Medbay changes: Under Needle and Knife

[Shaps-cloud]

Foreword
Hi friends, truth be told I wasn't planning on chipping in with any ideas on how medical could be changed since I enjoy the current status of medical, but since there seems to be a fervor growing saying that some changes should happen, I grew anxious about the changes that people were suggesting. I feel, in my own probably overinflated opinion, that most people miss the concepts that make playing medical personnel on /tg/ fun, and a little bit of grounding in reality is needed to protect gameplay from overenthusiastic and well meaning, but ultimately detrimental changes.

First and foremost, when discussing how medbay should change, there's a sentiment that medical procedures should be kept inside medbay Rather than restricting medicine to doctors, and those doctors to medbay, I say we should encourage crew members to be able to patch up any with first aid, and let doctors seek out patients to take care of the rest outside of medbay WITH FIELD SURGERY. And from there, anything that isn't really threatening per say but still presents a hindrance, like losing a limb or getting severe brain trauma can still be relegated to operating theaters with nice shiny facilities and a full array sterilized implements.

Doctors would be provided with Emergency Trauma materials in their medbelts that they now spawn with rather than having to grab one from a locker. For now these kits would be fairly sparse, just one suture kit and one spray bottle of disinfectant, but there are many possibilities that can be expanded upon as new options get added.


What I'd be willing to implement
One of the first additions for the system would be expanding on bleeding. Currently, the system is pretty shallow: If you have a certain amount of brute damage on a single limb, you start bleeding. The amount of blood you lose increases the more damage you have on that limb, and if you heal yourself below that threshold, the bleeding stops immediately. You can use gauze to halt the bleeding temporarily, but honestly you may as well just treat the brute damage itself first.

I propose that bleeding be tied to medical conditions that are applied when large amounts of brute damage are taken in one limb as before, but instead of instantly stopping the flow when the brute damage is healed, the flow only begins to slow once it falls below the threshold. Smaller wounds and cuts would be able to be handled by simply applying bandages which would still be available in public medkits (which would now temporarily staunch the flow of blood, helping the cut close itself rather than simply stopping the bloodflow completely for a few minutes) until the wound is fully healed, while receiving several chops to the chest with a fire axe would require extensive sutures to clear.

Similarly, I propose that severe burns that accumulate on one limb too much gain an infection status condition. This would (slowly!) progress once gained based on how bad the burns are, and at more advanced levels would begin dealing toxin damage and even risk limb loss if a serious wound was left alone for something like upwards of 5-10 minutes. First aid treatment would involve splashing water on it and applying bandages to halt the infection, or pouring potent alcohol on it to provide minor relief depending on how potent the alcohol is. Doctors would have disinfectant spray or rubbing alcohol that would quickly be able to treat the infections or fucked up skin, and only if the issue is repeatedly ignored for a long time would it need full on surgery to treat.

I'd be down to start implementing these if this got enough support, although I'm unsure how that would interact with the feature freeze starting next week with relation to it starting right before then. These ideas are fairly modular and don't require ripping up large parts of how medical works in order to implement, which has the benefit of being fairly quick to learn and make use of effectively.


Going forward
The common theme here is that sustaining too much of one damage type leads to status conditions which can be treated in a few different ways. Light to medium statuses can be handled by ghetto means or means commonly available in medkits (here, bandages and water/alcohol), more middling severity can be handled by doctors with specialized gear outside of medbay (providing suturing or sterilization outside of medbay), while letting the status condition fester too long without treatment requires more heavy intervention to cure (blood transfusion and necrotic flesh removal surgery). This could be expanded on for a number of different statuses, ideally even adding some basic forms of field surgery to the job by providing field surgery kits with implements like a field scalpel, bone setter, flesh grafter, medical tarpuline to act as a makeshift table, and whatever else people think of down the line. Letting doctors do simple 3 step surgeries in the field with these tools to pull shrapnel or other embedded objects out of people would be an interesting extension of this philosophy that someone could add in later if they so desired. Allowing doctors to leave medbay to find their patients and provide treatment in the field would allow said doctors to do their jobs in the field on the spot where the violence is happening (treating someone who was slashed up by an axe on the spot with sutures first rather then just dragging them to medbay) would add a new level of engagement for them since they're encouraged to get right into the thick of things rather than sit in medbay and wait for patients to come or be dragged to them.

Of course, spare trauma kit supplies could be found in medbay, and if someone outside of medbay desired and no one stopped them, they could take a set for themselves and be just as effective as a doctor at treating wounds out in the field if they so desired, but I don't really consider this a flaw. Just the same way that people will first look to engineers to hack open doors since they spawn with the needed tools, people will first look to doctors to get these simple treatments since it's much easier than going out of their way to break into medbay and treat themselves, then carry around that gear for the rest of the round.


Thoughts? Ideas?

I had sawrge edit it and shorten it without actually checking to see what he changed so hopefully this all still makes sense (ignore anything about any person with Q in their name, that was sawrge)

[captain sawrge]

You have no purpose my boo

[Shaps-cloud]

You have no purpose my boo

I am never letting you proof my copy ever again

[Luke Cox]

I'm definitely in favor of field medics and emergency field surgery, which I honestly should have thought of when I considered organ failure. At one point I even considered suggesting a separate surgeon job, but I wanted to keep my suggestion relatively simple and limit it to existing systems. Infections sound cool too, but we need to be careful to avoid adding too many layers of complexity. The reason I want an organ-based injury system is because it adds a level of severity to injuries (you die without a heart, you slowly die without lungs, etc) using an already present and grossly underutilized organ system. What I want to see implemented without question is the bleeding system that you lay out. I would actually go a step further and add a completely new type of damage called "laceration damage" or something of the sort.

Now that I think about it, both this and my organ failure idea could have pretty fucking sweet interactions if both were implemented simultaneously. What if organ failure was brought on from severe infections being left untreated? I imagine that surgery would also cause a fair bit of bleeding. What if someone needs emergency surgery to deal with heart failure but is bleeding all over the place? You'd have to treat their bleeding and pump them full of either corazone or more blood than they're bleeding out before you could operate.

Basically, add this and organ failure and I'll probably play CMO more than HoS.

[pubby]

By suture, do you mean adding item(s) to use alongside bandages?

Infections sound pretty neat. I think you're on the right track with them. Just please push the end result in the direction of limbs falling off and other comical handicaps rather than making people get dizzy and crit like bloodloss.

One low-hanging fruit regarding burn is to split it into three tiers: 1st degree, 2nd degree, and 3rd degree burns. Most damage would be 1st degree, but if you rack up a ton it converts into 2nd and then 3rd degree burns. The higher degrees would be harder to heal (i.e. ointment only works on 1st degree and kelotane on 1st and 2nd).

[D&B]

Why not separate damage into types?

Cutting, Bashing, and so on

[cedarbridge]

I'm all for any system that encourages people to patch in the field and heal in medbay. Yes, the inability to heal perfectly will "hurt antags but I think its worth it to make antags either play smart or accept that going loud might just not pan out as a one-man murderspree.

[cedarbridge]

Why not separate damage into types?

Cutting, Bashing, and so on

If we diverge too much we risk overcomplicating the system. Especially early into a re-design/revamp.

[BeeSting12]

I agree with this a lot more than making the current injuries harder to heal. Brain traumas were a step in the right direction- instead of making brain damage a number that has an effect on machines you can use, make it various effects that can be detrimental or beneficial. It makes the whole medical system feel much cooler and in depth.

Making more varied medical supplies needed to heal certain types of injuries is a good idea as well. Currently, a box in your backpack can heal 90% of all injuries you will ever receive. Nobody wants to carry around a ton of sutures/ointments/disinfectant spray/whatever to heal themselves, so I think this would be a nice way to make doctors important without making them absolutely necessary.

The most important thing to keep in mind here is to make a ghetto treatment for all mild to mid level injuries, and a ghetto treatment for the high level ones which are horrible ideas but might just work.

[Luke Cox]

I'm all for any system that encourages people to patch in the field and heal in medbay. Yes, the inability to heal perfectly will "hurt antags but I think its worth it to make antags either play smart or accept that going loud might just not pan out as a one-man murderspree.

The opposite is probably true imo. It'll make things a lot harder for their victims. Even if someone manages to escape them, there's no guarantee that they'll be able to heal in time.

[cedarbridge]

I'm all for any system that encourages people to patch in the field and heal in medbay. Yes, the inability to heal perfectly will "hurt antags but I think its worth it to make antags either play smart or accept that going loud might just not pan out as a one-man murderspree.

The opposite is probably true imo. It'll make things a lot harder for their victims. Even if someone manages to escape them, there's no guarantee that they'll be able to heal in time.

Combat is pretty binary already. This is especially true in the case of the casual murderhobo. They'll attack somebody and either 1) victim escapes 2) victim calls for help but dies anyway because the hobo finishes them off 3) super robust victim disarm spams to save themself

Injuries factor more into the antag because the victim usually falls into case 2 where they just up and die. Medical factors into case 1 where the victim gets away but suffered some wounding in the process or a midpoint between 1 and 2 where they call for help and sax long enough for help to arrive and chase off the guy before they're killed. If and when sec does find the hobo or some hero wounds them and chases them off, said antag under the proposed system would have more limited options. He can't risk going to a populated medbay because he's badly wounded (the point of going to medbay in the first place) and the "put a bandaid on the sucking chest wound" heal system doesn't exist anymore. So, the victim gets hauled off my a samaritain/paramedic and the hobo suffers while trying to sneak some sort of medical supplies or mug a miner (while wounded) for a healy pen.

[Luke Cox]

Uplink healing items maybe? Syndicate autosurgeons could be a thing

[cedarbridge]

Uplink healing items maybe? Syndicate autosurgeons could be a thing

Might make nukeops medical implants more popular too.

[kevinz000]

listen to the cmo main

[Luke Cox]

listen to the cmo main

[Qbopper]

anybody who plays medical could have told you even just by looking at the coding feedback thread's title that the proposed sleeper changes were a shortsighted bandaid fix - the ideas here sound like they could actually be coded within a decade, unlike the massive system wide reworks proposed in the past, and they don't make me want to change my medical preferences to off the moment I read them

the idea of being able to give yourself some minor healing but requiring a proper medic to get you fixed up sounds great - field surgeries are an excellent middle ground between "click on them with a brute pack to heal their chest after someone mauls them with a fire axe" and "drag them back to medical and perform a 30 step surgery if someone steps on glass with no shoes". the notion of setting up a triage center in some spare room next to a fight or disaster sounds really fucking fun

OP has my full support because this sounds like the medical system I want to see

in short,

listen to the cmo main

[captain sawrge]

Hey Asshole

[Qbopper]

hi what's up

[paradox97]

I play CMO a fair amount so I want to weigh in. I really like the idea of doctors being active outside of medbay and people coming to medbay for more complex procedures. At the risk of complicating a system I think infections being cured by antibiotics of some sort would also be another cool option. Particularly, and I do not have a specific system in mind, I would like to see antibiotic synthesis done by the virologist. Often I find my virologist just makes a mediocre virus, I help distribute it, and then the viro sits around and does nothing for the rest of the round. I haven't played CMO much since sentient viruses were added, so perhaps this is a non-issue now.

[Bluespace]

medbay changes
patients can be infected with GUILT strains
[youtube]f5mQntEYIFo[/youtube]

[cedarbridge]

medbay changes
patients can be infected with GUILT strains
[youtube]f5mQntEYIFo[/youtube]

Only if the CMO gets magic pentagram powers.

[Bluespace]

medbay changes
patients can be infected with GUILT strains
[youtube]f5mQntEYIFo[/youtube]

Only if the CMO gets magic pentagram powers.

it's called the healing touch and it is /art/

[XDTM]

FYI i'm coding massive changes to diseases so that might help

[Umber_Neno]

This all sounds really fun to play. Having an emergency response med kit and an actual use for ghetto surgery other than cargo nicked the surgery table sounds like it would make medic even more fun!

[Bombadil]

Legion cores would still bypass this whole system right? Because fuck having to go back to the station after you get stunned once by a goliath and pounded a bit

[cedarbridge]

Legion cores would still bypass this whole system right? Because fuck having to go back to the station after you get stunned once by a goliath and pounded a bit

Cores are snowflakey enough to basically bypass most medical things.

[SpaceInaba]

this makes me want to play medbay you've done the impossible shaps