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[
  {
    "id": 1,
    "situation": "Open Femur Fracture",
    "chat_text": "One of the crew fell from the mast and their thigh is completely deformed with a bone sticking out. They are barely awake and breathing very fast. There is a lot of blood and they look incredibly pale.",
    "responsive": "Drowsy",
    "breathing": "Rapid/Shallow",
    "pain": "10/10",
    "main_problem": "Heavy bleeding/deformed thigh",
    "temp": "36.2°C",
    "circulation": "Pale, weak pulse, BP 90/60",
    "cause": "Fall from mast during squall"
  },
  {
    "id": 2,
    "situation": "Tension Pneumothorax",
    "chat_text": "He got hit hard in the chest by the boom and now he can't catch his breath. He’s struggling to breathe, his neck veins are bulging out, and his lips are turning blue.",
    "responsive": "Alert/Anxious",
    "breathing": "Struggling",
    "pain": "8/10",
    "main_problem": "One side of chest not moving",
    "temp": "37.0°C",
    "circulation": "Distended neck veins, low BP",
    "cause": "Blown into shroud by boom"
  },
  {
    "id": 3,
    "situation": "Severe Scalp Laceration",
    "chat_text": "A heavy block hit her in the head and blood is literally pulsing out in a spray. She’s awake but there’s a massive amount of bright red blood everywhere.",
    "responsive": "Alert",
    "breathing": "Normal",
    "pain": "7/10",
    "main_problem": "Arterial spurting from head",
    "temp": "36.8°C",
    "circulation": "Rapid pulse, BP normal",
    "cause": "Hit by mainsheet block"
  },
  {
    "id": 4,
    "situation": "Traumatic Amputation",
    "chat_text": "Her hand got sucked into the electric winch. Three fingers are gone and the stumps are bleeding uncontrollably. She’s passed out and her skin is cold and white.",
    "responsive": "Unconscious",
    "breathing": "Labored",
    "pain": "N/A",
    "main_problem": "Missing fingers (R hand)",
    "temp": "35.5°C",
    "circulation": "Massive hemorrhage, shock",
    "cause": "Hand caught in electric winch"
  },
  {
    "id": 5,
    "situation": "Internal Hemorrhage",
    "chat_text": "He was thrown against the cockpit table during a roll. His stomach is becoming very hard and bloated, he’s breathing fast, and he looks like he’s going into shock.",
    "responsive": "Drowsy",
    "breathing": "Fast",
    "pain": "6/10",
    "main_problem": "Distended/rigid abdomen",
    "temp": "36.0°C",
    "circulation": "Cold/clammy, BP dropping",
    "cause": "Thrown against cockpit table"
  },
  {
    "id": 6,
    "situation": "Crush Injury (Foot)",
    "chat_text": "An anchor fell on his foot. The pain is a 9 out of 10, his foot is turning blue and cold, and I can't find a pulse anywhere on his ankle.",
    "responsive": "Normal",
    "breathing": "Normal",
    "pain": "9/10",
    "main_problem": "Swollen, blue, no pulse in foot",
    "temp": "37.2°C",
    "circulation": "Good BP, peripheral blockage",
    "cause": "Heavy anchor dropped on foot"
  },
  {
    "id": 7,
    "situation": "Flail Chest",
    "chat_text": "He slammed his chest into a winch. Part of his ribcage is moving inward when he breathes in and outward when he breathes out. He’s in a lot of pain and struggling for air.",
    "responsive": "Alert",
    "breathing": "Very painful",
    "pain": "9/10",
    "main_problem": "Paradoxical chest movement",
    "temp": "37.1°C",
    "circulation": "Fast pulse",
    "cause": "Chest slammed into winch"
  },
  {
    "id": 8,
    "situation": "Concussion/TBI",
    "chat_text": "She hit her head on the deck. She’s very confused, keep throwing up, and one of her pupils is much larger than the other.",
    "responsive": "Confused",
    "breathing": "Normal",
    "pain": "5/10",
    "main_problem": "Repeated vomiting, pupil dilation",
    "temp": "36.9°C",
    "circulation": "BP 140/90 (Rising)",
    "cause": "Slip on wet deck, head hit GRP"
  },
  {
    "id": 9,
    "situation": "Dislocated Shoulder",
    "chat_text": "He reached for the rail during a big wave and his shoulder popped out. It looks completely misshapen and he can't move his arm at all.",
    "responsive": "Alert",
    "breathing": "Normal",
    "pain": "8/10",
    "main_problem": "Visual deformity, arm locked",
    "temp": "37.0°C",
    "circulation": "Normal",
    "cause": "Reaching for rail during roll"
  },
  {
    "id": 10,
    "situation": "Impaled Object",
    "chat_text": "The spinnaker pole shattered and a long, sharp piece of carbon fiber is stuck deep in his thigh. It’s not bleeding much but the object is still in there.",
    "responsive": "Alert",
    "breathing": "Normal",
    "pain": "7/10",
    "main_problem": "Shard of carbon fiber in thigh",
    "temp": "36.8°C",
    "circulation": "Steady, bleeding controlled",
    "cause": "Shattered spinnaker pole"
  },
  {
    "id": 11,
    "situation": "Severe Hypothermia",
    "chat_text": "We pulled him out of the water after 30 minutes. He’s stopped shivering, he’s mumbles when he speaks, and his body feels ice cold and stiff.",
    "responsive": "Mumbling",
    "breathing": "Very slow",
    "pain": "None",
    "main_problem": "Shivering stopped, rigid",
    "temp": "31.0°C",
    "circulation": "Barely palpable pulse",
    "cause": "30 mins in 15°C water (MOB)"
  },
  {
    "id": 12,
    "situation": "Heat Stroke",
    "chat_text": "He’s been working in the engine room and now he’s unconscious. His skin is red and bone dry, he’s having a seizure, and he feels like he's burning up.",
    "responsive": "Unconscious",
    "breathing": "Snoring",
    "pain": "N/A",
    "main_problem": "Hot, dry skin; seizures",
    "temp": "41.1°C",
    "circulation": "Tachycardia (140 bpm)",
    "cause": "Engine room repair in tropics"
  },
  {
    "id": 13,
    "situation": "Saltwater Aspiration",
    "chat_text": "She swallowed a lot of water when she fell overboard. She’s coughing constantly, gasping for air, and her lips look blue.",
    "responsive": "Alert",
    "breathing": "Gasping",
    "pain": "6/10",
    "main_problem": "Persistent coughing, blue lips",
    "temp": "37.5°C",
    "circulation": "Rapid pulse",
    "cause": "Swallowed water during MOB"
  },
  {
    "id": 14,
    "situation": "Severe Dehydration",
    "chat_text": "He’s been seasick for days and hasn't peed in 24 hours. His eyes are sunken in, he’s very weak, and he has a slight fever.",
    "responsive": "Lethargic",
    "breathing": "Normal",
    "pain": "4/10",
    "main_problem": "No urine for 24h, sunken eyes",
    "temp": "38.2°C",
    "circulation": "Weak pulse, very low BP",
    "cause": "Chronic seasickness/vomiting"
  },
  {
    "id": 15,
    "situation": "2nd Degree Sunburn",
    "chat_text": "He fell asleep on deck and has a massive sunburn. Almost half his body is covered in large blisters and he’s shaking even though he has a fever.",
    "responsive": "Alert",
    "breathing": "Normal",
    "pain": "8/10",
    "main_problem": "Blistering over 40% of body",
    "temp": "38.5°C",
    "circulation": "Shivers, mild hypotension",
    "cause": "Fallen asleep on deck in doldrums"
  },
  {
    "id": 16,
    "situation": "Immersion Foot",
    "chat_text": "His boots have been wet for four days straight. His feet are completely white, numb, and the skin is starting to peel off in chunks.",
    "responsive": "Alert",
    "breathing": "Normal",
    "pain": "6/10",
    "main_problem": "Feet white, numb, peeling",
    "temp": "36.5°C",
    "circulation": "Poor capillary refill",
    "cause": "4 days in wet boots on watch"
  },
  {
    "id": 17,
    "situation": "Severe Hyponatremia",
    "chat_text": "He’s been drinking gallons of water but eating no salt. Now he’s staggering around like he’s drunk and his speech is totally slurred.",
    "responsive": "Confused",
    "breathing": "Normal",
    "pain": "2/10",
    "main_problem": "Slurred speech, staggering",
    "temp": "37.0°C",
    "circulation": "Normal BP",
    "cause": "Over-drinking water, no salt"
  },
  {
    "id": 18,
    "situation": "Deep Frostbite",
    "chat_text": "We’ve been handling ice-cold lines and his fingers have turned hard and gray-black. He can't feel them at all.",
    "responsive": "Alert",
    "breathing": "Normal",
    "pain": "3/10",
    "main_problem": "Fingers hard, black/gray",
    "temp": "35.8°C",
    "circulation": "Poor circulation to hand",
    "cause": "Hand handling icy lines"
  },
  {
    "id": 19,
    "situation": "Nitrogen Narcosis",
    "chat_text": "He came up too fast after checking the hull. He’s acting very strangely, giggling, and seems totally confused about where he is.",
    "responsive": "Giggling",
    "breathing": "Fast",
    "pain": "None",
    "main_problem": "Irrational behavior/confusion",
    "temp": "36.7°C",
    "circulation": "Normal",
    "cause": "Rapid ascent from hull check"
  },
  {
    "id": 20,
    "situation": "Lightning Strike",
    "chat_text": "The boat was hit by lightning. He’s unconscious and not breathing. I can't find a pulse and there are weird burn marks on his skin.",
    "responsive": "Unconscious",
    "breathing": "Arrested",
    "pain": "N/A",
    "main_problem": "Cardiac arrest, \"feather\" burns",
    "temp": "36.4°C",
    "circulation": "No pulse (requires CPR)",
    "cause": "Direct hit on mast during storm"
  },
  {
    "id": 21,
    "situation": "Acute Appendicitis",
    "chat_text": "She has a 9 out of 10 pain in her lower right stomach. If I press down and let go, the pain is even worse. She also has a fever.",
    "responsive": "Alert",
    "breathing": "Guarded",
    "pain": "9/10",
    "main_problem": "Rebound tenderness lower R",
    "temp": "38.9°C",
    "circulation": "High BP from pain",
    "cause": "Random/Bacterial"
  },
  {
    "id": 22,
    "situation": "Sepsis (Infected Wound)",
    "chat_text": "An old coral cut on his leg has red streaks coming out of it. He’s shaking with chills, has a high fever, and his blood pressure seems very low.",
    "responsive": "Drowsy",
    "breathing": "Rapid",
    "pain": "5/10",
    "main_problem": "Red streaks, shaking chills",
    "temp": "39.5°C",
    "circulation": "BP 80/50 (Septic shock)",
    "cause": "Uncleaned coral cut"
  },
  {
    "id": 23,
    "situation": "Anaphylaxis",
    "chat_text": "He got bit by an insect and now his throat is swelling up. He’s wheezing, covered in hives, and looks like he’s about to pass out.",
    "responsive": "Drowsy",
    "breathing": "Wheezing",
    "pain": "4/10",
    "main_problem": "Swollen throat, hives",
    "temp": "37.2°C",
    "circulation": "BP dropping rapidly",
    "cause": "Unknown insect bite/food"
  },
  {
    "id": 24,
    "situation": "Myocardial Infarction",
    "chat_text": "He says it feels like an elephant is sitting on his chest. The pain is going down his left arm, he’s sweating, and his pulse feels irregular.",
    "responsive": "Alert",
    "breathing": "Shortness",
    "pain": "9/10",
    "main_problem": "Crushing chest pain/Left arm",
    "temp": "37.0°C",
    "circulation": "Irregular pulse, sweating",
    "cause": "Clogged artery (Heart Attack)"
  },
  {
    "id": 25,
    "situation": "Diabetic Ketoacidosis",
    "chat_text": "He’s very confused and his breath smells sweet, almost like fruit. He’s breathing very deeply and fast and says he’s incredibly thirsty.",
    "responsive": "Confused",
    "breathing": "Deep/Fast",
    "pain": "3/10",
    "main_problem": "Fruity breath, extreme thirst",
    "temp": "37.4°C",
    "circulation": "Weak pulse",
    "cause": "Insulin pump failure"
  },
  {
    "id": 26,
    "situation": "Perforated Ulcer",
    "chat_text": "He has a sudden, agonizing pain in his stomach. His belly feels as hard as a board and he’s pale and sweating.",
    "responsive": "Alert",
    "breathing": "Shallow",
    "pain": "10/10",
    "main_problem": "Sudden, board-like abdomen",
    "temp": "37.8°C",
    "circulation": "Shock signs",
    "cause": "Long-term NSAID use (Advil)"
  },
  {
    "id": 27,
    "situation": "Kidney Stones",
    "chat_text": "He’s in 10 out of 10 pain in his side and back. He’s pacing around because he can't get comfortable and there is blood in his urine.",
    "responsive": "Alert",
    "breathing": "Fast",
    "pain": "10/10",
    "main_problem": "Agonizing flank pain/blood",
    "temp": "37.3°C",
    "circulation": "Pacing around, high BP",
    "cause": "Dehydration"
  },
  {
    "id": 28,
    "situation": "Acute Asthma Attack",
    "chat_text": "She’s having a massive asthma attack. Her inhaler isn't working and I can't hear any air moving in her chest at all. Her lips are turning blue.",
    "responsive": "Alert",
    "breathing": "Silent",
    "pain": "7/10",
    "main_problem": "No air movement (Silent chest)",
    "temp": "37.0°C",
    "circulation": "Tachycardia",
    "cause": "Mold in cabin/ventilation"
  },
  {
    "id": 29,
    "situation": "Ischemic Stroke",
    "chat_text": "One side of his face is drooping and he can't move his right arm or leg. He’s awake but his blood pressure is extremely high.",
    "responsive": "Alert",
    "breathing": "Normal",
    "pain": "2/10",
    "main_problem": "Facial droop, R-side paralysis",
    "temp": "36.8°C",
    "circulation": "BP 180/110",
    "cause": "Blood clot"
  },
  {
    "id": 30,
    "situation": "Status Epilepticus",
    "chat_text": "He’s been having a violent seizure for over five minutes straight and it won't stop. His breathing is irregular and he’s turning red.",
    "responsive": "Seizing",
    "breathing": "Irregular",
    "pain": "N/A",
    "main_problem": "Continuous convulsions >5min",
    "temp": "38.0°C",
    "circulation": "Rapid pulse",
    "cause": "Missed meds/High stress"
  },
  {
    "id": 31,
    "situation": "Carbon Monoxide",
    "chat_text": "Everyone in the cabin is lethargic with a headache. One person has bright red skin and is breathing very slowly. We suspect an exhaust leak.",
    "responsive": "Lethargic",
    "breathing": "Slow",
    "pain": "5/10",
    "main_problem": "Cherry-red skin, headache",
    "temp": "36.6°C",
    "circulation": "Normal",
    "cause": "Leaking heater/engine exhaust"
  },
  {
    "id": 32,
    "situation": "Ciguatera Poisoning",
    "chat_text": "We ate a barracuda and now he’s acting weird. He says cold water feels hot to him, and his heart rate has dropped to 40 beats per minute.",
    "responsive": "Alert",
    "breathing": "Normal",
    "pain": "6/10",
    "main_problem": "Hot feels cold, cold feels hot",
    "temp": "37.2°C",
    "circulation": "Bradycardia (Slow pulse)",
    "cause": "Eating reef fish (Barracuda)"
  },
  {
    "id": 33,
    "situation": "Box Jellyfish Sting",
    "chat_text": "He was stung by a jellyfish and went into cardiac arrest almost immediately. There are massive red welts all over his chest and legs.",
    "responsive": "Unconscious",
    "breathing": "Arrested",
    "pain": "10/10",
    "main_problem": "Massive welts, heart failure",
    "temp": "37.4°C",
    "circulation": "Cardiac arrest signs",
    "cause": "Swimming in doldrums"
  },
  {
    "id": 34,
    "situation": "Cellulitis",
    "chat_text": "A small cut on her leg has turned into a massive, hot, red swelling that is spreading quickly. She has a high fever.",
    "responsive": "Alert",
    "breathing": "Normal",
    "pain": "7/10",
    "main_problem": "Leg hot, red, and swollen",
    "temp": "39.0°C",
    "circulation": "Fast pulse",
    "cause": "Infected shaving cut"
  },
  {
    "id": 35,
    "situation": "Chemical Burn (Eyes)",
    "chat_text": "Battery acid splashed directly into his eyes. He can't open them, he’s in 10 out of 10 pain, and his eyes look hazy and white.",
    "responsive": "Alert",
    "breathing": "Normal",
    "pain": "10/10",
    "main_problem": "Cannot open eyes, white haze",
    "temp": "36.8°C",
    "circulation": "Normal",
    "cause": "Battery acid splash"
  },
  {
    "id": 36,
    "situation": "Aspiration Pneumonia",
    "chat_text": "He’s been sick since he inhaled some vomit. He’s coughing up green gunk, has a high fever, and is struggling to breathe.",
    "responsive": "Alert",
    "breathing": "Labored",
    "pain": "5/10",
    "main_problem": "Productive cough (green)",
    "temp": "39.2°C",
    "circulation": "Low oxygen saturation",
    "cause": "Vomit inhaled during storm"
  },
  {
    "id": 37,
    "situation": "Acute Urinary Retention",
    "chat_text": "He’s in extreme pain because he hasn't been able to pee for hours. His lower stomach is hard and bulging.",
    "responsive": "Alert",
    "breathing": "Normal",
    "pain": "9/10",
    "main_problem": "Bladder distended, cannot pee",
    "temp": "37.1°C",
    "circulation": "High BP",
    "cause": "Enlarged prostate"
  },
  {
    "id": 38,
    "situation": "Dental Abscess",
    "chat_text": "His tooth is broken and now his entire face is swollen. His eye is starting to swell shut and he has a high fever.",
    "responsive": "Alert",
    "breathing": "Normal",
    "pain": "8/10",
    "main_problem": "Face swollen, eye closing",
    "temp": "38.6°C",
    "circulation": "Normal",
    "cause": "Cracked tooth"
  },
  {
    "id": 39,
    "situation": "Pulmonary Embolism",
    "chat_text": "He suddenly got a sharp pain in his chest and can't breathe. His lips are blue and he’s coughing up a little bit of blood.",
    "responsive": "Alert",
    "breathing": "Sharp pain",
    "pain": "9/10",
    "main_problem": "Sudden SOB, coughing blood",
    "temp": "37.4°C",
    "circulation": "Cyanosis (Blue lips)",
    "cause": "DVT from long sitting/watch"
  },
  {
    "id": 40,
    "situation": "Bowel Obstruction",
    "chat_text": "He hasn't been able to go to the bathroom or pass gas. Now he is actually vomiting stuff that smells like a bowel movement.",
    "responsive": "Alert",
    "breathing": "Normal",
    "pain": "7/10",
    "main_problem": "Fecal vomiting, no gas",
    "temp": "37.6°C",
    "circulation": "Low BP, dehydrated",
    "cause": "Previous surgery/Adhesions"
  },
  {
    "id": 41,
    "situation": "Dengue Hemorrhagic",
    "chat_text": "He has a high fever and his gums are bleeding. He’s covered in dark, blackish bruises and looks very weak.",
    "responsive": "Drowsy",
    "breathing": "Normal",
    "pain": "7/10",
    "main_problem": "Bleeding gums, black bruises",
    "temp": "39.8°C",
    "circulation": "Low BP (Shock)",
    "cause": "Mosquito bite in Sumatra"
  },
  {
    "id": 42,
    "situation": "Malaria (Falciparum)",
    "chat_text": "He’s totally confused and has a 40.5°C fever. His eyes look yellow and he’s breathing very fast.",
    "responsive": "Confused",
    "breathing": "Rapid",
    "pain": "6/10",
    "main_problem": "Cycling high fever, yellow eyes",
    "temp": "40.5°C",
    "circulation": "Tachycardia",
    "cause": "Mosquito bite"
  },
  {
    "id": 43,
    "situation": "Giardia (Severe)",
    "chat_text": "He has constant, explosive diarrhea that smells like sulfur. He’s becoming very dehydrated and lightheaded.",
    "responsive": "Alert",
    "breathing": "Normal",
    "pain": "5/10",
    "main_problem": "Explosive sulfurous diarrhea",
    "temp": "37.5°C",
    "circulation": "Orthostatic hypotension",
    "cause": "Bad water tank hygiene"
  },
  {
    "id": 44,
    "situation": "Corneal Ulcer",
    "chat_text": "His eye is bright red and filled with pus. He says it feels like there is sand in it and he can't look at any light.",
    "responsive": "Alert",
    "breathing": "Normal",
    "pain": "9/10",
    "main_problem": "Constant sand sensation, pus",
    "temp": "36.8°C",
    "circulation": "Normal",
    "cause": "Contact lens left in too long"
  },
  {
    "id": 45,
    "situation": "Orchitis",
    "chat_text": "He has sudden, 9 out of 10 pain in his groin. One side is swollen to the size of a grapefruit and he has a fever.",
    "responsive": "Alert",
    "breathing": "Normal",
    "pain": "9/10",
    "main_problem": "Scrotal swelling (grapefruit)",
    "temp": "38.8°C",
    "circulation": "Pain-induced high BP",
    "cause": "Bacterial/STI"
  },
  {
    "id": 46,
    "situation": "Meningitis",
    "chat_text": "He has a very high fever and a splitting headache. His neck is so stiff he can't touch his chin to his chest and light hurts his eyes.",
    "responsive": "Lethargic",
    "breathing": "Normal",
    "pain": "9/10",
    "main_problem": "Stiff neck, light sensitivity",
    "temp": "40.1°C",
    "circulation": "BP 100/60",
    "cause": "Viral/Bacterial"
  },
  {
    "id": 47,
    "situation": "Staph (MRSA)",
    "chat_text": "He has a huge, painful, pus-filled lump that looks like a spider bite. It’s hot to the touch and he has a fever.",
    "responsive": "Alert",
    "breathing": "Normal",
    "pain": "6/10",
    "main_problem": "\"Spider bite\" look, pus-filled",
    "temp": "38.2°C",
    "circulation": "Normal",
    "cause": "Shared towels/gym gear"
  },
  {
    "id": 48,
    "situation": "Leptospirosis",
    "chat_text": "His eyes are bright red, his skin looks yellow, and his calves are in a lot of pain. He has a high fever and low blood pressure.",
    "responsive": "Alert",
    "breathing": "Normal",
    "pain": "8/10",
    "main_problem": "Calf pain, jaundice, red eyes",
    "temp": "39.4°C",
    "circulation": "Low BP",
    "cause": "Rat urine in bilge water"
  },
  {
    "id": 49,
    "situation": "Sea Urchin Granuloma",
    "chat_text": "He stepped on a sea urchin and has over 20 spines stuck in his foot. His joints are starting to feel stiff and lock up.",
    "responsive": "Alert",
    "breathing": "Normal",
    "pain": "4/10",
    "main_problem": "20+ spines, joints locking",
    "temp": "37.2°C",
    "circulation": "Normal",
    "cause": "Stepped on urchin in surf"
  },
  {
    "id": 50,
    "situation": "Ectopic Pregnancy",
    "chat_text": "She has a sudden, ripping pain in her lower stomach and just fainted. She is very pale, cold, and her blood pressure is very low.",
    "responsive": "Alert",
    "breathing": "Fast",
    "pain": "10/10",
    "main_problem": "Ripping pelvic pain, fainting",
    "temp": "36.5°C",
    "circulation": "BP 85/40 (Internal bleed)",
    "cause": "Ruptured fallopian tube"
  }
]