In CASE-015's critical endings, the mother stays in the frame
For paediatric teachers who debrief this case on a projector: the closing frames now open a conversation about the family and the decision that led there, and the whole run follows one family from arrival to the ending.
On 10 November CASE-015 went live in two steps, versions 1.33.0 and 1.34.0. The case, a six-month-old with tetralogy of Fallot during a hypercyanotic spell, keeps its text, decisions, scores and endings; only the pictures changed. All 88 frames now form a single visual series.
Who is in the frame when the case goes wrong
In the arrest ending, the mother stands sharp in the foreground with her hands over her mouth, while behind her, out of focus, the team bends over the couch. The child is not in the frame. In the worsening ending, the doctor holds a bag-valve mask over the child and calls for help; nobody is shown pressing on the chest, and the child's lips carry the strongest bluish tint the case uses.
The ending texts have not changed. Arrest follows observation only: in the case, asystole comes after 8 minutes, then 12 minutes of CPR with return of circulation and an uncertain neurological outcome. Worsening follows salbutamol: SpO₂ falls to 50%, acidosis builds, breathing stops, and the child needs emergency intubation and CPR, stabilising in intensive care only after a palliative Blalock–Taussig shunt.
The mother at the door is the mother in the last frame
On 7 November we noted that the mother in the first-stage pictures differed from the mother in stages 2–6. Version 1.34.0 redrew the five opening slides, the history screen and the ten history questions in the same series as the later stages, so the mother and the child are the same people from arrival to the ending.
Three ways to use the endings in a seminar
Put the arrest frame on the projector before reading the ending text, and ask what the mother needs to hear from the doctor in the next minute.
Read both critical ending texts aloud and have the group find, in their own run, the decision that leads to each.
Run the case on one screen from the first slide to the ending, so the group follows one family through every stage.
What the final images do not show
Neither image demonstrates a resuscitation procedure. In the arrest frame the child is out of view, so no skin colour appears. The case is in Russian.