Crash Course to Medical - by Triage Unit

[Varlun]

Hello! So, there's already a couple other good more in depth Medical guides out there, however for new players this really amounts to information overload. My intention with this guide is to just go over the essentials. If you can get this stuff down, you'll get by just fine in Medical.

In my experience, what medical needs most isn't someone that knows everything, rather it just needs someone that can handle the chaos when chaos shows up. When you have a ton of patients coming in all at once and not enough doctors to treat them all, things can get pretty overwhelming.

This is why I chose my cyborg name as Triage Unit, because my focus is mostly on sorting the dead or critical. Once those are handled, then I'll worry about further treatment. But in general, by that point, any of the other medical staff can handle it.

So without further ado, let's get into it!

---

CHEMICALS

---

Let's start simple, with chemicals. I'm only going to cover the most basic and common chemicals. Like what the sleepers have, or the cyborg's hypospray, etc. I'm also not going to overwhelm you with specific healing per tick numbers and yada yada. You just need to know what they do and that's good enough.

Charcoal - For toxin damage. No overdose point. Sleepers and cyborg hypospray have this.

Saline glucose - Slowly heals burn and brute and helps regenerate blood. No overdose point. Sleepers and hypospray have this.

Salbutamol - For suffocation. Not as fast as Epinephrine, but no overdose point. Sleepers have it.

Epinephrine - Quickly heals suffocation. Cyborg hyposprays have it. While the sleepers don't have it, it's easy to get ahold of. EpiPens have it

Mannitol - For brain damage. The medical vending machines have it. When people are cloned from an unupgraded cloner, they'll need one of these pills.

Oculine - For eye damage. Vending machines.

Strange Reagent - This is the revival drug. For newcomers to medical, I would avoid this entirely. It's only to be used in rare situations and it's not great because it does a lot of damage.

That's all you need to know about chemicals to get by!

---

REVIVING

---

Sorting the dead is the first priority. This is probably the most complex part about medical, because there's many many ways people can be dead and many different things that can prevent people from being revived. Whether they ghosted, have been dead too long, have too much damage, closed the game, have too much brain damage...

A corpse can be revived if it's been dead less than 5 minutes and has less than 180 total burn/brute damage.

So the first thing you want to do is go ahead and scan them to check their damage. If burn/brute combined is over 180, heal them a bit to get below this point. Then attempt to use the defibrillator.

There's 3 different FAILED revival messages you can get:

Resuscitation failed - Severe tissue damage detected: This is from having more than 180 damage.

Resuscitation failed - Heart tissue damage beyond point of no return for defibrillation: Been dead too long.

Resuscitation failed: They're not revivable. Examine them (not with scanner, normal examine) to see if they committed suicide, or if they're catatonic (they ghosted).

One neat trick that's good to do, if you want to be 100% sure whether you should be done with a corpse or not, throw them in a morgue slab real quick. Cyborgs will need someone with hands to help with this. The lights on the slab will tell you if they have a soul. Green or purple means they do, red means no. So you can forget about red, but otherwise you should seek further help. THE LIGHTS ONLY UPDATE WHEN THE SLAB IS CLOSED! You can either just hand them off or attempt to learn what's wrong and why you can't revive them. For 95% of cases though, you can get by without knowing that much!

---

CLONING

---

If all else fails, it's time to consider cloning. Vox and slime can't be cloned, and there's a couple other things that can prevent cloning.

If you scan someone and see they are SUPER messed up, like everything is broken and 500+ damage and other nonsense... just clone them. There's no sense in having them stuck in surgery for an hour. Don't think of cloning as a last resort.

So, when someone is placed in the cloning scanner, they get a popup (like terror spiders or w/e) to re-enter their body. If they're not in their body at the time of pressing scan, you get the "Mental interface error". So with autoprocessing turned off, it's important to try a few times to scan. Give them a chance to re-enter their body. It's still not a huge deal because if nothing else the Coroner SHOULD notice the purple/green light. I'd still go ahead and check yourself just to be sure, but take them back out. The Coroner will get mad if you just throw bodies into slabs and leave them.

If autoprocessing is turned on, it will be constantly trying to re-scan, so just leave them in the scanner for a few seconds.

If you want to be really productive when nothing else is going on, a great thing to do is to bring people in for clone pre-scanning. Use the crew manifest and your PDA (or equivalent as cyborg) and try to get all of Command, Medical, Research, Engineering, Security and Supply to come in. Myself, I usually just message the department heads and request that they tell their entire department at once to come in if they want. It's probably a good idea to target the miners FIRST, before they initially leave, in case the worst happens!

---

CARDIAC ARREST

---

I wanted to make a note here regarding cardiac arrest. When you scan someone with your health scanner that's in critical, it could tell you that they're in cardiac arrest. It's important to pay attention to what the cure is. There's 3 different cures. Epinephrine, saline glucose, and shock. If it's shock, you use a defibrillator. Cyborgs have a handheld defibrillator that's more handy for specifically this purpose. The more critical someone is, the more likely they'll go into various forms of cardiac arrest (Yes, they can get all 3 at once). So as general practice I like to go ahead and give them 20u of Epinephrine and Saline Glucose, then have my defib handy as I continue to scan them and monitor their health. A lot of times people will die during this process, because it takes a minute for it to be cured. No big deal, just defib them.

---

SURGERY

---

I recommend avoiding surgery. While necessary, it's a time consuming and sorta complicated process. I simply don't enjoy doing it myself so I refuse to do it. Remember how I mentioned that what medical needs isn't someone that knows everything, but someone that can essentially work triage when stuff starts hitting the fan?

So, if you've healed up your patient but when you scan them it says they have fractures or broken bones or internal damage etc, take them to the chairs by surgery and call for a surgeon to that OR (left is OR1, right is OR2).

In general you will be able to hand off people for surgery to other doctors. They need something to do after all, no sense in trying to do EVERYTHING yourself. And again, it's very time consuming, and while you're stuck in surgery there's potentially other critical or dead patients arriving in medbay that require far more immediate attention.

---

SUIT SENSORS

---

The lifeblood of medical, especially cyborgs (ESPECIALLY if you have multiple monitors!). I like to encourage all medical staff to check the suit sensors of patients themselves during treatment. If they REALLY don't want them maxed for whatever reason, they can turn them back down again after they leave. Drag their sprite onto yours, at the bottom you can toggle their sensors.

Immediately after cloning someone, go ahead and scan them again! If they're part of the aforementioned departments. Don't pre-scan civilians or other people of less consequence.

Pre-scanning is a very involved and time consuming thing to do but, can be very effective. It could surely result in antags deciding to blow up cloning, that's how you know you did a good job.

One trick I like to do as cyborg, while I'm pre-scanning, I'll block them with my body on harm intent in the scanner so I can have time to toggle their sensors. Few people complain about this.

Don't forget to handle suit sensors of the dead! Always toggle them off when putting them into the morgue! And if they're being cloned, AGAIN, go ahead and max them on their corpse before stripping them for the new body.

---

That's about it, I'm sure I'll end up adding a little bit to this here and there, as I wrote all this off the top of my head. But that's most of it! Please leave a comment and let me know what you think!

Edited February 25, 2020 by Varlun

[Greey]

You forgot the part where medical is supposed to gib slimes on arrival.

[UltraMonster]

I think that's just enough information I need to give medical a try.

Thanks!

[NTSAM]

If I may add a quick, very necessary tip:

Always examine your patients, and corpses. There's an easier way to check if someone's unrevivable: Their body will say "... their soul has departed," if there's no way in hell they'll be coming back in that body (respawnability off, posessing a ghost role or midround, w/e). You also get flavor text like "They have severe bruising!/burns!" if they have 50+ brute or burn and text like "They are bleeding!" or "They have severe cellular damage!", useful in triage situations.

[rwn]

very useful, wish i'd seen this sooner! i had already written up some medical shortnotes but this will help me fill it out better. good work!

[Mitchs98]

While I admire the fact that there's more medical players out there willing to learn and even write guides for other people, quite a bit of the information in this guide is a bit inaccurate or just untrue. I'll summarize my points VIA bullet, overall it's a decent guide for a brief touch on medical knowledge however.

• Strange Reagent is, in-fact, the only way to revive Slimes and Vox outside of debraining and putting them in a humanoid monkey body. It's also useful to use on other races that have only been dead for around 5~ minutes, which is 3 minutes past the defib timer of 2 minutes. There's absolutely no reason to not simply tell newbies how to use it rather than dissuading them from using it altogether. It is a VERY important chemical they NEED to learn to use as it is quite literally the main way to revive two races in the game.
• Revival timer for defib is, presently 2 minutes, not 5. 
• There's actually five failed defib messages you can get. 1. Failed to pick up any electrical activity; this means their heart is no longer present in their body. 2. Failed to revive; patient's brain is unresponsive. This means they ghosted or left the game. Always hit them with a defib 2-3 more times just in-case to be sure, also ensuring you examine them to make sure soul isn't departed to make sure you aren't just wasting your time.
• Cloning is very much a last resort in most situations. The only real time it's acceptable to consider it otherwise are rare circumstances; 1. They have absolutely 0 blood. 2. They have MASSIVE Brute/Burn/Toxins(500+). 3. Medbay is utterly swamped and saving them would result in other patients dying or their conditions worsening beyond repair. If you don't know HOW to fix someone that's in need of more intensive care that's a different story, it's a far different tune to just be too lazy/not want to do your job because cloning can do it for you instead. "Let them die and clone them." doctors need to end.
• Your entire section on surgery is just plain wrong, and really only acceptable if your reason for not doing surgery is due to roleplay purposes I.E being a nurse. Surgery is not at all time consuming once you learn it, and it is VERY much a necessary part of medbay. You shouldn't refuse to do surgery, especially life saving surgery, just because you don't like to do it. Don't sign up for medical if you don't want to treat people fully when needed. Yes, ideally, there should be doctors around that know the surgery and are willing to do it but that's far from always the case. Someone working triage is all well and good but if shit HAS hit the fan ALL of medical should be able to be all hands on deck and do what's needed to keep the crew going, that includes surgery! Anyone and their mother can put patches on people or inject them with saline, it's genuinely not that hard of a skill to learn and master. But at the end of the day that won't matter one bit if your patient is suffering from bones stabbing into all their organs while they internally bleed out everywhere. "Someone else will handle it, it'll be fine." is the exact wrong message newbie doctors need to be sent, period.
• I really can't stress this point enough, anyone reading this guide should flat out ignore the 'guide' on surgery. If you're just starting out and trying to learn it's acceptable to not do it at first because you're trying to learn. Not because someone else will do your job, yes your job all doctors regardless of title should generally know surgery when needed, for you, or that you dislike it. While, yes, it does make the fair point of there's no sense in trying to do everything yourself if you're still learning you should still make a genuine effort to try and learn how to do it. Especially if you're playing a medical cyborg who is 9/10 expected and needed to aid in surgery.

[Varlun]

22 minutes ago, Mitchs98 said:

-Snip-

I'm quite certain I've defibbed people that have been dead past 2 minutes. I usually examine corpses first to check the time of death. So I'm not willing to give up on that statistic yet.

I disagree with you on cloning. It's not a last resort. If this were a more roleplay heavy server, then sure, you might have a case. And this server used to be that way. But it isn't anymore. From a purely mechanical standpoint- especially when the cloner has been upgraded- cloning is simply a much easier and FASTER solution to people that are badly damaged.

I never said "Let them die and clone them." and I've never done that myself. Regardless of how bad they are, if they're alive, I try to keep them that way. But if they're severely busted up and they croak, I'll go ahead and drag them to the cloner instead of fighting the fight because I know they'd end up in surgery for at least several minutes, when it only takes about a minute to clone.

It's just biomass. There's always plenty. And the cloning process is handled by machine, no labor required, whereas surgery obviously requires a surgeon.

The surgery thing is mostly my personal preference, and my recommendation is what it is partially because it'll make it easier for people to get into medical. A lot of people are intimidated by surgery. Your message is exactly the opposite of what my guide is intended to send.

[Mitchs98]

2 minutes ago, Varlun said:

I'm quite certain I've defibbed people that have been dead past 2 minutes. I usually examine corpses first to check the time of death. So I'm not willing to give up on that statistic yet.

I disagree with you on cloning. It's not a last resort. If this were a more roleplay heavy server, then sure, you might have a case. And this server used to be that way. But it isn't anymore. From a purely mechanical standpoint- especially when the cloner has been upgraded- cloning is simply a much easier and FASTER solution to people that are badly damaged.

I never said "Let them die and clone them." and I've never done that myself. Regardless of how bad they are, if they're alive, I try to keep them that way. But if they're severely busted up and they croak, I'll go ahead and drag them to the cloner instead of fighting the fight because I know they'd end up in surgery for at least several minutes, when it only takes about a minute to clone.

It's just biomass. There's always plenty. And the cloning process is handled by machine, no labor required, whereas surgery obviously requires a surgeon.

The surgery thing is mostly my personal preference, and my recommendation is what it is partially because it'll make it easier for people to get into medical. A lot of people are intimidated by surgery. Your message is exactly the opposite of what my guide is intended to send.

Once again, I'll use bullet points to address your responses.

• #define DEFIB_TIME_LIMIT 120 <-- Defib timers are only 2 minutes. Code doesn't lie. There IS a PR to bump it back up to 5 minutes, but presently it is in-fact only 2 minutes and has been for several months now back when Newcrit was first introduced.

• Roleplay has absolutely nothing to do with me having a case or not nor the point I was making. I was speaking on a whole, player experiences included. Easier and faster doesn't inherently mean it should be used, especially when you're signing up for a role to treat people not jam them into a machine that ANYONE can do. And them dying mid-treatment is far from and excuse to just give up and slam them into the cloner unless medbay is truly swamped with treating other people. Cloning takes much longer than a minute, especially unupgraded. And who cares if they're in surgery for a few minutes? Quite a few people don't LIKE being cloned. A lot of people that think doctors that do just resort to cloning are in-fact bad, lazy, and just tend to not care. And no, there isn't always plenty of biomass. There have been plenty of rounds I've been in first hand that we either run out or none is just ever made ever.

• Your guide on surgery is sending the message of newbie doctors avoiding it altogether, because why bother? Someone else will just come along and do it for me, why would I do it or try to learn? Yes, surgery can be intimidating. That's no reason to discourage people from learning it at any point. And again, if that is your personal preference, defer to my statement of not being in medical. At-least for the times it is very much needed to save crew when other surgeons aren't around or knowledgeable enough to do it.

[Lalchi]

just gonna point out the surgery part of @Mitchs98 wich i completly agree with

No matter the heal you do, if your patient just wake up with all his ribs reaping out his lungs and heart, you actually did, well, nothing. He's gonna die, flat out, the next 2 minutes.

Now for the newcomer who want to learn surgery but stressed by the pressure the medbay sometimes demands, you have otherway to learn surgery.

Roboticist : the pressure is pretty rare over there, and when it does ask you to learn robotics, you can start your first baby step on surgery too. Debrain, implants, cybernetic repairs or attachement. It's a great way to learn the basic tools of surgery ESPECIALLY on debrain surgery. Why ? Cause the guy you debrain gonna die anyway, so mistakes are not important.

Coroner : When it doesn't really ask for surgery (just autopsy with tools that does everything for you), you still can practice surgery on the corpse. They're dead, so who cares if you mess up ? Practice by taking organs out, medbay can use those organs too, so that's great. If a body has severe broken bones or other inside injuries, try to heal them. Yes, even if they're dead, that's the point. Mistakes are not important on dead corpse.

 

Spoiler

And then, the ultimate god way of learning :

Create your private server and fuck around.

 

[Greey]

3 minutes ago, Mitchs98 said:

• ending the message of newbie doctors avoiding it altogether, because why bother? Someone else will just come along and do it for me, why would I do it or try to learn? Yes, surgery can be intimidating. That's no reason to discourage people from learning it at any point. And again, if that is your personal preference, defer to my statement of not being in medical. At-least for the times it is very much needed to save crew when other surgeons aren't around or knowledgeable enough to do it.

I get two simple implants almost every single round, and finding myself being in medbay for twenty to thirty minutes for a breathing tube implant and a medical hud implant is just disgusting. More people should learn BASIC surgery. I completely agree with this point not only for serious cases but this as well.

 

[Pyxis]

On 2/28/2020 at 12:47 PM, Greey said:

I get two simple implants almost every single round, and finding myself being in medbay for twenty to thirty minutes for a breathing tube implant and a medical hud implant is just disgusting. More people should learn BASIC surgery. I completely agree with this point not only for serious cases but this as well.

 

On that note, for me, if I am not sure about where to put the implant or just want to confirm, I always ask the person IC-ly or even LOOC. This makes the surgery a lot shorter and easier for both side.

I have also seen people that wishing to be implanted told the surgeon specifically where to implant so there are less confusion (eg. I want the medical hud implant in my eyes).

On the other hand, if people do have some rare implants, please do reach out to the doctor to make sure they know what to do, or even just list out the steps/teach them. I still remember my first(and only) time doing the cybernetic heart transplant, I think I killed the patient couple times before I was able res her with SR. At least that person was really nice about it.

[rwn]

1 hour ago, Pyxis said:

On that note, for me, if I am not sure about where to put the implant or just want to confirm, I always ask the person IC-ly or even LOOC. This makes the surgery a lot shorter and easier for both side.

I have also seen people that wishing to be implanted told the surgeon specifically where to implant so there are less confusion (eg. I want the medical hud implant in my eyes).

On the other hand, if people do have some rare implants, please do reach out to the doctor to make sure they know what to do, or even just list out the steps/teach them. I still remember my first(and only) time doing the cybernetic heart transplant, I think I killed the patient couple times before I was able res her with SR. At least that person was really nice about it.

with you on this one; i tried to learn surgery recently and am getting faster at it! but there are some things i still need practice with (implants especially) - i think any steps you can take to communicate the steps would be great, especially if you're like me and willing to do surgery that you've never done before!