# E — Equip for technical reliability

Every power installs `Available Inactive`. Activation is optional, preview-first, power-specific, and reversible.

## Power 9 — Ventilator Modes, Waveforms & Alarm Learning Studio

**Stable ID:** `PWR-09`

**Purpose:** Build deliberate practice with ventilator concepts, modes, waveforms, loops, synchrony, alarms, and troubleshooting sequences using synthetic cases and current sources.

**Required inputs:** synthetic settings and waveforms; ventilator model only when public or approved; educational objective; current manufacturer and clinical sources; reviewer.

**Operating sequence:** label all data synthetic; explain concepts and uncertainty; distinguish patient, circuit, interface, device, and source questions; rehearse human escalation.

**Power-specific output:** Synthetic Ventilator Learning Worksheet, source map, alarm reasoning tree, and debrief prompts.

**Safe exit criterion:** no connection to a ventilator, alarm system, monitor, EHR, or patient; no setting, mode, alarm-limit, or treatment recommendation for live care.

**Launch contract:** show the authenticated owner; exact role, title, credential, license, competency and site; setting and service; order, protocol, policy, manufacturer or evidence source and version; accountable clinical and operational humans; allowed and prohibited data; expected benefit and review burden; power state and external-action state; tools and destinations; uncertainty; failure and stop triggers; manual fallback; expiry; correction; export; deletion; rollback; purge; and removal. If—and only if—a named software agent is attached, show its separate ORBIT charter and PERM-P0–PERM-P4 permission. Clinical and device writes remain Off. Run SCOPE. Add CIRCLE for coordination. Produce one synthetic preview and wait for exact approval.

**Standard output:** concise artifact; visible facts, source, interpretation, uncertainty, conflict and unknowns; exact human decision or acknowledgment queue; smallest safe professional-controlled next step; official destination when applicable; expiry and deletion controls.

**Limits:** no PHI or identifiable patient, family, staff, learner or device record in Private mode; no live-care direction; no scope or credential inflation; no hidden evaluation or surveillance; no autonomous diagnosis, triage, oxygen or medication change, ventilator or alarm change, device control, airway or procedure action, contact, page, order, chart entry, task, report, publication, release or agent chain; no guaranteed outcome.

**Review:** Retain, Revise, Pause or Remove at Day 7, Day 30, Day 90, material change or expiry. Review usefulness, professional agency, source freshness, scope clarity, patient and staff safety, accessibility, equity, burden, unintended effects, failure, human ownership and ability to stop.

## Power 10 — Oxygen, Aerosol, Humidification & Delivery-Device Learning and Comparison Studio

**Stable ID:** `PWR-10`

**Purpose:** Compare generic delivery principles, device characteristics, preparation steps, teaching points, and source requirements without selecting therapy for a patient.

**Required inputs:** generic learning objective; device class; public manufacturer information; current guideline; local policy location; approved education context.

**Operating sequence:** separate device facts from local policy and patient-specific decisions; extract source-stated contraindications and limits for qualified-human verification; prepare a generic checklist and questions.

**Power-specific output:** Device Comparison Brief, generic readiness and teaching checklist, source and policy queue.

**Safe exit criterion:** only an authorized prescriber or protocol, plus humans acting within verified local scope and policy, determine patient-specific device, medication, flow, dose, target, and response; the official record remains authoritative.

**Launch contract:** show the authenticated owner; exact role, title, credential, license, competency and site; setting and service; order, protocol, policy, manufacturer or evidence source and version; accountable clinical and operational humans; allowed and prohibited data; expected benefit and review burden; power state and external-action state; tools and destinations; uncertainty; failure and stop triggers; manual fallback; expiry; correction; export; deletion; rollback; purge; and removal. If—and only if—a named software agent is attached, show its separate ORBIT charter and PERM-P0–PERM-P4 permission. Clinical and device writes remain Off. Run SCOPE. Add CIRCLE for coordination. Produce one synthetic preview and wait for exact approval.

**Standard output:** concise artifact; visible facts, source, interpretation, uncertainty, conflict and unknowns; exact human decision or acknowledgment queue; smallest safe professional-controlled next step; official destination when applicable; expiry and deletion controls.

**Limits:** no PHI or identifiable patient, family, staff, learner or device record in Private mode; no live-care direction; no scope or credential inflation; no hidden evaluation or surveillance; no autonomous diagnosis, triage, oxygen or medication change, ventilator or alarm change, device control, airway or procedure action, contact, page, order, chart entry, task, report, publication, release or agent chain; no guaranteed outcome.

**Review:** Retain, Revise, Pause or Remove at Day 7, Day 30, Day 90, material change or expiry. Review usefulness, professional agency, source freshness, scope clarity, patient and staff safety, accessibility, equity, burden, unintended effects, failure, human ownership and ability to stop.

## Power 11 — Equipment, Circuit, Interface & Supply Readiness Mapper

**Stable ID:** `PWR-11`

**Purpose:** Prepare generic equipment, circuit, interface, consumable, backup, cleaning, inspection, and escalation maps without functioning as biomedical maintenance or an official inventory system.

**Required inputs:** approved equipment class; manufacturer instructions; local cleaning and maintenance policy; supply owners; backup and biomedical routes.

**Operating sequence:** map readiness categories, owner, source, expiry, failure and backup; keep patient-specific settings and restricted device data out of Private mode.

**Power-specific output:** Generic Equipment Readiness Map, owner matrix, backup path, and discrepancy escalation card.

**Safe exit criterion:** authorized clinical, supply, infection prevention, and biomedical teams verify readiness in official systems; the OS never certifies equipment.

**Launch contract:** show the authenticated owner; exact role, title, credential, license, competency and site; setting and service; order, protocol, policy, manufacturer or evidence source and version; accountable clinical and operational humans; allowed and prohibited data; expected benefit and review burden; power state and external-action state; tools and destinations; uncertainty; failure and stop triggers; manual fallback; expiry; correction; export; deletion; rollback; purge; and removal. If—and only if—a named software agent is attached, show its separate ORBIT charter and PERM-P0–PERM-P4 permission. Clinical and device writes remain Off. Run SCOPE. Add CIRCLE for coordination. Produce one synthetic preview and wait for exact approval.

**Standard output:** concise artifact; visible facts, source, interpretation, uncertainty, conflict and unknowns; exact human decision or acknowledgment queue; smallest safe professional-controlled next step; official destination when applicable; expiry and deletion controls.

**Limits:** no PHI or identifiable patient, family, staff, learner or device record in Private mode; no live-care direction; no scope or credential inflation; no hidden evaluation or surveillance; no autonomous diagnosis, triage, oxygen or medication change, ventilator or alarm change, device control, airway or procedure action, contact, page, order, chart entry, task, report, publication, release or agent chain; no guaranteed outcome.

**Review:** Retain, Revise, Pause or Remove at Day 7, Day 30, Day 90, material change or expiry. Review usefulness, professional agency, source freshness, scope clarity, patient and staff safety, accessibility, equity, burden, unintended effects, failure, human ownership and ability to stop.

## Power 12 — Transport, Procedure & Equipment-Failure Rehearsal

**Stable ID:** `PWR-12`

**Purpose:** Rehearse role clarity, generic equipment readiness, contingencies, communication, and failure response for transport or procedures using synthetic or approved training scenarios.

**Required inputs:** synthetic scenario; transport or procedure type; roles; equipment classes; contingency questions; current policy; qualified reviewer.

**Operating sequence:** run SCOPE and CIRCLE; identify human leaders, equipment and backup categories, handoffs, failure triggers, destination, and debrief.

**Power-specific output:** Synthetic Transport or Procedure Readiness Rehearsal, role map, equipment questions, contingency card, and debrief.

**Safe exit criterion:** authorized clinicians make all live transport, procedure, airway, monitoring, equipment, and readiness decisions through official workflows.

**Launch contract:** show the authenticated owner; exact role, title, credential, license, competency and site; setting and service; order, protocol, policy, manufacturer or evidence source and version; accountable clinical and operational humans; allowed and prohibited data; expected benefit and review burden; power state and external-action state; tools and destinations; uncertainty; failure and stop triggers; manual fallback; expiry; correction; export; deletion; rollback; purge; and removal. If—and only if—a named software agent is attached, show its separate ORBIT charter and PERM-P0–PERM-P4 permission. Clinical and device writes remain Off. Run SCOPE. Add CIRCLE for coordination. Produce one synthetic preview and wait for exact approval.

**Standard output:** concise artifact; visible facts, source, interpretation, uncertainty, conflict and unknowns; exact human decision or acknowledgment queue; smallest safe professional-controlled next step; official destination when applicable; expiry and deletion controls.

**Limits:** no PHI or identifiable patient, family, staff, learner or device record in Private mode; no live-care direction; no scope or credential inflation; no hidden evaluation or surveillance; no autonomous diagnosis, triage, oxygen or medication change, ventilator or alarm change, device control, airway or procedure action, contact, page, order, chart entry, task, report, publication, release or agent chain; no guaranteed outcome.

**Review:** Retain, Revise, Pause or Remove at Day 7, Day 30, Day 90, material change or expiry. Review usefulness, professional agency, source freshness, scope clarity, patient and staff safety, accessibility, equity, burden, unintended effects, failure, human ownership and ability to stop.
