TGMC:Guide to Medicine

This page is a part of the TGMC wiki. TGMC is a project based on the CM-SS13 codebase.

This page is currently under construction! The following page is currently in the process of being created, is undergoing a major structural rework and/or is being moved. The reason for this is: "This page is severely outdated, being updated overtime."

Also see Hypospray guide!

This guide assumes that you are a medical role, such as a Medical Officer or Corpsman. If you are not a medical role, you will have to contend with certain fumble checks in advanced medical care, taking more time and in some cases cause a chance of failure (and damage to your patient.).

Trauma care is vital for the long term success of any Marine Operation. In a role expected to provide medical care to marines, it's important for you to understand as much about the medical system as possible, to provide expedient and efficient care to your patients. With aid of this guide, you should be able to work your way through almost any problem you will encounter, presuming you have enough time to provide treatment.

Using this guide

For new players, or those unfamiliar with medication, triage and how to identify trauma, the intention of this guide is to allow quick access to information, and presented in a way that hopefully allows new players to identify trauma in game quickly. If you have a symptom or condition you don't know how to treat or if it is dangerous, use 'Find on Page' (Ctrl + F on PCs) and search for keywords or symptoms you see until you get the advice you need. Also be aware that the ingame Mentor Help (F1) can also put you in contact with knowledgeable players!

Identification

You're going to want the proper equipment to diagnose an injury before anything else, so be sure to grab a HealthMate HUD and wear it so you can actually identify who needs your help, and grab a health analyzer to see what is exactly wrong with them. Diagnosis is the first and foremost step in administering treatment.

Your HealthMate HUD Will make it easier to identified wounded Marines through a display on their sprite.

• At full Health, a marine will have a Green bar above them. As they take damage, it will slowly turn Yellow, then Orange, then Red, and finally a Blinking Red when they are in danger of dying.

Examining (Shift + Left Click) a Marine is a quick way to judge a person's state at a distance. Not only will you notice missing limbs, but a person with bleeding wounds will have blood flowing through their clothing.
Your handy Health Scanner is your primary means of diagnosing injuries and conditions requiring your aid. Use directly on a Marine to scan their health. Without Medical Skills this process will take a few seconds.

• Be sure not to just check Basic Damage, but also for Organ Damage, Fractures, Internal Bleeding, Blood Level and any chemical contents before deciding upon forms of treatment.

Body Scanners, found in Medical Bay and Medical Facilities on the surface, are the strongest of all Medical Scanners. They give perfect detail on all issues with a patient, if you know how to read it.

• The most recent scans from the body scanner can be recalled if you're wearing a HealthMate HUD and Examine (Shift + Left Click) a person, just note the time of the scan!

Failure to identify not only what injuries a marine has, but also what chemicals are already in their system, could result in ineffective care, risk an overdose, or even Death.

Types of basic damage

The most common damage inflicted upon marines, and easiest to treat.

A Health Scanner will show Brute Burn Toxin Suffocation and Cloneloss values.

Brute

• Brute damage represents physical trauma.
  • The most common damage you will encounter: Slashes, Being Shot, Explosions, and being hit with objects are the most common causes of Brute damage.
  • Will induce pain relative to the amount of damage present.
  • Brute damage will always be linked to a specific limb or organ. Some treatment methods will require you to directly target that body part to heal.
  • Will cause Bleeding if the damage is substantial enough.
  • In case of severe or critical brute damage to a single limb, fractured bones are highly likely.
  • When applying Gauze, or Advanced Trauma Kits, the medical wheel will show brute damage on a limb as red cuts and gashes.
    • Gauze and Advanced Trauma Kits will both stop bleeding from wounds, but Trauma Kits will heal the wound and cause it to start healing.
    • Bicardine, Meralyne, Tricordrazine, Doctor's Delight, Neuraline and Russian Red will treat brute damage across the entire body, however some of these (Doctor's Delight, Neuraline, and Russian Red) have substantial side effects.
    • Surgical Sutures can be used during Surgery to directly heal brute damage on the targeted limb. Repeat the step until all damage is repaired on that limb.
    • The Autodoc procedure Surgical Brute Treatment repairs all (external) brute on all limbs at once.
    • Cryotubes found in the ship's Medbay (with Cryomix Beaker inserted) will quickly heal Brute damage while the tube is active.

Burn

• Burn damage represents thermal damage to tissue.
  • Less common than Brute, but still the second most common damage type. Primary sources of Burn damage include fire, acid, lasers and extreme weather, such as the Sand Storms of Big Red.
  • Burns produce higher relative pain per damage than any other damage type (20% more pain compared to an equal amount of Brute damage.)
  • Burn damage will always be linked to a specific limb. Some treatment methods will require you to directly target that body part to heal.
  • Burns do not have any obvious symptoms, and can't be easily identified through examinations.
  • When applying Ointment or Advanced Burn Kits, the medical wheel will show burn damage on a limb as yellow burns or boils.
    • Ointment and Advanced Burn Kits can directly treat burn damage on the targeted limb, but Burn Kits will heal more, and cause the wound to start healing.
    • Kelotane, Dermaline, Tricordrazine, Doctor's Delight, Neuraline and Russian Red will treat brute damage across the entire body.
    • Surgical Sutures can be used during Surgery to directly heal burn damage on the targeted limb. Repeat the step until all damage is repaired on that limb.
    • The Autodoc procedure Surgical Burn Treatment repairs all (external) burns on all limbs at once.
    • Cryotubes found in the ship's Medbay (with Cryomix Beaker inserted) will quickly heal Burn damage while the tube is active.

Toxin

• Toxin damage represents chemical damage to the body.
  • Primary sources of Toxin damage include exposure to Neurological agents, Medicinal side effects and overdoses, or a damaged Liver.
  • Toxin damage is less painful than Brute or Burn damage (25% less painful as an equal amount of brute damage).
  • Toxin damage affects the entire body at once, and is not restricted to a single limb, all treatment methods treat all toxins as a whole.
  • Toxin damage has no obvious symptoms on examination, though Vomiting is often a symptom of high level of Toxin damage or its causes.
    • Dylovene, Hyrolane, Arithrazine, Tricordrazine, Doctor's Delight and Russian Red will treat toxin damage across the entire body.
    • The Autodoc procedure Toxin Damage Chelation treatment clears all Toxin damage.
    • Cryotubes found in the ship's Medbay (with Cryomix Beaker inserted) will quickly heal Toxin damage while the tube is active.

Suffocation

• Suffocation damage, sometimes referred to as 'Oxyloss' represents de-oxygenation or lack of oxygen in the target's body.
  • Suffocation is almost always a symptom of a bigger problem and not simply a lack of breathable air in the area.
  • Sources of suffocation damage include, but not limited to: Blood loss, Extreme Stamina Depletion, Shock or Critical Condition.
  • Suffocation is less painful than Brute and Burn damage (25% less painful than an equal amount of Brute damage.)
  • Suffocation damage affects the entire body at once, and is not restricted to a single limb, all treatment methods treat all suffocation as a whole.
  • In most cases, simply treating the suffocation with medicine will not prevent further suffocation, but treating the source of the suffocation will allow the body restore oxygenation on it's own.
  • Gasping for air is one possible sign of Suffocation in a person.
    • Primarily treated by fixing the conditions that cause suffocation. (Low Blood, Neurotoxin present in body.)
    • Dexalin, Dexalin Plus and other Medications will treat Suffocation damage across the entire body.
    • CPR can be done on unconscious patients to breathe for them, lowering their Suffocation damage.
    • Cryotubes found in the ship's Medbay (with Cryomix Beaker inserted) will quickly heal Suffocation damage while the tube is active.

Cloneloss

• Cloneloss also known as Cellular Damage or Genetic Damage, is instability at the genetic level.
  • Caused by using several strong Medications. Currently, Russian Red, Neuraline, and being Cocooned will cause Cloneloss.
  • Cloneloss damage affects the entire body at once, and is not restricted to a single limb, all treatment methods treat all Cloneloss as a whole.
  • Causes pain equal to it's amount.
  • Itchy Skin/Body is a possible symptom of Cloneloss Damage.
    • Cryotubes loaded with Cryoxadone and Clonexadone are the main treatment for cellular damage.
    • Sleeping on a bed will slowly treat cellular damage, twice as fast if sheets are also present, but this is incredibly risky and time consuming.

Types of advanced damage

For a more in-depth treatment of surgery to heal advanced damage, see the Guide to Surgery

In addition to the above 5 types of damage:

Pain

• Pain is caused by nearly every other form of damage and injury a person can receive.
  • Untreated wounds are more painful than those that are stabilized or cared for.
  • Of the 4 common types of damage, Burns are the most painful, with Suffocation and Toxin being the least painful.
  • Causes Stuttering, decreased vision and slowing of movement, increasingly debilitating as pain level rises.
  • Extreme levels will cause collapse and stun, with maximum pain threshold causing blackouts and fainting.
  • Painkillers will offset pain, but will not reduce the severity of wounds. Once painkillers are metabolized, if wounds persist so will the pain.
    • Stabilize broken limbs or those with shrapnel in them, and treat injuries to reduce felt pain.
    • Paracetamol and Synaptizine will numb mild pain
    • Tramadol will numb strong pain
    • Oxycodone will numb severe pain.

Fractures and Broken Bones

• Fractures and Broken Bones are a direct result of extreme amounts of Brute damage to a single limb.
  • Above a specific threshold (25 for Arms, Legs, Hands and feet, 50 for Head, Chest and Groin), each additional attack or effect that causes brute damage may fracture the limb.
  • If not stabilized, Fractures and Breaks cause extreme amounts of pain, and attempting to move can cause additional damage.
  • Hands and Arms will cause patients to drop items, Legs and Feet will cause extreme slowness in movement and tripping if not stabilized.
  • Head, Chest and Groin can cause additional Brute damage and internal injuries if not stabilized.
  • Dragging a person with such injuries is not advised, splint all fractures and breaks before moving, or use a roller bed to move them.
    • Splints will stabilize the limb, reducing pain and preventing further injury and side effects. Splints can fall off if limb is further damaged.
    • Bone Repair Surgery will repair fractured bones in the limb. Bones can rebreak if Brute damage is not healed first, so treat it first!
    • The Autodoc procedure Broken Bone Surgery will repair all fractures in the body.
    • Cryotubes also repair broken bones over time, provided brute damage is still present on the limb when healing it.

External Bleeding

• External Bleeding is caused by Brute damage and can randomly happen to a limb with each attack.
  • If a person is bleeding, they will leave blood drops on the floor, and deplete their body's reserve of blood over time.
  • If left untreated, bleeding can potentially become infected, as well as lead to low blood.
    • Gauze and Advanced Trauma kits will stop bleeding on the targeted limb
    • Bicaridine and other brute treatment methods will also stop external bleeding when the brute damage to the limb is completely healed.

Internal bleeding

• Internal bleeding is caused randomly when Brute damage to a limb exceeds the fracture threshold, as well as from attacks with armor penetration (most ballistic weapons.)
  • Internal Bleeding can be identified on a Medical Scanner as an Internal Bleeding notice at the bottom of the UI.
  • Internal Bleeding can lead to low blood, causing suffocation as blood drops below specific thresholds.
  • Internal Bleed will progressively get more severe if left untreated, increasing the rate of blood loss over time.
    • QuickClot will prevent this bleeding from getting worse, and pause bleeding while the medication is in the system.
    • QuickClot Plus treats Internal Bleeding quickly, though this causes extreme pain and Toxin buildup.
    • Surgery will instantly heal all Internal Bleeding per limb completed on, but is far slower than other methods.
    • The Autodoc procedure Internal Bleeding Surgery repairs all Internal Bleeding across all limbs.
    • Cryotubes (with Cryomix Beaker inserted) will heal Internal Bleeding while the tube is active.

Blood compatibility table

Recipient	Donor
	O−	O+	A−	A+	B−	B+	AB−	AB+
O−
O+
A−
A+
B−
B+
AB−
AB+

Low blood

• Low blood is a condition caused by untreated bleeding or adverse effects of certain medicines and chemicals.
  • Low blood directly causes Suffocation and eventually Toxin damage and loss of consciousness as it get worse.
  • A standard human has 560u of blood in their system.
  • Below 501u (90%), suffocation damage will regularly occur (up to 20) and the patient will feel woozy.
  • Below 336 (60%) more severe suffocation damage will regularly (up to 40), eyesight will become blurry, patient may faint at irregular intervals.
  • Below 224u (40%) suffocation and toxin damage will regularly continue until death or treatment.
  • Below 122u (~21%), results in immediate death. Revival via Defibrillation is impossible until raised above this value.
    • Blood Transfusion with an IV and appropriate Blood Bag Type(See table to right) for quickest replenishment.
    • Isotonic Injectors, containing Saline-Glucose slowly help restore blood levels.
    • Eating Food will restore nutrition, allowing slow replenishment of Blood Levels. Slower than Saline-Glucose, but stacks.
    • NanoBlood will instantly restore blood level to 40% if it is initially lower, and then restore more blood depending upon if the patient has more or less than 60% of their normal value.
  • Above 600 units, excess blood will flow out of the body, but this process does not deal damage. Quickclot will prevent this bleeding while in the system, but all excess blood will leak once it runs out.

Infections

• Infections are bacterial buildups in the body.
  • Caused by untreated brute and burn injuries, as well as improper (dirty) surgery.
  • Health Scanners will identify presence of Infections, and an increase in body temperature can also be used to predict a developing infection before it becomes a problem.
  • Will identify every limb or organ with an infection as well as the severity of the infection.
  • Left untreated, Infections will cause Toxin damage in the body overtime, and ultimately can lead to Necrosis if not treated.
    • Spaceacillian is the primary method for treating infections, and will quickly cure any less severe Infections
    • Gauze and Trauma Kits on external bleeding and ointment or Burn Kits will patch and salve them, preventing them from getting infected, or the infection getting worse.
    • Polyhexanide can be administered to fight severe (but not Necrotic) infections, though this will cause additional toxin damage and likely put the the patient to sleep.
    • Surgery, in proper sterile conditions, will purge an infection on cauterization.
    • The Autodoc procedure Limb Disinfection Procedure for limbs and Organ Infection Treatment for organs will respectively purge the appropriate limbs of infection.

Necrosis

• Necrosis is the final stage of Infection
  • Health Scanners and Body Scanners will both identify limbs with necrotizing tissue.
  • Usually caused by improper surgery, such as not using proper PPE or a dirty environment and gear.
  • Other Infections caused by untreated bleeding or burns can also develop into Necrosis is left untreated too long.
  • Overuse of Vali gear can cause Necrosis in limbs. If you see this, laugh in their face before fixing it!
  • Necrosis will deal more Toxin damage than lesser infections, and will attempt to spread to other limbs until the patient is either dead or the Necrosis is treated.
    • Necrosis Treatment Surgery is the primary method for fixing necrotizing tissue on the targeted limb.
    • The Autodoc procedure Necrosis Removal Surgery will remove and treat all necrotic tissue on the patients body.

Organ damage

• Organ damage is a perforated or injured organ.
  • Can be caused by any condition that causes Internal Bleeding, such as unstabilized broken bones, or armor piercing attacks.
  • Detectable by Health Scanner, revealing damage to each organ.
  • Causes continual damage or side effects relative to the damage the organ sustained.
  • Heart and Lungs can both be identified by damage to stamina, as well as Suffocation damage.
    • Heart damage will lower maximum health and stamina.
    • Lung damage will decrease your stamina regen and add a slowdown.
    • Eye damage will decrease your vision, making it blurry and eventually blinding you.
  • Liver and Kidneys can be identified by Toxin damage continually building up despite no obvious source.
    • Kidney health affects the amount of chems that a body can process at any given time. A healthy liver can process 5 at once, decreasing with health.
    • When processing a number of chems above a bodies chemical threshold, patients will experience dizziness, confusion.
  • Stasis Bags will prevent organ damage from killing marines inside of them.
    • Peridaxon Plus will repair organs, but will metabolize into large amounts of Toxin damage.
      • Warning: Peridaxon Plus has a 1u OD limit. Never administer more than 1u at a time, and always administer with a Toxin treating medicine
    • Organ Surgery can performed to treat all organs at once.
    • The Autodoc procedure Surgical Organ Damage Treatment will treat all organ damage and brain damage at once.
    • Cryotubes (with Cryomix Beaker inserted) will heal Organ damage while the tube is active.

Dismemberment

• Dismemberment is the complete removal of a limb.
  • Caused by extreme brute damage to a specific extremity (Hand, Arm, Foot, Leg or Head)
  • Is Extremely painful, and can result in additional bleeding or infections if not treated promptly.
  • Dismembered arms can not be used to hold items, and missing feet or legs slow a victim considerably.
  • Dismemberment of the Head, also called Decapitation, is instantly fatal, can not be treated or reversed.
  • Wearing a Helmet or other appropriately armored headgear will prevent decapatations.
  • Organic limbs decompose and become lifeless after dismemberment, preventing their reattachment.
    • Surgically prepare the stump before applying the appropriate prosthetic limb (Robotic Arm to missing arm or hand, Robotic Leg to missing leg or foot. Be sure to check for LEFT or RIGHT)
    • The Autodoc procedure Limb Replacement Surgery will automatically replace all missing limbs with the appropriate robotic counterpart.

Shrapnel and foreign objects

• Shrapnel and foreign objects are any object embedded inside the flesh that can not be pulled out.
  • Bullets are the most common form of shrapnel, an unfriendly result of friendly fire.
  • Detectable by Health Scanners, Shrapnel shows up as an Implant in the affected limb.
  • Shrapnel will continue to cause pain and potentially cause additional brute damage (and all side effects that brute damage can cause) to the limb if not stabilized or removed.
    • Splinting a limb with shrapnel in it will prevent further damage and discomfort as long as the splint remains in place.
    • Use Medical Tweezers on the limb to remove one piece of shrapnel. Multiple pieces will require multiple attempts.
      • Tweezers inflict Brute damage based on (lack of) Medical Skill. Untrained personnel are likely to cause Broken Bones, trained personnel considerably less so.
    • Shrapnel removal surgery to remove one piece of shrapnel per use of a Hemostat. Does not require sawing through bone.
    • The Autodoc procedure Foreign Body Removal Surgery to remove all pieces of shrapnel at once.

Alien Larva

• Alien Larva or Pregnancy Infestation is the result of a Larval Hugger impregnating a Marine.
  • Larva or Embryos can be detected with Health Scanners, saying "Foreign object detected".
  • A victim has 5 minutes to seek medical attention to have the parasite removed.
  • The embryo will go through 5 stages of growth while in the body, causing shaking of the victim with each growth phase, as well as other symptoms the host may detect.
  • Larval Accelerant Toxin will double the rate of growth in a victim.
  • If the Larva reaches the final stage of growth without being removed, it will emerge from the victim's chest, instantly killing the host and producing a Xeno Larva.
    • Stasis bags and poor health will slow the larva's gestation and a Cryotube will halt it all together.
    • Surgically remove from chest after opening rib cage. Will result in one Larva Embryo that can be grinded into Larval Jelly for advanced chemical production.
    • The Autodoc procedure Foreign Body Removal Surgery will remove and destroy the embryo.

Overdose

• Overdose is what happens what a patient is given (or self administers) too much of a particular kind of medicine or chemical.
  • Overdose thresholds vary depending by chemical, though most common ones have a 30u threshold.
  • Increased damage or debilitating effects will occur if Critical Threshold is surpassed.
  • See the Guide to Chemistry for a full list of thresholds an effects
  • Always scan before administering medication to avoid Overdosing a patient.
    • Hypervene will remove 5u of every chemical per 1u injected or ingested. Apply until Overdose stops.

Death

For a full breakdown, see the Guide to Defibrillation

People die when they are killed. However, there's a difference between being dead and being dead. And the former is one you can treat. The recently departed still yet cling to this mortal coil, and with a Defibrillator and some elbow grease Incredibly High Electrical Current you can pull their soul back into the land of the living (assuming they wish to), however, there are a number of stipulations to reviving someone:

• They must have not been dead for longer than 5 minutes. Performing CPR will extend this timer, and putting the corpse in a Stasis Bag will slow down the timer.
  • If the dead is a Synth, the can be revived at any point after their death no matter how long it's been.
• They must not have basic damage (brute/burn/tox/oxy/cloneloss) of any type greater than 200.
• They must have a functioning heart and brain.
• They must not have committed suicide.
• They must have an actual player associated with their mob (no reviving the long-dead colonist bodies).
• They must not be wearing an Suit (Such as any armor) that would interfere with the resuscitation.

Please remember that you can use trauma and burn kits on dead bodies to help repair the damage and make them valid for reviving. The defibrillator also heals some damage (Of all basic types besides Cloneloss) itself, the greater the medical skill the more powerful the defibrillator healing ability is. These values are as follows:

• Squad Leader: 4 per shock
• Squad Medic, Staff Officer, Field Commander: 8 per shock
• Captain: 12 per shock
• Doctor or Synth: 16 per shock