The Medbay Commandments

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Surrealistik
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The Medbay Commandments

Post by Surrealistik » 16 Jan 2017, 15:53

Reposting out of desperation because I'm sick of shitty doctors/CMOs.


#1: Thou Shalt Restock Vendor Med-Supplies:

When you've expended/are finished with an auto-injector or chemical bottle, or are about to expend a consumable such as a Trauma Kit, restock it into a vendor with an open maintenance panel by dragging the expended item onto the vendor.

You can also refill a vendor with consumable supplies that come in stacks such as trauma kits by separating stacks of those kits (click on the stack in one hand with an empty hand active) and restocking the separated item into the vendor as above.


#2: Thou Shalt Obey Thy Order of Triage:

The order in which you should treat (triage) patients is as follows:

#1: Dead bodies (revive them fast with the Defib or lose them forever; see Commandment #6).
#2: Larva infections (commence surgery immediately; if they're too advanced, kill the patient and revive with defib; depending on how advanced their infection is, this can become priority #1. Remember, you can dramatically slow the progression of infection via the Cryotube and Cryo/stasis bag as needed).
#3: Patients in critical/fresh revivals (stabilize and reassess triage; this should be uncommon if Medics are doing their job. Properly stocked cryotubes are helpful for emergency and rapid stabilization; bring revivals and the critically injured there. For blood loss, treat with iron, dexplus/dexaline, tricord and blood IVs).
#3: Dead bodies (clone them).
#4: Decapitated bodies with available head (reattach head via surgery then clone).
#5: Organ damage (apply Peridaxon and/or Inaprovaline and Dexplus to stabilize if necessary).
#6: Fractures/limb replacement (commence surgery).
#7: Everyone else (Tricord injectors should usually be sufficient; typically Medics take care of these people so they're uncommon. Medibots will also deal with them).

While you're dealing with a lower priority case, be willing and prepared to abandon them immediately to service a higher priority case.


#3: Thou Shalt Prepare Thy Person:

Mandatory equipment:
  • Lab coat and HealthHUD
  • Latex gloves
  • Medical rig with defibrillator (activated and ready to shock)
  • Sterile mask (helps reduce infection incidence during surgery)
  • HF2 Health Analyzer, Splint, spare trauma/burn kits and pill bottles
  • A cryobag and rollerbed
  • a hypospray filled with hyperzine so you can inject yourself to go at sanic speed as needed for moving to patients, moving patients to medbay for treatment, escaping aliens, or helping others escape aliens, etc.
  • A syringe pouch full of syringes filled with Oxycodone from the Medvend oxy bottles (restock them as needed) so you can bypass anesthetic tanks for speedier surgeries (or in the event you don't have access to one).
  • A spare empty syringe stored in your suit slot to use as needed.
  • Space cleaner/surgery cleaner spraybottle to quickly spray and disinfect yourself.
Also highly recommended:
  • A lighter and low damage sharp object (like a glass shard) so you can apply them to badly damaged, revivable corpses in order to reapply advanced burn and trauma kits as needed.
  • Two syringes: one filled with water and the other with potassium for instantly purging ODs.
  • A hypospray with a 15U Spaceacillin + 15U Paracetamol mix to prevent infection during surgery and dose your patient with pain killers in lieu of anesthetic (may not be necessary if you have access to good surgery pills), one filled with 15U Peridaxon + 10U Quickclot + 5U Dexplus (to supplement your surgery injector when not using the anesthetic tank, and for critical/revival patients). Label all hyposprays accordingly with the labeler in the chemistry lab.
  • A pill bottle filled with 20U Oxy + 2U Spaceacillin + 2U Paracetamol for quick surgeries without using anesthetic.
  • pill bottle filled with Alkysine + Imidazoline in a 1 : 5 ratio for quick eye/brain fixes.
#4: Thou Shalt Prepare Thy Workplace:

Make sure you have a good cryomix ready 60U: (10U Cryoaxadone, 10U Cloneaxadone, 10U Imidazoline, 10U Iron, 5U Peridaxon, 5U Alkysine, 5U Dexalin Plus, 5U Spaceacillin) or 120U (use buckets from the autolathe): (10U Cryoaxadone, 10U Cloneaxadone, 10U Tricordrazine, 10U Bicaridine, 10U Dylovene, 10U Dermaline, 10U Kelotane, 10U Imidazoline, 10U Iron, 5U Quickclot, 5U Paracetamol, 5U Peridaxon 5U Alkysine (slow metabolism rate), 5U Dexalin Plus, 5U Spaceacillin) that the coolers are online and set to a target temperature of 30, and that you have Peridaxon ready (either via the cryomix or in pill/liquid format, preferably both). I highly recommend moving a Medvend, such as the one in the locker room, near the cryotubes for convenience when treating the critically injured. Note that patients need to be capable of getting cold, and thus cold protective wear like that worn by marines on the Ice Colony map must be removed before they can properly benefit from the cryotubes. Set the cryotube charge level 5 and target temperature to 60 degrees to minimize power wastage.

Have blood IVs stocked with O- in surgery and key areas (like the scanners/cryo); restock empty blood bags as needed. Bring one of the Medvends in the central storage room outside near the sleepers/scanner.

Insist that Researchers build 2 cloners upstairs (normally it's best to put one just south of the cloner gas cooler and oxygen tank, and another in the 3 tiles of window immediately south of the blood vendor/locker room) and that they have at least 3 Medbots made: 1 for the Medbay and 1 for each dropship, and preferably 6 (2 for each location). If they suck, are busy with chem or lazy, you can make them yourself by combining an empty medikit with a robotic arm from the organ printer, a health scanner and a proximity sensor from the autolathe (you may need to fill it with metal from dismantled chairs/cable coil from the pilot vendors and spare beakers).

Ordering an extra surgery crate from Requisition is almost always a good idea.

Prepare IV mixes for surgery: you'll want a bottle of pure paracetamol and spaceacillin. Spaceacillin allows you to avoid having to wash your hands or spend extra time applying spaceacillin. Paracetamol can allow you to avoid having to use the anesthetic tank in an emergency (best supplemented with oxy/inaprovaline/soporific). Put the surgery tools in a bag for ease of transport/manipulation (or don't if you use macros for ultrafast surgeries). Try to have one of each limb built by the organ printer, and try to get spare metal for each organ printer. It is generally useful to have a Medbot in surgery as well. If you can, try to get a MedVend in at least one of the surgery rooms, or the hallway between them so you can restock and obtain medication on the fly immediately. This also helps you maintain vendor supplies in the probable event of a Medbay blackout due to MTs not doing their job.

Set Medbots to report their treatment so you get an automated notification when someone enters Medbay in need of assistance (EDIT: This functionality is apparently broken at the moment).

For extra credit, you can prepare ghetto surgery kits by having the autolathe print off sets of surgical tools, putting them in a bag along with spare medical masks and tanks, and substituting the two instruments it can't create with their ghetto equivalents (cable coil for fix-o-vein and screwdriver for bone gel).

Deploying a spare MedVend to the FOB to support a field surgeon, or to the MedEvac dropship to support that ship's surgeon is a good idea.

Lastly, it certainly is advised (but not a priority/necessity) to have the autolathe print out a set of welders, and get some cable coil from the MTs for your surgery theatres to repair robolimbs/prosthetics.

Turn on the microphone of the fixed radio in the cloning room so cloned people can cry out in terror if they're neglected, thereby notifying you of their distress (Medbots will also do so while stabilizing them).


#5: Thou Shalt Diagnose Thy Patient:

Diagnosis is relatively simple; it consists of the following procedure:
  1. Actually listen to your patient: This is usually a good first step (unless the patient is crit/unconscious), particularly where larval infections are concerned. Keep in mind that some people will try to bullshit you for priority treatment though, and they particularly like to lie about being infected (which can quickly be confirmed via a body scanner if you have access to one).
  2. Scan with HF2 Health Analyzer: Key limitations of the analyzer: It does not detect organ damage, embedded shrapnel/projectiles and their locations, or larval infection status, nor does it pin point the location of internal bleeding or fractures in the chest, groin and head areas. Note the presence of any chemical overdoses or dangerous chems and treat with dylovene/purge with water + potassium/employ sleeper dialysis as most expedient and needed.
  3. You can use deduction to determine the existence of the following conditions without use of a body scanner (such as during field surgery):
    * Lung and/or Heart damage = Persisting oxy damage without the patient having low blood levels or being in critical condition (100 total damage or more). This is especially likely if the chest is fractured/splinted.
    * Appendicitis, appendix, liver or kidney damage. This is especially likely groin if the chest is fractured/splinted. = Vomiting and/or persisting toxin damage without infection or toxic reagents in the patient's blood stream.
    * Eye damage causing blindness = Patients eyes do not respond to pen lights. This is especially likely groin if the head is fractured/splinted. Generally the patient will let you know about this vocally.
    * Embedded shrapnel/projectiles = right clicking gives you the option to yank out an object, but the object is too small. These are likely to be found in areas with organ damage, and particularly the chest.
    * Internal bleeding locations = any body part with brute damage that will not go down and is slowly increasing (and is not robotic). These are more likely to be found in areas with fractures.
    * Head/chest/groin fractures = body parts where there is notable organ and/or brute damage.
    * For all other issues like larval infections, you'll have to depend on your patient to tell you what's wrong.
  4. Get a final/confirmation of diagnosis by using the body scanner on your patient if possible: Note that larval infections will not be differentiated from shrapnel/projectiles lodged in the chest, and you are advised to treat all unknown bodies in the chest as larval infection unless contradicted by information from the patient (unless others are confirming larval infection), or you do not know about it ICly.
#6: Thou Shalt Be Efficient In Thy Surgery:

Be sure to use the body scanner on your patient and keep the report window open for reference so you don't waste time operating on the wrong section, or miss something. If you closed the report window, simply examine your patient and click on the link for his last scan. If you don't have use of a body scanner, consult Commandment #5 above.

You have several options to expedite surgery:

You can use the autodoc's manual mode to treat any affliction barring larval infestation by inputting the correct procedures; note that as of this writing however, there is only one (1) autodoc so you may not get to use it. An overview of the autodoc and its functions: wiki/Surgery#The_Autodoc_System . As the autodoc is slower than manual surgery and even considerably so, I only recommend it when you and all doctors are otherwise occupied.

Spray yourself with 5U of space cleaner/sterilizine before commencing surgery to avoid infection. Highly recommended is a sterile mask and latex gloves to minimize risk of infection. You may also inject/IV your patient with Spaceacillin for further assurance (previously it seemed like Spaceacillin alone could stave off necrosis, but not anymore).

Once done with sanitation, you'll preferably want to pill/inject the patient with Oxycodone and, if possible Paracetamol/other painkiller + Spaceacillin (I personally use a pill consisting of 20U Oxycodone+2U Paracetamol+2U Spaceacillin). You will want to monitor painkiller levels throughout longer surgeries; it is helpful to have syringes and a hypospray full of Oxycodone to top up as needed. Alternately, you can fall back on the anesthetic mask and tank; preferably with your patient equipping these items and activating his own internals (good luck). During especially long surgeries (involving 4 or more procedures), you will generally want to use the tank and mask (and even if you're using such a mix, the tank and mask can prove to be less of a headache overall due to the need to redose). Note that if your patient is wearing the anesthetic tank and mask, it is advisable to remove it during the cautery step for maximum speed and efficiency.

Above all, know your surgery steps ( wiki/Surgery ) and try have all your surgical implements together in a bag or on one space (floor beneath you or a table) so you can easily switch through them. If you must repair organs/IB, combine fracture and organ/IB repair whenever possible.

It's generally best to keep the tools needed to perform the next two steps in hand so you can do them in sequence with minimum delays. If you're fast enough, you can swap out a tool for prior step in exchange for another needed for the next step, while completing the current step. Keeping your tools in a pile beneath you, or in a bag/tray (with the added benefit of them being easier to transport in the event of emergency), can help expedite surgery and prevent mishaps where they flip off a table. Binding .click drop to an easily accessed button can improve the speed of tool cycling. Further, you can bind a set of keys (like the numpad keys) to the pick-up command via macros for each tool for optimal tool swap times (Example: pick-up cautery | Note that this precludes you from putting your tools in a bag/tray though).

It is highly recommended you body scan your patient one final time post-surgery if you can spare the time to do so; dosing him up with Sleeper chems might also be a good idea in terms of after care.

Note that you can do surgery on a roller bed outside the official theatres in a pinch. In Medbay it's best to do this either by the cryotubes or the scanners and sleepers.

Also, in the event of especially bad cases where a patient has multiple instances of internal bleeding, heavy blood loss and/or significant organ damage, you'll almost certainly want to operate on them while they're dead and their situation can't deteriorate further; revive as needed to reset their death timer. For best results, revive while they're beside a well stocked cryo when their surgeries are complete in order to expedite and optimize recovery if necessary; just pop them in when you're finished.


#7: Thou Shalt Be Efficient In Thy Cloning:

Do not leave corpses waiting around to be cloned if you can at all help it; stick em in to the cloner and clone ASAP. Throwing corpses/patients around is a great time saver if you don't have a roller bed to expedite their movement. Be sure to regularly check in on the cloning area and cloning hall for bodies.

Once you've started the cloning process, bring the corpse to the cryotubes for the cloned marine to go through. Do _not_ strip them; leave that to the cloned marine to do. Stripping wastes time, and risks loss/theft of items.

If you're the CMO (or Researcher), you can use your ID to prematurely eject a clone at 60% completion by using it on the cloning pod, thereby significantly accelerating the process; do so whenever you can.

Be sure to promptly bring all ejected clones to the cryotubes (where you hopefully have an appropriate cryomix ready).

Once a clone is finished healing in the cryotube, remove from the tube and force feed coffee ASAP (it might be a good idea to bring the coffee dispenser over from Mess Hall); this will revive the target quickly and significantly expedite recovery.



#8: Thou Shalt Be Efficient In Thy Defibbing:

#1: After confirming the patient is revivable (he has a squiggly line instead of a skull for his MedHUD icon), quickly inject your patient with appropriate medications to treat the damage he's taken (tricord, kelotane, dermaline for burns, bicaridine for brute, dylo for toxin, etc. Inaprovaline is generally recommended for stabilizing the patient), and preferably pain killers so he can act on his own power as soon as possible. These medications will ensure he recovers quickly, and will be metabolized upon revival. Splint any broken areas if necessary. If you don't know how long the patient has been dead for, skip to #2 in order to reset his brain/permadeath timer ASAP, _then_ administer drugs. If you and the patient are near a stocked, functioning cryotube with Dexplus, you can skip the administration of drugs; just be sure to dunk him into cryo ASAP.
#2: Use trauma and burn packs to heal as much brute and burn damage up above the 200 threshold as possible. Oxy damage will be removed by defibrillation. Note that it may be necessary (albeit silly) to remove heavily damaged limbs since they contribute to the 200 damage threshold. Using the circular saw on your patient laid out on a bed of some kind with the Aid intent active is the best way to do this; if necessary you can hack wildly.
#3: Remove any armor/exosuit and defibrillate the patient. Pay
#4: Apply chems if you had to skip this step in #1. Note that you can use CPR to help remove Oxy damage from the patient and prevent suffocation by clicking your unconscious patient with the help intent while your mouth and the patient's mouth have no coverings (like gas masks); especially useful if you lack stabilizing chems like Inaprovaline.
#5: Apply Peridaxon if necessary to fix any heart damage the defibrillator may have caused.
#6: Remember to recharge your defibrillator (restocking it will recharge it). You can restock your trauma/burn kits at a MedVend.

Note that if necessary, you can dose a patient with QuikClot cut a patient with glass shards or burn with a lighter to reopen/reburn wounds in order to reapply Trauma and Burn kits. Each use of a defibrillator will also remove some burn and brute damage and will remove all oxy damage, helping you clear the 200 damage threshold.

As stated in Commandment #6, it can be situationally advantageous to perform surgery on a dead patient as you don't have to worry about anesthetics or further deterioration.


Larva Removal Technique:

A good way to quickly nullify and larva growing in a marine is to kill and then quickly revive with the defibrillator. Note that killing via distributed bayonet stabs all over his body (with one point of focus to minimize fractures; perhaps an arm or leg to avoid recurring organ damage) is best as it will enable you to most rapidly prepare his body for healing via trauma packs to each area while wasting minimal ammo. Be careful to incur minimal fractures however. Generally recommended when a marine is close to bursting, or there is no field surgeon that is readily accessible.

No longer possible due to yet more marine nerfs. Marines that are still revivable will continue to grow larva.

Note that in cases of heavy/extreme overdose, it is best to purge all chems before attempting to revive. You can do this by injecting the patient with a combination of potassium, sugar and phosphorous.


#9: Thou Shalt Not Overdose Thy Patient:

Very important; certain chems have especially lethal overdose effects, such as Hyperzine, QuikClot, Peridaxon and... coffee. Some may even cause a patient to become unrevivable due to destroying organs/dealing excess toxin damage. A destroyed heart can be replaced theoretically in order to revive someone if you're fast enough, but toxin damage cannot be restored for the deceased.

Memorize the overdose levels from this chart: wiki/Chem_Guide

It is always a good idea to use your health analyzer to scan your patient first before applying chemicals.

In the unfortunate event of a dangerous overdose, the best solution is to immediately purge all chems via injecting water + potassium OR phosphorous + sugar + potassium OR aluminum + potassium + sulfur. If this cannot be done, apply meds to help counteract the damage and get the patient to a sleeper immediately for dialysis.


#10: Thou Shalt Be Prepared for Shitlers:

Fill a hypospray with Chloral Hydrate for use on the unruly and problematic, and the occasional mercenary stupid enough to invade your Medbay. Label it accordingly (Slep Juice, Annoying Marine B Gone, whatever). Note that these injectors will be completely useless against Xenos (and apparently Predators after recent updates?) who do not metabolize the chemicals. Anesthetic autoinjectors from the MedVends will do in a pinch.

In the unlikely event you need to straight up kill someone (Predators/Iron Bears mainly), 10+ U of Hyperzine will do the job near instantly.

EDIT: Lately I've found this isn't as important now as it has been in the past.


#11: Thou Shalt Not Take Up Chemistry If Thou Art Bad At It:

Self-explanatory and important. Only do chemistry if you can do it fast and efficiently (or no one else is doing it at all/more capable; common sense). You should be able to mint at _least_ 8 full pill bottles of a staple like the Fast KeloDerm mix (see below) before the marines depart while spending minimal chem charge via use of MedVends or you're not qualified.

It's best to learn chemistry as the Researcher, or during low pop. The guide to chemistry: wiki/Chem_Guide

You will _definitely_ want to bind a conveniently accessed key like Mouse 4/5 to set-transfer-amount to help expedite chemistry. I also recommend binding Mouse 4/5 to .click drop as well.

Don't forget to get authorization from the CMO and/or CO for the distribution of non-standard drugs. Here is a convenient form for their signature if necessary:
► Show Spoiler
Guide to chemistry: wiki/Chem_Guide

Several excellent staple recipes:


Retooled chem recipe section in light of several cumulative changes to chemistry/marine law:

Classic Recipe Keloderm:
► Show Spoiler
Fast Dex+
► Show Spoiler
Manufacturing Process (Alkysine):
Label: 20 OXY + 8.75 ALKY + 1.25 SPACE
Manufacturing Process (Surgery):
  • Add 5U Phoron to Bluespace Beaker (if no Phoron present).
  • Vend/restock 8x bottles of Tramadol, adding 160U to your Bluespace Beaker.
  • Vend/restock 1x bottle of Dylovene, adding 35U to your Bluespace Beaker.
  • Vend/restock 1 bottle of Spaceacillin, adding 10U to your Bluespace Beaker.
  • Load your Bluespace Beaker into the Chem Dispenser.
  • Add 160U Ethanol
  • Add 35U Chlorine and Nitrogen
  • Remove from Chem Dispenser.
  • Put Bluespace Beaker into the ChemMaster and produce 2 sets of 4 pills from the following batch: 80 Oxy + 35 Alkysine + 5 Spaceacillin (4 pills / batch)
  • Flush/save excess other than Phoron.
  • Repeat.
Manufacturing Process (Alkysine):
Label: 80 Oxy + 8.25 Alkysine + 1.75 Spaceacillin (4 pills / batch)
Manufacturing Process (Surgery):
  • Add 5U Phoron to Bluespace Beaker (if no Phoron present).
  • Vend/restock 8x bottles of Tramadol, adding 160U to your Bluespace Beaker.
  • Vend/restock 1x bottle of Dylovene, adding 20U to your Bluespace Beaker.
  • Vend/restock 1 bottle of Spaceacillin, adding 10U to your Bluespace Beaker.
  • Load your Bluespace Beaker into the Chem Dispenser.
  • Add 160U Ethanol
  • Add 20U Chlorine and Nitrogen
  • Remove from Chem Dispenser.
  • Put Bluespace Beaker into the ChemMaster and produce 2 sets of 4 pills from the following batch: 80 Oxy + 8.25 Alkysine + 1.75 Spaceacillin (4 pills / batch)
  • Flush/save excess other than Phoron.
  • Repeat.
Manufacturing Process (Combat):
  • Add 5U Phoron to Bluespace Beaker (if no Phoron present).
  • Vend/restock 8x bottles of Tramadol, adding 160U to your Bluespace Beaker.
  • IF NO PARACETAMOL IN BEAKER: Vend/restock 1x bottle of Tramadol, adding 10U to your Bluespace Beaker.
  • Vend/restock 2x bottles of Inaprovaline, adding 60U to your Bluespace Beaker.
  • Load your Bluespace Beaker into the Chem Dispenser.
  • Add 160U Ethanol
  • Add 10U Sugar and Water
  • Remove from Chem Dispenser.
  • Put Bluespace Beaker into the ChemMaster and produce 2 sets of 4 pills from the following batch: 80 Oxy + 30 Inaprovaline + 10 Paracetamol (4 pills / batch)
  • Repeat, retaining the Paracetamol for the next batch.
[/spoil]

Imialkysine (Dr. Layzee's Braineye Fix):
► Show Spoiler
Big Tricard:
► Show Spoiler
Big Iron:
► Show Spoiler
Nerfed ASSBLAST U-S-A:
► Show Spoiler

Note that the use of paracetamol features the risk that tramadol doses administered by Medics turns it into poison. If you use it, be sure to warn Medics about its presence in the mix and to check for para before dosing with tramdaol. Replace with whatever curative you like if you don't wish to try paracetamol.

General rules to follow:
  • Try to keep pill batches to 8 per 120 U of mix; that will allow you to fill at least one pill bottle per Bluebeaker input. 4 will work if you need to fit in more chemicals.
  • Every medication intended for combat/field use should have some Paracetamol in it if possible; this allows marines to stay on their feet and relatively unimpeded by pain. Keep doses small to avoid problematic complications in the event of mixing with Tramadol which creates toxin.
  • Always, always try to minimize the cost of your chems in terms of charge by using MedVend pills and restockable chemicals. It is a good idea to pull a MedVend immediately beside you while you make chems (the niche opposite the grinder in the Medbay chem lab is a good place). Note that this is less necessary due to chem dispenser recharging much more quickly than it did in the past.
  • Unless you want to get in trouble with the admins, distribute pills only to Medics.
  • For safety reasons, try to keep the dosage level of each chemical for each pill to half the OD dose, though putting it right at the OD level can work in some cases.

#11: Thou Shalt Exhibit Medbay Etiquette:

Don't interrupt other people's surgeries unless they requested help or clearly have no idea what the fuck they're doing.

Don't play musical chairs with the chemistry station while someone is obviously using it and had just briefly stepped out; ask if you can use the chem master first (unless it's an emergency; use common sense). Also try not to needlessly crowd the person using the chem master if you can go elsewhere to do the same thing (like using a Medvend).

Get the fuck out of the way of people dragging bodies/patients/rollerbeds.

Keep your workspace clean during slow periods when you're not doing something more useful (because you can't) by cryoing those who are SSD, morguing bodies that have departed souls (strip them in the hall before doing so), and cleaning blood/puke/etc with space cleaner spray bottles.


#12: Thou Shalt Transport the Fallen With Expeditious Haste:

One does not simply drag bodies upon the Sulaco (or elsewhere) due to the slowness that has been added when pulling objects (including marines/bodies). The reason why Commandment 3 insists on a roller bed is to negate the huge speed penalty involved when doing so. Pulling is fine for very short distances as it's not worth the time investment to buckle someone into and out of the roller bed you should be constantly dragging about, but anything beyond that demands you do so. If you _must_ handle a corpse/patient without a roller bed, use the Grab intent (after upgrading) to toss them down long corridors and such.

As usual, hyperzine can be of great help in getting places quickly, including while dragging.


Note that it's generally a good idea to pay attention to reports/sounds of the drop ship coming in so you can quickly gather and treat the wounded at the hangar with your roller bed.


#13: Thou Shalt Keep Thineself Busy:

No patients? Chem dispenser expended so you can't make any more drugs (unlikely now; keep making pills pill head, use vendor chems if necessary)? Is it hogged by someone else? Rest is for the weak. Here's a solution: go take a fuckton of empty flasks from Mess Hall food vendors (use a crate or transport them 12 at a time with your pockets, labcoat, hands and backpack slots; bonus points if you can get webbing), drop them off at Medbay hangar near the Rasputin, and fill em up with 60 Oxycodone or Tramadol from the vendors.

To fill with Oxy, dispense all 6 injectors and use a syringe to extract 15 U, then inject into your flasks. I recommend doing this as the last step. Filling with Oxycodone will make this take substantially longer so it may not be worthwhile.

Label your flasks accordingly when completed, then load them onto the Rasputin as it comes if you have Command approval (otherwise load em in the smart fridge).

Don't stop making flasks in this way until you get patients/people to clone.

Once you've completed your flasks, label them appropriately. Note that completing flasks and applying chems/pills in sequential order will also help make sure you can better keep track of your process and not accidentally double dose any flask with a chemical/pill.

You can also make surgery kits by printing surgery tools via the autolathe, and using ghetto substitutes for the items you cannot produce (cable coil for fix-o-vein, screwdriver for bone gel, wrench for bone setter). Put them into a backpack along with a pill bottle of 20U Oxycodone / 2U Spaceacillin / 2U Paracetamol pills and a roller bed for a complete surgical kit.

Thanks to the MedVac CAS system, you can now serve on the MedVac dropship as an EMT doctor to stabilize and heal patients airlifted from the battlefield, making it into your very own ambulancemobile:
► Show Spoiler
For this you will need a blood IV, a MedVend/WeyLand MedPlus vendor, a roller bed, a surgery kit (probably not a good idea now; recent nerfs have made the failure chance for surgery on a moving dropship particularly high) and at least one cryobag as per the picture. It helps to move one of the first aid dispensers to the place indicated for ease of access and quality of life. Highly recommended: at least one Medibot (empty medkit + robo arm + HF2 analyzer + motion sensor from the autolathe) a spray bottle of space cleaner/sterilizine, a reservoir of hyperzine and hypospray loaded with hyperzine (extremely useful for quickly getting patients from the dropship to Medbay if you weren't able to fully treat them on the trip back to the Almayer), 20U Oxy + 2U Para + 2U Spaceacillin and the Dr. Layzee Brain + Eyefix pills (allowing you to quickly conduct and complete surgery). You can use syringes loaded with Oxycodone via restocked vendor bottles + Inaprovaline injectors as anesthetic in lieu of these designer pills as needed.

Finally, if you have nothing better to do, monitor the crew console and report any wounded/dead as expedient.




#14: Thou Shalt Be Prepared for Emergencies:

Shit happens and you'll want to be ready; often in a major crisis you'll need to relocate from Medbay.

As stated, you should have a hypospray loaded with hyperzine for emergencies, preferably with a reservoir to refuel it from (large beaker/spray bottle you can draw out of with a syringe).

Surgery pills, namely the 20U Oxy + 2U Para + 2U Spaceacillin and the Dr. Layzee Brain + Eyefix stated earlier are highly desirable for field surgery.

A roller bed, cryobag and at least one defibrillator along with your usual assortment of medical supplies.

A bag of surgical tools ready to go.

A WeyLand MedPlus vendor that's loose and ready to be pushed.

A crowbar is useful for opening depowered airlocks. You'll want a wrench to move vendors as needed. A station bounced radio is extremely useful in the event comms go out.

Lastly, after (or even during, depending on Medbay's security) an attack on the ship or Medbay, you'll want to consult the crew monitor at the first opportunity to determine the status and location of any dead or badly injured crew.

As a bonus, a medibot ready to build and deploy at your new location is a good idea: empty a Medkit of everything but an HF2 analyzer and motion sensor, bag a robotic arm. When you arrive on site, remove these components and assemble them: use the arm on the empty medikit, then the analyzer on the medikit assembly, and finally the motion detector.

Beyond that, you'll want to memorize and become proficient at quick diagnosis without a Medscanner per Commandment #5: Thou Shalt Diagnose Thy Patient; you will need to without a scanner conveniently nearby.

You need to be able to quickly redeploy and set up shop wherever you're needed in an emergency (Hyperzine is instrumental to this, and allows you to move vendors quickly by pushing them, in addition to the general mobility boon), like the CIC for example; here you can see an impromptu but effective treatment and surgery area set up in the upper left corner of the command centre:
► Show Spoiler

#15: Thou Shalt Know Thine Terminology:

ATK: Advanced trauma kit.

ABK: Advanced burn kit.

BigBicard: Large bicaridine doses used to treat brute damage (usually 15U+).

BigDerma: Large dermaline doses used to treat burn damage (usually 15U+).

BigDex: Large dexplus doses used to treat oxy damage and defer oxy damage from organs/bloodloss (usually 15U+).

Boner: Someone with fractures.

Chem: Chemicals/chemistry.

Crit: Critical condition. Patients identified as crit require immediate treatment.

Cryo(mix) In the context of medical, this usually refers to the cryotubes. Cryomix refers to the chemical inputs for the cryotubes. Can also mean the cryobeds for disposal of SSD players.

Cryobag Blue stasis bag often used to halt deterioration in the condition of badly wounded or infected casualties for safe medevac to Medbay.

DAF: Dead As Fuck. The biological equivalent of FUBAR: used to describe patients who are beyond saving and cannot be revived.

ICS/IMS: Incision Management System. Advanced surgical tool that cuts open a patient, spreads tissue and clamps bleeders, thereby doing three surgical steps in one.

IronSugar: Chem mix intended to restore blood. Generally a bad idea as sugar is very inefficient for this purpose compared to iron and costs just as much chem charge; use pure iron instead.

IV: Intravenous Drip; wheeled intravenous units that are used for injecting a steady stream of chemicals into a patient (usually blood, or painkillers or spaceacillin with a slow metabolism rate).

Keloderm: Kelotane and dermaline chemical mix used to treat burn damage; a traditional staple chemical mix prepared for Medics pre-deployment.

MedEvac/CaseEvac: The winch medevac system used by dropships to retrieve the wounded from the operational area.

OR: Operating Room.

Peridex: Peridaxon and dexplus chemical mix used to treat organ damage and oxygen loss caused by it; a traditional staple chemical mix prepared for Medics pre-deployment.

Preggo: Someone infested with a larva/chestburster. Don't use this term until you're familiar with the larva portion of the life cycle.

QC: Quikclot; chemical used for treating internal bleeding. Cannot be synthesized via the chem dispenser; must be taken from injectors.

Stims/Meth/Assblast (USA): Hyperzine, either by itself, or in some chemical mix.

TNB: Tag N Bag, usually in reference to DAFs. This means put them in a body bag and ship them off to the morgue.
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Re: The Medbay Commandments

Post by Rain7x » 19 Jan 2017, 09:26

This is really good but the one thing I disagree with is dead people, unless they are an important role I think they should be right after organ damage.
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Re: The Medbay Commandments

Post by Surrealistik » 19 Jan 2017, 12:26

Rain7x wrote:This is really good but the one thing I disagree with is dead people, unless they are an important role I think they should be right after organ damage.
You must revive them quickly or risk them ghosting forever.

Further, if the organ damage is really bad enough to warrant immediate attention, chances are they'll be in critical or close to it.
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Re: The Medbay Commandments

Post by Rain7x » 19 Jan 2017, 17:57

Surrealistik wrote:You must revive them quickly or risk them ghosting forever.

Further, if the organ damage is really bad enough to warrant immediate attention, chances are they'll be in critical or close to it.
Ah good point. I see why you put it there then.

This is a really good guide.
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Re: The Medbay Commandments

Post by Surrealistik » 23 Jan 2017, 04:15

Updated to account for the recent (myopic) removal of cloning and upgrade of defibs.
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Re: The Medbay Commandments

Post by Nightcaper » 23 Jan 2017, 23:38

Surrealistik wrote: Note that killing via distributed bayonet stabs all over his body (with one point of focus to minimize fractures; perhaps an arm or leg to avoid recurring organ damage) is best as it will enable you to most rapidly prepare his body for healing via trauma packs to each area while wasting minimal ammo. Be careful to incur minimal fractures however.

So... just stab them in the left leg only, repeatedly? Wouldn't distributing stabs all over the body just mean more possible fractures? I didn't really understand this part.

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Re: The Medbay Commandments

Post by Surrealistik » 24 Jan 2017, 01:57

Nightcaper wrote:So... just stab them in the left leg only, repeatedly? Wouldn't distributing stabs all over the body just mean more possible fractures? I didn't really understand this part.
Fractures have a damage threshold; as long as it's slow enough (say one stab worth of injury) no fracture should occur.
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Re: The Medbay Commandments

Post by Casgair » 24 Jan 2017, 22:51

I like the guide, but I have to admit from my experience as a Doctor (I don't Medic that often) the need for Spaceacillin isn't something that comes up so often as to take the time to put it in a mix. I'd almost be more inclined to fit Iron in there somewhere as it helps with blood regeneration.

Also, if you really plan on going all out in chem, use existing pills as much as possible to stretch out what you can accomplish with the Chem Dispenser such as:
For Oxycodone, get your beaker almost full (at least 15u of space) with Ethanol and at least enough Phoron to act as a catalyst, take the beaker out of the dispenser and fill with tramadol pills.
Clonex: 2 dexalin pills from the Oxygen kits is enough to make 180u of clonex and reduce your phoron use.
Bicard: 120u of Carbon + 4 Inapprovaline pills = 240u Bicard
Dermaline: Get some Oxy+Phosphorus and drop in those Kelotane pills. Leave some kelo in for faster acting DermaKelo if you want; converting everything into Derma will get you the most bang for your chem dispenser buck, though.

Similarly, Imidazoline, Arithrazine/Ryetalyn can be done with Dylovene pills. Tricord likewise could be done totally with pills (if they dissolved by themselves or you leave a little of something else in) but TBH tricord recovery rates are so garbage I usually just put them in mixes where I simply can't think of anything else to fit into a pill.

Also as a little side note for anyone who might be unaware, if you have a pill bottle in your pocket(s) or suit storage, you do not need to have an empty hand to take out a pill. Simply drag the bottle on top of yourself and take what you need. Probably old news to most people, but it might help new medics keep from worrying about not having their SMG out while getting a pill.
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Re: The Medbay Commandments

Post by Surrealistik » 24 Jan 2017, 22:56

Casgair wrote:I like the guide, but I have to admit from my experience as a Doctor (I don't Medic that often) the need for Spaceacillin isn't something that comes up so often as to take the time to put it in a mix. I'd almost be more inclined to fit Iron in there somewhere as it helps with blood regeneration.
Spaceacillin is recommended only for injection immediately prior to surgery to avoid the need to wash hands and for flask filling intended to be filled using only MedVend available chems. Infection isn't especially common outside of surgery, but it can be devastating if left unchecked.
Also, if you really plan on going all out in chem, use existing pills as much as possible to stretch out what you can accomplish with the Chem Dispenser such as:
For Oxycodone, get your beaker almost full (at least 15u of space) with Ethanol and at least enough Phoron to act as a catalyst, take the beaker out of the dispenser and fill with tramadol pills.
Clonex: 2 dexalin pills from the Oxygen kits is enough to make 120u of clonex and reduce your phoron use.
Bicard: 120u of Carbon + 4 Inapprovaline pills = 240u Bicard
Dermaline: Get some Oxy+Phosphorus and drop in those Kelotane pills. Leave some kelo in for faster acting DermaKelo if you want; converting everything into Derma will get you the most bang for your chem dispenser buck, though.

Similarly, Imidazoline, Arithrazine/Ryetalyn can be done with Dylovene pills. Tricord likewise could be done totally with pills (if they dissolved by themselves or you leave a little of something else in) but TBH tricord recovery rates are so garbage I usually just put them in mixes where I simply can't think of anything else to fit into a pill.
Yes, MedVend (and other) pills and chems have been repeatedly mentioned throughout the guide as ways of conserving chem charge. That said, chem charge regen has apparently been accelerated such that charge saving isn't as necessary.
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Re: The Medbay Commandments

Post by Casgair » 24 Jan 2017, 23:10

Surrealistik wrote:MedVend (and other) pills and chems have been repeatedly mentioned throughout the guide as ways of conserving chem charge. That said, chem charge regen has apparently been accelerated such that charge saving isn't as necessary.
Ah, missed that when skimming the guide, my bad. I might have to try having a spaceacillin bottle or two on my person with a dedicated hypo in the future. From my own experience it seems like if marines get infected it's from having wounds left untreated for lengths of time more so than messy surgery, so I just never really thought about it.

What are your thoughts on Leporazine for field surgery on the Ice Colony? Worth the trouble?

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Re: The Medbay Commandments

Post by Nightcaper » 24 Jan 2017, 23:13

Surrealistik wrote:Fractures have a damage threshold; as long as it's slow enough (say one stab worth of injury) no fracture should occur.

It did bring up a question though, is stabbing someone dead and then defibbing them back alive considered an exploit to bypass chestbursting? It's a handy trick, but I'm wondering if it might just be cheesy enough to be considered an exploit, and I'd rather keep my notes as clean as humanely possible.


Another question I've hesitated to ask mostly out of fear of being labeled incompetent, but... these are more of ideal guidelines that any decent doctor SHOULD follow, right? e.g: If chems just really isn't my thing (I can follow the recipes but I'm slow and inefficient), does this make me a bad doctor even if I'm more than able with medicine, surgery, defibbing and other medical disciplines? I strive to be a competent doctor but I still have weaknesses that will take time to break through, chems being one of them, and I wouldn't want to feel like the ONE guy who just can't be the master of musical chairs.

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Re: The Medbay Commandments

Post by Surrealistik » 25 Jan 2017, 00:47

Casgair wrote:What are your thoughts on Leporazine for field surgery on the Ice Colony? Worth the trouble?
No. Get a proper surgery theatre set up with a heater.
Nightcaper wrote:It did bring up a question though, is stabbing someone dead and then defibbing them back alive considered an exploit to bypass chestbursting? It's a handy trick, but I'm wondering if it might just be cheesy enough to be considered an exploit, and I'd rather keep my notes as clean as humanely possible.
If it is, I don't care given the overall nerfs to soldier revival.
Another question I've hesitated to ask mostly out of fear of being labeled incompetent, but... these are more of ideal guidelines that any decent doctor SHOULD follow, right? e.g: If chems just really isn't my thing (I can follow the recipes but I'm slow and inefficient), does this make me a bad doctor even if I'm more than able with medicine, surgery, defibbing and other medical disciplines? I strive to be a competent doctor but I still have weaknesses that will take time to break through, chems being one of them, and I wouldn't want to feel like the ONE guy who just can't be the master of musical chairs.
You can be a good doctor without being a good chemist, though I recommend working on your weaknesses during low-pop when incompetence doesn't matter as much. When it comes to chem, the key is finding a good, efficient procedure/algo which uses a minimal number of clicks for minting each type of pill so that you can do it automatically without having to actively think about it. Binding a conveniently accessed key to setting transfer amounts is critical.

The cardinal sin when it comes to chemistry is wasting chem charge; even if you're turning chem charge into basic 105 Bicaridine and 15 Tramadol batches to fill time and get rid of excess charge, that's fine as long as you're not letting chem charge overflow above capacity.
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Re: The Medbay Commandments

Post by Surrealistik » 12 Feb 2017, 20:04

Updated due to yet more marine nerfs.
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Re: The Medbay Commandments

Post by Jroinc1 » 12 Feb 2017, 20:29

Surrealistik wrote:Updated due to yet more marine nerfs.
I mean, you did get endless perdiox, bicardine, and oxy from vendors roundstart...

Kinda worried that that'll cause chemistry to die out, honestly. I heard a mod today saying that alkysine heals CLONE damage...
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Re: The Medbay Commandments

Post by Surrealistik » 06 Sep 2017, 00:59

Updated.
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Re: The Medbay Commandments

Post by Mook476 » 06 Sep 2017, 01:39

The holy commandments.
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Re: The Medbay Commandments

Post by Surrealistik » 07 Sep 2017, 19:38

Updated with some tips/tricks I forgot/chose not to mention.

Smoke purges (something I find a bit meta and try not to encourage but seems necessitated by terrible medics), and soporific + oxy mixes for fast, long lasting and effective anesthetic.
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Re: The Medbay Commandments

Post by Jackie Estegado » 08 Sep 2017, 13:42

I really don't like your uber chems. Separated chem pills are the best, max peridex+ is what I think good.
And I would advise making dexalin plus a high priority, if you make it into 10 unit pills it will make reviving people so much easier, it will basically keep anyone alive for 30 seconds provided they don't get any other damage than suffocation.
Also using hypos for spaceacilin and sopor/chloral is a waste. There is a very limited amount of them and just my setup of 1-1 qc, peri, dex+, hyperzine hypos use up almost half of them. You can just keep two anesthetic injectors in your labcoat.
And spaceacilin is a complete waste in itself, if you have both the gloves and the mask on you will almost never have your patient get an infection (by the way I think untreated wounds can cause infection after a long time, not just the one that needs to be treated via brute kit).
When reviving someone that you don't know how long could have been dead, or you know that he has been indeed then use the defib to revive before you start treating them to reset the counter or you risk losing the patients giving while administering all the chems. Dexalin plus can even keep most cases like that alive (which can be injected via hypo quickly even after defib).
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Re: The Medbay Commandments

Post by Surrealistik » 08 Sep 2017, 14:46

Jackie Estegado wrote:
08 Sep 2017, 13:42
I really don't like your uber chems. Separated chem pills are the best, max peridex+ is what I think good.
And I would advise making dexalin plus a high priority, if you make it into 10 unit pills it will make reviving people so much easier, it will basically keep anyone alive for 30 seconds provided they don't get any other damage than suffocation.
Also using hypos for spaceacilin and sopor/chloral is a waste. There is a very limited amount of them and just my setup of 1-1 qc, peri, dex+, hyperzine hypos use up almost half of them. You can just keep two anesthetic injectors in your labcoat.
And spaceacilin is a complete waste in itself, if you have both the gloves and the mask on you will almost never have your patient get an infection (by the way I think untreated wounds can cause infection after a long time, not just the one that needs to be treated via brute kit).
When reviving someone that you don't know how long could have been dead, or you know that he has been indeed then use the defib to revive before you start treating them to reset the counter or you risk losing the patients giving while administering all the chems. Dexalin plus can even keep most cases like that alive (which can be injected via hypo quickly even after defib).
#1: The idea of peridex cut with bicard and tramadol is to arrest internal bleeding, and revive ASAP while letting the victim get to safety. You can use it as a combat drug for emergency revivals or for standard treatment; this increment in versatility is significant and gives the drug more practicality/applicability.

Combat drugs feature chem combinations that provide optimal benefit for minimum clicks/time (as well they should being combat drugs).

#2: Said peridex plus pills combined with bicard/tramadol are first priority.

#3: I believe there's 4x hypos, besides the 2x per vendor, with the CMO starting with one; that's more than enough. In practice, I basically never see this limit reached. Per the meta as it exists now, you can easily afford a hypo for space + soporific. If hypospray use increases in the future (due to say, this guide), this may change. Further, QC in Medbay is absurdly niche because Medics have almost always taken care of internal bleeding first, and in the unlikely event you need to deal with it, you have injectors via the Lifesaver belt. A hypo devoted to it is needless (unless you're out to kill some mercs/predators I guess). Though I will grant that a soporific hypo isn't strictly necessary due to anesthetic injectors, it's convenient and you get more mileage out of it than a QC hypo easily. Chloral/oxy + soporific hypos offer better outcomes than anesthetic injectors alone due to taking effect immediately, so they cannot be entirely substituted.

#4: Infection is absolutely a risk without washing if you don't use Spaceacillin, even with the mask/gloves, and washing takes up valuable time.

#5: Sure, I'd recommend perhaps skipping over the chems if you have no idea how much time is left, but you have to get the patient above threshold first. I'll also be mentioning the value of reviving by a stocked cryotube if possible which can obviate the need for administering chems/aftercare.
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Re: The Medbay Commandments

Post by Jackie Estegado » 09 Sep 2017, 14:43

When the fight gets on the Almayer I just always run out of qc if I use only injectors. With a hypo and a beaker full of a qc mix I can easy treat 15-20 internal bleedings without having to resupply.
And I don't know with whats you and infection, I haven't gotten a single infection mid-surgery last month, plus you can use a space cleaner to clean your hands which takes less time than Spaceacillining.
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Re: The Medbay Commandments

Post by Surrealistik » 09 Sep 2017, 15:19

Jackie Estegado wrote:
09 Sep 2017, 14:43
When the fight gets on the Almayer I just always run out of qc if I use only injectors. With a hypo and a beaker full of a qc mix I can easy treat 15-20 internal bleedings without having to resupply.
And I don't know with whats you and infection, I haven't gotten a single infection mid-surgery last month, plus you can use a space cleaner to clean your hands which takes less time than Spaceacillining.
Almayer invasions are different, but even then you've got medics taking care of IB, and IB cases aren't exactly common, while you often have access to vendors to restock. Bottom line, QC hypos make literally no sense pre invasion, and have limited utility post (unless you're exploiting it to open wounds you can trauma pack which is pretty cheaty/meta IMO, or to kill humanoids).

I'm pretty sure drawing and using a spaceacillin hypo takes about the same or less time than using space cleaner on your hands, while spaceacillin is _guaranteed_ and lasting infection prevention.
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Re: The Medbay Commandments

Post by Wubs4Scrubs » 12 Sep 2017, 09:07

Fill a hypospray with Anesthetic either extracted from autoinjectors, or a 1/5 mix of Chloral Hydrate to Soporific for use on the unruly and problematic (5 Chloral, 25 Soporific), and the occasional Iron Bear/Predator stupid enough to invade your Medbay. Label it accordingly (Slep Juice, Annoying Marine B Gone, whatever). Note that these injectors will be completely useless against Xenos who do not metabolize the chemicals.

In the unlikely event you need to straight up kill someone (Predators/Iron Bears mainly), 9+ U of QuikClot (3x Autoinjectors) will do the job near instantly.
I am nearly certain that doing this would result in a warning or ban for powergaming.
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Re: The Medbay Commandments

Post by Surrealistik » 13 Sep 2017, 05:13

Wubs4Scrubs wrote:
12 Sep 2017, 09:07
I am nearly certain that doing this would result in a warning or ban for powergaming.
I don't encourage seeking out and killing predators/soldiers/etc with this, but doctors should be aware of their options in the event of a desperate situation.
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Re: The Medbay Commandments

Post by Feweh » 13 Sep 2017, 16:08

You guys should definitely try and over-dose Predators now and see what happens now.

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Re: The Medbay Commandments

Post by Crab_Spider » 13 Sep 2017, 16:39

Feweh wrote:
13 Sep 2017, 16:08
You guys should definitely try and over-dose Predators now and see what happens now.
Predators don't suffer from overdoses. In fact, it appears they don't take toxin damage at all. Unfortunately Mr. Feweh, you neglected to take into account my back up chems which were made specifically for taking out predators and humans.
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