► Show Spoiler
- 1.1: The Medbay: An Introduction
- 1.2: The Ten Medbay Commandments (source: The Medbay Commandments by Surrealistik)
- 1.3: Initial Preparations: Tools of the Trade
- 1.4: My First: Surgery
- 1.5: My First: Chemistry
- 1.6: My First: Triage
- 1.7: My First: Autopsy
- 1.8: My First: Field Hospital
- 1.9: Advanced Procedures: Surgery
- 1.10: Advanced Procedures: Chemistry
- 1.11: Keeping Your Medbay Immaculate (and out of trouble with the law!)
1.1: The Medbay: An Introduction
Congratulations on being hired by the glorious USCM! As a doctor and surgeon, you'll be working hands on in the USS Almayer's very own medbay! Ah yes, the medbay. So fancy, so cutting edge (sorta), far from the frontlines and oh so sterile. The place where injured marines are nursed back to full fighting capacity, and a place where death itself is defied by battle hardened surgeons. As a USCM contracted doctor, you are expected to have a decent knowledge of medical procedures that range from bumps, bruises and broken bones to complete organ replacement. You'll find that the USCM has generously supplied you with a number of Wey - Yu Medical Dispensers, Blood Dispensers, an entire system designed for you to be able to mass produce medications and a huge variety of other things that range from medkits to personal loadouts for any situation you can think of.
* * * Remember your Hippocratic Oath, and be sure to keep yourself busy at all times. You're a doctor, not an MT. * * *
On the lower level you'll find:
- The Autodoc System: An extra helping hand used to treat marines who have many injuries while you tend to others that are awaiting treatment in the lobby.
- Chemistry: The location where the magic of medication making occurs! Comes fully stocked with a Wey - Yu Medical Dispenser, a SmartFridge for storing your medications, a ChemDispenser, a ChemMaster3000 and all the other materials you need to ensure your marines have a steady supply of medications to keep them in tip top fighting condition out on the battlefield.
- 4 Cryotubes: A system that utilizes cold temperatures and either Cryoxadone or Clonexadone (or a mix of both if that's more your style) to stabilize critical condition marines and reduce the overall damage to a more manageable level that you can repair with surgery. These are extremely helpful so be sure to utilize them often.
- Medical Storage: A stockroom that contains 2 Wey - Yu Medical Dispensers, 2 Blood Dispensers, a large variety of medkits and pill bottles and a generous number of M276 Medical Pattern Rigs and Lifesaver Bags.
- 4 Operational Theaters: Your primary workspace! This is where you'll save lives and build yourself a reputation for being a god among men in the medbay. Here you'll find an operating table, an IV drip, a surgical kit and a locker containing 5 sets of anesthetic tanks and medical masks. Also, you'll find a bioprinter which will allow you to print a variety of replacement limbs and organs!
- 5 Advanced Body Scanners: Used to diagnose internal injuries that marines may suffer from. Injuries can range from broken bones to organ damage to foreign objects - the scanner will tell you exactly what's wrong with a marine and give you a good idea of how to treat them. The advanced body scanner will give you the exact location of a broken bone, unlike the HF Health Analyzer which will only notify you if there is a broken bone present.
- A Medical Records Terminal: Used for taking notes on patients (RP aesthetic), whether it be tracking prescription uses (looking at you Nightingale.) or metal (in)stability. Also gives a DNA strand code that would match up with what the MP's Forensic Scanner would give them.
- A Crew Vitals Terminal: Can be used to keep track of the vitals of each (human) individual on the Almayer and on the planet / station. Gives the amount of brute / oxygen / toxin and burn damage each player has. Also gives the location of any Survivor on the Almayer / planet / station.
* * * Don't use this to monitor for living Survivors on the planet/station, it'll get you bwoinked by staff. * * *
On the upper level you'll find:
- The Armory: Where you'll find firearms and bulletproof vests for the medical staff to use, in case of emergency.
- The Breakroom: Stressed? Relax and unwind in the breakroom, complete with food and drink vendors!
- The Morgue and Autopsy: This is where you'll conduct autopsies on corpses found on the battlefield. Here you can determine the time of death, how the death occurred (type of damage) and a possible weapon used. You'll also find a number of morgue slabs which will be used to store corpses until it is necessary to creamate them using the incinerator.
- Research and Containment: Here you'll find the researchers, but what they do is outside the scope of this thread, so I won't touch too much on it.
1.2: The Ten Medbay Commandments:
Source: The Medbay Commandments
#1 Thou Shalt Restock Vendor Med - Supplies
* * * A majority of items found in the vendors can be restocked / refilled. To do this, simply click and drag the used item back into the dispenser from which it came (I.E. Autoinjectors from the MarineMed, medication bottles from the Wey - Yu Medical Dispensers and blood bags from the Blood Dispensers). Be warned though, some items can not be restocked / refilled (I.E. pill bottles from the MarineMeds). Restocking and refilling spent items will allow you to have more or less an infinite supply of x item. * * *
#2 Thou Shall Obey Thy Order of Triage
Although subject to different opinions, the standard order of triage priorities is as follows:
1) Defibbable bodies - as indicated by a lightning bolt when wearing the Health HUD. Defib these patients fast or lose them forever.
2) Larva infections - you won't have much to go by on this one without an advanced body scanner. The patient in this case knows best, and you make decisions based off what they say happened (larval infections have to be cleared first RP - wise, otherwise you run the risk of being called out for power gaming (knew about larval infections despite not seeing one firsthand or something like that). Work fast because once a larva bursts from the patient, the patient is immediately husked and cannot be revived.
3) Marines in critical or have just been revived - stabilize these patients ASAP, whether by administering pills, sticking them into a cryotube or performing surgery.
4) Organ damage - use an advanced body scanner to assess the levels of organ damage and treat accordingly. Administer Peridaxon / Inaprovaline / Dex+ and treat as necessary.
5) Fractures and limb replacements - stabilize fractures using splints until you can completely fix them with surgery. Print out limbs using the bioprinter to replace lost limbs (ideally, your medics or pilots will notify you via the medical channel what limbs are missing in advance).
6) Everything else - brute damage that doesn't involve a broken bone can be treated using Bicard or Tricordazine, burns can be treated using Kelotane and toxin damage can be treated using Dylovene.
Don't be afraid to abandon patients who are lower on the list for those who are much higher.
#3 Thou Shall Prepare Thy Person
You'll use a multitude of tools, but the absolute staple items are the ones that'll be found on your person at all times.
1) HF Health Analyzer - a condensed version of the advanced body scanner. This handheld device will fit into your pockets, satchel or medical pouches and will give you an overall display of a marine's health. Their overall health reported as a percentage, the types of damage sustained and how severe that damage is (damage over 200 is unsustainable and will prevent a defibrillation unless treated until the value is below 200), broken bones (note: the HF Health Analyzer will only tell you if there are broken bones present, it won't tell you specifically where the broken bones are - use the advanced body scanner to pinpoint these), internal bleeding and brain damage. Also, the HF will tell you the current amount of blood the marine has as well as their body temperature.
2) Health HUD - a device that is worn over the eyes and displays a visual health gauge. This will help you differentiate between who is in critical condition and who is not. It will also provide a visual of marines who are still able to be revived (lightning bolt) and those who are husked and cannot be revived (skull).
3) M276 Medical Pattern Rig or Lifesaver Bag - contains the basics in regards to medications. The M276 Medical Pattern Rig starts you off with some autoinjectors, ointment and a bandage and has a total carrying capacity of 14 while the Lifesaver Bag (my personal favorite) starts you off with a variety of pills, some autoinjectors, 2 ATK, 2 ABK and splints and has a carrying capacity of 21. It should be noted that you can put roller beds and defibrillators into the M276 Medical Pattern Rig while with the Lifesaver Bag you cannot.
Optional items that can be equipped:
► Show Spoiler
At the start of the round, take care of the smaller things if you aren't tasked with chemistry duty. This includes prepping all the IVs found in medbay with O- (negative) blood. Additionally, place an extra O- blood bag on the each of the tables in the OTs in the event a marine has lost a lot of blood and one blood bag isn't enough. This allows the operating surgeon to switch to a full bag without having to leave the OT. Also, be sure to place a bottle of space cleaner (for disinfection) and a bottle of antibiotics (to combat infections) on the table in each of the OTs as well.
The cryotubes should be stocked with Cryoxadone, Clonexadone or a mixture of the two. 4 beakers of Cryoxadone (30u in each beaker) spawn at the beginning of each round, and can last you an entire round if managed correctly. What's the difference between Cryoxadone and Clonexadone you might ask? Well the answer is this: Cryoxadone is a more simple version of Clonexadone that works slower than Clonexadone at a slightly higher temperature. In essence, Clonexadone is an improved version of Cryoxadone.
Some of the more experienced doctors might have a personal mixture that they use in the cryotubes - these mixtures often use a mixture of medications in addition to Cryoxadone / Clonexadone (I.E. Dr. Rock's Miracle Elixir). Feel free to experiment with different combinations, but be warned that CM staff are notified if a foreign substance is added to the cryotubes (I.E. adding something like Phoron).
Depending on who is currently on shift in the medbay, you might have access to medbots. These little guys can be constructed and used anywhere in - game. Often times you'll see them in the triage area of medbay or in the FOB itself. Each medbot can inject injured marines with a set volume (controlled by medical staff using their ID card) of Tricordazine. Very helpful when there's a rising number of injured awaiting treatment in the medbay, or to help those injured on the battlefield last a little longer on their trip back to the USS Almayer.
To construct the medbots, you'll need;
► Show Spoiler
Diagnosis is easy, and the procedure is more or less the same for every situation;
1) Listening to your patient - listening is the first thing you should do. Who else would be better at explaining what happened other than the person it happened to? Unless your patient is unconsciouss due to pain crit, they should be able to tell you what's wrong with them or at least give you some context to work with. Keeping an eye on the logs is useful as well. "x gasps for air!" is a dead giveaway of a ruptured lung, or other chest organ related injury (heart / lung damage). "x yells like an idiot!" may indicate severe brain damage. Vomiting indicates severe toxin damage, so on and so forth.
2) HF Health Analyzer - while not as specific as the advanced body scanner, the HF Health Analyzer can still tell you what's wrong with a patient overall. The HF Health Analyzer can detect the presence of broken bones, brain damage and internal bleeding. Additionally, the HF also gives the patient's health in the form of a percentage, and then breaks down the types of damage suffered (Brute, Burn, Oxygen and Toxin) and how severe the damage is (100 overall (in a single category, or spread among multiple) is the threshold before a patient usually dies and 200 is the threshold at which defibrillators will no longer revive a patient).
3) Advanced Body Scanner - this is what will give you your final diagnosis. The difference between the Advanced Body Scanner and the HF is that the ABS can pinpoint the location of foreign objects, broken bones, organ damage and internal bleeding. Make sure that after you place your patient inside of the ABS that you click the console to the right of it, otherwise the scan won't be finalized and you won't be able to bring up the scan by examining your patient while wearing the Health HUD. Additionally, if you're running triage, be sure to scan each patient in the ABS before dumping them in front of an OT. Nothing is more annoying to a surgeon who's got a long queue of marines to work on than a long queue of marines who haven't been scanned.
#6 Thou Shalt Be Efficient in Thy Surgery
Once you've scanned your patient in the advanced body scanner, you have two options to choose from - the Autodoc or manual surgery.
1) The Autodoc System - use the manual mode and select from the list of options the surgeries that are required. The autodoc can treat anything you can treat, with the exception of larval infections, these muse be done manually!. It does not necessarily matter what order you choose the procedures in, so long as you choose the correct ones. Additionally, the Autodoc system can replace limbs - just remember to stock it with fresh metal after every couple of limb replacement procedures. Feel free to use the Autodoc generously, but be warned that many times you'll find a growing line of marines with equally growing impatience waiting to be treated.
* * * DO NOT USE THE AUTODOC ON AUTO MODE. JUST DON'T. ANY DOCTOR OR CMO WORTH THEIR SALT WILL GUT A DOCTOR WHO USES THE AUTODOC ON AUTOMODE. * * *
Opinions on the auto feature of the Autodoc varies from doctor to doctor, but the general consensus is that auto mode is not as efficient as manually picking procedures, or even doing them manually. It's also been reported that sometimes the Autodoc will get "stuck" on a procedure when it comes to marines who have severe damage that accumulates faster than the medication the Autodoc uses can heal / stabilize - leading to a sort of limbo where the marine inside neither dies nor gets healed like he should.
2) Manual Surgery - the reason you're on the USS Almayer to begin with. After you've scanned a marine with the ABS, take them on over to an unoccupied OT. There should already be an anesthetic tank and a medical mask sitting on the operating table - if not, there's a locker in the upper corner closest to the hallway with additional anesthetic tanks and medical masks. Put the anesthetic tank and medical mask on your patient, set the internals and you're ready to go!
Occasionally, a new doctor won't know that surgeries can be compounded into one single procedure, taking longer to fully heal a marine than it should. Be sure to brush up on the different types of surgeries found here: Surgical Procedures.
An example of compounding surgeries;
► Show Spoiler
#7 Thou Shalt Be Efficient in Thy Defibbing
* * * New medics, this Commandment also includes you so pay attention - especially if you're new to the role. * * *
A defibbable patient is any marine that has just recently died. If you're wearing the Health HUD, you'll see a small thunder bolt icon rather than a skull icon. If they've just recently flatlined, give the body a scan using the HF and treat them with the appropriate medications (Bicaridine for brute damage, Dermaline for burns, etc). Additionally, Inaprovaline will help stabilize them (their health bar won't be blinking red) and administering some painkillers (Tramadol or Oxycodone work fine) will allow them to move on their own, given that they're able to in the first place. Split any broken bones and go ahead and apply the ATK or ABK to appropriate areas.
If you don't know how long a body has been dead, but they're still able to be revived, immediately defib them and then treat as explained above. The reasoning for this is because each time a flatlined marine is defibbed, his death timer resets (I'm not sure what the exact death timer is, but I believe it's about 5 minutes).
Additionally, redress your patient after you've defibbed and triage treated them - I.E. put their armor back on. Not absolutely necessary, but with the new timer to put on armor, it's more of a generosity than anything else.
Some notes about defibrillators;
► Show Spoiler
Some medications, and even coffee, have lethal overdose effects. Some notable medications include Hyperzine and QuickClot. Be especially careful when administering these medications as they may cause enough organ damage to cause a marine to become unrevivable. If you manage to catch these ODs early enough, it's possible to purge the drugs from their systems and / or replace the organs altogether if you're fast enough. Toxin damage cannot be fixed if the patient has flatlined already.
Additionally, some drugs create toxins and will kill your patient, Hyperzine and Peridaxon for example.
Study up on each chemical and drug, and their OD limits here: List of Drugs and their OD limits.
#9 Thou Shalt Be Prepared for Shitlers
This doesn't happen all too often, every once in awhile you'll get a gung - ho, impatient marine in your medbay. Ideally, you can and should call the MPs, however we don't always have an ideal round. In that type of situation, do not be afraid to fight back using tools available to you. Anesthetic autoinjectors will quickly subdue an unruly marine long enough for you to buckle him to a rollerbed and put him in isolation for the MPs to pick up. Hyposprays filled with a minute amount of Chloral Hydrate diluted with Soporific will knock a marine out in a pinch as well.
* * * Be sure to use only a small amount of Chloral Hydrate - 5u is the OD limit, anything higher will certainly kill anyone you spray. Not good. * * *
#10 Thou Shalt Not Take Up Chemistry if Thou Art Bad at It
It's pretty much as stated. The pre - deployment rush can get crazy, even if you're experienced. Sometimes medics don't speak at all and will come in with a request that's outside of the standard medic medications, catching you off guard (Medics, if you're reading this, please speak up if you want something outside of the usual Tricordazine, Dex+, Iron and Dermaline pills please
). Sometimes medics request more than they really need. Sometimes the MPs let them through the checkpoints as soon as they wake up from cryo for some reason. Don't cause the first deployment to be medic - less because you need additional time to prepare their medications - allow someone with more experience to handle the rush, and then feel free to practice chemistry after they're completely done.1.3: Initial Preparations: Tools of the Trade:
Source: Surgery and Tools
Here in the Medbay, you're given many tools and resources to make sure that the marine force is kept in tip top fighting conditions. This section is to help you familiarize yourself with the tools and key medications at your disposal. There are also commonly found equivalents to most of the tools, such as kitchen knives, lighters and wrenches, but these improvised tools have a high failure rate (25% or higher).
Surgery;
► Show Spoiler
► Show Spoiler
So now we get to the meat and bones of this role. Surgery. If you're successful, you've replenished the ranks of the USCM and extended a marine's time in the round. If you fail, however... you understand. At first, surgery may seem daunting and complex, but it really isn't. It's merely a matter of how well you can follow directions and how good you are at micromanagement under a timer. Once you've gotten comfortable with performing a surgery, then comes the task of doing enough surgeries that you've become able to diagnose a large number of problems without the help of an ABS. Baby steps is all it takes.
Once you've prepared your patient with the appropriate pre - surgery treatments (pills, cryotubing, etc), bring them to an open Operating Theater. You can do this quickly by buckling them into a roller bed instead of dragging a heavy marine body behind you. Inside the OT, put the anesthetic tank and medical mask on the marine, or let them do it themselves if they're able. Set their internals and place them on the operating table. By the time you've placed them onto the operating table, they should be unconscious due to the anesthesia - double check this by examining them, the logs should say "x is unresponsive and appears to be sleeping". - and you're ready to begin.
* * * It should be noted that anything that comes covered in blood increases the risk of infection / necrosis. Any lit cigars / cigarettes will also lead to infection / necrosis, so be sure to throw them in the trash before beginning surgery. * * *
A majority of the problems you deal with will often involve broken bones, and the procedure for this is relatively simple.
► Show Spoiler
► Show Spoiler
► Show Spoiler
Ah, Chemistry. The make or break for Medbay. Please refer to Commandment #10! Chemistry is one of the more intense start - of - the - round tasks to take on as there are many things to take into consideration. Often times, if you have to ask yourself a question about whether the marines will have access to x or be exposed to y, the answer is generally yes and your chemistry actions should reflect that. Grab your BlueSpace Beaker and hold onto your pants, because Chemistry is a pretty wild ride sometimes.
Why a BlueSpace Beaker you ask? Simple. There's only 1 BSB on the whole ship, unless the marines somehow manage to find one wherever they're deployed to (but that's rare, I've only ever seen it happen once since I've started playing). It holds 300 units as opposed to the 120 units held by a common large beaker, which is key in producing more complex medications / more medication. Don't let ANYONE remove this from your Medbay, even if it gets you killed (a joke, sorta).
Once the round has started, mosey on over to chemistry and start preparing your workspace - personally I take all the Pill Bottle Boxes and empty out all the Pill Bottles right next to the stool for sake of fluidity, but feel free to do whatever makes you feel faster.
Grind Phoron so that you have some ready in case you need to make medications that require it (not many, mainly Clonexadone and Oxycodone). There are multiple Phorons in the ingot that's sitting on the table (much akin to sheets of metal) - examine to see how many you have left! Don't grind your entire supply otherwise you'll find yourself asking Engineering if they can share theirs. Hold the Phoron in one hand and click it with your other empty hand to separate it out one by one.
Chemistry is a largely variable process, that depends on the one manning the Chemistry Lab. There are plenty of variations to medications in regards to dosages, whether it's due to habit of making x - dose or otherwise. Feel free to experiment with your own doses. Just remember that if you make anything considered a medic essential under 5u, you've made garbage and you should feel bad. I'm not being mean, I'm being truthful, 5u is only good for quick fixes that don't involve broken bones or organ damage.
For sake of simplicity, I will only go over the more common medications and their recipes. Baystation chemistry has many recipes, some available in CM and some not - look for the Advanced Procedures: Chemistry section for more details on Baystation chemistry recipes that aren't on the CM wiki.
Chemistry setup varies from doctor to doctor, some prefer throwing the pill boxes completely where as I prefer to take each bottle out individually and create one stack right next to the stool. Find what works best for you and allows you to be as proficient as possible. If you use up all the pill bottles that spawn in chemistry, a spare box spawns in the leftmost locker in the storage room.
* * * WHEN CREATING PILLS, BE SURE TO CHANGE THE APPEARANCE OF EACH MEDICATION AND LEAVE THE NAME AS IS. DO NOT CONFUSE YOUR MEDICAL TEAM AND MEDICS. * * *
Dexaline+: staple oxygen damage treatment. Dex+ is only a quick transport fix for a ruptured lung or heart damage - in other words, it won't stop oxygen damage from accumulating once it fully metabolizes. If your patient isn't going to make it to the Almayer within a reasonable amount of time, supplement the Dex+ pill with a Peridaxon pill which will give them an extended amount of time before accumulating significant oxygen damage.
► Show Spoiler
► Show Spoiler
► Show Spoiler
► Show Spoiler
Almost all rounds will end up going bottoms up, some faster than others. It's always handy to have a 6th sense for these sort of things so you're prepared, but if you don't, no worries! Here's what to do.
1) Any incoming injured marines should immediately be looked at. If no ABS is available, use your HF and work from there until an ABS opens up.
2) Scan your patient and make take note of any medications currently in their system - this is important. DO NOT OD MARINES BECAUSE YOU FAILED TO CHECK YOUR HF SCANNER. Administer any medications needed and splint any locations that may have an unsecured broken bone.
3) After you've scanned your patient using the ABS, bring them to the surgery hallway and place a holotag on them. Speak with your CMO to determine what each color indicates. Personally, I have ORANGE indicate non - life threatening injuries and broken bones. RED indicates more severe injuries such as internal bleeding, organ damage etc. BLACK is usually used to indicate a dead marine (more for marines who don't have the required training for HealthHUD use). Infected patients should be taken care of ASAP - if you have no tools available to perform surgery - place the infected marine into a Stasis Bag until an OT or a surgeon becomes available. Be sure you let them know that the bagged marine you're bringing them has a foreign body in the chest and not just some schmuck looking to cheese his way to treatment.
4) If staff numbers permits, stick around in the surgery hallway and try to maintain stable condition for marines waiting for surgery. If your staff numbers don't permit for you to stick around, be sure to do a treatment run after you drop off a new marine. Load up the Autodoc if it's not in use and direct marines out of the medbay to prevent it from becoming overcrowded and hard to work in.
CMOs DELEGATE TASKS WHEN THINGS START TO GET HECTIC! Each OT should be occupied by a surgeon at ALL TIMES (given staff numbers permit). Have a doctor or two running triage if possible, and another doctor making pills to supplement triage. Call all hands on deck, including Researchers - and if anyone refuses to show up, don't be afraid to threaten them with a call to the MPs for neglect of duty. Medics can help with triage, but if the operation is still in effect, they are not obliged to stick around your medbay - they have lives to save on the battlefield.
1.7: My First: Autopsy
Autopsies are at a weird place at the moment, not important but also not completely useless, so I won't cover it too much here - if you're really interested in the concepts of autopsies, it's probably better to figure it out in - game.
Autopsies are performed to determine the cause of death of an individual. Rather straightforward, but still involves a few steps.
A quick incision using a scalpel on the desired body part, and then a quick scan using the Autopsy Scanner. After you get the prompt saying that the scan is complete, print out the report sheet (right click > print report, or your Use hotkey) and it'll plop a sheet of paper on your hand with the following information:
1) The time of death.
2) The types of damage inflicted on the body part.
3) A list of possible weapons used - I.E. "A crowbar" for brute damage, etc.
Additionally, you can take a photo using a Camera and attach it to the data print out - you can't fax it with the photo, however.
Like I said, autopsies aren't anything too useful - more for an RP a e s t h e t i c than anything else really. It can help with "murders" but most "murders" that occur are bwoinked by the staff and dealt with that way.
1.8: My First: Field Hospital
Ah, field hospitals. Nice to have, difficult to maintain. If the operation is going well enough, the marines should have already secured a medical bay for you planetside. If things aren't going too well, then you're probably on your own when it comes to a sterile work environment. If you need to create your own, ask engineering to provide you with the materials to create one or even better, an engineer to create one for you! Just be aware that field hospitals often fail due to the many variables in the game (marines being bald and xenos managing to overrun them, primarily). Additionally, if you aren't able to secure a medical bay (and with it, an operating table) then you're relegated to performing surgery on a roller bed - which has increased chances of action failure (resulting in more injuries). A word of advice, take how many Space Cleaner bottles you think you might need and double it, trust me. Infections run rampant planetside, even more so when you're cutting marines open.
1.9: Advanced Procedures: Surgery
Well maybe not so advanced, as a majority of the surgeries can be found on the wiki page (found here: Surgery!). Not much else can be explained that hasn't already been explained on the wiki page. Just remember to always compound surgeries and be thorough!
► Show Spoiler
.
