Your department sees the once-in-three-years case too. Cairn is the open-source system that gets you ready for it — and it is free.
One local champion takes a branch, keeps what fits, swaps in your doses and phone numbers, and practices with the team. Then shares what they learned back.
A cairn is a stack of stones left by those who walked the trail before you — so you can find the way in bad weather.
From the ground up: equipment lists — the right kit, where you can find it. Cognitive aids that run the clock and the checklist with you. Training built into the tools themselves. Ready at the top.
Add a stone if you can. It becomes part of the trail for whoever comes next.
One patient becomes two. ACLS, then a resuscitative hysterotomy, then a newborn to resuscitate — three protocols in six minutes, on one screen, in one continuous case. Step through what the team actually sees.
Illustrative walkthrough. Every dose, energy setting and time target is localized and clinically validated by the adopting site before use.
One repository, plain static files, no build step. Take all of it or just the pieces your department needs.
Anatomy in ink, the one action in red — never more than one red idea per figure. Related procedures share a base drawing and differ only by that idea: the hysterotomy's vertical midline cut and the C-section's transverse one sit on the same uterus. The same glyph rides the drawer label, the poster and the live card, so the cart and the screen agree.
Live, checkable cognitive aids for codes, pediatric, OB and neonatal emergencies, trauma, and rare procedures — timers and dosing engines, not PDFs.
Aids for the whole team, including the hard conversations: consultant calls, code status, breaking bad news, and the post-event debrief.
Every kit, item, and size — searchable, scored against seven national equipment standards, with gap-recording you can export as findings.
Print-ready drawer faces, stock strips, and kit cards. Color finds the drawer; words and pictograms name it; QR codes close the loop to the live card.
Pillow-patient drills that chain real workflows, plus a laminatable visual-simulation deck. A table and fifteen minutes — no mannequin, no sim lab.
Wall posters for the resus bay, plus a provenance record for every tool: source guideline, edition, and the date a human last checked it.
It starts with one local physician champion. No developers required — the mechanical steps are the kind an AI assistant does for you.
Reach out and we'll hand you the repository. Fork it into your own copy — independent history, your hosting, your control. Free static hosting publishes it automatically.
Keep the parts that fit your ED. Edit the marked config blocks — your doses, assays, phone numbers, cart layout — then validate every value clinically.
Run the simulations with your real team and real carts. New hires find the equipment; what they can't find feeds your readiness audit.
A better checklist, a clearer label, a gap in coverage — contribute it upstream so the next department starts further up the trail.
The loop closes on itself: simulations double as orientation walks, what the new hire can't find feeds the equipment readiness audit, and the audit tells you which kit indicators to print next. Practice and preparedness are the same activity.
A rural ED sees everything an urban trauma center sees — just rarely. When the once-in-three-years case arrives, recall under stress is not a plan. Checklists and practiced teams are.
Critical management steps missed in simulated operating-room crises with checklists versus without them.1
Americans live in rural areas, served by emergency departments that are typically low-volume and far from tertiary backup.2
Rural hospitals closed or converted away from inpatient care since 2005 — the departments that remain carry more, with less.3
1. Arriaga AF, et al. Simulation-based trial of surgical-crisis checklists. N Engl J Med. 2013;368:246-53. 2. US Census Bureau, 2020 Census urban–rural classification. 3. UNC Cecil G. Sheps Center for Health Services Research, Rural Hospital Closures tracker. See also Goldhaber-Fiebert SN, Howard SK. Implementing emergency manuals. Anesth Analg. 2013;117:1149-61.
Everything lives in one repository under a permissive license: the manual, the cognitive aids, the kit lists, the label and poster templates, the simulation scripts, and the guideline-provenance records that say which source each tool is written against and when a human last checked it.
Adoption starts with an introduction: reach out, and we hand you the repository along with the people who maintain it. From there it's a fork — your copy, your hosting, your clinical validation. No patient data, ever, by design.
Clinical review panel, co-maintainers, contribution pathways — the structures are forming now, and early voices shape them. If you want a say in how a shared rural readiness commons is run, this is the moment.
Tell us you're interestedBe the physician champion for your department — or just follow along while you decide. We'll connect you with the branch, the localization worksheet, and the people who have already walked the trail.
Prefer to work at your own pace? Say so in the note — we'll send you the repository and the localization worksheet and leave you to it.
Thanks — we'll be in touch with the repository, the localization guide, and an introduction to the network.