Spin the Wheel of Madness and wait for the spinner to stop. The spinner must complete at least two rotations, otherwise you spin again. After the spinner has stopped, determine where the front-pointer () and tentacle-pointer () are pointing. If the spinner stops directly on a line, then consider that it points to the next clockwise location.

Resolve the spinner in the following order: take an action determined by the spinner, then draw tentacles (and resolve them), then spawn a Shambler (and resolve Shamblers), and then finally move the Great Old One.