TGMC:Guide to medicine
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TGMC is a project based on the CM-SS13 codebase.
This guide assumes that you are a medical role, if you are not a medical role you will have to contend with certain fumble checks in advanced medical care so please keep that in mind.
Medical care is, quite literally, the difference between life and death and you should absolutely know what you're doing before attempting to render aid - you could make things worse. If you're going to treat someone, you're going to have to know what tools you need, how to identify injuries, what machinery and facilities you must use, and how to keep people from dying while in treatment.
You're going to want the proper equipment to diagnose an injury before anything else, so be sure to grab a medical 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.
Types of basic damage
Humans can be injured in a multitude of ways, from the immediately obvious to the more subtle.
- Brute is the most common type of damage you'll most likely come across and is a catch-all term for physical trauma: Cutting, slashing, bashing, battering, gunshots, and so on. It is also the damage type to most likely have additional complications associated with it, such as organ damage, broken bones, internal bleeding, and so on. Severe brute damage is immediately obvious, even to those without a scanner, as significant brute trauma will cause blood to soak through the patient's clothes, noticeable with a shift-click to examine.
- Burn will be the second most common type of damage you'll encounter and refers to the injuries acquired from fire, acid, and ambient temperature extremes (such as the cold from Ice Planet). Burns usually do not have other complications associated with them, nor cause bleeding but are not as obvious to the casual observer.
- Toxin damage is a less commonly encountered damage type and you're less liable to come across it. Toxin damage can be caused by organ failure, overdoses, chemical side-effects, and, rarely, deliberate poisoning. Toxin damage has no visible external tells but someone with large amounts of build-up will be vomiting.
- Suffocation damage is more common than toxin damage but almost just as invisible. Suffocation is caused by oxygen deprivation, blood loss, and certain types of organ damage. Someone suffering from suffocation will be gasping, noticeable in the chat window.
- Halloss damage is not really a damage type but I would be remiss to not at least mention it. Halloss is shorthand for hallucination damage, that is, the damage that is not physically present and you can treat it as something akin to fatigue. It's most common source is from a Queen screech and alien tackles. You cannot treat halloss, but its recovery can be expedited by standing still and the "Hold!" order.
Types of advanced damage
If you looked at the above section and thought to yourself "That doesn't seem so bad", then I have some disappointing news for you as there is an additional layer of complications to manage. These types of damage are the results of complications from the above sources and they are as follows:
- Pain is caused by near every damage type and for this reason, you should carry painkillers at all times. Pain severity reflects the type and severity of the injury sustained, with burns causing the most pain of any of the damage types. Pain can also be accrued from halloss and the effects of MP equipment (batons, tear gas and so on). Pain causes slowdown, stuttered speech, knock-down and even unconsciousness.
- External bleeding is caused by brute damage and randomly occurred when it is received, but is more likely to happen with severe damage as a matter of statistical probability. Bleeding will cause slowdown and blood loss - resulting in a fast build-up of suffocation damage, and then toxin damage if left untreated.
- Fractures are a direct result of brute damage and have a chance of happening when the damage to a body part exceeds a certain amount. For the extremities (arms, hands, legs and feet) this is 25 damage. For the chest, head and groin it is 50. Fractures have varying effects depending on where they are found but all cause large amounts of pain and they will worsen if left untreated and the patient allowed to move.
- Internal bleeding is caused randomly when brute damage is received but most often is caused by armour-piercing attacks. Internal bleeding cannot be patched like external bleeds can and will slowly cause untreatable brute damage in the affected area - followed by blood loss and even death.
- Infections are caused by failing to properly follow surgical procedure and untreated brute and burn injuries, though not all injuries will become infected. Infections will cause a slow-build-up of toxin damage if left untreated but the true horror of an infection is if it is allowed to go necrotic - dealing massive damage to the affected body part and will quickly result in death if not treated.
- Organ damage can be caused by a number of things - brute trauma, chemicals, overdoses, toxin damage and fractures in the affected bodypart. Most non-vital organs when damaged cause a moderate build-up of toxin damage when they themselves are damaged, but the heart and lungs will deal oxygen instead. The brain does not cause damage but it will cause the patient to drop things and they will simply drop-dead permanently if it is damaged too much. A severely damaged brain or heart will prevent any kind of revival, short of admin intervention.
- Eye damage is still technically organ damage, but it does not cause any kind of damage build-up, nor is it a vital organ like the brain. Instead, when the eyes are damaged, they will cause blindness and pain. Eye damage is gained rarely by brute trauma to the head and more commonely by welding without protection.
- Dismemberment is something that anyone can diagnose as the patient is missing a limb. Suffice to say, the loss of a limb is extremely traumatic, causing heavy bleeding, significant pain and an inability to use that particular limb anymore.
- Shrapnel and foreign objects is anything that has become embedded in the patient - causing a build-up of brute damage if the patient moves without the affected area being splinted.
- Alien infestation is the result of getting too friendly with a facehugger. If left untreated, the patient will birth a healthy, bouncing baby larva who will one day grow up to do the same thing to you and your friends. A scanner will register it as a "foreign object", much like shrapnel.
Now that you know the signs and the effects of various damage, it is time for you to learn how to treat them.
For a more in-depth treatment of surgery see the TGMC:Guide_to_Surgery
- Brute - Brute can be treated directly with salve and trauma kits, and chemically with bicardine and tricordazine. As well as surgically through the autodoc's Surgical Brute treatment.
- Burn - Burn can be treated directly with salve and burn kits, and chemically with kelotane, dermaline and tricordazine. As well as surgically through the autodoc's Surgical Burn treatment.
- Toxin - Toxin can be treated with dylovene and tricordazine, as well as with the autodoc's Toxin Chelation treatment.
- Suffocation - Can be treated with CPR (clicking on a fellow, unconscious Human with a free hand on help intent) but more practically with dexalin and dexalin+. Dexalin+ works instantly but can only be found roundstart as an autoinjector.
- Pain - Pain can be treated with paracetamol (mild relief), tramadol (strong relief) and oxycodone (relieves all pain).
- Fractures - Splints will prevent the worsening of fractures and help manage the ill-effects of a broken bone. To treat, surgery must be performed - either manually or via the autodoc's Broken Bone Surgery treatment.
- External bleeding - Can be treated with bandages or trauma kits.
- Internal bleeding - Can be halted with quick-clot, but it will not heal the bleeding. Normally requires surgery or the autodoc's Internal Bleeding treatment to fix, however, a bicardine overdose will also heal internal bleeding. Make sure to give the patient anything that treats burns before doing so.
- Organ damage - Peridaxon will prevent organs from getting worse on their own and halt the negative effects of organ damage, but it will not treat the actual damage. It must be actually treated through either surgery, or the autodoc's Surgical Organ treatment.
- Eye damage - Can be treated chemically with imidazoline or surgically. To treat with the autodoc, select the Eye Surgery treatment.
- Dismemberment - Requires a limb replacement, either an organic or robotic one. Must undergo surgery or the autodoc's Limb Replacement treatment. Please note that the autodoc can only replace a missing limb with a mechanical one.
- Shrapnel and foreign objects - If externally embedded, simply right-click the patient and select the "Yank out object" verb. If internally embedded, you will have to perform surgery - Use the body scanner to isolate the shrapnel's location and reduce the time spent on exploratory surgery. The autodoc's Foreign Body Removal Surgery treatment will locate and remove any foreign bodies present.
- Alien infestation - Stasis bags and poor health will slow the larva's gestation and a cryopod will halt it all together. It must be removed with surgery to save the patient, the autodoc's Foreign Body Removal Surgery will also remove alien embryos.
For a full breakdown, see the Guide to Defibrillation
People are going to die, that's a simple fact. 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 the mortal coil and with a defibrillator, 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.
- They must not have basic damage (brute/burn/tox/oxy) of any type greater than 200.
- They must have a functioning working heart and brain.
- They must not be suiciding.
- They must have an actual player associated with their mob (no reviving the long-dead colonist bodies).
- They must not be wearing an exosuit (such as marine armour) that would interfere with the resuscitation.
Please remember, that you can use trauma and burn kits on dead bodies to help repair the damage done and make them valid for reviving. The defibrillator also heals some damage (of all basic types) itself, the greater the medical skill the more powerful the defibriliator's healing ability is. These values are as follows:
- Staff Officer or Squad Leader: 4 per shock
- Medics: 8 per shock
- Doctors: 12 per shock
- CMO or Synth: 16 per shock
In a hectic situation, you're going to need to be able to discern who needs treatment immediately as a snap judgement and focus on who needs your help more. The first rule of performing your duty of care is to not panic. Take a deep breath and try to remember this rule of thumb as to who needs you more:
- The recently dead
- Xeno hosts
- Those in critical condition
- Immobile patients
- Everyone else
The recently dead are on a hard timer and the longer you leave them, the more likely that timer will have expired and making them permanently dead, no matter what everyone else's problem is - they're unlikely to be in as much need as they do. You can identify the recently dead by the lightning bolt symbol that your health HUD assigns them. Xeno hosts can afford to wait but they're on a timer as well and if it expires - their deaths are just as permanent. In a triage situation, stabilisation matters first, once people are out of the danger zone - you can focus on the underlying causes. Don't be afraid to conscript marines as nurses to tend to the wounded if you absolutely need a hand.