Fetal MonitoringATLAS
connecting
Fetal MonitoringATLAS
connecting
Practice strip · measure before you decide
Almost everything this simulator asks you to decide comes down to a number you can measure on the paper — seconds between a contraction peak and a deceleration nadir, beats of variability, contractions in ten minutes. Estimating those by eye is where readings disagree. Below is the working strip: freeze it and try the calipers before you open your first case.
Freeze the paper, then click once to drop caliper A and again for caliper B. The shaded band measures both channels at once. On this strip the nadir lands somewhere between 22 and 31 seconds after each contraction peak — the exact number moves a little from contraction to contraction, because variability is real noise and it shifts the lowest point. It never comes close to the few seconds an early deceleration shows, and that separation is the whole reading. Measure two or three and see the spread for yourself.
Most misreadings start the same way: someone sees a deceleration first and builds an impression before the baseline exists. The order below is the whole method, and every case in the bank is these five observations with one of them altered.
Three measurements decide most cases, and all three come from the same two clicks on a frozen strip.
Nadir about four seconds after the peak, recovering before the contraction ends, is early. Twenty seconds or more, recovering after it ends, is late. Depth tells you almost nothing.
Count them inside the shaded span and read the rate per ten minutes. The lower channel is where tachysystole, hypertonus and precipitate labour all live.
Real machines record at 1, 2 or 3 cm per minute — 3 in North America and Japan, 1 in most of the world. It is not cosmetic: at 3 cm/min variability looks reduced to someone trained on 1 cm/min, and exaggerated the other way round. The device runs at 3 cm/min by default. Change it and watch the same fetus look different.
Use the ◀ 1 min buttons to travel back. Deterioration is gradual and invisible in a single window — the diagnosis is usually the direction, not the number.
The action shelf stays locked until you commit to a category, and that is deliberate. A wrong category costs 20 points and the debrief will tell you the error started there — because a plan built on the wrong category is wrong even when the actions look sensible.
Every criterion must be met: baseline in range, moderate variability, no concerning decelerations. One benign feature never carries the rest, and the deceleration type never assigns the category on its own.
Everything that is neither I nor III, which is most of normal labour. The useful question is never “which category” but “is it moving?”
Absent variability qualifies on its own, with or without decelerations. The definition does not bend to how dramatic the scene is.
When you confirm your actions the strip starts running again from that moment and morphs toward what your management earned. Watch it — the consequence is the teaching, and it is easy to skip past to the debrief.
You did what the case required. Sometimes the tracing recovers; sometimes it stays exactly as it was, because nothing on the shelf could have improved it — and knowing which is which is the point.
You did reasonable things and left out the one that mattered. This is the most instructive outcome in the simulator: the paper looks briefly better and then resumes its course.
The tracing runs to where it was heading. In a few cases nothing changes on the paper at all — because the harm was never going to appear there.
Three ways in, and they differ by what stays on screen — not just by how many cases. Switch levels in the top bar; move up when you stop needing to check the criteria.
The five observations arrive already read, the criteria stay beside you, and the paper opens frozen so you measure before anything moves. Every pattern appears at least once. Start here even if the patterns feel familiar — the measuring is the part that is new.
Nothing is read for you — the baseline and the variability come off the strip. Adds reversible causes, the obstetric emergencies, maternal illness that shows up on the fetal channel, and the cases where the right answer is to leave the labour alone.
The pattern is no longer named, because recognising it is the exercise. Adds deterioration that no single window shows, mimics with no drug to blame, the machine recording the wrong heart, and the emergencies where the fetal tracing is not the problem at all.
Collected from what actually goes wrong in the bank.