Doctor Nyla's medical guide for Scrubs

[Germ Man]

Good morning, Scrubs. Doctor Nyla Morgan here.
You may have walked into me before, seen me work. You’ll probably know me as the head of security, but to some, I am The Surgeon.
Yes, yes.. I know what you’re thinking “How are you so good at what you do?” and yes, you are right, I’ve put a lot of hard work and guts into becoming who I am.
But there is nothing keeping you from achieving this level of expertise as well.
All it takes is a good teacher. And whaddya know? I’m right here.

So, you want a lesson about medical treatment?
Glad you’re interested. Many people sign up as medical personnel and can’t tell the difference between a femur and a tumor.. What? You can’t? Oh boy..

Alright, take notes, Scrubs.


Lesson Number One: The Medbay

You’ve arrived in the NSS Cyberiad’s state of the art medical ward. 
(Unless you are the brig physician. In this case, skip to Lesson Number Two: Preparation)
What makes it state of the art?

Two sleepers, both of which are located aft of the entrance. Aft? That’s south.
Four Body Scanners, the green thing that lets you see inside the patients.
Four Nanomeds, that can vend all kinds of medical equipment.
Three Cryo Tubes, two directly next of the sleepers, one in the starboad ward, also housing;
The Cloning Lab, which lets you clone people. Also located in the starboard ward are;
The CMO Office and the;
Genetics Lab, which uses radiation to gain superpowers.
Surgery is situationed aft of the sleepers.
Virology is located even further south. Home of diseases and sometimes cures.
Medical Storage, containing spare medicine and equipment, located between cloning and;
Chemistry, starboard of the lobby. Directly opposite of;
The Reception, where nobody ever sits. Also housing the paramedic’s garage.

Lesson Number Two: Preparation

Intimately familiar with your workplace? Good. Cause now, you’ll have to use it.

Check your headset.
Say “:m Testing” to announce your presence. Or use “:m Hi” instead. Don’t care which. Just make it known that you are there. Kay?

First, swing by the medical storage and open the lockers on the right.
Each one’s got some nice stuff in it, but we’re only interested in the defibrillator. Grab it.
Close the lockers. Don’t want people stealing our stuff, right?
Now you want to grab some handy tools. Equip a medical belt  Open the locker next to the shelf, put a pill bottle and an Epipen into your belt.
On the table, you’ll find Medical Huds. You guessed it: put one on.
Now you can see the health of the crew. 
Green is good. Orange, not so much. Red is bad, Dark Red? Stabilize them.

Get out of the storage after locking everything.
Toss the defibrillator on the table between the cryotubes. Put one of the blue beakers into each tube.
Start up the freezer or they won’t work. Turn the temperature down all the way. Do the same in cloning.
Look in your backpack.
The internals box contains an epipen. Put that on your belt. The first aid box? Epipen. Belt.
Your first aid box also contains a health scanner. Put that in your labcoat, on your labcoat, or into a pocket.
Get to one of the NanoMed Vendors and vend a health scanner upgrade and install it. It’ll show you more detailed information now.
Later on, fill your pill bottle with some Synthflesh patches, SR and Saline Glucose pills from chemistry, if they made any.

What do you have now?
A med hud.
A medical belt, with a pillbox and 3 epi pens.
An upgraded health scanner.
Cryo tubes are set up, a defibrillator is on standby. Do not keep it on your person.

Brig Physician? Grab a medical headset from the medical storage locker, use a screwdriver, pick up the encryption key and put it into you bowman headset. Test it with :m and throw the used medical headset in the trash. Ask politely if you may take the spare defibrillator in the storage.

Surgeon?
Open the upper locker in the the Operating Room. Grab the duffel bag and put your surgery tools inside. Equip your gear, put the defibrillator on the table, lock the locker. Behind you, there’s the anesthetics locker. Take a mask and a tank, put them on the table. Lock it.
In the OR Storage, you grab a mask out of a box, the cleaner bottle, leave the IV Drip and the Blood Bags for now. Head over to a NanoMed vendor and put one Spaceacillin Syringe in your belt. That’s all.
Oh, one thing I should mention:
For the love of god, if I see you carrying around the duffel bag with the tools, I will personally kick you ass.

Chemist?
Open the chemistry wardrobe and use a gas mask to protect yourself from any fumes, grab a chemistry bag as well.
Wear your scientist goggles to see all reagents inside a container.
Absolutely NEVER mix water with potassium.
Set the Chemical Heater to 1000K.
Always make Synthflesh Patches, Mitocholide bottles, 1u Strange Reagent Pills, Formaldehyde bottles, Charcoal Pills.
Saline Glucose Solution mixed with Iron is great to restore blood. Make some of those pills as well.

 

Lesson Number Three: Treating patients

People will slowly trickle into the medbay for now.
Their injuries will usually range from minor burns and brute damage to braindamage workplace related injuries.

Nothing a Sleeper won’t be able to fix. They have an endless supply of chemicals.

Brute is fixed with Styptic Powder. About 2u for 1 point of damage.
Burns are healed with Silver Sulfadiazine. Same dosage.
Toxins are purged with Charcoal from the Nanomed. 1u heals about 2 points of damage.
Oxygen is treated with Salbutamol. The surgeons will be thankful if you use a lot of it.
10 u Epinephrine when patients are critical. Trust me, it saves lives.
Injuries that aren’t healing? Robotic limbs. Send ‘em to get tools and patch it up.

Give the patient a scan in the green body scanner afterwards.
Anything showing up there? Internal Bleeding? Liver damage? Broken bones?
Send them down to the surgery rooms, after telling them what the scanner said.

Later on, your sleeper may be upgraded by the scientists.
You’ll get advanced chemicals that are extremely useful.

Pentetic Acid treats Toxins, but causes burn and brute. Good at purging poisons, too.
Omnizine will heal all injuries. Do not overdose. Go with ~10u.
Mutadone for people that are shaking, mute, give off radiation.. It fixes genetic mishaps.
Occuline will treat most eye damage and fixes deafness.
Mannitol will fix brain damage.

If people are bleeding, often times they can be fixed with Styptic Powder.
Give them a scan for Internal Bleeding. Administer a maximum dose of Salbutamol, some Saline Glucose Solution and Iron. Send them to surgery, stat.
90% blood level is ok.
85% is still fine. (Should they be a donor, stop now.)
80% can become troublesome.

75% will start making them pass out. Consider a blood bag.
60% is really bad. Use a blood bag.

Lesson Number Four: Oh no! A corpse!

Aaah yes. A dead body. Sooner or later, you’ll encounter a deceased crewmember, be it in the lobby, cloning, the morgue, or even in surgery.
There’s nothing wrong with that. Do not freak out. Stay calm.
What should you do? Just remember D.E.A.D.

Defibrillate
Epinephrine
Analyse and treat
Defibrillate

Should they not come back to life after D.E.A.D. inject them with formaldehyde to keep their body from rotting. Should push come to shove, you will save the surgeons a lot of trouble this way.

Now, here we go. The big one.
The one thing many of the new scrubs get wrong.
The one chemical that can make you a hero, or the dumbass that gets fired for malpractice.

Strange Reagent

Consisting of holy water, unstable mutagen and omnizine, a 1u pill of this stuff will revive a dead person. Granted, their soul still wishes to reside in their body (If their player wants to play.)

Fix them up. Injections and digestion won’t work on a corpse, they cannot metabolise chemicals.
Use Synthflesh patches, they will treat burns and brute.
Your first aid kit? It’s got two stacks of advanced burn and advanced trauma kits. 6 uses.
Apply them locally on the corpse. Usually the head, torso, lower body. Limbs tend to be robotic and won’t work.
Use your health scanner again. Are they below 90 combined brute and burn damage?
If so, use your Strange Reagent pill on them.
They should still have Epinephrine in them from D.E.A.D. so they should be ok for about 30 to 40 seconds.
Depending on the cause of death, administer charcoal and salbutamol. Put them into the cryotube, SR gave them Genetic Damage.
Give them a body scan. Infections? Spaceacillin. Dead organs or septic limbs? Scream for Mitocholide and A surgeon that knows their stuff.

Do not use Strange Reagent unless you fixed them to below 90 combined brute and burn damage.
I know what you’re thinking: “But Nyla, it only gibs at 150 combined damage”
And yes. Yes, you are absolutely right. BUT:
It also takes gene damage into consideration. Which usually clocks in at 50 points.
90 brute/burn total + 50 genetic damage = 140 total. SR is safe.


Lesson Number Five: Surgery and You

Here’s my personal forte. The field that I shine in.
Now, follow my lesson, and you too, will surpass your status as a glorified butcher, and become a surgeon.
However, do not take me as an example. I am an extremely experienced surgeon. I rely on speed, more than anything. Do not do this, unless you know what you are doing.
If you see me ether a patient, then drag him onto my table without a scanner print, that is bad form. You do not do that. Unless you know you can pull it off, it is malpractice.

Here is what you do:

Look at the operating computer.
It will show you the next step in your surgery.
There is no shame in using it for reference.

Be confident in your abilities and know your limits.
If you know you can perform a surgery, go for it.
An IB surgery can be quick and easy. Anesthetics, cut, clamp, fix the vein, cauterize.
However, if you are unsure if you can fix a septic limb? Call for help.
(There is no need to be ashamed to look at the operating computer and the wiki for refernce.)

Have the wiki open.
There is no excuse to not do this.
Even I sometimes have it open, even though I don't need it.

Be prepared.
Have anesthetics on your table. Have the surgery back on it.
Have a bottle of Mitocholide, a dropper set to 1u and an empty beaker to put it into.
The Spaceacillin syringe from Lesson 2? Infections. 5u should suffice. 10u to make sure. 15 if they had septic parts and you want to be on the safe side.
Never put anesthetics on Vox or Plasmamen. Use Hydrocodone or Ether. I’d suggest to stay away from morphine.

Know your steps.
Every surgery starts with the scalpel, hemostat and retractor combination.
(Exceptions are plastic surgery and amputation)
Do not think more than two steps ahead. Keep your focus.
Yes, you will want to use the bonegel and bonesetter to mend the chest… But first you have to get in there and fix the organs.

Difficult Surgeries:

Alright, your friendly neighbourhood voxy is dragged in.
Give them a quick first look.
Are they bleeding? Judging by the blood on the floor… I’d say yeah.
Are they gasping? Might be from the blood loss. Might be something more severe.
Do they have their breather mask on? Can’t see? Ah well..
Are they conscious? Doesn’t look like it.
Their health bar is dark red. Stop picking your nose. Epinephrine, stat.

Pump them full of salbutamol, they’re bleeding.
If you see toxin build up, administer charcoal and try turning on their internals.
Use the body scanner.

What’s that?
Chest is broken and has internal bleeding.
Lungs are ruptured.
Liver’s dead.
Skull is broken.
Brain is injured.
Left leg is septic.
Left arm is broken and has Internal bleeding.
Blood level at 45% O-

Yes. This happens often.
Now’s your time to shine, Scrub.

First, you ether them. 20u if you’re quick. You're not, use more. (Dialysis if you’re done too quick)
Yell for Mitocholide in your OR (OR1 is left, OR2 is right)

Remove the left leg, this is the most vital part for now.
Select their left leg
Scalpel, amputation, Bonesaw. Put your tools away, you’ll need both hands.
Take the dropper, right click it, set transfer amount, 1u. Take 1u of mito, put it into the empty beaker.
Grab their leg from the floor, splash the beaker on it.
Scalpel, leg, hemostat, Spaceacilling syringe 5u.
Their leg is done. Far from over, Scrubs.

Remove the liver.
Select their lower body.
Scalpel, organ manipulation, scalpel, hemostat, retractor, hemostat, select liver.
Do the same you did with the leg.
Put the liver into their body, use the brute kit, retractor, cautery, the other 10u of spaceacillin.

OR Theatre Storage. Quick.
Grab the IV Drip. Take an O- bloodbag from the freezer and put it in the drip.
Pull it to the vox. Drag the Drip’s sprite onto the Vox’ sprite.
Continue surgery.

Fix the internal bleeding.
If you were quick, the Vox should be at around 30% to 35% blood.
The drip should bring that up by 25%.
First, go for the lungs.
Select their upper body
Scalpel, organ manipulation, scalpel, hemostat, retractor, bonesaw, retractor, brute kit, retractor, bone gel, bone setter, bone gel, cautery. Done.

Fix the internal bleeding on the chest, yes, it's separate from the lungs.
Select their upper body.
Scalpel, Internal Bleeding, Scalpel, hemostat, retractor, Fix-O-Vein, cautery.
Same with the arm.

If you were quick, the vox should be at 50% bloodlevel now.
Unplug them from the drip (same as attaching them)
Drag the vox to a sleeper. Salbutamol. More Ether. (Styptic if you’ve hurt them. It happens with ether.)
Grab another bloodbag.
Back to surgery. Click the drip with an empty hand, insert the new bloodbag. Attach the vox.

At this point, the vox will slowly stabilise, if you’ve cauterized all the wounds.
But you are not done.

Fix their brain as you fixed their lung, this will take care of the broken skull as well.
Next you fix their broken arm.

Take your cleaner bottle, aim behind the surgery table, clean the vox and the floor of blood.

Put them in the scanner, see if you’ve missed something.
All good?
Shake the Vox awake “All good.”
Move to the sink, wash your hands, open the door for your patient.
“Take care.”

You are no longer a Scrub.

 

Edited June 20, 2018 by Germ Man

[necaladun]

This is great and you should feel great.

[Hawker]

Awesome post. To add to this, Someone told me once that a spray bottle with Mitocholide is a good way of reviving a pile of limbs. Drop em on the ground and spray em.

[mura128]

Incredibly well written, to the point, and doesn't cut out any necessary info. This is the perfect guide for anyone looking to play as an MD, surgeon, or brig physician.