arrayApplication field
Numeric physiologic state with explicit concepts and units; observations describe when values are measured or disclosed.
- Optional; omitted values remain unspecified.
ReferencePatient
Patient
Vital signs
A clinical snapshot that can change as the scenario progresses.
Format definition
Define physiologic variables separately from measured observations and support authored trends.
Scenario standard · Execution capabilities
Normal ranges by age
Use the patient's age to choose a row. ‘Under’ excludes the upper age; the next row starts at that age. Values at either end of a vital-sign range are within range.
| Age | Group | HR | RR | Systolic BP | Diastolic BP |
|---|---|---|---|---|---|
| Birth to under 28 days | Newborn | 100–205 | 30–53 | 67–84 | 35–53 |
| 28 days to under 1 year | Infant | 100–180 | 30–53 | 72–104 | 37–56 |
| 1 to under 3 years | Toddler | 98–140 | 22–37 | 86–106 | 42–63 |
| 3 to under 6 years | Preschool | 80–120 | 20–28 | 89–112 | 46–72 |
| 6 to under 12 years | School age | 75–118 | 18–25 | 97–115 | 57–76 |
| 12 to under 16 years | Adolescent | 60–100 | 12–20 | 102–120 | 61–80 |
| 16 years and older | Older adolescent / adult | 60–100 | 12–18 | 90–120 | 60–80 |
Ranges shared across ages
These defaults also require a known age. HR is in beats/min, RR in breaths/min, and blood pressure in mmHg.
| Vital sign | Normal range | Unit |
|---|---|---|
| Oxygen saturation (SpO2) | 95–100 | % |
| Temperature | 36.5–37.3 | °C |
| End-tidal CO2 (EtCO2) | 35–45 | mmHg |
How a reading is interpreted
| Priority | Use | Meaning |
|---|---|---|
| 1 | Authored flag | An explicitly authored flag takes precedence, including none or not-interpreted. |
| 2 | Authored reference interval | Use the scenario's own range. A text-only interval leaves numeric interpretation unspecified. |
| 3 | Age-based default | If neither is supplied, use the patient's age and the tables above. Missing or invalid age leaves the reading uninterpreted. |
Parameters
patients[].variables[]
object
Optional; omitted means unspecified
One numeric physiologic variable belonging to this patient.
observations[].variableId
string
Optional; omitted means unspecified
On collection, snapshot this variable's current value into a new measurement; later trends do not rewrite past results.
events.effects[].durationSeconds
number
Optional; omitted means unspecified
Duration of a linear authored change from current value to target. Instant changes use set-variable.
events.effects[].interpolation
"linear"
Optional; omitted means unspecified
The format supports one explicit interpolation rule; no inferred dose-response or disease model.
resources[].diagnostic.orthostaticResponse
object
Optional; omitted means unspecified
Report standing BP relative to current resting BP when requested, without changing resting physiology. An authored learner result takes precedence.
Behavior and validation
- Core vital concepts use hr (beats/min), sbp/dbp (mmHg), rr (breaths/min), spo2 (%), temperature (Cel), and etco2 (mmHg). Normal-value interpretation uses the usim:age-based-vitals profile published in referenceProfiles, shared by preview, PDF, and other consumers.
- Read age from the patient’s demographics.age in days, months, or years. For display, 28 days is approximately 0.077 years. Calculations use the exact conversion (days ÷ 365.25 or months ÷ 12), without rounding. Do not infer age from weight, title, or appearance.
- For a known numeric vital measurement: explicit observations[].flag takes precedence, then an authored observations[].referenceInterval, then the age-based default. A text-only authored interval suppresses automatic numeric interpretation. Validate authored intervals and unit agreement; never fall back to defaults after an invalid override. Compare strictly below low or above high; endpoints are within range. Derived flags are output interpretation, not mutations of authored values or flags. Defaults never infer critical severity.
- The default profile uses awake/resting values after postnatal transition, not physiologic limits or treatment targets. Changing a patient's age immediately changes the default range applied to both initial and event vitals; it never changes the actual authored values. Keep the profile version fixed for reproducible interpretation. Custom numeric concepts require an authored reference interval; no vital defaults apply to unrelated laboratory tests.
- orthostaticResponse requires the orthostatic-results execution capability. Snapshot both resting BP variables when the diagnostic is requested; compute standing systolic = baseline systolic minus systolicDrop and standing diastolic = baseline diastolic minus diastolicDrop. Persist that request-time snapshot through delayed release. This produces a result, not a set-variable effect: resting physiology is unchanged, and no heart-rate response is inferred.
- An authored nonblank result takes precedence over the computed orthostatic report. Missing baseline BP, nonpositive computed pressure, or computed systolic not greater than diastolic produces an unavailable result, never invented values. Invalid references, units, or drop parameters invalidate the document. Explicit learner disclosure still controls delivery; a disconnected monitor does not prevent a requested bedside measurement.
- The format supplies no default orthostatic drop. The included positive teaching resource authors systolicDrop 20 and diastolicDrop 10 mmHg; 130/80 therefore reports 110/70. Suite maps this payload to events.objects[].orthostaticResponse and its single patient's current sbp/dbp. Portable patient/variable references require an adapter; the Suite importer does not accept portable documents directly.
- A new set or trend targeting the same variable cancels its prior trend. Trend start value is the value at that simulated instant. Validate finite values and concept bounds; unit mismatch is an error.
Shared format conventions · All format elements · Download specification
Field reference
6 records in this view
objectApplication field
One numeric physiologic variable belonging to this patient.
- Required when the containing object is present.
stringApplication field
Stable variable identifier used by effects and observations.
- Required when the containing object is present.
stringApplication field
The meaning of the variable, such as usim:hr for heart rate.
- Required when the containing object is present.
numberApplication field
The initial numeric value in the declared unit.
- Optional; omitted values remain unspecified.
stringApplication field
The unit of this value; core concepts use the standard unit defined by the specification.
- Required when the containing object is present.