{ "scenario": { "id": "stable-baseline-01", "name": "Stable Baseline \u2014 Routine Inpatient Monitoring", "description": "52-year-old female admitted for elective cholecystectomy. Completely uneventful 8-hour post-op monitoring period with all vitals remaining normal throughout. This is a CONTROL scenario that validates the system does NOT generate false alerts on a stable patient. NEWS2 remains 0 at every observation cluster.", "durationMinutes": 480, "tags": [ "stable", "baseline", "control", "surgery", "post-op", "cholecystectomy", "no-alert" ] }, "patient": { "firstName": "Linda", "lastName": "Weston", "dateOfBirth": "1974-02-18", "gender": "Female" }, "encounter": { "department": "Surgery", "encounterType": "Inpatient", "attendingPhysician": "Dr. James Nakamura", "roomBed": "SURG-204B", "admissionReason": "Elective laparoscopic cholecystectomy \u2014 routine post-operative monitoring" }, "events": [ { "offsetMinutes": 0, "type": "observation", "data": { "code": "HEART_RATE", "value": 72, "unit": "bpm", "source": "Device" }, "note": "Post-op arrival to surgical floor. All vitals normal, patient alert and comfortable. NEWS2=0" }, { "offsetMinutes": 0, "type": "observation", "data": { "code": "RESP_RATE", "value": 14, "unit": "/min", "source": "Device" } }, { "offsetMinutes": 0, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 124, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 0, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 74, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 0, "type": "observation", "data": { "code": "TEMP_C", "value": 36.8, "unit": "\u00b0C", "source": "Manual" } }, { "offsetMinutes": 0, "type": "observation", "data": { "code": "SPO2", "value": 98, "unit": "%", "source": "Device" } }, { "offsetMinutes": 0, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "Manual" } }, { "offsetMinutes": 0, "type": "observation", "data": { "code": "GCS_EYE", "value": 4, "unit": "score", "source": "Manual" } }, { "offsetMinutes": 0, "type": "observation", "data": { "code": "GCS_VERBAL", "value": 5, "unit": "score", "source": "Manual" } }, { "offsetMinutes": 0, "type": "observation", "data": { "code": "GCS_MOTOR", "value": 6, "unit": "score", "source": "Manual" } }, { "offsetMinutes": 30, "type": "observation", "data": { "code": "HEART_RATE", "value": 74, "unit": "bpm", "source": "Device" }, "note": "First routine check \u2014 minor physiological noise, all normal. NEWS2=0" }, { "offsetMinutes": 30, "type": "observation", "data": { "code": "RESP_RATE", "value": 15, "unit": "/min", "source": "Device" } }, { "offsetMinutes": 30, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 122, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 30, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 76, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 30, "type": "observation", "data": { "code": "TEMP_C", "value": 36.7, "unit": "\u00b0C", "source": "Manual" } }, { "offsetMinutes": 30, "type": "observation", "data": { "code": "SPO2", "value": 98, "unit": "%", "source": "Device" } }, { "offsetMinutes": 30, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "Manual" } }, { "offsetMinutes": 60, "type": "observation", "data": { "code": "HEART_RATE", "value": 70, "unit": "bpm", "source": "Device" }, "note": "Second routine check \u2014 all normal. NEWS2=0" }, { "offsetMinutes": 60, "type": "observation", "data": { "code": "RESP_RATE", "value": 14, "unit": "/min", "source": "Device" } }, { "offsetMinutes": 60, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 126, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 60, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 73, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 60, "type": "observation", "data": { "code": "TEMP_C", "value": 36.8, "unit": "\u00b0C", "source": "Manual" } }, { "offsetMinutes": 60, "type": "observation", "data": { "code": "SPO2", "value": 99, "unit": "%", "source": "Device" } }, { "offsetMinutes": 60, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "Manual" } }, { "offsetMinutes": 60, "type": "observation", "data": { "code": "GLUCOSE_MG_DL", "value": 118, "unit": "mg/dL", "source": "Lab" }, "note": "Routine post-op labs \u2014 all within normal limits" }, { "offsetMinutes": 60, "type": "observation", "data": { "code": "POTASSIUM_MEQ_L", "value": 4.0, "unit": "mEq/L", "source": "Lab" } }, { "offsetMinutes": 61, "type": "observation", "data": { "code": "WBC_K_UL", "value": 8.2, "unit": "\u00d710\u00b3/\u00b5L", "source": "Lab" } }, { "offsetMinutes": 90, "type": "observation", "data": { "code": "HEART_RATE", "value": 73, "unit": "bpm", "source": "Device" }, "note": "Third routine check \u2014 all normal. NEWS2=0" }, { "offsetMinutes": 90, "type": "observation", "data": { "code": "RESP_RATE", "value": 15, "unit": "/min", "source": "Device" } }, { "offsetMinutes": 90, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 120, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 90, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 74, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 90, "type": "observation", "data": { "code": "TEMP_C", "value": 36.9, "unit": "\u00b0C", "source": "Manual" } }, { "offsetMinutes": 90, "type": "observation", "data": { "code": "SPO2", "value": 98, "unit": "%", "source": "Device" } }, { "offsetMinutes": 90, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "Manual" } }, { "offsetMinutes": 120, "type": "observation", "data": { "code": "HEART_RATE", "value": 71, "unit": "bpm", "source": "Device" }, "note": "Fourth routine check \u2014 patient reports mild incisional discomfort. All vitals normal. NEWS2=0" }, { "offsetMinutes": 120, "type": "observation", "data": { "code": "RESP_RATE", "value": 14, "unit": "/min", "source": "Device" } }, { "offsetMinutes": 120, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 125, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 120, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 75, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 120, "type": "observation", "data": { "code": "TEMP_C", "value": 36.8, "unit": "\u00b0C", "source": "Manual" } }, { "offsetMinutes": 120, "type": "observation", "data": { "code": "SPO2", "value": 98, "unit": "%", "source": "Device" } }, { "offsetMinutes": 120, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "Manual" } }, { "offsetMinutes": 120, "type": "medication", "data": { "drugName": "Acetaminophen", "dose": 1000, "doseUnit": "mg", "route": "PO", "administeredBy": "RN Garcia" }, "note": "Acetaminophen 1000mg PO for mild post-op incisional discomfort" }, { "offsetMinutes": 150, "type": "observation", "data": { "code": "HEART_RATE", "value": 66, "unit": "bpm", "source": "Device" }, "note": "Patient sleeping \u2014 mild sleep bradycardia, HR dips to 66. Entirely normal. NEWS2=0" }, { "offsetMinutes": 150, "type": "observation", "data": { "code": "RESP_RATE", "value": 12, "unit": "/min", "source": "Device" } }, { "offsetMinutes": 150, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 118, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 150, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 70, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 150, "type": "observation", "data": { "code": "TEMP_C", "value": 36.7, "unit": "\u00b0C", "source": "Manual" } }, { "offsetMinutes": 150, "type": "observation", "data": { "code": "SPO2", "value": 98, "unit": "%", "source": "Device" } }, { "offsetMinutes": 150, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "Manual" } }, { "offsetMinutes": 180, "type": "observation", "data": { "code": "HEART_RATE", "value": 73, "unit": "bpm", "source": "Device" }, "note": "Sixth check \u2014 patient awake, back to baseline. NEWS2=0" }, { "offsetMinutes": 180, "type": "observation", "data": { "code": "RESP_RATE", "value": 15, "unit": "/min", "source": "Device" } }, { "offsetMinutes": 180, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 126, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 180, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 76, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 180, "type": "observation", "data": { "code": "TEMP_C", "value": 36.9, "unit": "\u00b0C", "source": "Manual" } }, { "offsetMinutes": 180, "type": "observation", "data": { "code": "SPO2", "value": 97, "unit": "%", "source": "Device" } }, { "offsetMinutes": 180, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "Manual" } }, { "offsetMinutes": 210, "type": "observation", "data": { "code": "HEART_RATE", "value": 75, "unit": "bpm", "source": "Device" }, "note": "Seventh check \u2014 all normal. NEWS2=0" }, { "offsetMinutes": 210, "type": "observation", "data": { "code": "RESP_RATE", "value": 16, "unit": "/min", "source": "Device" } }, { "offsetMinutes": 210, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 128, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 210, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 78, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 210, "type": "observation", "data": { "code": "TEMP_C", "value": 36.8, "unit": "\u00b0C", "source": "Manual" } }, { "offsetMinutes": 210, "type": "observation", "data": { "code": "SPO2", "value": 98, "unit": "%", "source": "Device" } }, { "offsetMinutes": 210, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "Manual" } }, { "offsetMinutes": 210, "type": "observation", "data": { "code": "GLUCOSE_MG_DL", "value": 105, "unit": "mg/dL", "source": "Lab" }, "note": "Second routine lab draw \u2014 all within normal limits" }, { "offsetMinutes": 210, "type": "observation", "data": { "code": "POTASSIUM_MEQ_L", "value": 4.1, "unit": "mEq/L", "source": "Lab" } }, { "offsetMinutes": 240, "type": "observation", "data": { "code": "HEART_RATE", "value": 72, "unit": "bpm", "source": "Device" }, "note": "Eighth check \u2014 all normal, temp 37.0. Surgical wound check performed. NEWS2=0" }, { "offsetMinutes": 240, "type": "observation", "data": { "code": "RESP_RATE", "value": 14, "unit": "/min", "source": "Device" } }, { "offsetMinutes": 240, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 124, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 240, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 74, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 240, "type": "observation", "data": { "code": "TEMP_C", "value": 37.0, "unit": "\u00b0C", "source": "Manual" } }, { "offsetMinutes": 240, "type": "observation", "data": { "code": "SPO2", "value": 98, "unit": "%", "source": "Device" } }, { "offsetMinutes": 240, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "Manual" } }, { "offsetMinutes": 235, "type": "order", "data": { "orderType": "Procedure", "description": "Surgical wound assessment \u2014 laparoscopic cholecystectomy port sites", "orderedBy": "Dr. James Nakamura" } }, { "offsetMinutes": 240, "type": "order_result", "data": { "orderDescription": "Surgical wound assessment \u2014 laparoscopic cholecystectomy port sites", "resultSummary": "All four port sites intact, clean and dry. No erythema, swelling, drainage, or dehiscence. Steri-strips in place. No signs of infection." }, "note": "Routine post-op wound check \u2014 normal findings" }, { "offsetMinutes": 300, "type": "observation", "data": { "code": "HEART_RATE", "value": 70, "unit": "bpm", "source": "Device" }, "note": "Check at 5 hours \u2014 all normal. NEWS2=0" }, { "offsetMinutes": 300, "type": "observation", "data": { "code": "RESP_RATE", "value": 15, "unit": "/min", "source": "Device" } }, { "offsetMinutes": 300, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 122, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 300, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 73, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 300, "type": "observation", "data": { "code": "TEMP_C", "value": 36.9, "unit": "\u00b0C", "source": "Manual" } }, { "offsetMinutes": 300, "type": "observation", "data": { "code": "SPO2", "value": 99, "unit": "%", "source": "Device" } }, { "offsetMinutes": 300, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "Manual" } }, { "offsetMinutes": 360, "type": "observation", "data": { "code": "HEART_RATE", "value": 74, "unit": "bpm", "source": "Device" }, "note": "Check at 6 hours \u2014 all normal. NEWS2=0" }, { "offsetMinutes": 360, "type": "observation", "data": { "code": "RESP_RATE", "value": 14, "unit": "/min", "source": "Device" } }, { "offsetMinutes": 360, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 130, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 360, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 78, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 360, "type": "observation", "data": { "code": "TEMP_C", "value": 37.0, "unit": "\u00b0C", "source": "Manual" } }, { "offsetMinutes": 360, "type": "observation", "data": { "code": "SPO2", "value": 98, "unit": "%", "source": "Device" } }, { "offsetMinutes": 360, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "Manual" } }, { "offsetMinutes": 420, "type": "observation", "data": { "code": "HEART_RATE", "value": 71, "unit": "bpm", "source": "Device" }, "note": "Check at 7 hours \u2014 all normal. NEWS2=0" }, { "offsetMinutes": 420, "type": "observation", "data": { "code": "RESP_RATE", "value": 16, "unit": "/min", "source": "Device" } }, { "offsetMinutes": 420, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 126, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 420, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 75, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 420, "type": "observation", "data": { "code": "TEMP_C", "value": 36.8, "unit": "\u00b0C", "source": "Manual" } }, { "offsetMinutes": 420, "type": "observation", "data": { "code": "SPO2", "value": 98, "unit": "%", "source": "Device" } }, { "offsetMinutes": 420, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "Manual" } }, { "offsetMinutes": 480, "type": "observation", "data": { "code": "HEART_RATE", "value": 73, "unit": "bpm", "source": "Device" }, "note": "Final check at 8 hours \u2014 all vitals normal. Patient stable, tolerating diet, ambulating. NEWS2=0. Ready for discharge planning." }, { "offsetMinutes": 480, "type": "observation", "data": { "code": "RESP_RATE", "value": 14, "unit": "/min", "source": "Device" } }, { "offsetMinutes": 480, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 124, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 480, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 74, "unit": "mmHg", "source": "Device" } }, { "offsetMinutes": 480, "type": "observation", "data": { "code": "TEMP_C", "value": 36.9, "unit": "\u00b0C", "source": "Manual" } }, { "offsetMinutes": 480, "type": "observation", "data": { "code": "SPO2", "value": 98, "unit": "%", "source": "Device" } }, { "offsetMinutes": 480, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "Manual" } } ], "expectedOutcomes": [ { "afterOffsetMinutes": 0, "type": "score", "scoreType": "NEWS2", "expectedMinimum": 0, "description": "NEWS2 score is 0 at baseline (T+0). All parameters in normal range: HR 72 (score 0), RR 14 (score 0), SBP 124 (score 0), SpO2 98 (score 0), Temp 36.8 (score 0), AVPU 0 (score 0), no supplemental O2 (score 0)." }, { "afterOffsetMinutes": 150, "type": "score", "scoreType": "NEWS2", "expectedMinimum": 0, "description": "NEWS2 score remains 0 during sleep period (T+150). Sleep bradycardia HR 66 still within NEWS2 score-0 range (51-90), RR 12 still within score-0 range (12-20). No alert should fire." }, { "afterOffsetMinutes": 240, "type": "score", "scoreType": "NEWS2", "expectedMinimum": 0, "description": "NEWS2 score remains 0 at mid-monitoring (T+240). All vitals stable and well within normal ranges. Surgical wound check normal." }, { "afterOffsetMinutes": 480, "type": "score", "scoreType": "NEWS2", "expectedMinimum": 0, "description": "NEWS2 score remains 0 at end of 8-hour monitoring period (T+480). No alerts fired throughout entire scenario. Patient stable for discharge planning. This confirms the system correctly avoids false positives on a stable patient." } ] }