100 points)", 
                    "conditions": [
                        {
                            "type": "airwayTube", 
                            "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
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You waited too long to secure the airway. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 360
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "GA1SECURE", 
            "whatNextMsg": "Deepen the anesthetic.", 
 			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 68, 
            "baseAbpM": 86, 
            "baseAbpS": 108, 
            "baseBicarb": 24, 
            "baseHr": 99, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 5.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 12, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 46, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 14, 
            "papM": 18, 
            "papS": 28, 
            "papW": 12, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Lightly anesthetized with intravenous agents.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 90, 
            "sat40": 95, 
            "sat100": 96, 
            "spSignal": 2, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.5, 
            "stSegV5": -0.3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "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": "GA2", 
                    "comment": "You administered adequate anesthetic for this patient. (+100 points)", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 1.6
                        }
                    ], 
                    "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": "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": 0, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "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": 5, 
            "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": 93, 
            "spSignal": 2, 
            "spontRr": 18, 
            "spontTv": 140, 
            "sputumAmount": 0, 
            "stSegII": -0.5, 
            "stSegV5": 3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "GA1SECURE", 
                    "comment": "The autonomic response is abating.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 0
                }, 
                {
                    "nextState": "GA2", 
                    "comment": "You deepened the anesthetic.", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "doa", 
                            "value": 2.2
                        }
                    ], 
                    "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": "GA2", 
            "whatNextMsg": "Maintenance phase. Instruct the surgeon to make the incision. Monitor the patient carefully.", 
 			"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": "Adequately anesthetized.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 93, 
            "spSignal": 2, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.5, 
            "stSegV5": 3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "GA3", 
                    "comment": "You instructed the surgeon to make the incision appropriately. (+200 points)", 
                    "conditions": [
                        {
                            "type": "makeIncision", 
                            "value": true
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "GA3", 
                    "comment": "You instructed the surgeon to operate. (+200 points)", 
                    "conditions": [
                        {
                            "type": "doingSurgery", 
                            "value": true
                        }
                    ], 
                    "points": 200
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "GA3", 
            "whatNextMsg": "Deep maintenance anesthesia.", 
 			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 56, 
            "baseAbpM": 68, 
            "baseAbpS": 94, 
            "baseBicarb": 24, 
            "baseHr": 78, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 5.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 14, 
            "finalState": 1, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 12, 
            "papM": 16, 
            "papS": 28, 
            "papW": 12, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are pinpoint.", 
            "rateEbl": 5, 
            "rateUo": 1.5, 
            "recordMsg": "Deeply anesthetized.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 93, 
            "spSignal": 2, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.5, 
            "stSegV5": 3, 
            "temperature": 36.9 
        }, 
        {
            "name": "GA4", 
            "whatNextMsg": "Excessively deep anesthesia during maintenance. Decrease anesthetic depth.", 
 			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 42, 
            "baseAbpM": 50, 
            "baseAbpS": 66, 
            "baseBicarb": 24, 
            "baseHr": 82, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 5.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 14, 
            "finalState": 1, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Regular rate and rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 12, 
            "papM": 16, 
            "papS": 28, 
            "papW": 12, 
            "pulseMsg": "The pulse is present.", 
            "pupilsMsg": "The pupils are pinpoint.", 
            "rateEbl": 5, 
            "rateUo": 1.5, 
            "recordMsg": "Very deeply anesthetized.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is warm and dry with normal capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 88, 
            "sat40": 91, 
            "sat100": 93, 
            "spSignal": 1, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.5, 
            "stSegV5": 3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "GA3", 
                    "comment": "You lightened the anesthetic depth appropriately. (+50 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "doa", 
                            "value": 2.8
                        }
                    ], 
                    "points": 50
                }, 
                {
                    "nextState": "DESATBRADY1", 
                    "comment": "You allowed the patient to become severely hypoxic. (-1000 points)", 
                    "conditions": [
                        {
                            "op": "LT", 
                            "type": "o2Sat", 
                            "value": 63
                        }
                    ], 
                    "points": -1000
                }
            ]
        }, 
        {
            "name": "DESATBRADY1", 
            "whatNextMsg": "Must reverse hypoxia immediately and treat bradycardia.", 
 			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 48, 
            "baseAbpM": 62, 
            "baseAbpS": 92, 
            "baseBicarb": 24, 
            "baseHr": 32, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 0.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 12, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Slow, regular rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 8, 
            "papM": 12, 
            "papS": 18, 
            "papW": 8, 
            "pulseMsg": "The pulse is weak and slow.", 
            "pupilsMsg": "The pupils are small.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Hypoxic and bradycardic.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is cyanotic with poor capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 62, 
            "sat40": 64, 
            "sat100": 66, 
            "spSignal": 1, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.5, 
            "stSegV5": 3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "DESATBRADY2", 
                    "comment": "", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 0
                }
            ]
        }, 
        {
            "name": "DESATBRADY2", 
            "whatNextMsg": "Must reverse hypoxia immediately and treat bradycardia.", 
 			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 38, 
            "baseAbpM": 50, 
            "baseAbpS": 72, 
            "baseBicarb": 24, 
            "baseHr": 22, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 0.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 12, 
            "finalState": 0, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Very slow, regular rhythm, without murmurs.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
            "papD": 8, 
            "papM": 12, 
            "papS": 18, 
            "papW": 8, 
            "pulseMsg": "The pulse is weak and very slow.", 
            "pupilsMsg": "The pupils are large.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "Hypoxic and severely bradycardic.", 
            "rhythm": "Sinus1", 
            "skinMsg": "The skin is cyanotic with poor capillary refill.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 62, 
            "sat40": 64, 
            "sat100": 66, 
            "spSignal": 1, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.5, 
            "stSegV5": 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": 62, 
            "sat40": 64, 
            "sat100": 66, 
            "spSignal": 0, 
            "spontTv": 0, 
            "spontRr": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.5, 
            "stSegV5": 3, 
            "temperature": 36.9, 
            "trans": [
                {
                    "nextState": "DEAD", 
                    "comment": "", 
                    "conditions": [
                        {
                            "op": "GT", 
                            "type": "time", 
                            "value": 30
                        }
                    ], 
                    "points": 0
                }
            ]
        }, 
        {
            "name": "DEAD", 
            "whatNextMsg": "Notify the family.", 
 			"airwayStr": "nl",
            "aspirateCvpMsg": "10 mL blood was aspirated from the CVP catheter.", 
            "baseAbpD": 18, 
            "baseAbpM": 18, 
            "baseAbpS": 18, 
            "baseBicarb": 24, 
            "baseHr": 0, 
            "basePot": 4.2, 
            "breathSoundsMsg": "The breath sounds are equal bilaterally.", 
            "cardiacOutput": 0.2, 
            "contPip": 28, 
            "contPlateau": 26, 
            "cvp": 18, 
            "finalState": -2, 
            "glucose": 122, 
            "hct": 38, 
            "heartSoundsMsg": "Heart sounds are absent.", 
            "hiCo2ProdFlag": false, 
            "laryTubeSuccess": 1, 
            "lidReflexMsg": "The lid reflex is absent.", 
            "lmaSuccessFlag": true, 
            "mentalStatusMsg": "The patient is unresponsive.", 
			"overdoseFlag": false,
            "papD": 18, 
            "papM": 18, 
            "papS": 18, 
            "papW": 18, 
            "pulseMsg": "The pulse is absent.", 
            "pupilsMsg": "The pupils are fixed and dilated.", 
            "rateEbl": 0, 
            "rateUo": 1.5, 
            "recordMsg": "The patient cannot be resuscitated.", 
            "rhythm": "Asystole1", 
            "skinMsg": "The skin is cyanotic.", 
            "skipAheadHours": 0, 
            "skipAheadMsg": "", 
            "sodium": 142, 
            "sat20": 62, 
            "sat40": 64, 
            "sat100": 66, 
            "spSignal": 0, 
            "spontRr": 0, 
            "spontTv": 0, 
            "sputumAmount": 0, 
            "stSegII": -0.5, 
            "stSegV5": 3, 
            "temperature": 36.9
        }
    ]
}