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| { | |
| "task_id": "dka-management-rollout", | |
| "description": "Synthetic rollout for DKA \u2014 insulin protocol and anion-gap monitoring. Reviews chart, writes progress note, places orders, and signs the encounter.", | |
| "reset_request": { | |
| "patient_id": "pat-1003" | |
| }, | |
| "actions": [ | |
| { | |
| "type": "click", | |
| "selector": "[data-testid='patient-card-pat-1003']" | |
| }, | |
| { | |
| "type": "click", | |
| "selector": "[data-testid='activity-notes']" | |
| }, | |
| { | |
| "type": "fill", | |
| "selector": "[aria-label='Note author']", | |
| "text": "Patrick Sullivan, MD" | |
| }, | |
| { | |
| "type": "fill", | |
| "selector": "[aria-label='Note title']", | |
| "text": "Progress Note" | |
| }, | |
| { | |
| "type": "fill", | |
| "selector": "[aria-label='Progress note content']", | |
| "text": "S: Patient brought in by family, confused and vomiting for 2 days. Missed insulin doses. Reports polyuria and polydipsia.\nO: Blood glucose level 487 mg/dL. Anion gap 28 (Na 138 - Cl 98 - HCO3 12). Serum bicarbonate 12 mEq/L. pH 7.18 on VBG. Potassium 5.2 (likely spurious in setting of acidosis). Phosphate low. Ketones large in urine and serum.\nA: DKA, severe (pH <7.2, bicarb <15, anion gap >25). DKA precipitant: medication non-compliance, assess for infection. Potassium monitoring critical as insulin will shift K intracellularly.\nP: Insulin drip per DKA protocol (0.1 units/kg/hr after bolus). Fluid resuscitation: NS 1L bolus then 500 mL/hr. Basic metabolic panel q2h. Potassium chloride 20 mEq in each liter when K <5.0. Insulin management: transition to subQ when anion gap closes and patient tolerating PO. Monitor for cerebral edema." | |
| }, | |
| { | |
| "type": "click", | |
| "selector": "[data-testid='save-note-button']" | |
| }, | |
| { | |
| "type": "wait", | |
| "milliseconds": 600 | |
| }, | |
| { | |
| "type": "click", | |
| "selector": "[data-testid='activity-orders']" | |
| }, | |
| { | |
| "type": "fill", | |
| "selector": "[aria-label='Order name']", | |
| "text": "Insulin drip" | |
| }, | |
| { | |
| "type": "fill", | |
| "selector": "[aria-label='Order category']", | |
| "text": "MED" | |
| }, | |
| { | |
| "type": "fill", | |
| "selector": "[aria-label='Order parameters']", | |
| "text": "Per protocol, titrate to goal" | |
| }, | |
| { | |
| "type": "fill", | |
| "selector": "[aria-label='Order rationale']", | |
| "text": "Indicated for DKA management" | |
| }, | |
| { | |
| "type": "click", | |
| "selector": "[data-testid='save-order-button']" | |
| }, | |
| { | |
| "type": "wait", | |
| "milliseconds": 600 | |
| }, | |
| { | |
| "type": "fill", | |
| "selector": "[aria-label='Order name']", | |
| "text": "Basic metabolic panel" | |
| }, | |
| { | |
| "type": "fill", | |
| "selector": "[aria-label='Order category']", | |
| "text": "LAB" | |
| }, | |
| { | |
| "type": "fill", | |
| "selector": "[aria-label='Order parameters']", | |
| "text": "STAT" | |
| }, | |
| { | |
| "type": "fill", | |
| "selector": "[aria-label='Order rationale']", | |
| "text": "Indicated for DKA management" | |
| }, | |
| { | |
| "type": "click", | |
| "selector": "[data-testid='save-order-button']" | |
| }, | |
| { | |
| "type": "wait", | |
| "milliseconds": 600 | |
| }, | |
| { | |
| "type": "click", | |
| "selector": "[data-testid='sign-encounter-button']" | |
| } | |
| ] | |
| } | |