Week 5: Game Play Puzzles

Each procedure in the game will be presented as a physical or logical puzzle the first time to focus attention on the components. In successive performances of the procedure, the gameplay will shift to more of a simulation of the procedure to provide practice and to drill the procedure under different conditions. For example, the game will include a scheduled trach change, an emergency trach change due to plugging, and an emergency trach change due to decannulation (the trach coming out accidentally). The emergency status changes the procedure.

Here are draft plans for the procedural puzzles:

Pulse Oximeter puzzle

The pulse ox consists of these objects in this order: the pulse ox machine, the on button, the patient cable, the sensor cable, pulse ox tape, and the patient’s toe. The player must assemble these objects in the correct order by noticing the connections. Each connection will have shapes or dots that relate to an end of the connecting piece. If the player makes an incorrect connection, all of the pieces separate. When the player assembles the puzzle, she can push the on button to turn on the readout. The successful completion of the puzzle will cause the vitals dashboard to appear. The nurse supervisor will come in to explain that dashboard.

Medicine puzzle

The player must find the dosage on the medicine bottle and stop the syringe plunger at the correct dose. There are three medications and the bottle must be matched to the correct syringe. The plunger keeps moving and gets faster the longer that the player waits. If the wrong amount is drawn up, an error sound plays and the puzzle resets. If any one syringe resets three times, all of the syringes are discarded and the game starts over. When the player draws up the correct dosage in three syringes, she can drag it to Bailey to finish the task.

Suction puzzle

There is a vague illustration of the suction machine in the care plan and it shows how the air flows through the machine. The player will search the shelves to locate all of the parts of the suction machine and assemble it. If the machine is not correctly or completely assembled and the player turns it on, there will be a visual cue of where the air is escaping. Once the machine is assembled, it stays assembled for the rest of the game.

The second part to this puzzle is suctioning the patient’s trach. This is the part that will repeat in successive levels. The player must find the trach depth in the care guide and move the suction catheter out to that length. The player must remove the cap from the trach, insert the catheter and put a finger over the open hole to create the suction. When the player completes this action, a reward sound will play, the breathy noise will stop but Bailey will cry. (Often little kids don’t like the feeling of being suctioned.)

Trach Change Puzzle

The puzzle will concentrate on ordering steps represented by cards. The cards will clarify the purpose of the supplies. The second puzzle concentrates on how to insert the trach.

Trach Puzzle 1: Steps

These steps will be written and illustrated on cards. The player must put the cards in order. This could be straightforwardly or done with sliding tiles. The steps won’t be numbered in the game. The player must use critical thinking to reason out why the steps are done in the order required.

Steps to a planned trach change:

1)        Lay out supplies: Clean trach, lube, split gauze, obturator, saline wipes, clean trach tie, cleaning swabs, gloves.

2)        Put on gloves to maintain a clean working space.

3)        Put the obturator in the clean trach so that the cannula is stiff.

4)        Undo the old trach tie while holding the trach in the stoma.

5)        Use the saline wipes to clean all around the neck, front back and sides.

6)        Use the swabs to clean under the old trach.

7)        Put lubricant on the end of the clean trach.

8)        Pull the old trach out of the stoma.

9)        Put the clean trach into the stoma with a curving gesture.

10)  Pull out the obturator.

11)  Slide split gauze under the new trach.

12)  Fasten the trach tie to both sides of the trach.

13)  Adjust the tightness of the trach tie so that you can just get two fingers under it.

Reward for getting it right: visual and graphic rewards, promotion in the game, positive feedback

Consequences for failure: the puzzle resets, feedback about steps out of order.

Trach Puzzle 2: Inserting the trach

This puzzle starts with a visual diagram of the trachea with the stoma to show how the trach should be inserted and positioned. Then the game will be a trajectory-style game (like Angry Birds) to insert the trach with the proper curving motion. This mini-game will show how the obturator is important for proper insertion.

Oxygen Puzzle

This puzzle will ask the player to connect pieces to create a flow. During the game, the flow will be represented by a deflated balloon to be inflated. The balloon will have tubing coming out from it. On the other side, there will be an oxygen tank. The player will have a bin of supplies including unrelated supplies. They must find the correct supplies to connect the flow of oxygen and inflate the balloon. When that is successful, they can drag the tubing to the child.

Feedback will be given for correct and incorrect actions. There are no consequences or resets for incorrect choices, but they won’t be able to progress until they complete the puzzle.

Steps:

1)        Put the washer on the regulator over the hole where the oxygen will flow through.

2)        Put the regulator on the tank valve aligning the holes.

3)        Tighten the T-Screw on the regulator.

4)        Use the tank key to twist the valve open.

5)        Attach the tubing to the regulator nipple.

6)        Turn the regulator dial to 3 liters.

Nebulizer Puzzle

A nebulizer gives vaporized medicine that is inhaled. This game will be portrayed as a recipe or chemistry experiment when the components must be produced based on illustrated directions that just show shapes (to require interpretation). Successful completion of each component will be rewarded with sounds and graphics. Successful completion of the puzzle allows the medicine to be given to Bailey. The puzzle must be completed to progress.

Component 1:

1)        Put the green cone into the neb cup. (example instruction: 🔺+ |_| )

2)        Screw the top onto the neb cup.

Component 2:

3)        Squeeze the medicine into the neb cup.

4)        Attach the neb cup to the trach mask.

Component 3:

5)        Attach the tubing to the machine.

6)        Attach the tubing to the bottom of the neb cup.

7)        Turn the machine on.