All the surgical steps and tools used in the game are real which makes this an interesting game as it enables you to learn how serious injuries are treated in the real world and how the human body works. Although ER Simulator is a free game it is in fact a 'Lite' version, once you have completed the fifth level you will have to decide whether you want to make a one-time purchase of $5.99 at the in-app store to get the remaining levels. Purchasing the full version of the game will remove all the adverts in the game and unlock all the possible decorations. One good thing about this game is that you will not need to constantly spend money on it as there are not too many micro-transactions.