Guide to Medical

=A Guide to Medical=

So you want to be a doctor? Well there's a few things you should know about working in the medical department first!

This guide will cover everything regarding basic medical procedures, for surgery or cloning see the Guide to Surgery or Guide to Genetics

Tools of the Trade

There's a plethora of equipment available to any aspiring doctor, most of which can be found in the NanoMed dispenser.

• - A pair of latex gloves, lowers infection chances when performing surgery and handling patients.
• - A sterile mask, lowers infection chances when performing surgery and provides mild protection against airborne viruses. Will also prevent you from throwing up from hanging around dead bodies.
• - A medical belt, it can store almost any small medical item such as trauma kits, syringes, or beakers.
• - A standard issue medical HUD. This will allow you to immediately infer how injured someone is.
• - An advanced trauma kit, used for any form of physical injury, both preventing infection, and closing non-surgical wounds. Heals 12 brute damage topically per application, though only works once per damaged limb, unless more wounds form.
• - A burn kit that can double as a trauma kit in a pinch, specialized for burns. This will prevent infection in, but not seal, wounds. Heals 12 burn damage topically per application, though like the trauma kit works only once per wounded limb.
• - The bread and butter of the medbay, gives detailed information on injuries. It's suggested you also get the upgrade at the NanoMed.
• - A syringe, or sharp. Can take blood samples, or be filled with reagents and used manually or fired by a syringe gun.
• - A roller bed, used for moving patients with broken bones to prevent further injury to internal organs.
• - A set of medical splints, can be used on broken limbs to prevent further injury.
• File:Stasisbag.png - A stasis bag, it will immediately stabilize any person as long as they're in the bag. Can also be ID-locked.
• - A defibrillator, used for reviving recently deceased patients.
• File:Crewmonitor.png - A handheld version of the crew monitor computer, lets you see everyone's suit sensors on the fly.
• File:IVdrip.png - Used for giving or taking blood. Can also be used to inject chemicals, or as a portable coffee-machine.

A Breakdown of Basic Chemicals

Whilst working in the medbay there is a wide variety of chemicals you might encounter.

While this doesn't cover nearly all the chemicals, it's a good primer on chems you'll frequently encounter and need.

• Charcoal - Charcoal slowly purges all other reagents from the victim patient, and also heals toxin damage.
• Salbutamol - Salbutamol slowly fixes oxygen damage, and will temporarily halt oxyloss.
• Salicylic Acid - Salicylic Acid slowly heals brute injuries, but only if the patient has less than 50 brute damage.
• Styptic Powder - Styptic Powder will heal any brute injuries. While toxic if ingested, it's not when in patch form, or from the sleeper. Depletes rapidly, but heals both on contact application and depletion.
• Silver Sulfidiazine - Silver Sulfidiazine will heal any burn injuries. While toxic if ingested, it's not when in patch form. Functions like Styptic Powder, but for burns.
• Synthflesh - Synthflesh can be used to treat both brute and burn injuries. It only works when in patch form or when sprayed on.
• Epinephrine - Present in all autoinjectors. It will rapidly reduce oxygen damage down to a cap, make them ready to take their next breath if able, and will gradually repair other injuries in critical patients. Excellent for initial emergency care.
• Ephedrine - As a stimulant, will help critical patients with getting up.
• Ether - Ether will eventually knock a person out - typically only effective in doses above 30u.
• Morphine - Morphine will allow a patient to temporarily ignore pain, but can also induce unconsciousness.
• Mannitol - Mannitol is used for brain damage, most often for the recently cloned.
• Mutadone - Mutadone will cure almost all genetic defects, as well as powers. Effective even in trace amounts.
• File:Beakercryox.png Cryoxadone - Cryoxadone is used in cryotubes, and heals toxin, oxygen, brute, burn and cloning damage.
• File:Perfluopill.png Perfluorodecalin - Perfluorodecalin will rapidly heal oxygen damage and oxyloss, but will also temporarily mute the patient.
• File:Penteticpill.png Pentetic Acid - Pentetic Acid rapidly purges all chemicals, and quickly heals toxins damage while dealing minor brute and burn damage.
• File:Mitocholidepill.png Mitocholide - Mitocholide heals damage to internal organs, and can even fix ruptured lungs. Heals 1 point on all organs per 1 u ingested, over time.
• Oculine - Repairs eye damage, unless retinal detachment is present or it's genetic.
• File:Strangepill.png Strange Reagent - Will immediately bring the person back to life. Gibs bodies that have more than 150 damage if ingested.

Damage Types and Basic Treatments File:Advkit.png

Most damage will fall under four major categories: Suffocation, Toxin, Brute, and Burn. These will show up on the Health Analyzer and in low amounts are very easily treated. There are also treatment kits for each of these categories located within medical storage.

Suffocation Damage

This shows up as a BLUE number on the Health Analyzer and Crew Monitoring Console

Suffocation results from being in areas with low oxygen, low blood count, or from the patient being in a critcal state.

• If damage comes from being in a low-oxygen environment, internals or being in an oxygen safe place will slowly heal the patient.
• Salbutamol or Perfluorodecalin will heal the damage. Perfluorodecalin is much more effective but will temporarily mute the patient.
• Epinephrine will slow progress of suffocation damage in critcal patients.
• CPR will also slow progress of suffocation in critical patients. (On help intent, click on the patient with nothing in your hands to administer CPR).

Toxin Damage

This shows up as a GREEN number on the Health Analyzer and Crew Monitoring Console

Toxin damage sometimes causes vomiting. Getting a blood sample of the patient with a syringe and using a Mass Spectrometer will reveal what toxins are located in the patient's blood. Radiation will also cause Toxin damage.

• Administer Charcoal.
• Monitor the patient's vitals for any changes. Some poisons are tricky and stay in the system for a long period of time.
• In extreme cases, put patient into cryosleep. Less effective than charcoal, but only way to treat critical patients.

Brute Damage File:Brutekit.png

This shows up as a RED number on the Health Analyzer and Crew Monitoring Console

Brute damage is caused by anything that can beat up a person, cut them, or fill them full of lead. It is often paired with broken bones and internal bleeding.

• Locate the injuries using a Health Analyzer.
  
• Apply Gauze or a Trauma Kit.
  
• More extreme injuries, or brute damage located in multiple areas, will require the administration of Styptic Powder. Always bandage locations that show up as bleeding to prevent blood loss.
• Robotic limbs damage cannot be treated by the standard equipment located in Medbay. Those patients should be sent to the Roboticist for repairs.
• Brute damage that does not heal with standard treatment methods is likely internal bleeding. Ensure they see a surgeon IMMEDIATELY to have it mended. If surgery is busy, while they wait, make sure they take saline-glucose and iron pills, and keep them inside a cryo tube to slow the worsening of the injury.

Burn Damage File:Firekit.png

This shows up as a ORANGE number on the Health Analyzer and Crew Monitoring Console

Burn damage can result from fire, electrocution, energy weapons, or exposure to extreme cold.

• Locate the injuries using a Health Analyzer.
  
• Apply Ointment.
  
• More extreme injuries, or burns to multiple places of the body will require either Silver Sulfadiazine or Synthflesh medication.
  
• Synthflesh is the stronger medication and will also heal Brute damage.
• Robotic limbs damage cannot be treated by the standard equipment located in Medbay. Those patients should be sent to the Roboticist for repairs.

Unlisted Damage

Some damage does not show up in any category, but will show that the person is injured

Creatures in the Research and Development location can cause genetics damage when attacking people. Being a new clone can also come with genetics damage, or heavy experimentation with genetics can cause this as well. Fighting on the holodeck will result in holo-damage. Hallucinations brought on by drug use or genetic defects will cause unlisted damage as well.

• Attempt to confirm how injury was received.
• Genetics damage is easily healed with time spent in a cryo chamber.
• Holo-damage is cured by having the patient sleep it off.
• For hallucination damage, treat cause of damage, (a clean SE shot from a geneticist, or charcoal if it's a chemical), and then let patient sleep it off as you would with holo-damage. Sedating the patient for their own safety is highly suggested.

Triage

In situations where there are multiple critical patients being reported or flooding into medbay, use the Triage System. Wearing a Medical HUD will help you spot out which individuals are in the most desperate need of treatment first.

Color	Description	In-game definition	Real world treatment type	Suggested in-game treatment
Black	Patient is dead	Patient is dead	Remove to prevent infections	If the death is recent, use a defibrillator. If not, ignore until all live patients dealt with, then take to cloning.
Red	Patient is seriously injured and in danger of dying	Critical condition (vitals below 0) Lethal disease in late stages Heavy bacterial infections	Immediate treatment	Treat their condition as soon as possible. If unable to treat immediately (OR busy, no vaccine), put them to cryosleep. For diseases, inject Spaceacillin to stop progress. If you observe broken bones either through a scan or patient account, have the patient lie down immediately to halt further damage to internal organs.
Yellow	Patient is severely injured, but not in life danger	Vitals between 0 and 30 Potentially lethal disease in it's early stages Broken Limbs	Delayed treatment	Treat as soon as as all red triage patients are stabilized or put in cryo.
Green	Patient has light injuries	Vitals between 30 and 80	Minimal treatment	Ignore until the last of the yellow triage patients have been taken care of. You should remove people from the cryo cells before attending to these patients.
White	Patient is uninjured	Vitals between 80 and 100	There is no reason to treat them when you have a million more seriously wounded people	Ignore until all green triage patients have been taken care of.

Other Conditions, and Their Treatments

There are other conditions that don't fall into the situations above, but nonetheless require some form of intervention lest the patient die or suffer some other malignant effect.

Bacterial Infections

Causes:

• Untreated Open Wounds
• Failure to Maintain Hygiene during Surgery

Symptoms:

• Patient's temperature is higher than normal
• Patient is receiving toxins damage without any chemicals inside them (bad sign)
• Will show specific locations in a body scanner, though low infection levels won't show up

Left Untreated, Develops Into:

• Organ Damage/Failure
• Necrosis
• Death

Treatment Options:

• For external infections, have a surgeon open and seal the infected regions
• If the infected spots hit "Acute", follow this up with an injection of 10u of Spaceacillin, to head off any potential further infections
• If internal organs are infected, inject with large amounts of Spaceacillin. No, the supply in the medvends is not enough, and it's seldom practical to make the amount needed with the fungus scrapings found in maintenance. Your best bet in this case is either using an Oddysseus's sleeper that's scanned Spaceacillin, or having a medical cyborg on hand to inject ~100u+ Spaceacillin. Your patient will not be able to leave for a while.

Broken Bones

Causes:

• Brute damage is beyond a certain threshold on a limb

Symptoms:

• Patient is unable stand and/or hold items
• Patient reports moving bones inside a body part
• Health analyzer will point out specific broken limbs (arms, legs, not torso or head)
• Will show up in a body scan

Left Untreated, Develops Into:

• Organ Damage/Failure (In the upper/lower torso, head)
• Lack of Mobility/Ability

Treatment Options:

• For initial care, you can splint the patient's limbs to allow them to use them at somewhat reduced capacity.
• If none of the limbs are broken, but your scanner reports broken bones, HAVE THE PATIENT LIE DOWN. Failing to do so will cause the organs in the broken body part to be turned to meat soup as the bones swish around. Being buckled upright will not prevent this; Beds (and roller beds), and simply resting on the floor, will.
• If any of the core body parts are damaged, transport them to surgery on a roller bed.
• Before surgery, mend the damaged limbs as much as you are able to, so that the limbs don't simply reshatter once you fix them.

Organ Damage

Causes:

• Heavy Trauma
• Liver Failure in tandem with high Toxins damage
• Broken Bones

Symptoms:

• Lung damage: Gasping while otherwise healthy, suffocation in a breathable environment
• Heart damage: Patient suffers symptoms of blood loss while having a healthy amount of blood
• Brain damage: Presence will show on an advanced medical analyzer, will also have trouble using machines and may say ridiculous things
• Eye damage: Patient reports blurred/blinded eyesight
• Liver damage: Patient reports both dull and acute pains throughout their body
• All except brain: Patient reports pains in the containing body part
• Shows up on body scanner

Treatment Options:

• Treat the causes of the damaged organs first.
• If available, administer amounts of Mitocholide equal to the largest damage of all of the organs
• Otherwise, bring them down to surgery to have their organs fixed

The Medical Sleeper File:SleeperConsole.png

Sleepers are a useful addition to the medbay and perform a few important functions, though there are a few caveats.

• Sleepers by default can inject a person with up to 20u of Epinephrine, Salbutamol, Styptic Powder, and Ether.
• Sleepers are intended for mild to moderate injuries, and can't be used on anyone with more than 125 damage, though this can be enhanced though upgrades.
• However, Sleepers can still inject Epinephrine (and ONLY Epinephrine) to stabilize critical patients past this point, making them good for primary care.
• Sleepers, when upgraded can dispense a much wider array of healing chemicals, though be careful not to overdose on ones like Epinephrine and Omnizine.
• Sleepers are meant for mildly injured patients.
• Sleepers can perform dialysis.

Dialysis

Now what's this dialysis thing I keep yacking on about!? Well, it's simple really!

When someone has ingested or been shot up with a large amount of reagents, a sleeper can rapidly drain them of said reagents.

To perform Dialysis, you will need...

1. A sleeper.
2. A beaker, put it in the sleeper by clicking on it.
3. File:SleeperConsole.png Once your patient is in the sleeper, click the Sleeper Console and hit "Start Dialysis" in the menu.

The beaker will rapidly begin to fill with any reagent present in the patient's blood, along with a small amount of blood at a rate of 5u per cycle.

Notes on Dialysis

• You may need to empty the beaker out a few times to fully remove all reagents.
• About 1/5 of what you will remove will be the patient's blood.
• This is a quick and easy way to effortlessly remove highly toxic chemicals, or even recycle them if you're a traitor!

Defibrillation and YOU!

You've read the guide, you've spent time honing your skills, but your patient still died! What now!?

The Defibrillator is the answer to your prayers!

Defibrillators are a very useful item when used appropriately and correctly, and there are a few steps you should take prior to usage.

• Ensure the patient isn't wearing anything in their exosuit slot. If something is in the exosuit slot, remove it.
• Scan the patient to see what damage they have, and have the appropriate treatment ready.
• Ensure the patient doesn't have more than 200 Brute/Burn damage, if they do fix it prior to defibrillation.
• Ensure that you have the means to treat the patient immediately - this generally means cryotubes.

Defibrillators are also a time sensitive device, and if the person has been dead for more than three or four minutes they won't work!

Usage

• Pick up the defibrillator and put it in your backpack slot, or keep it in your hand.
• Make sure you're standing next to the patient, and the patient isn't being moved.
• Right-click the defibrillator, and hit "Toggle Paddles". If the defibrillator is in your hand, drop it on the ground.
• Make sure the paddles are in your active hand, and click them once. This will put them in both hands.
• Target the chest area of the patient on help intent, and click the patient.
• Defibrillation will now begin, and takes roughly five seconds.

Upon successful use of the Defibrillator you'll receive one of four messages.

Resuscitation successful. This means the patient is now alive.

Resuscitation failed. This means the patient is not presently in their body. They're either logged out, or ghosting.

Resuscitation failed - Severe tissue damage detected. This means the body is too damaged, but still reviveable. Use Synthflesh, Silver Sulf, and Styptic patches to bring the person under 200 total brute/burn damage and try again. Chemicals that only heal over time will not function on cadavers.

Resuscitation failed - Heart tissue damage beyond point of no return for defibrillation. This means you waited too long for defibrillation, send them away for cloning.

Notes About Defibrillation

• If the patient has numerous fractures (More than four), it may ultimately be faster to clone them.
• If a patient died from ruptured lungs, have another doctor apply Perfluodecalin while you're using the defibrillator.
• It's almost always a good idea to ensure the patient has Epinephrine in their system before defibbing, as this will make sure whatever they died of doesn't just kill them again, since patients will be critical once revived.
• If a patient died from heavy toxins, have another doctor apply Charcoal/Pentetic Acid while you're using the defibrillator.
• You can use a screwdriver on a defibrillator to take out the battery for recharging.

Cryogenics

Located directly next to the cloner, this part of medical takes in critically wounded patients and mends their injuries through the chemical mix you place inside. Keep in mind it only injects chemicals into patients with injuries, so you might need to get creative to make sure they get the full effect of the other chemicals.

Usage

Cryo usage is fairly simple, but also intensive on the patient. Reserve it for emergency patients.

1. Make sure your patient is not holding anything in their hands, and that they aren't wearing temperature-resistant equipment such as a hardsuit.
2. If your patient had to drop something like a hardsuit, store and lock it inside of the locker nearby so a random assistant who wandered into medical can't steal it and run off, never to be seen again.
3. Place the patient into the cell by either dragging their sprite onto the cryo cell, or grabbing them and clicking on the cell.
4. Turn the cell to "On", and activate auto-eject so they won't be left in there forever should you be in some way interrupted.
5. If there are wounds that aren't healing, use your health analyzer to check if the damaged areas are prosthetic or not. If they are, forward them to robotics, or someone else with a welder. If the limb that fails to heal is organic, however, have them go to surgery IMMEDIATELY, as they have internal bleeding and will die quickly without aid. If there isn't any room in surgery, give the patient lots of saline-glucose and iron, and keep them in cryo to prevent it from worsening until care can actually be administered.

Setup

At the start of each shift, the tubes start nearly completely set up, but needs some further work to get the whole system to go on a moment's notice. Do as follows:

1. File:Beakercryox.pngTake the beakers of cryoxadone on the table next to the tubes, and place 1 each inside.
2. Use the freezer to the southeast of the room and turn it on, setting it to the lowest temperature it will go.

Cryo Mixes

While pure cryoxadone will get the job done, you probably want to add a few more things to the medicine vat. For example, clones will normally come out with high amounts of brain damage, and so will need mannitol. By adding an amount of mannitol to the beaker, you can both repair their genetic damage at the same time you fix their brain.

Keep in mind that the way the cryo tube works, is that every 10 seconds or so it removes 1 unit from the beaker and injects all the chemicals into the patient, at a 10 times multiplier. Thus, if you want to extend the lifetime of a drug, applying it through cryo is a good way to get the full mileage, though cumbersome.

Example: Cryoxadone, decays at about .4 units per second. For a 100% cryoxadone mix, every 10 seconds, 1 unit will be depleted from the beaker, and 10 units will be injected. Over the 10 seconds, 10*.4 units will be processed by the occupant. Since the patient could only process 4 of the 10 units injected, 6 units will remain inside the patient's system. This will repeat until the patient is finished healing.

• Cryoxadone, is of course the primary ingredient. Keep it to 40%, and there will be a perfect balance of cryox processed and cryox injected.
• Mannitol will fix the brain damage of both clones and patients with head trauma. 40% is the most efficient you can get with it, but to be realistic you probably want about 20%
• Mutadone will cure all mutations, positive or negative, if any amount enters the patient's system. It can be handy to put it in the tubes so as to quickly get clones functional again, but will also frustrate geneticists and their beneficiaries. Something that will do the same trick is a pill bottle full of mutadone pills right next to the cryo tubes, so that you can selectively treat genetic disabilities. If in a mix, even as little as 1% will be more than enough.
• Mitocholide is a relatively harrowing drug to make, but will mend all internal organs at 1 per unit processed. As with cryoxadone, it decays at .4 units per second, so 40% is the highest efficiency you can get.

Racial Differences

Depending on the race of the patient in question, specific forms of treatment may prove to be ineffective or even adverse to the health of the patient. Here's a breakdown of all the do's and dont's when it comes to the various species you may encounter during a shift. As Humans, Unathi, Tajaran, Vulpkanin and Kidan are all the exact same in medical terms (and require no special knowledge for treatment) we'll be omitting them from this section of the guide.

Vox

• Breathe nitrogen, meaning they shouldn't be anesthetized.
• Take toxin damage when breathing oxygen.
• Have a cortical stack implant in the head, keeping them in a "relatively" sane state.
• Can't be cloned.
• While they can be brain-transplanted, the lack of a cortical stack in the new body makes them insane.
• Strange Reagent can turn them into psuedo-zombies.
• Surgery works normally on Vox.
• Never remove their mask, or nitrogen tank.
• As they can't be cloned or successfully brain-transplanted, Vox should always be top priority for treatment when critical or dead.

Slime People

• Have no blood, and bleed water.
• Have no pulse.
• Don't need to be anesthetized.
• Can't be cloned. To clone put their slime-core in a new body, and clone the new body.
• Can be brain-transplanted. Simply remove the slime-core and treat it like a brain.
• Don't take organ damage.
• Surgery works normally on Slime People.
• If their limbs become too damaged, they may require amputation and replacement.

Independent Positronic Chassis (IPC) File:IPCSmall.png

• Have no blood.
• Have no pulse.
• Extremely susceptible to EMPs.
• Can't be cloned.
• Can't be brain-transplanted.
• Basic damage can be repaired the same as robotic limbs.
• Surgery does not work normally on IPC's.
• Can't be defribbed.
• Should NEVER be morgued.
• Always bring their body over to robotics if destroyed.

Grey File:GreyMSmall.png

• Take damage from water.
• Suffer no injury from sulphuric acid.
• Surgery works normally on Greys.

Plasma(wo)men File:PlasmamanMSmall.png

• Have no blood.
• Have no pulse.
• Breathe plasma, meaning they shouldn't be anesthetized.
• Will suffocate when breathing oxygen.
• Will combust when exposed to non-plasma environments.
• Suit must be removed before defibrillating. Have a fire extinguisher handy.
• Can be cloned. Have their suit a fire extinguisher, and a defibrillator handy.
• Once they start cloning they'll quickly burn to death. Eject them from the cloner, extinguish the body and then apply a defibrillator. Stick them in a cryotube afterwards.
• Surgery works normally on Plasma(wo)men.
• Never remove their mask, or plasma tank.
• Never remove their suits while alive.

Facilities

What follows is a basic list of the facilities present in the medbay, and some links regarding their functions.

Surgery Room File:Surgery.png

The surgical area of Medbay is comprised of several smaller rooms. There's the two Operating Theatres for surgeries, and an observation area with some beds and chairs. See: Surgery for more details on preforming surgeries.

Chemistry File:Chem.png

The main housing station for the chemist. They are in charge of the making and passing out of chemicals to assist members of the station. See: Guide to Chemistry for more details.

Genetics

This is where the geneticist works on manipulating the human genome, torturing monkeys, and cloning a dead body or two during a shift. See: Guide to Genetics for more details.

Virology File:Centrifuge.png

Hopefully, a virologist will spend more time in here curing diseases rather then releasing them. See: Guide to Virology for more details.

Medical Storage

This area contains the majority of the tools you will need for curing patients, it's right by the front lobby. There's also an exam room that has a canes and other useful implements.

Patient Blood Room File:Medbed.png

This area is best used for non-critical patients awaiting treatment for blood loss, or patients needing to rest after treatment.

Morgue

This is where cadavers are stored. There is an autopsy table located here, as well as several morgue trays. See: Guide to Cadavers for details on dealing with dead bodies.