From CM Wiki
Tools of the Trade
|Used for cutting through flesh.|
Improvised Equivalents: Kitchen Knife, or Glass Shard.
Incision Management System (IMS)
|Used for cutting through flesh, skips bleeder clamping and organ rearranging. Basically acts as a scalpel, hemostat, and retractor in one step during the initial incision. Only functions as a scalpel in steps after the first.|
|Used to stop bleeding during an operation, or to remove foreign and undesirable objects from a patient's body.|
Improvised Equivalents: Wirecutters if you are going to use it to extract items from the patient or Cable Coil if you are going to use it to stop the bleeding of a patient.
|Used for setting bones back into place. If used on a bone that is not broken then you will break it.|
Improvised Equivalents: Wrench
|Used for repairing broken/shattered bones.|
Improvised Equivalents: Screwdriver
|Used for re-arranging organs, and moving cut ribcages & skulls.|
Improvised Equivalents: Crowbar
|Used for sealing incisions in a patients skin. Burns skin together.|
Improvised Equivalents: Cigarette, Lighter, or Blowtorch
|Used for repairing veins and arteries.|
Improvised Equivalents: Cable Coil
|Used for cutting through bones.|
Improvised Equivalents: Hatchet or Machete
Advanced Trauma Kit
|Used to patch all organs except for the brain and eyes.|
- Improvised tools generally have a fairly high failure chance starting at about 25%.
Surgery is a simple process with a series of steps. Once these steps are memorized it should become effortless and routine to perform. Keep in mind that once you have mastery over the basics, it's a good idea to aim to be as fast and efficient as possible due to the importance of recycling casualties back into the fight, or even preventing them from dying in the case of Foreign Object/Alien Embryo Removal.
There are two ways of doing this, anesthetic (with mask or using the surgery table) and powerful painkillers.
Note: if the patient's lungs are ruptured, they will occasionally not breath in the anesthetic. Depending on the damage to the lungs, they will either occasionally breath in the anesthetic or it won't work at all. Therefore, you will have to give the patient the anesthetic via Injection, until his lungs are not ruptured anymore.
Inserting an Anaesthetic Tank into the Surgery Table
Firstly click on the surgery table with an anaesthetic tank in hand. You must make sure your operating table has an anaesthetic to be able to put your patient to sleep. If the tank runs out, simply click on the table with no patient on it, with an empty hand and pop in a new one.
Anesthetic tank and medical mask
If there is no available operating table then, the first step is applying anesthetic to the patient via the anesthetic tank and medical mask and turning on its internals (encourage your patient to put on the tank and mask, and turn the internals on as this is fastest and allows you to proceed with step two immediately). It is advisable to remove the anesthetic tank and medical mask during the cauterizing step for maximum efficiency.
If in a rush, or you just want to do things quickly, you can give your patients Oxycodone for quick surgeries without anesthetic (15-20U recommended). You need to work quick though. Note that every form of anesthetic other than the anesthetic tank has a chance of causing your patient to flinch during the surgery, you can supplement the oxycodone with Tramadol, Inaprovaline or Paracetamol to eliminate any flinch chance. Use your medical scanner to monitor your patient's painkiller levels and re-dose as necessary. Using painkillers can cause distress in the patient (screaming over the radio about getting operated on without anesthetics, standing up and trying to leave or fight back).
The third step is to place your patient on the surgical table (grab your patient, then click the table with your grabbing hand selected). After words you must hook up the anaesthetic to the patient (click hold and drag the surgery table to the patient). After a short delay, your patient will be under general anaesthetic which will allow you to operate safely.
If you must do to circumstances, you can improvise with a roller bed or even a table, but these improvised surfaces add a failure chance to each surgical step (a table's failure chance is higher). This will also require your patient to wear the anaesthetic tank and medical mask. Now that the preparations are done, you can begin with the actual surgery.
|Foreign Object/Alien Embryo Removal (Everywhere except mouth/eyes.)||Removal of unknown objects, such as shrapnel, implants, or alien embryos from the body.
|Bone Repair Surgery (Everywhere except mouth/eyes.)||This surgery is used for mending broken bones and fractures.
|Internal Organs Surgery (Groin, Chest.)||Mending broken internal organs such as the heart or appendix. Note that this surgery excludes the eyes and brain as they have their own surgeries respectively.
|Limb Replacement Surgery (Limbs: Legs, Arms, Hands, Feet.)||The replacement of missing limbs with robotic ones. Robot arms and legs are used to replace hands and feet; there is no need to further amputate if that's all the patient has lost.|
|Eye Surgery (Eyes.)||Mending the eyes to cure blindness and eye damage.
|Brain Damage Surgery (Head.)||Fixing up the brain.
|Internal Bleeding Surgery (Everywhere except mouth/eyes.)||This surgery mends the torn/ripped arteries and veins within the body to stop internal bleeding.
|Facial Reconstruction Surgery (Mouth.)||This surgery fixes facial deformities caused by severe damage to the head. I.E. "Unknown as (name)" when speaking.
|Amputation (Limbs: Legs, Arms, Hands, Feet.)||Removal of a limb.
|Synthetic Head Re-Attachment Surgery (Head.)||Re-attaching a decapitated synthetic head.
Note: There isn't a timer on defibbing a synthetic.
|Necrosis Treatment Surgery (Limbs: Legs, Arms, Hands, Feet.)
Necrosis is currently disabled.
|Treating necrosis by cutting away the necrotic tissues and treating the affected area.
|Organ Removal/Transplantation Surgery (Groin, Chest, Head.)
Currently disabled and not performable.
|Removing an organ from the body and transplanting a new organ.|
The Autodoc System
The Autodoc system is located in the middle of the treatment center and is only usable by the medical staff (and Squad Medics during WO). Note that while the autodoc is an extremely useful machine in medical, it cannot conduct larva removal surgery.
Very often people will come in with multiple problems at once. For instance, you might have a patient who has a fractured skull, brain damage, and shrapnel in their head. Performing three separate surgeries is very time consuming when other marines may be waiting. It is possible to condense the surgery down to one in such a manner:
- Broken skull, brain damage, and head shrapnel removal surgery
- Use the Incision Management System. OR (->->) to make an incision.
- Cut through the skull
- Open up the skull
- Here it gets a bit tricky, use a hemostat repeatedly to pull out bone chips and shrapnel until you get a message that nothing more can be found in the brain. Both types of removal can take several rounds or attempts.
- Use the FixOVein and Trauma Kit to repair hematomas and damage to the brain and eyes if necessary
- Use the Health Analyzer to check that the patient does not have brain damage! If the patient still has brain damage go back and use the hemostat and FixOVein more until the Analyzer shows no brain damage.
- Close the skull back up
- Use bone gel on the damaged bones in the skull
- Piece together the broken or fractured skull
- Add bone gel once more
- Seal up the incision
- Use the Health Analyzer again to see if the patient needs antibiotics or anti-toxins and administer them as needed
What about an infected marine with a broken chest, internal bleeding, and a ruptured lung? Here you'll want to use medication from the vendors in medbay in order to tackle the problems at hand.
- Alien embryo removal, ruptured lung, and broken chest surgery (with a side of internal bleeding)
- First use one Quick-clot and one Dexalin Plus injectors to stop internal bleeding and to halt suffocation damage from the ruptured lung. While you can stop internal bleeding surgically, in the vast majority of cases a quick jab with Quick-clot is preferable. Keep a couple of Dex+ injector on hand to keep the patient from dying from the ruptured lung.
- Make an incision quickly
- Ignore bleeders and rearrange organs. Removing the larva ASAP is the top priority right now
- Cut open the rib cage
- Separate the rib cage
- Begin pulling out the alien embryo
- Repair the ruptured lungs and any other damaged organs, note that a mechanical heart requires to fix
- Now stem the bleeders with the hemostat
- Close up the rib cage
- One application of bone gel for the cut rib cage. Cut rib cages and skulls require one application of bone gel after they've been pushed back together.
- Set the broken bones in the chest
- An application for the set bones. In general remember that fixing a broken bone requires two application of bone gel before the setting it.
- Cauterize the incision, your patient should be recovering nicely now
- Again, use the Health Analyzer to double-check your work and to dispense spaceacillin or dylovene as needed
- Patients can often tell you where they need surgery if an advance scanner is not available.
- The hemostat step can be saved for later in the surgery or skipped entirely at the cost of damaging your patient over time.