If you would like to make a patient with a particular problem
appear in the Waiting Room, here's the "secret" way to look at any of
the 400 problems you want to.
1.Start the game.
2.Choose any patient and click on the "Select Patient" button.
3.Choose "Waiting Room" from the "Go To" menu.
4.While at the sign-in desk, when a video is playing, press the letter
"P" (for "problem") on the keyboard. The video should stop, and you
should see the doors that lead to the hallway.
5.Click the cursor on the far left side of the screen (the cursor
should be a red, left-facing arrow).
6.On the next screen, type in the number of the medical problem you
want to see and press Enter. The patient with that medical problem
will appear in the Waiting Room.
A few examples of interesting and gross graphics are:
172 Lawnmower injury with amputated toe
173 Firecracker injury with amputated fingers
174 Finger caught in lawnmower
176 Gunshot injury to forearm
200 Finger caught in engine
202 Powersaw accident with deep thigh cut
294 Arrow impaled in head
295 Gunshot wound to head
388 Burned soles of feet
389 Bad hand burn
See the back of the Player's Guide for a listing of the 400
available medical problems and their corresponding numbers.
The Midnight Shift
A Review of Emergency Room
I really hate working the midnight shift, you don't get enough
sleep, the constant noise, and the long hours reading the Continuing
Medical Education (CME) brochures and reports. Just yesterday I was
reading about knee injuries, simple fractures and stab wounds. Oh, the
joy ! Don't take me wrong, late shifts at Legacy Memorial Hospital can
be very lively at times to say the least. Take for example last
weekend, fifty-five emergency cases in less than three hours. I guess
I should have expected it during campaign season. Politics, I will
never understand them. Me, I would much rather work during the day.
There are more doctors available for consulting and treatment which
really makes a difference. Besides, a really cute nurse works that
shift. But when you are just a medical student, life gives you no
Dr. Boss, the shift supervisor, is a tyrannical attending
physician. He is a great doctor, no doubt, but he sure could benefit
from some interpersonal relationship skills. Great, here he comes, I
better go to the waiting room and look like I am busy. I w onder what
is on TV tonight. Hey, maybe I will get lucky and intercept a code
blue on the way in. No code blues here but, I did find Allan. His full
name is Allan Alvarez, a 17 year old Hispanic male. The ambulance
attendants are rolling him into the wai ting room as I am getting
ready to look busy. Allan looks disoriented and fearful. He does not
speak English but his facial expression communicates that which needs
no language: He needs help. A short conversation with the paramedic
reveals that Allan is suffering from a stab wound on his right side,
he is also allergic to pollen, exercises regularly and has no record
In accordance to the new state laws, I must not admit Allan as a
patient until I can verify that he is not an illegal alien. However, I
don't have the luxury of extra time or the personal conviction to deny
Allan medical treatment so, I take him in as my patient. Lucky for me,
Dr. Boss is not close at hand. I immediately start to fill in my SOAP
(Subjective, Objective, Assessment, Plan). I always think of it as the
medical equivalent of the army's KISS (Keep It Simple Stupid). After
completing the subje ctive sections I order that my patient be taken
into the examination room.
Allan's skin is diaphoretic (sweaty), pale and cool to the touch.
He looks ill and in pain. I move quickly to place the stethoscope over
his heart and abdomen. I then place the sphingonanometer on his right
upper arm and find that his blood pressure is b elow normal and
falling quickly. I am relieved, however, to find that his pulse is
functional and strong. A quick examination of the abdomen area reveals
a palpable liver edge and a stab wound on the upper right quadrant
next to the rectus abdominus (cen tral stomach muscles). I finish my
examination and request that Allan is transported to the treatment
room. On the way to the treatment room, I finish filling the objective
part of the SOAP: a skin tear located on the right upper quadrant and
an increase d heart rate with bowel sounds absent. The increased heart
rate, decreased blood pressure, clammy-pale skin and penetrating
trauma indicate internal hemorrhaging.
Hospital policy requires that all doctors keep their
observations, treatments and plans well documented (for legal
protection). This is the main reason for diligently filling the SOAP
questionnaires (it also helps to keep you concentrated on the task at
hand during those occasions when a few lost second could mean the
difference between life and death). By the time we reach the treatment
room I have also made my assessment of the situation: liver puncture
wound with internal bleeding. With this diagnosi s in hand, I know
what to do next: read the CME on stabbing to assist me in finding the
correct treatment. I knew from medical school that the liver is a
large, reddish-brown, glandular organ that secretes bile and is active
in the formation of certain b lood proteins. It is also very fragile
and any puncture wound causing continuos bleeding will likely result
in hemorrhaging shock and eventually permanent damage or even death.
This is one of those cases where every second counts. I follow
the CME treatment directions and provide Allan with much needed
intravenous (IV) fluids, a blood transfusion, oxygen via nasal prongs
and order his immediate transfer to the trauma unit. Ther e, a
dedicated trauma surgeon will take care of the internal bleeding and
perform any needed surgery. Once I perform the immediate emergency
treatment, I finish my SOAP requirements by completing the plan
directives: IV access, IV fluids, blood substitut es, oxygen and
transfer to trauma unit. As the head nurse prepares Allan for the
transfer, he holds my hand and says something in Spanish. I smile at
him and then think for a moment, what would had happened if I had
denied him admission into our hospital.
As a dedicated team of nurses takes Allan away, I ready myself
for the forthcoming reprisals from Dr. Boss and the politicians. Oh
well, when you are a medical student, human dignity gives you no
choices. Note: It is the hope of the reviewer that this "w
alk-through" will help you get a glimpse of "Emergency Room". In
addition to scenarios similar to this one, there are a wide variety of
medical situations covered (400 total) by this emergency room
simulation. These situations range in complexity from a simple bee
sting, to sexually transmitted diseases and Code Blues.
Emergency Room requires that you do a lot of on-screen reading of
different subjects regarding emergency medical treatment and general
human anatomy and physiology. I do not recommend this title for the
faint of heart, but if you spend any time in the em ergency room of
Legacy Memorial Hospital, you will learn a thing or two. I know I did.