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Special Bonus

-No mistakes - 800
-Fewer than 2 thrombi passed through - 700
-Completed with 240 left - 300
-3 COOLs earned - 200

Get inside the patient and hit skip when the screen is in the middle of the transition. There are five blood vessels here. At the start, one thrombus will come from each one. You can see them without using the ultrasound if you concentrate, but you cannot treat them without using it. What we want to do here is ultrasound the first 3 thrombi and stop them with the forceps. I'm going to recommend that you leave the other 2 alone until after you've treated the first 3, because treating all 5 within the allotted time is impractical. Maybe even impossible. You can stop those 2 to buy yourself time if you wish, but by the time you've finished treating the first 3, those 2 will have started moving again and that means you will only get GOODs when you treat them rather than COOLs. It doesn't really matter for the XS if you get GOODs on those, but it's not that hard to treat the first ones before those two get past, so you might as well.

From left to right, the first thrombi that will appear will come from blood vessel #1, #3, and #4. So we're going to choose those as the first ones to treat. As soon as you've magnified, switch to the ultrasound and use it on the ends of those three blood vessels until you've located the three thrombi. Once that's done, quickly pinch them with the forceps one right after the other, and then switch to the scalpel to make an incision in each one. I like to pinch them from right to left, and then go back from left to right cutting them. You'll want to do this very quickly on all 3. Once they're all cut, switch to the drain. We're going to drain all 3 of them before they get a chance to start moving again. What you want to do is start by draining the FIRST thrombus that you cut. If you cut them up like me, that will be the leftmost one. Then you want to quickly move the drain to the second one that you cut, and so forth. You must drain all 3 of them before they start moving again. It's not too hard, but if you screw up I suggest restarting. Don't use the gel just yet. Leave the cuts as they are.

By the time you've finished treating those thrombi, the two that we left alone should be close to the bottleneck near the top of the screen. Fortunately for us, the bottleneck causes them to slow down somewhat. Quickly use the ultrasound on them and stop them with the forceps. Treat them the same way that you treated the first three. There's a very good chance that by the time you stop them, they'll be so close together that you will be able to drain both at the same time. This saves you a bit of time and makes things easier on you.

After you're done with those, it's time to spread antibiotic gel all over the 5 cuts. But be careful, as soon as you gel the first one and Angie remarks "Treatment complete!", five very fast thrombi will come up from each vessel. Concentrate and try to see them without the ultrasound. They move very fast but there is an area near the bottleneck in which they will slow down somewhat. Do not use the scalpel until you've stopped all 5 thrombi. The first one that will reach the bottleneck is the thrombus from vessel #2, and this will be the first one you want to stop. After that, use the ultrasound on the area where vessels #4 and #5 converge. You should spot both thrombi from these vessels here and be able to stop them. Then, go back and use the ultrasound near where you stopped the first thrombus. The one from vessel #1 should be around here. Finally, stop the one coming from the central vessel, as this one happens to be the slowest. The main thing here is that you want to use your ultrasound on the areas where the blood vessels converge.

Once all 5 of them are stopped, switch to your scalpel and make an incision. As soon as you do, Derek will automatically activate his Healing Touch. Once this happens you're pretty much home free. Cut up all 5 thrombi at once. With the power of the Healing Touch you have plenty of time to drain all 5 of them before they start moving again. Gel the cuts after you've drained. When you're done with that, 2 very slow thrombi will come up from blood vessels #1 and #4. Again, with the Healing Touch these are absolutely no problem. Take care of them as usual. After you gel the incision areas, you'll be done.

The opening in this patient is very strange, so to get the COOL in the final suture you're going to have to do it a bit differently. The opening is really big and unlike the other times where you'd make the lines wider than the opening, here you'll want to actually make the lines narrower than the opening. Check the video to see what I mean. Finally, if you've done everything correctly there will be no need to use stabilizer. Simply apply the bandage and you're done.