HemoSim

A game about keeping alive a patient who is slipping away. HemoSim puts you behind a monitor. On the other side is a patient in shock: the pulse climbs, the pressure drops, urine output stops. You have drugs, fluids, a defibrillator and very little time. Every lever you pull changes the whole system, and almost never only in the direction you wanted. Three ways to lose a patientHypertensive heart failure: the heart won't pump and pulmonary pressure rises. Hemorrhage: volume drains away and compensatory tachycardia eventually gives out.

Septic shock: resistance collapses and capillary leak empties the system from inside. Ten variables, all coupledPulse, mean arterial pressure, central venous pressure, cardiac output, blood volume, systemic vascular resistance, pulmonary capillary pressure, pulmonary artery pressure, stroke work and urine output. They all move at once, and none of them moves alone.A drug cabinet with immediate effectDopamine, dobutamine, epinephrine, nitroglycerin, furosemide, saline, propranolol, amiodarone, transfusion, antibiotics, the defibrillator and BIPAP ventilatory support. Turning up a vasopressor fixes the pressure and breaks something else.

That's the game. Cockpit ModeSwap the monitor for a cockpit of analog instruments: gauges, an annunciator panel with warning lights, and a tabbed multifunction display. Workups — blood gas, blood count, echocardiogram, lactate, Swan-Ganz catheter — are requested and take a few seconds to come back. As in real life, you can't read what you haven't measured. The Swan-Ganz unlocks three gauges that stay dark until then.…