Found Unresponsive
ESI 128 F · Found unresponsive, suspected opioid overdose
Pick a patient to enter the room, or take a full multi-patient shift. Every encounter is debriefed against the certifying exam's critical actions.
Check microphone and speakers28 F · Found unresponsive, suspected opioid overdose
3 Y · Choking, stridor
82 M · Sudden tearing back pain
3 Y · Inconsolable crying, grabbing at abdomen
28 F · Bloating and frequent loose stools
24 M · Facial trauma after assault, airway compromise
17 F · Nausea, tremors, ringing in the ears
37 M · Severe shortness of breath
68 F · Generalized weakness and lethargy
6 M · Vomiting, abdominal pain, bloody diarrhea, and leg pain
55 M · Severe abdominal pain and vomiting
38 M · Severe low back pain with leg weakness and inability to urinate
19 F · Acute left lower quadrant pain
78 M · Acute shortness of breath, gasping for air
42 F · Altered mental status with agitation and tachycardia
52 M · Confused and unsteady, found by family this morning
7 F · Facial swelling and trouble breathing after eating a snack
85 M · Progressive confusion over two days
38 F · Worsening confusion, severe headache, and trouble walking straight
3 M · Left arm pain and refusal to move the arm after playground play
58 M · Severe abdominal pain and dizziness after a motorcycle crash
28 M · Severe pain and burns to the face and arms after a warehouse explosion
68 M · Crushing chest pain, then sudden unresponsiveness
42 M · Worsening hand pain, swelling, and new fever after a bite
42 M · Chest pain after recreational drug use
26 M · Severe chest pain after vomiting
35 M · Left chest pain and worsening shortness of breath after a motorcycle crash
78 M · Collapse, weakness, and dizziness
58 M · Altered mental status and abdominal pain
72 F · Progressive confusion, refusal to eat, and severe constipation
4 F · Bloody diarrhea and tea-colored urine
48 F · Severe diffuse abdominal pain, nausea, and vomiting
16 M · Cold-water submersion with cardiac arrest and ROSC
28 F · Severe lower abdominal pain and heavy vaginal bleeding
78 M · Fever and altered mental status
62 M · Progressive shortness of breath and near-syncope
14 M · Collapsed during track practice
32 M · Legs giving out, feels like he is dying
42 F · Jaw pain and progressive neck swelling with trouble swallowing saliva
58 M · Progressive facial swelling and dyspnea
67 M · Fever, confusion, and worsening abdominal pain
20 M · Severe headache, neck stiffness, and confusion
32 F · Three days of progressive mid-back pain and fever
89 F · Found down at home, confused
48 F · Worsening frontal headache, fever, and right eye swelling and pain
28 F · Severe headache for 2 days and a new rash with easy bruising
44 M · Severe right-sided headache and neck pain with transient vision loss
42 M · I cannot breathe and I am burning up
4-month-old M · Turned dark blue during a feeding
62 M · Worst headache of his life with confusion
78 M · Hypotension and confusion after a ground-level fall
58 F · Dyspnea, anxiety, and dizziness that began during hemodialysis
42 M · Severe, burning left hand pain after a workplace exposure
42 M · Took a large quantity of pain medication in a suicide attempt
58 M · Severe left lower quadrant abdominal pain for 36 hours
68 M · Acute confusion and left-sided weakness
68 M · Fever and lethargy
16 M · Progressive right leg pain and a limp
22 F · Worsening lower abdominal pain and high fever
52 M · Progressive left leg swelling and pain for three days
38 M · Severe low back pain and left leg weakness
58 M · Vomiting large volumes of bright red blood
58 M · Abdominal pain, vomiting, and inability to pass flatus
24 d M · Bloody stools, poor feeding, and increasing fussiness
8-day-old F · Not waking up to feed, breathing fast
58 F · Left-sided weakness and slurred speech
34 M · Fever and a painful spreading rash with lip lesions
67 F · Sudden severe right eye pain and headache
9 mo F · Severe coughing spells with color change and apnea
10 mo F · Screaming on and off for 8 hours, now hard to arouse
5 mo M · Unresponsive infant, ongoing CPR
4 M · Abdominal pain after a reported fall
64 M · Severe pelvic and left thigh pain after being struck by a vehicle
34 M · Stab wound to the left chest with chest pain and difficulty breathing
31 M · Gunshot wound to the left chest with worsening breathing
62 F · Fever and right upper quadrant abdominal pain for 2 days
38 F · Witnessed generalized seizure 5 days postpartum
58 M · Acute left knee pain and fever, demanding antibiotics and discharge
41 F · Progressive fatigue and proximal muscle weakness over 10 weeks
32 M · Severe perianal pain for three days
58 F · Persistent indigestion and upper back discomfort
67 F · Worsening shortness of breath over 48 hours
28 F · Severe right-sided flank pain
26 F · Right lower quadrant pain, nausea, and anorexia
48 M · Witnessed seizure, now confused, with one week of fevers and new bruising
38 F · Actively seizing for 20 minutes
18 mo F · Shaking episode with fever, difficult to arouse
78 M · Acute severe abdominal pain
52 M · Fever, productive cough, worsening shortness of breath
32 M · Severe neck pain and inability to move arms or legs after a dive
45 F · Acute shortness of breath and a swollen right leg
19 F · Progressive chest pain and shortness of breath
14 M · Something bit my leg and it burns
82 M · Sudden severe abdominal pain for three hours
67 F · Witnessed fainting episode
29 F · Syncope while jogging, three days of fatigue and dizziness
42 F · Sudden palpitations and mild chest tightness
5-week-old M · Fussiness and not eating
68 F · Generalized weakness and palpitations
62 F · Severe right thigh pain and swelling
2 F · Fever and refusal to walk or move the neck
38 M · Found unresponsive, confused and somnolent
76 F · Found unresponsive at home
58 M · Epigastric and right upper quadrant pain
70 F · Painless vision loss in the right eye
82 F · Syncope, confusion, weakness, nausea, and strange vision
28 F · Progressive weakness and double vision over 5 days
18 M · Right shoulder pain and deformity after a fall
| Patient | Presentation | ESI | Practice | Enter |
|---|---|---|---|---|
| 28 F | Found UnresponsiveFound unresponsive, suspected opioid overdose | 1 | Free demo | Enter room |
| 3 Y | Choking ToddlerChoking, stridor | 1 | Unseen | Get access |
| 82 M | Chest and Back PainSudden tearing back pain | 1 | Unseen | Get access |
| 3 Y | Fussy ToddlerInconsolable crying, grabbing at abdomen | 2 | Unseen | Get access |
| 28 F | Abdominal Pain After TravelBloating and frequent loose stools | 3 | Unseen | Get access |
| 24 M | Facial TraumaFacial trauma after assault, airway compromise | 1 | Unseen | Get access |
| 17 F | Toxic IngestionNausea, tremors, ringing in the ears | 2 | Unseen | Get access |
| 37 M | Severe Respiratory DistressSevere shortness of breath | 1 | Unseen | Get access |
| 68 F | Weakness and LethargyGeneralized weakness and lethargy | 2 | Unseen | Get access |
| 6 M | Abdominal Pain and a Rash in a ChildVomiting, abdominal pain, bloody diarrhea, and leg pain | 2 | Unseen | Get access |
| 55 M | Abdominal Pain and Groin MassSevere abdominal pain and vomiting | 2 | Unseen | Get access |
| 38 M | Acute Back PainSevere low back pain with leg weakness and inability to urinate | 2 | Unseen | Get access |
| 19 F | Acute Pelvic PainAcute left lower quadrant pain | 2 | Unseen | Get access |
| 78 M | Acute Shortness of BreathAcute shortness of breath, gasping for air | 1 | Unseen | Get access |
| 42 F | Agitation and TachycardiaAltered mental status with agitation and tachycardia | 1 | Unseen | Get access |
| 52 M | Alcohol IntoxicationConfused and unsteady, found by family this morning | 2 | Unseen | Get access |
| 7 F | Allergic ReactionFacial swelling and trouble breathing after eating a snack | 1 | Unseen | Get access |
| 85 M | Altered Mental StatusProgressive confusion over two days | 2 | Unseen | Get access |
| 38 F | Altered While SkiingWorsening confusion, severe headache, and trouble walking straight | 2 | Unseen | Get access |
| 3 M | Arm Pain in a ChildLeft arm pain and refusal to move the arm after playground play | 4 | Unseen | Get access |
| 58 M | Blunt Abdominal TraumaSevere abdominal pain and dizziness after a motorcycle crash | 1 | Unseen | Get access |
| 28 M | BurnSevere pain and burns to the face and arms after a warehouse explosion | 2 | Unseen | Get access |
| 68 M | Cardiac ArrestCrushing chest pain, then sudden unresponsiveness | 1 | Unseen | Get access |
| 42 M | Cat BiteWorsening hand pain, swelling, and new fever after a bite | 3 | Unseen | Get access |
| 42 M | Chest Pain After Drug UseChest pain after recreational drug use | 2 | Unseen | Get access |
| 26 M | Chest Pain and VomitingSevere chest pain after vomiting | 2 | Unseen | Get access |
| 35 M | Chest Tube InsertionLeft chest pain and worsening shortness of breath after a motorcycle crash | 2 | Unseen | Get access |
| 78 M | Collapse While WorkingCollapse, weakness, and dizziness | 2 | Unseen | Get access |
| 58 M | ConfusionAltered mental status and abdominal pain | 1 | Unseen | Get access |
| 72 F | Constipation in an Elderly PatientProgressive confusion, refusal to eat, and severe constipation | 2 | Unseen | Get access |
| 4 F | Diarrhea and Discolored UrineBloody diarrhea and tea-colored urine | 2 | Unseen | Get access |
| 48 F | Diffuse Abdominal PainSevere diffuse abdominal pain, nausea, and vomiting | 1 | Unseen | Get access |
| 16 M | DrowningCold-water submersion with cardiac arrest and ROSC | 1 | Unseen | Get access |
| 28 F | Early PregnancySevere lower abdominal pain and heavy vaginal bleeding | 2 | Unseen | Get access |
| 78 M | Elderly Patient with DementiaFever and altered mental status | 2 | Unseen | Get access |
| 62 M | Emergent PericardiocentesisProgressive shortness of breath and near-syncope | 1 | Unseen | Get access |
| 14 M | Exercise-Induced Syncope in an Adolescent AthleteCollapsed during track practice | 2 | Unseen | Get access |
| 32 M | Exertional CollapseLegs giving out, feels like he is dying | 2 | Unseen | Get access |
| 42 F | Facial SwellingJaw pain and progressive neck swelling with trouble swallowing saliva | 2 | Unseen | Get access |
| 58 M | Facial Swelling and Respiratory DistressProgressive facial swelling and dyspnea | 2 | Unseen | Get access |
| 67 M | Fever and Altered Mental StatusFever, confusion, and worsening abdominal pain | 2 | Unseen | Get access |
| 20 M | Fever and ConfusionSevere headache, neck stiffness, and confusion | 1 | Unseen | Get access |
| 32 F | Fever and Thoracic Back Pain in a Spinal Cord Injury PatientThree days of progressive mid-back pain and fever | 2 | Unseen | Get access |
| 89 F | Found Down at HomeFound down at home, confused | 2 | Unseen | Get access |
| 48 F | Frontal HeadacheWorsening frontal headache, fever, and right eye swelling and pain | 2 | Unseen | Get access |
| 28 F | Headache and PetechiaeSevere headache for 2 days and a new rash with easy bruising | 2 | Unseen | Get access |
| 44 M | Headache with Vision LossSevere right-sided headache and neck pain with transient vision loss | 2 | Unseen | Get access |
| 42 M | HIV with Respiratory FailureI cannot breathe and I am burning up | 1 | Unseen | Get access |
| 4-month-old M | Hypercyanotic Spell in an InfantTurned dark blue during a feeding | 1 | Unseen | Get access |
| 62 M | HypertensionWorst headache of his life with confusion | 2 | Unseen | Get access |
| 78 M | Hypotension After a FallHypotension and confusion after a ground-level fall | 1 | Unseen | Get access |
| 58 F | Hypotension During DialysisDyspnea, anxiety, and dizziness that began during hemodialysis | 1 | Unseen | Get access |
| 42 M | Industrial BurnSevere, burning left hand pain after a workplace exposure | 2 | Unseen | Get access |
| 42 M | Intentional OverdoseTook a large quantity of pain medication in a suicide attempt | 2 | Unseen | Get access |
| 58 M | Left Lower Quadrant PainSevere left lower quadrant abdominal pain for 36 hours | 3 | Unseen | Get access |
| 68 M | Left Sided WeaknessAcute confusion and left-sided weakness | 2 | Unseen | Get access |
| 68 M | Lethargic Elderly PatientFever and lethargy | 1 | Unseen | Get access |
| 16 M | Limping TeenagerProgressive right leg pain and a limp | 3 | Unseen | Get access |
| 22 F | Lower Abdominal Pain with FeverWorsening lower abdominal pain and high fever | 3 | Unseen | Get access |
| 52 M | Lower Extremity Swelling PostoperativeProgressive left leg swelling and pain for three days | 3 | Unseen | Get access |
| 38 M | Lower Extremity WeaknessSevere low back pain and left leg weakness | 2 | Unseen | Get access |
| 58 M | Massive Hematemesis in a CirrhoticVomiting large volumes of bright red blood | 1 | Unseen | Get access |
| 58 M | Nausea and VomitingAbdominal pain, vomiting, and inability to pass flatus | 2 | Unseen | Get access |
| 24 d M | Neonatal HematocheziaBloody stools, poor feeding, and increasing fussiness | 1 | Unseen | Get access |
| 8-day-old F | Neonatal ShockNot waking up to feed, breathing fast | 1 | Unseen | Get access |
| 58 F | Neurologic DeficitsLeft-sided weakness and slurred speech | 2 | Unseen | Get access |
| 34 M | Oral RashFever and a painful spreading rash with lip lesions | 2 | Unseen | Get access |
| 67 F | Painful Red EyeSudden severe right eye pain and headache | 2 | Unseen | Get access |
| 9 mo F | Paroxysmal Cough in 9-Month-OldSevere coughing spells with color change and apnea | 2 | Unseen | Get access |
| 10 mo F | Paroxysmal CryingScreaming on and off for 8 hours, now hard to arouse | 2 | Unseen | Get access |
| 5 mo M | Pediatric Cardiac ArrestUnresponsive infant, ongoing CPR | 1 | Unseen | Get access |
| 4 M | Pediatric TraumaAbdominal pain after a reported fall | 2 | Unseen | Get access |
| 64 M | Pelvic TraumaSevere pelvic and left thigh pain after being struck by a vehicle | 1 | Unseen | Get access |
| 34 M | Penetrating Chest Trauma in the Agitated PatientStab wound to the left chest with chest pain and difficulty breathing | 1 | Unseen | Get access |
| 31 M | Penetrating Chest Trauma with DecompensationGunshot wound to the left chest with worsening breathing | 1 | Unseen | Get access |
| 62 F | Post-Transplant FeverFever and right upper quadrant abdominal pain for 2 days | 2 | Unseen | Get access |
| 38 F | Postpartum SeizureWitnessed generalized seizure 5 days postpartum | 1 | Unseen | Get access |
| 58 M | Procedure RefusalAcute left knee pain and fever, demanding antibiotics and discharge | 2 | Unseen | Get access |
| 41 F | Progressive WeaknessProgressive fatigue and proximal muscle weakness over 10 weeks | 2 | Unseen | Get access |
| 32 M | Rectal PainSevere perianal pain for three days | 3 | Unseen | Get access |
| 58 F | Reflux SymptomsPersistent indigestion and upper back discomfort | 2 | Unseen | Get access |
| 67 F | Respiratory FailureWorsening shortness of breath over 48 hours | 2 | Unseen | Get access |
| 28 F | Right Flank Pain with Clinical DeteriorationSevere right-sided flank pain | 2 | Unseen | Get access |
| 26 F | Right Lower Quadrant Pain in a Young WomanRight lower quadrant pain, nausea, and anorexia | 3 | Unseen | Get access |
| 48 M | Seizing and AlteredWitnessed seizure, now confused, with one week of fevers and new bruising | 2 | Unseen | Get access |
| 38 F | SeizureActively seizing for 20 minutes | 1 | Unseen | Get access |
| 18 mo F | Seizure and FeverShaking episode with fever, difficult to arouse | 2 | Unseen | Get access |
| 78 M | Severe Abdominal PainAcute severe abdominal pain | 2 | Unseen | Get access |
| 52 M | Severe Pneumonia with Septic ShockFever, productive cough, worsening shortness of breath | 1 | Unseen | Get access |
| 32 M | Shallow Water AccidentSevere neck pain and inability to move arms or legs after a dive | 1 | Unseen | Get access |
| 45 F | Shortness of Breath with Leg SwellingAcute shortness of breath and a swollen right leg | 2 | Unseen | Get access |
| 19 F | Sickle Cell and Chest PainProgressive chest pain and shortness of breath | 2 | Unseen | Get access |
| 14 M | Snake BiteSomething bit my leg and it burns | 2 | Unseen | Get access |
| 82 M | Sudden Abdominal PainSudden severe abdominal pain for three hours | 1 | Unseen | Get access |
| 67 F | SyncopeWitnessed fainting episode | 2 | Unseen | Get access |
| 29 F | Syncope with RashSyncope while jogging, three days of fatigue and dizziness | 2 | Unseen | Get access |
| 42 F | TachycardiaSudden palpitations and mild chest tightness | 2 | Unseen | Get access |
| 5-week-old M | The Irritable InfantFussiness and not eating | 1 | Unseen | Get access |
| 68 F | The Weak Dialysis PatientGeneralized weakness and palpitations | 2 | Unseen | Get access |
| 62 F | Thigh SwellingSevere right thigh pain and swelling | 1 | Unseen | Get access |
| 2 F | Toddler with FeverFever and refusal to walk or move the neck | 2 | Unseen | Get access |
| 38 M | Toxic Alcohol IngestionFound unresponsive, confused and somnolent | 1 | Unseen | Get access |
| 76 F | Unresponsive Elderly PatientFound unresponsive at home | 1 | Unseen | Get access |
| 58 M | Upper Abdominal PainEpigastric and right upper quadrant pain | 3 | Unseen | Get access |
| 70 F | Vision LossPainless vision loss in the right eye | 3 | Unseen | Get access |
| 82 F | Visual Disruption and BradycardiaSyncope, confusion, weakness, nausea, and strange vision | 2 | Unseen | Get access |
| 28 F | Weakness and Blurred VisionProgressive weakness and double vision over 5 days | 2 | Unseen | Get access |
| 18 M | Shoulder DislocationRight shoulder pain and deformity after a fall | 3 | Unseen | Get access |
Two simultaneous critical patients, one with sudden tearing chest and back pain and one found unresponsive from a suspected opioid overdose. Manage both as the shift clock runs.
As trauma team leader at a Level II center with the surgeon scrubbed in elsewhere and only a resident, one nurse, and one tech, triage and manage three simultaneous arrivals while anticipating delayed deteriorations and competing family demands.
Sole attending in a community ED when three ambulances arrive at once with critically ill patients. Evaluate, prioritize, and manage all three concurrently while navigating a one-bed ICU shortage.
Sole attending at 02:00 in a 30-bed ED at capacity with 15 boarders. Stabilize a new high-speed motorcycle trauma while two deteriorating boarders decompensate, all under severe resource constraints.
Triage attending in a busy urban ED when five new patients arrive at once. Evaluate each, order the initial workup, assign to the correct care area, hand off the critically ill, and reassess as results return.
Attending in the pediatric ED during peak respiratory season when three children arrive at once in moderate respiratory distress. Triage, manage parental expectations, and monitor for deterioration with only two monitored beds.
Triage attending on a chaotic evening with a full waiting room at 120 percent capacity. Evaluate five new patients, order diagnostics, assign each to the right care area, and reassess those who remain in the waiting room.