- Vital signs now start changing as soon as you press Next - ECGs match each case: ST elevation in myocardial infarction, U waves in hypokalaemia and QT prolongation, and ectopics or bigeminy where the chart records them - The rhythm chosen by Arrest now follows the pathophysiology: PEA for haemorrhage, hypoxia, pneumothorax and tamponade; VF for myocardial infarction and hypokalaemia; asystole for AV block

- New "Improve" button: switch any case toward recovery at any point when the team responds well. Together with "Arrest", the outcome follows what the learners do - More in the free version: up to 3 shocks per scenario, and the "post-operative respiratory failure" chart case free to try — with Next, Arrest, blood gas and auscultation - Clearer case preview: tap ⓘ or press and hold a case to see a one-line summary, history, scene, and how the case unfolds step by step with vital-sign changes - Set the pacing capture threshold from the remote - The remote's "AED pads on" button now appears only in AED mode and flashes while waiting for pads - Easier-to-read pacing controls

- 52 patient chart cases, including 9 new cases; "Neurosurgical ward" added to the unit filter - New "Arrest" button: move any case into cardiac arrest at any point, so the instructor decides on the spot whether the patient deteriorates. Press "ROSC" to restore circulation - At the deterioration point, the blood gas and imaging buttons show that case's results; reference blood gases are shown during arrest and after ROSC - Tap ⓘ or press and hold a case to preview the patient, scene and course before loading it - Exam lists now highlight the case's blood gas, imaging and breath sounds - Reference images are mirrored for right-sided pneumothorax cases - Improved rhythm and pupil findings

A major update. - AED mode: turn the dial to AED for voice-guided analysis, charging and shock. No shock limit, even in the free version - Dial layout now matches a real defibrillator (monitor, AED, internal discharge, energy, pacing) - 43 patient chart cases. Filter by the learners' unit and load a case onto the monitor in one tap. "Next" steps through the case: vitals and rhythm change gradually, and blood gas, imaging and breath sounds follow the timeline. Instructor debriefing guide for every case - Chart dates are shown relative to today - English, Japanese and Spanish interface, with English charts - Fixes for reset, pacing, NIBP display and more

- AED mode: set the dial to AED and follow the voice prompts through analysis, charging and shock (no shock limit in the free version) - Dial layout now matches a real defibrillator, with internal discharge as a dial position. A charge is discharged automatically after 60 seconds - Switch between Japanese, English and Spanish on the home screen - Scenario presets now also set the chest X-ray or echo

Fixed resuming after a reset while paused. Charge button no longer cancels a charge. Pre-arrest NIBP no longer reappears after ROSC; older readings are dimmed. Other sounds are lowered while checking a pulse

Clearer pulse-check sound, and fixed a case where it could keep playing

Larger vital-sign numbers — easier to read from across the room, including on 11-inch iPads

- Minor improvements and fixes

English and Spanish app name and system dialogs

- Alarms no longer pause when the rhythm is changed - Scenario presets reviewed: blood gas, breath sounds, heart sounds and pupils now match each clinical picture. Respiratory arrest and unilateral absent breath sounds are now silent - 3 new blood gases: opioid respiratory depression, intracerebral haemorrhage, postoperative respiratory failure - Fixed display on external monitors - Links to the user guide and support on the home screen - Fixed the monthly plan sometimes not appearing on the purchase screen

■ A new monthly plan ・Use the full version only in the months you teach. New subscribers can try the first month at an introductory price. ・The plan renews automatically. The app reminds you once after a session, with a direct link to manage or cancel it. ■ 23 scenario presets ・Added cardiac tamponade, long QT (before TdP), pulmonary embolism, postoperative respiratory failure and hyperkalaemia. ・Anaphylaxis now uses stridor, and tension pneumothorax now has absent breath sounds on one side. ・Presets now set the heart sounds too. ・Reviewed presets whose vital signs did not match their blood gas (opioids, intracerebral haemorrhage, MI, airway obstruction, postoperative respiratory failure). ■ Fixes ・Fixed the tabs and the buttons at the bottom of the remote overlapping or leaving a gap.

・Fixed the tabs and the buttons at the bottom of the remote overlapping or leaving a gap.

Code Blue Monitor 2.0 connects everything from preparing a session to debriefing it. ■ Setting up a session ・A new "Set up" tab: patient (adult to neonate), units, language, chart case and phase, blood gas course, imaging, pupils and a sound check, all on one screen. ■ 18 scenario presets ・Intracerebral haemorrhage, inferior MI with bradycardia, anaphylaxis, tension pneumothorax, COPD exacerbation, acute heart failure, opioid-induced respiratory depression, hypoglycaemia, diabetic ketoacidosis and more, grouped into circulation, respiratory, and neurology & metabolic. ・Choosing one sets the breath sounds, pupils and blood gas as well as the rhythm and vital signs. ■ Paediatric patients ・Choose an age and weight and the alarm limits follow, with the recommended energy (2 J/kg, 4 J/kg) shown to the instructor. ・The defibrillator dial has been rebuilt to match a real device (2–270 J). ■ Blood gases by course ・Asthma, sepsis, haemorrhage, myocardial infarction, airway obstruction, DKA and seizure, each from early through worsening, pre-arrest, arrest, ROSC and recovery. Teach what a "normalising" PaCO₂ in asthma actually means. ■ Debriefing ・Create a debriefing record: vital sign trends and the full event log, shareable as a PDF. ■ Easier to use ・The remote is split into four screens and shows which tests are selected. Breath and heart sounds play for as long as you hold the button. ・A light appearance, and the defibrillator can be hidden to show larger waveforms. ・Choose your units: mmHg or kPa, mg/dL or mmol/L, °C or °F. ・Spanish interface. ・The dial clicks as you turn it, the start-up self-test checks each item in turn, and the date and battery are shown while the device is switched off. ■ Fixes ・Fixed the unstable connection between the iPad and iPhone; it now reconnects automatically. ・Fixed the buttons at the top of the screen not responding while the 12-lead ECG was open. ・Fixed the waveforms briefly disappearing when the layout changed.

・Fixed the buttons at the top of the screen (Home, Pause, Reset, Full screen) not responding while the 12-lead ECG was open. ・The dial now clicks as you turn it, like a real device. ・The start-up self-test now checks each item in turn. ・The date and battery are shown while the device is switched off. ・Fixed parts of the remote staying dark in the light appearance.

■ New ・18 scenario presets: intracerebral haemorrhage, inferior MI with bradycardia, anaphylaxis, tension pneumothorax, COPD exacerbation, acute heart failure, opioid-induced respiratory depression, hypoglycaemia, DKA, post-seizure and more, grouped into circulation, respiratory, and neurology & metabolic. ・A preset now sets the breath sounds, pupils and blood gas as well as the rhythm and vital signs. ・The remote shows which tests are currently selected, and plays the breath and heart sounds for as long as you hold the button. ・A light appearance, easier to read in a bright room. ・Hide the defibrillator to show the waveforms full screen — useful for rhythm recognition and vital sign training. ・A "Set up" tab: patient (adult to neonate), units, language, chart case and phase, blood gas course, imaging, pupils and a sound check, all on one screen. ・Paediatric support. Choose an age and weight and the alarm limits follow, with the recommended energy (2 J/kg, 4 J/kg) shown to the instructor. The dial now includes 2–30 J. ・Blood gases chosen by course: seven conditions, each from early through worsening, pre-arrest, arrest, ROSC and recovery. ・A debriefing record: vital sign trends and the event log, shareable as a PDF. ・Choose your units: mmHg or kPa, mg/dL or mmol/L, °C or °F. ・Spanish interface. ・Added anaphylactic shock to the blood gases, conjugate gaze deviation to the pupils, and a chest X-ray of pulmonary oedema. ■ Improvements ・Tabs reorganised, with larger text. ・The defibrillator dial rebuilt to match a real device: 2–270 J, with larger numbers. ・The remote is split into four screens (Rhythm & vitals, Presets, Tests, Connection), with monitor power, pause and reset at the top. ・The remote says when it is not connected, and stays usable while disconnected. ・Larger alarm-silence and pacing buttons. ・Alarms no longer break when the rhythm changes during CPR. ・The charge tone is quietened while palpating the pulse. ・Vital sign alarm tones adjusted to match a real monitor. ・Lighter rendering on large screens. ■ Fixes ・Fixed the unstable connection between the iPad and iPhone; it now reconnects automatically. ・Fixed the waveforms briefly disappearing when the layout changed. ・Fixed the waveforms being wiped each time the sweep wrapped around. ・Fixed the remote sometimes not updating its display. ・Fixed inconsistent haemoglobin values across the haemorrhage course.

■ New ・A "Set up" tab. Before a session, set the patient (adult to neonate), units, language, chart case and phase, blood gas course, imaging and pupils, and check the sound — all on one screen. ・Paediatric support. Choose an age and weight and the alarm limits adjust to that age, with the recommended energy (2 J/kg, 4 J/kg) shown to the instructor. The defibrillator dial now includes 2–30 J. ・Blood gases are now chosen by course: asthma, sepsis, haemorrhage, myocardial infarction, airway obstruction, DKA and seizure, each with early → worsening → pre-arrest → arrest → ROSC → recovery. Advance the stages with Next to teach how a PaCO₂ "normalises" in asthma, or how lactate clears after a seizure. ・Debriefing record: vital sign trends and the full event log on one page, shareable as a PDF via AirDrop, mail or Files. ・Choose your units: mmHg or kPa, mg/dL or mmol/L, °C or °F. ・Spanish interface (some items are shown in English). ・Added anaphylactic shock to the blood gases, conjugate gaze deviation to the pupil findings, and a portable chest X-ray of pulmonary oedema. ■ Improvements ・Reorganised the screen: tabs are now Set up, Rhythm, Vitals, Settings, Tests & findings and Log, with the pacing controls moved into the Rhythm tab. Larger text on the tabs and in the settings. ・The defibrillator dial has been rebuilt to match a real device: 2–270 J, with larger, better-spaced numbers. ・The remote is now split into four screens (Rhythm & vitals, Presets, Tests, Connection), so you no longer scroll to reach a control. Monitor power, pause and reset are at the top. ・Power, CPR and pulse commands from the remote are now resilient to lost or duplicated messages, and the power command is resent automatically if it did not take effect. ・When the remote is not connected, it says so at the top and when you press a control. The screen remains usable while disconnected. ・Larger alarm-silence button. ・Alarms no longer stop or restart when the rhythm is changed during CPR. ・The charge tone is quietened while palpating the pulse so the pulse can be heard. ・Vital sign alarm tones adjusted to match a real monitor. ・The dial is easier to find when the device is switched off. ・Case names removed from the exam headings that learners see ("Blood gas analysis (respiratory arrest)" → "Blood gas analysis"), so learners read the findings instead. ■ Fixes ・Fixed the unstable connection between the iPad and iPhone. The link now reconnects automatically if it drops. ・Fixed the waveforms being wiped and redrawn each time the sweep wrapped around. ・Fixed the remote sometimes not updating the CPR status and other indicators. ・Fixed inconsistent haemoglobin values across the haemorrhage course.

■ Improvements ・Fixed the waveforms being wiped and redrawn every few seconds (introduced in 1.95). ・Reduced periodic stutter of the ECG on older iPads (e.g. iPad Pro 2nd generation). Value updates no longer trigger unnecessary redraws, and a "Lighter rendering" switch in Display & settings lowers the rendering load further.

■ Improvements ・The iPad–iPhone link now reconnects automatically. If the screen turns off or the devices move apart, the connection is restored within seconds once they are back. ・Smoother ECG drawing on older iPads (e.g. iPad Pro 2nd generation). Drawing is now batched per frame, and devices that keep dropping frames automatically switch to a lower rendering resolution. ・Long-pressing a button or rhythm name no longer selects text or shows the Copy / Look Up menu. Double-tap zoom is disabled. ■ Fixes ・Fixed the top of the home screen (role selection) being cut off on iPhone. ・Fixed the control panel not being height-limited on iPadOS 15.0–15.3, which squeezed the monitor area.

■ Fixes ・Fixed versions 1.92 and 1.93 not connecting the iPad and iPhone, and not restoring the full-version purchase. We apologise for the inconvenience. If you own the full version, tap any lock icon and choose "Restore purchase". ・Fixed the top buttons being hidden behind the status bar when using an iPhone as the monitor in portrait. ・Fixed the NIBP "Measure" button going off-screen on an iPad in portrait. ・Fixed some leads appearing nearly flat on the 12-lead during VF and torsades. ・Fixed the 12-lead automated interpretation not showing findings for the shark-fin ST elevation rhythm. ■ New ・28 patient-chart cases (shared with our SIM-Chart simulated EHR). Advance the phase and learners receive the records and results up to that point. ・Add your own images to the imaging list — your hospital's X-rays or self-made results, with findings. ・Alarm limits can now be set. Tap a value tile to open the settings. Respiratory-rate alarm added. ・Scenario presets now also set a matching blood gas (26 cases). ・A pulse on/off toggle on the bottom bar of the remote. Palpating when there is no pulse now shows a notice. ・During chest compressions a compression-generated pulse can now be felt even in pulseless rhythms (it sounds different from a native pulse). ■ Improvements ・Larger monitor area and defibrillator dial in the learner view. ・EtCO₂ and arterial pressure can be set during cardiac arrest; if left alone they show 6 mmHg and 62/16 mmHg during CPR. ・S1 and S2 heart sounds are easier to tell apart. ・Larger text in the control panel and exam screens. ・Fixed remaining Japanese text in the English interface.

■ New ・28 patient-chart cases (shared with our SIM-Chart simulated EHR). Advance the phase and learners receive the records and results up to that point. ・Add your own images to the imaging list — your hospital's X-rays or self-made results, with findings. ・Alarm limits can now be set. Tap a value tile to open the settings. Respiratory-rate alarm added. ・Scenario presets now also set a matching blood gas (26 cases). ・A pulse on/off toggle on the bottom bar of the remote. Palpating when there is no pulse now shows a notice. ・During chest compressions a compression-generated pulse can now be felt even in pulseless rhythms (it sounds different from a native pulse). ■ Improvements ・Larger monitor area and defibrillator dial in the learner view. ・EtCO₂ and arterial pressure can be set during cardiac arrest; if left alone they show 6 mmHg and 62/16 mmHg during CPR. ・S1 and S2 heart sounds are easier to tell apart. ・Larger text in the control panel and exam screens. ・Fixed remaining Japanese text in the English interface. ■ Fixes ・Fixed version 1.92 showing an outdated interface on some devices. We apologise for the inconvenience. ・Fixed the top buttons being hidden behind the status bar when using an iPhone as the monitor in portrait. ・Fixed the NIBP "Measure" button going off-screen on an iPad in portrait. ・Fixed some leads appearing nearly flat on the 12-lead during VF and torsades. ・Fixed the 12-lead automated interpretation not showing findings for the shark-fin ST elevation rhythm.

■ New ・28 patient-chart cases (shared with our SIM-Chart simulated EHR). Advance the phase and learners receive the records and results up to that point. ・Add your own images to the imaging list — your hospital's X-rays or self-made results, with findings. ・Alarm limits can now be set. Tap a value tile to open the settings. Respiratory-rate alarm added. ・Scenario presets now also set a matching blood gas (26 cases). ・A pulse on/off toggle on the bottom bar of the remote. Palpating when there is no pulse now shows a notice. ・During chest compressions a compression-generated pulse can now be felt even in pulseless rhythms (it sounds different from a native pulse). ■ Improvements ・Larger monitor area and defibrillator dial in the learner view. ・EtCO₂ and arterial pressure can be set during cardiac arrest; if left alone they show 6 mmHg and 62/16 mmHg during CPR. ・S1 and S2 heart sounds are easier to tell apart. ・Larger text in the control panel and exam screens. ■ Fixes ・Fixed the top buttons being hidden behind the status bar when using an iPhone as the monitor in portrait. ・Fixed the NIBP "Measure" button going off-screen on an iPad in portrait. ・Fixed some leads appearing nearly flat on the 12-lead during VF and torsades. ・Fixed the 12-lead automated interpretation not showing findings for the shark-fin ST elevation rhythm.

■ New ・28 patient-chart cases (shared with our SIM-Chart simulated EHR). Advance the phase and learners receive the records and results up to that point. ・Add your own images to the imaging list — your hospital's X-rays or self-made results, with findings. ・Alarm limits can now be set. Tap a value tile to open the settings. Respiratory-rate alarm added. ・Scenario presets now also set a matching blood gas (26 cases). ・A pulse on/off toggle on the bottom bar of the remote. Palpating when there is no pulse now shows a notice. ■ Improvements ・EtCO₂ can be set during cardiac arrest; if left alone it drops to 6 mmHg. ・The arterial pressure during CPR can now be set by the instructor; if left alone it shows 62/16 mmHg. ・S1 and S2 heart sounds are easier to tell apart. ■ Fixes ・Fixed the top buttons being hidden behind the status bar when using an iPhone as the monitor in portrait. ・Fixed some leads appearing nearly flat on the 12-lead during VF and torsades. ・Fixed the 12-lead automated interpretation not showing findings for the shark-fin ST elevation rhythm.

■ New ・28 patient-chart cases (shared with our SIM-Chart simulated EHR). Advance the phase and learners receive the records and results up to that point. ・Add your own images to the imaging list — your hospital's X-rays or self-made results, with findings. ・Alarm limits can now be set. Tap a value tile to open the settings. Respiratory-rate alarm added. ・Scenario presets now also set a matching blood gas (26 cases). ・EtCO₂ can be set during cardiac arrest; if left alone it drops to 6 mmHg. ■ Improvements ・S1 and S2 heart sounds are easier to tell apart. ■ Fixes ・Fixed some leads appearing nearly flat on the 12-lead during VF and torsades. ・Fixed the 12-lead automated interpretation not showing findings for the shark-fin ST elevation rhythm.

■ New ・Heart sound auscultation: normal, S3 gallop, aortic stenosis, mitral regurgitation, pericardial friction rub and muffled sounds (tamponade). Sounds follow the ECG beats — irregular in AF, fast in VT, silent when there is no pulse. ・Pupil examination: normal, miosis, mydriasis, anisocoria (right / left) and sluggish reflex. Shine the penlight to see the direct and consensual light reflex. ・Added snoring respiration (tongue obstruction) to breath sounds. ・Added a Code Blue overhead announcement to ambient sounds. ■ Improvements ・Remote buttons in three columns, with device controls moved to the top. ・Removed vital presets; use the individual sliders. ・The two devices now connect more reliably, with automatic retries and a connection guide on the home screen. ・New app icon. ■ Fixes ・Fixed buttons at the top of the screen being hidden in portrait orientation. ・Fixed the 12-lead report remaining in Japanese when the app was set to English. ・Fixed blood pressure values overflowing their panel.