Guide to Paramedic

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MedTech 101: A Reference Guide for Emergency First Response

So you want to play medical technician - welcome aboard!

Just to note, this is guide is supposed to be a reference - it's here for you to check against if you're unsure about something, if you're new and have no idea how to break into the role, or if you just have some downtime and want some pointers. It is not the "right" way to play medical technician, and you should not try to memorize this guide or get overly worried about doing exactly what it says. The role is 90% practice - you'll learn what works best for you in time.

Gearing Up

The first thing you'll want to do when you start your shift is to grab the gear you'll need.

If you're having trouble finding any of your gear, grab another paramedic to give you a tour of the department. Also, keep in mind that this is a lot of gear - you might have trouble fitting all of it in your bag, and you might find you don't need or want all of it. Bare minimum equipment is listed in red. Ask another paramedic if you're having trouble with bag space! Ditching your emergency safety kit (the red box in your bag) can help free up some room, though you might want to keep a set of internals handy if you like breathing.

Now, for your equipment and where to get it.

The Locker Room

Your locker contains some basic equipment, and a lot of spare clothes to accessorize with if lime-green-and-yellow EMT jackets are your thing. Make sure a locker hasn't already been used before you start clearing it out - you can use the nearby hand labeler to write your name on your locker, if you like.

Here you can find:

  • MedHUD: This shows you some basic medical information when looking at people - namely, heart rate and whether or not they're alive. People with mechanical hearts (and lifeforms that don't have hearts) will appear "flatlined" on the HUD - this is normal. You can also spawn with a MedHUD from loadout rather than getting it from your locker, if you prefer.
  • Storage Accessories: Holds stuff. You probably won't be able to fit everything you want without these.
    • EMT Belt: Holds medicines and various other medical supplies. Goes on your belt slot.
    • White webbing: Attaches to your uniform - fits about five small items, or more tiny items. You can also spawn with webbing (or equivalent storage items, like drop bags) from loadout rather than getting it from your locker.
  • Advanced first aid kit, which contains:
    • Advanced trauma kits (i.e. ATKs): Used to treat brute-force trauma. Stops bleeding, and speeds up the rate at which brute-force wounds heal (both from natural healing and from various trauma-healing chemicals). The advanced first aid kit contains three ATKs, and there's more in the NanoMed - make sure to have at least one ATK on you!
      • Gauze does the same thing, but less effectively - most crew have it readily available in their emergency safety kit though, so it's very handy for non-medical personnel.
    • Medical splints: Prevents broken and fractured limbs from causing pain, and significantly slows down blood loss from internal bleeding. Can only be applied to arms, legs, hands, and feet.
    • Advanced burn kits (i.e. ATBs): Used to treat burns. Helps prevent infections, and speeds up the rate at which burns heal (from natural healing and burn-healing chemicals alike).
    • Pill bottle of assorted medicines (optional): Contains some basic medicines, in pill form. Liquid medicines are much easier to use quickly, but the pills can be handy if no liquid medications are available.
  • Health analyzer (optional): Displays a readout of health information when used to scan a patient - the frontline tool in diagnosing and treating patients! Optional because your PDA (and any other medical PDA) contains a built-in health analyzer, and can do anything a health analyzer can plus send e-mails. Obviously, grab a health analyzer if you don't have your PDA for whatever reason.
  • Medic's combi-knife (optional): A multi-purpose knife/screwdriver/glass-cutter. You can shove it in your boot.
  • Gas mask and extended-capacity emergency oxygen tank (optional): A set of internals, for you or your patient. In case of a hull breach, you should probably take them if you're ditching your emergency safety kit and you need to breathe - the extended-capacity emergency oxygen tank has twice as much oxygen as the blue tank in your emergency safety kit, to boot. As an aside, increasing the release pressure on an oxygen tank (up to about 64kPa) can partially mitigate lung damage - useful if you need to stay mobile while gasping.
  • Roll of medical tape (optional): For discouraging nosey bystanders from butting their heads into medical emergencies.
  • Box of autoinjectors (optional): Single-use needles requiring little-to-no medical training, which can be used to quickly inject their contents into a patient. The ones here are filled with 5u Inaprovaline, though there are other types of autoinjectors, and their contents can be changed by drawing/injecting from the autoinjector with a syringe. These are more for civilian use than for medical personnel, though you find other autoinjectors useful.
  • Various clothes and spare equipment, including a first responder jacket and MT rig, sterile shoes and a jumpsuit, several spare headsets and medical bags, and an EMS helmet. Mostly just here for accessorizing. The jackets have pockets, though!

The NanoMed

The NanoMed is a vending machine near the ETC entrance, containing a variety of medical equipment, including bandages, splints, and certain medications. You'll want to pick up the following:

  • A bottle of Inaprovaline and a bottle of Dylovene - see Chemicals for information on what these chemicals specifically do. Store in your EMT belt for easy access.
  • Syringes: Your #1 tool and main way of distributing medication - take two, so you have a backup if the first one gets lost or breaks.
    • Holds up to 15u of liquid, and injects someone with 5u at a time by default - press harder (i.e.: click your patient again) to inject more at once.
    • Press "z" in hotkey mode to toggle whether you're drawing or injecting liquid quickly.
    • Put one in your pocket, and the other either in your bag or behind your ear.

In and Around the Emergency Treatment Center

The following equipment can be found around the department, scattered around the Emergency Treatment Center (ETC) and reception desk.

  • Roller bed: Used to move patients.
    • Note: Dragging patients on the ground will worsen any wounds they might have and can kill them very quickly. Avoid this - use a bed. If you forgot your bed, use a stasis, rescue, or body bag. If you forgot that too, call for backup or get creative.
    • To use:
      • Click in your hand to unfold.
      • Drag a person's sprite to the bed to buckle them to it.
      • Click the bed while a person's on it to unbuckle them.
      • Right click and select "drag", or ctrl + click the bed to drag it.
      • Drag an unoccupied bed to an empty tile to fold it back up.
  • Liquid medicine: Namely, a bottle each of Dexalin Plus, Tramadol, Bicaridine, and KeloDerm. These will be in the Refrigerated Medicine Storage (i.e. the fridge near the pharmacy lab), though you'll need to wait for the pharmacist or one of the doctors to make them - otherwise, you'll need to improvise. See Chemicals for detailed information.
  • IV bag of NanoBlood: When injected into a patient via IV (or syringe), NanoBlood metabolizes into 4u normal blood per 1u NanoBlood. Use on patients suffering from blood loss.
    • NanoBlood is compatible with all recipients, regardless of blood type and species - thus, it is essentially always better than blood transfusion.
    • An IV bag of NanoBlood (or any other chemical) can be attached to an IV pole or a roller bed and hooked up to a patient, or attached to a patient manually from your hand. You can also inject or draw chemicals directly from the IV bag via syringe.
    • You can adjust the output rate of an IV bag - by default, it transfers 0.2u, but you can increase this to 1u or 2u. To avoid a NanoBlood overdose (or just, wasting NanoBlood), these settings should only be used in situations of critical blood loss.
    • You can also adjust whether the IV bag is injecting or drawing liquids. The "draw" setting is mainly used for blood donations.
  • Autocompressor: Automatically performs CPR on a patient when fitted over their chest.
    • Use when a patient's heart has failed to ensure their blood keeps pumping while you're too busy running to the ETC to perform CPR (see Defibrillators and CPR Arrest for CPR details). Not quite as effective as actual CPR (specifically, it is equivalent to someone with basic medical skills performing CPR, without mouth-to-mouth), but vital for keeping a patient stable during transport. You can use both at once if they're in the OR.
    • You may need to remove bulky outerwear (jackets, spacesuits, etc.) before you're able to put this on someone.
    • This will NOT help someone with a mechanical heart. The only way to help someone with a busted mechanical heart is to get it repaired in the OR, ASAP.
  • Rescue bag (optional): A deployable bag with an oxygen tank. You can stick patients in this, and it works like a roller bed, except that it has a self-contained atmosphere.
    • Vital for rescuing people in hostile atmospheres (space, exoplanets, etc.). The oxygen tank can eventually run out, however, so be sure to check its levels.
    • Science might also supply you with an upgraded version called a stasis bag - this functions like a rescue bag, except that it also puts the patient inside in cryostasis. EXTREMELY useful, especially in high-stakes triage situations.
  • Compact defibrillator (optional): Acts like a full-sized defibrillator, except that it attaches to your belt slot rather than your back slot - simply equip the defibrillator on your belt slot, click it to take the paddles in-hand, and target the patient's chest in order to (hopefully) restart their heart. Keep in mind that restarting the heart outside of the ETC is chancy (since the heart will quickly stop again if the underlying causes aren't treated, and besides pain, most causes of heart failure require surgical intervention), and that the medical department only starts with one compact defibrillator - don't worry if you don't have one. See Defibrillators and CPR for more info on defibrillation.
    • Note: Avoid taking the auto-resuscitators (i.e. the full-sized defibrillators) out of the medical department - or at the very least, make sure one or both ORs has a defibrillator on hand. They're way more important in the OR than in the field!
  • Adrenaline auto-injector (optional): An auto-injector containing 5u of adrenaline - when used on a patient undergoing cardiac arrest, the adrenaline will restart the patient's heart. Essentially, a single-use alternative to the compact defibrillator - see Chemicals for more details on adrenaline.

Lower Medical Storage

Lower medical storage is located directly below the ladder in the morgue - ask someone to show you around, if you're lost. A lot of spare medical equipment is stored there, including several pill bottles, a spare defibrillator and set of surgery tools, as well as several sets of emergency gear for power outages and other crises - as a first responder, you'll want to grab the latter.

  • Pry bar: A mini-version of a crowbar, works just as well. Use to force open depowered doors and emergency shutters that refuse to budge.
  • Shortwave Radio: Allows for short-range communication - use when TCOMMS go down, or for communicating with your team in space or on an exoplanet. Turn it on (only the power, not the speaker or microphone), stick it in your pocket, and speak into it the same way you'd talk over common.
  • Flashlight (optional): A flashlight - useful for when the power goes out, or when you're crawling through maintenance.

Miscellaneous Gear (Optional)

Lastly, there's a few optional pieces of gear from across the Torch which you might find helpful, depending on your approach to paramedic-ing - with some practice, you'll figure out what works best for you.

  • Tablet Computer: Allows you to access the Suit Sensors program on-the-go - leaving the program open on your tablet allows you to see when there's a sensors alert, wherever you are. Extremely useful for rapid response. Can be spawned with via loadout, or can be purchased from one of the computer vendors around the ship.
  • EVA Gear (Voidsuits and Hardsuits): Space-worthy suits, designed to protect the wearer in under- or over-pressured environments - necessary for space rescues, planet missions, and hull breaches. EVA gear is mandatory for first responders on Code Red - don't carry it around/wear it casually during non-emergencies though, as 1. EVA gear is bulky, sweaty, and uncomfortable and 2. you'll look like a jackass. See Internals and EVA for instructions on how to set up and use voidsuits and hardsuits.
    • The streamlined medical voidsuit is the standard-issue voidsuit available to the medical department - two streamlined medical voidsuits can be found in primary EVA storage on Deck 4, and third is located in the Bridge Deck EVA storage near the Aquilla docking port.
    • The rescue suit control module is the medical department's hardsuit - it is more durable than a voidsuit and comes with a number of useful modules (including a chemical injector, built-in defibrillator, health analyzer, and medHUD, as well as a cooling unit and a set of maneuvering jets) at the cost of being more difficult to operate and taking up your bag slot. It can be found in lower medical storage, near the pry bars.
    • You can also use a softsuit, as a last resort - these can be found in any of the emergency oxygen lockers around the ship, though come with a significant slowdown.
    • If you are going to be moving around in space, you may also want a jetpack. If you are mechanical (e.g. an FBP or an IPC), you will need a suit cooler or you risk overheating. Both of these can be found in primary EVA storage.
  • Loaded toolbox or toolbelt: Handy for emergency breaking and entering or quick prosthetic repairs, assuming you have appropriate skills in Construction or Complex Devices, respectively. Can be found in Primary Tool Storage.
  • Roll of duct tape: Can be used to patch tears in EVA suits, potentially meaning the difference between shrugging off a carp bite and dying horribly of depressurization - useful for space rescues. Can be found in Primary Tool Storage.

As an aside, once you get a bit more familiar with Paramedic-ing, there's a few more pieces of gear you might find helpful - voidsuits, inflatables, duct tape (for patching your voidsuit) and a set of tools (for emergency breaking and entering) can all be incredibly useful in the line of duty. With some practice, you'll figure out what works best for you.

Chemicals

As a paramedic, your chemicals are some of your most important tools. Knowing what to inject and when can mean the difference between saving a patient and killing them. We'll go into more detail on the "when" in the "Treating Your Patient" section - here, we'll be discussing what each of the chemicals do.

First off: the basics. Inaprovaline and Dylovene start out in the NanoMed vendor in the ETC - the rest will need to be made in the chemistry lab.

You should have a bottle of each of these on-hand - get them as soon as you can.

A quick note: chemicals are injected into the bloodstream, and thus are reliant on blood flow to be effective. The weaker a patient's blood flow (due to heart failure, blood loss, or severe brain damage), the less effective your chemicals are going to be. Your chemicals are going to be vital in treating the sources of weak blood flow, so you should still inject them - but you'll need to couple them with NanoBlood, autocompression, CPR, and/or surgery if they are to keep your patient alive.

The Basics

  • Inaprovaline
    • A catch-all stabilization chemical - good for buying your patient more time. Very versatile - its effects include:
      • Stabilizes a patient's heart rate (potentially preventing cardiac arrest)
      • Slows down the rate of brain damage
        • At minor levels of brain damage, this can let natural healing catch up and fix the brain itself.
      • Slows down the rate of bleeding (both internal and external)
    • Mixes 1:1 with Dylovene to create Tricordrazine, even inside a patient.
      • This will make both the Inaprovaline and Dylovene useless.
      • Tricordrazine heals brute trauma, and will therefore close surgical incisions, making surgery on a patient with Tricordrazine in their system impossible and VERY dangerous.
      • Do NOT inject both Inaprovaline and Dylovene into a patient in or about to go into surgery.
    • Inaprovaline is applies in many more situations than Dylovene, and just generally gives you more time to help your patient - therefore, if you need to choose between Inaprovaline and Dylovene, you should usually prioritize Inaprovaline (barring poisoning, radiation, Unathi organ failure).
    • Inaprovaline is very effective for stabilization - upon finding a critical patient, unless you know it's one of the above cases, you should give them Inaprovaline ASAP.
  • Dylovene
    • A general use anti-toxin. Its uses include:
      • Helps removes toxins from the bloodstream quicker
      • Protects the liver (and subsequently, other organs, if the liver has already been chewed through) from toxin damage
      • Can heal liver damage, as long as the liver isn’t necrotic or decaying
      • Reduces the impact of drug-related symptoms (hallucinations, sleepiness, etc.)
    • As discussed, mixes 1:1 with Inaprovaline to create Tricordrazine, even inside a patient.
      • DON'T INJECT BOTH DURING SURGERY.
      • DON'T.
    • Dylovene should be applied in cases of: poisoning, radiation poisoning, liver damage and failure (usually caused by one of the afore-mentioned issues). For either case, you should keep the patient on Dylovene until the poison and/or radiation has cleared their system, in order to protect their liver.
      • Minor liver damage can be treated with just Dylovene, rather than needing cryotubes or surgery.
      • You'll also want to prioritize Dylovene when working on Unathi with mass organ failure, to prevent worse organ failure.
  • Dexalin Plus
    • Supplies artificial oxygen to the bloodstream - use to treat patients with oxygen loss.
    • Dexalin Plus will cause the brain to act as though it is receiving 80% of maximum oxygen from the lungs even if the lungs have failed. Dexalin, its weaker counterpart, does the same but at 50% oxygenation.
    • Note that Dexalin Plus and Dexalin will ONLY treat oxygen loss from direct oxygen deprivation (i.e. environmental causes or lung failure). It does not help with oxygenation due to lack of blood flow (due to blood loss, heart damage, or brain damage).
    • Injecting Dexalin/Dexalin Plus won't hurt in cases of low blood flow, however - so, if you're unsure of the cause of a patient's oxygen loss, it's still a safe bet to inject it anyways.
  • Tramadol
    • A medium-strength opioid painkiller. Treats pain, which can help lower heart rate and prevent cardiac arrest.
    • Along with Inaprovaline, very useful in quickly stabilizing patients with high heartbeats. (It's also nice to not leave your patients writhing in agony, all that.)
    • Causes opioid poisoning and suffocation when mixed with alcohol. Do not mix Tramadol and alcohol.
    • Note: using more Tramadol will not kill more pain. If Tramadol is insufficient to prevent your patient from hitting cardiac arrest-levels of pain, administer Oxycodone and/or Deletrathol as well.
  • Bicaridine
    • Treats brute trauma. Use for external cuts, scrapes, bruising, etc.
    • Will also treat external bleeding, eventually (though bandaging a bleeding wound with an ATK is quicker).
    • As with Tricordrazine, this will also seal surgical incisions. Once again: DON'T INJECT BEFORE OR DURING SURGERY.
    • A Bicaridine overdose (30u or more) has a chance to heal internal bleeding as long as there is more than 30u in the patient's system.
      • This method is dangerous and should not be used except in dire emergencies where no doctor is available, as a Bicaridine overdose also simulates the effects of heart failure, not to mention that the method prevents surgery and wastes a ton of medicine.
  • KeloDerm
    • Kelotane and Dermaline both treat burns, with Dermaline being more effective that Kelotane. Typically, they are mixed in a 1:1 ratio for greater effectiveness and labeled as KeloDerm.
    • Treats burns. Also helps prevent infections.

The six chemicals above are your bread and butter as a paramedic. You should know what they do and when to use them like the back of your hand.

There are other chemicals you'll find yourself working with, though. You should likewise know what these do and when to apply them - however, they're generally narrower in application than your basics, and you shouldn't generally be carrying around bottles of them; rather, these chemicals are mostly for use in the ETC.

Other Common Chemicals

  • Tricordrazine
    • Treats both brute trauma and burns, albeit slowly.
    • Made by mixing equal parts Dylovene and Inaprovaline (as mentioned above).
    • Usually administered via the Sleepers by injecting equal parts Inaprovaline and Dylovene.
    • Generally, used for post-operative care - heals up incision wounds nicely without wasting your valuable Bicaridine.
      • A severely injured patient can be injected with both Tricordrazine and Bicaridine, in order to promote quicker healing.
  • Alkysine
    • Treats brain damage. Requires at least 85% maximum blood flow to take effect. Has a slowdown effect while in the body.
      • For minor brain damage, Inaprovaline is usually more efficient.
    • An OR chemical, usually kept in the ORs for use during surgery.
  • Peridaxon
    • Treats organ damage, albeit unreliably. Can be administered surgically to revive decaying organs (i.e., is the surgeon's job).
    • Can also be administered non-surgically to treat organ damage, though this is slow, inconsistent, and comes with a considerable slowdown effect.
    • Another OR chemical.
  • Oxycodone
    • A more powerful painkiller than Tramadol - also an opioid. Use when a patient is absolutely mangled.
    • Another OR chemical.
    • Like Tramadol, causes opioid poisoning and suffocation when mixed with alcohol.
    • Like Inaprovaline, can mix with Dylovene in the patient. This creates Noexcutite, which prevents jittering - this is harmless, at least, and doesn't have any negative impact on surgery, but also means that the patient won't be benefitting from the Dylovene or the Oxycodone.
  • Hyronalin
    • Removes radiation from the patient's system. Less potent than Arithrazine.
    • Should typically be administered alongside Dylovene, to prevent the radiation from damaging the liver.
  • Arithrazine
    • Removes radiation from the patient's system - much more effective than Hyronalin, but volatile. Causes brute trauma and burns to the patient.
    • Typically used only for extreme and acute radiation poisoning. Should be administered alongside Dylovene and Hyronalin. Often coupled with Tricordrazine as well, to mitigate Arithrazine's side effects.
    • Can also treat organ damage, and does so quicker than Peridaxon. This is kind of an exploit, though, so use sparingly.
  • Spaceacillin
    • Antibiotic. 15u-filled syringes can be found in the NanoMed.
    • Use to treat infections.
  • Cryoxadone, Clonexadone, and Nanite Fluid
    • All of these are chemicals which get loaded into the Cryotubes. Chemists often mix them together in a 1:1:1 mix for maximum efficiency.
    • Cryoxadone treats brute trauma, burns, genetic degradation, and organ damage. Clonexadone does the same, but is more powerful. Nanite fluid heals prosthetic body parts.
    • Clonexadone can also be used to make synthmeat, by combining 5u blood with 1u Clonexadone. This can be used to refill the Bioprinter
  • Adrenaline
    • Acts as a cardiac stimulant - can restart the heart of a flat-lined patient, though causes some heart damage in the process. Can also cause shaking and increased heart rate.
      • If using adrenaline to restart the heart, be sure that the underlying issues which caused the heart to stop are fixed - otherwise the heart will just stop again!
      • Be cautious when using multiple times on the same patient, as repeat uses can damage the heart enough that it requires surgical intervention.
    • Adrenaline autoinjectors allow for easy injection and can be found in emergency burn pouches and fire first-aid kits.
    • Adrenaline also occurs naturally in people when injured, especially after burns - don't be surprised to see it in the field!
  • Deletrathol
    • A medium strength, non-opioid painkiller - as strong as Tramadol, but causes dizziness. Doesn't interact with alcohol, though, so helpful if your patient's been drinking!
    • Can't be produced in the chemistry lab - only found in autoinjectors in emergency burn pouches and fire first-aid kits.

Niche Chemicals

  • Paracetamol
    • A mild, non-opioid painkiller. Basically Tylenol.
    • Can be administered in the Sleepers.
  • Ryetalyn
    • Treats mutations and disabilities (which can be caused by radiation). Use for patients who are blind/deaf/randomly having seizures without any clear cause. Any amount of 0.1u or more is fully effective.
  • Noexcutite
    • Prevents shaking and jitters, which aren't mechanically dangerous but can make it easier to click a patient during surgery. Noexecutite can by made on the fly by mixing Dylovene and Oxycodone - handy for dealing with shaky patients in the OR.
  • Synaptizine
    • Treats hallucinations - good for trainee engineers who stared at the SM. Toxic at doses over 5u.
  • Imidazoline
    • Treats eye damage - good for trainee engineers who welded without welding goggles. Eye damage can also be treated surgically or with Cryotubes, though, so Imidazoline isn't made very often.
  • Ethylredoxrazine
    • Neutralizes alcohol in the bloodstream to instantly sober up patients - good for trainee or non-trainee engineers who got a little rowdy at the bar.

Together, these chemicals are essentially all of the ones you'll be working with - there's a few, more niche chemicals you might see in the course of your work, but these are used only infrequently. Feel free to brush up on the Guide to Chemistry if you're interested in learning more about specific-case chemicals like this.

Medical Machinery

On top of your gear and your chemicals, you'll also want to know how to operate some of the machines around the medical bay.

Body Scanners

While your health analyzer can give you some cursory information on a patient's health, in many cases, they'll need a more thorough scan: this is where the body scanner comes into play. One can be found in the ETC, and another in the medical staging area - to use them, simply place a patient inside the device and scan them. This will output a detailed list of health information, including damaged organs, broken bones, severed arteries, foreign objects, genetic degradation, and any number of things your analyzer can't identify on its own. In general, when a patient comes into the ETC, it's a good idea to run them through the body scanner - it can be easy to miss something on your handheld analyzer.

You can then push the scanner output - this makes it visible from the consoles in the Operating Rooms, where the physicians can easily access the information during surgery. This is very important for the surgeons - except for critical cases (who ought to be rushed to the OR as soon as possible), you ought to always scan and push the results for patients heading into surgery.

Sleepers

The sleepers can be found in the ETC - these are general-purpose medicinal units, and can be used for a number of functions.

  • Administering Medication: Sleepers can be used to inject basic medication, including: Inaprovaline, Soporific, Paracetamol, Dylovene, and Dexalin. These are all fairly basic chemicals, but the sleeper contains an unlimited amount of them, making it useful in saving your own chemicals when performing routine duties, like post-operative care. Note, that by administering equal parts Inaprovaline and Dylovene, one can use the sleeper to administer Tricordrazine - this can take care of most post-operative incisions.
  • Dialysis and Stomach Pumping: Sleepers can also be used to remove reagents from a patient's bloodstream (via dialysis) and stomach (via stomach pump). Your health analyzer and the sleeper will both indicate whether the reagent is in the bloodstream or stomach - activate the respective function until the reagent is fully out of the patient. Note that the sleeper's attached beaker must have space available in order to use this functionality. Also note that dialysis filters out a patient's blood - when using the dialysis function, be sure to keep an eye on the patient's blood levels.
  • Stasis: Finally, sleepers have a limited stasis functionality, which can be set to a stasis factor of 3x, 5x, or 10x. Generally, the cryotubes are more effective for putting a patient into stasis (having a stasis factor of 16x to 20x depending on temperature); however, if the cryotubes are already occupied, this function can be very useful in slowing down patient vitals in a triage situation.

Cryotubes

The cryotubes can be found in the top corner of the ETC, near chemistry. To use them, ensure that a beaker is loaded in the machine (it should be filled with Cryoxadone, Clonexadone, and/or Nanite Fluid), turn the tube on, and place your patient inside the tube.

Cryotubes perform a number of functions. Firstly, they place a patient in cryostasis - this drastically slows down the rate at which a patient's health declines, and is vital for triage situations where the ETC is overloaded with patients. Secondly, they automatically pump the patient with whatever chemicals are loaded into the machine (a doctor or chemist probably handled that): usually, Cryoxadone, Clonexadone, and/or Nanite Fluid, all of which only function in extreme cold. Using these chemicals, the cryotube can treat burns, physical trauma, genetic degradation, some levels of organ damage, and - if Nanite Fluid is included - injuries to inorganic body parts.

Note that the higher the rate of stasis, the slower a patient processes chemicals, including Clonexadone and the like - thus, these two functions conflict with one another. To promote one function over the other, the temperature of the cryotubes can be adjusted via the freezer, located in maintenance behind the chemistry lab. The temperature of the tubes is typically set between 80K and 120K, with lower temperatures prioritizing stasis over healing, and vice versa - the freezer is set to 80K by default. When adjusting the temperature, you should notify the other medical staff, and ask what temperature they would prefer the tubes set at.

Typically, cryotubes are sufficient to treat minor organ damage - while they are capable of treating more serious organ damage, cryotubes treat damage pretty slowly and it's usually much quicker to just treat the damage surgically or chemically (and also, being frozen in a tube for 5-10 minutes is usually very un-fun for the player in the tube).

Also note that in order for cryotubes to work correctly, they need to have Cryoxadone and/or Clonexadone loaded - without these medications, you're just freezing the patient to death. Also, the patient cannot be wearing a voidsuit, hardsuit, or other space gear - this will prevent them from reaching low enough temperatures for the medications to function.

Operating Tables

Operating tables are located in both Operating Rooms, as well as in the morgue. They provide a safe, stable surface for surgery.

Attached to each operating table are neural suppressors - these anesthetize the patient on the table when turned on, knocking them unconscious for surgery. Be sure that these are switched on before the surgeon starts operating - if multiple people attempt to turn the suppressors on, they will turn them off by accident, so be sure to double-check. Otherwise, you are liable to end up with one very traumatized patient and a malpractice suit.

Suit Sensors Monitoring Consoles

There are three console monitors around medical reception, all of which start with the Suit Sensor Monitoring application booted up. If you have a tablet computer, you can also download the application yourself for easy access on the go.

Viewing these monitors allows you to access health and location data for crewmembers aboard the ship, dependent on their suit sensor settings - this allows you to quickly tell if anyone is in need of medical aid (assuming their sensors are on) and where to run to (assuming their sensors are sending location data). Switching to map mode allows you to see crewmembers with location data on in a real-time map of the S.E.V. Torch, which can be quite useful for less familiar locations and for navigating maintenance.

You can also determine a person’s location by referencing their coordinates, which is particularly useful for space rescues - note that vertical position is listed in reverse order compared to deck numbers (e.g., Deck 5 is coordinate level 1, Deck 4 is level 2, etc., up to the Bridge Deck, which is level 6).

When someone is having a serious medical issue, the monitors (and your tablet, if the application is booted up) will flash red - this is your cue to get running.

Note, that the Suit Sensor Monitoring application is vulnerable to ion storms - when the ship flies through one, sensor data will randomly flash various, wildly incorrect health and location data. This is not a cause for alarm, but might make you jump a good few times.

The Bioprinter and the Prosthesis Fabricator

The bioprinter and prosthesis fabricator are both located in OR1 - these print out meat-organs and synthetic parts, respectively. You are likely to be asked to print parts from them while assisting with surgery. The bioprinter requires you to insert a blood sample from a patient into the machine, and can then print out any required internal organ, which should be handed off to the surgeon or stored in the adjacent freezer until needed. The prosthetic fabricator does not require a DNA sample, and can simply print organs as needed - it is capable of printing both internal organs and limbs. Typically, it is preferable to use the bioprinter over the prosthesis fabricator where possible, as synthetic organs take much more adjustment and are in general of poorer quality than organic transplants.

Both the bioprinter and the prosthesis fabricator require material in order to print parts. The bioprinter can be refilled with meat (including synthmeat, which can be made by mixing 5u blood with 1u Clonexadone) as well as removed organs. The prosthesis fabricator can be refilled with steel sheets, which are available in the morgue, as well as EVA storage and throughout maintenance.

Defibrillators and CPR

Sometimes, you will encounter a patient with a stopped heart (i.e. cardiac arrest, or "asystole" or you're fancy). This is very dangerous, but you have a number of tools at your disposal to restart and/or mitigate cardiac arrest.

Defibrillation is the safest and surest method of restarting a stopped heart - there are three auto-resuscitators (i.e. full-sized defibrillators) around the medical department (one in reception, one near OR2, and a spare in lower medical storage), plus a compact defibrillator. In order to use a defibrillator, remove your bag and equip the defibrillator in your bag slot (or your belt slot, for the compact defibrillator), take the paddles in-hand with your other hand empty, and target the patient's chest to restart the heart. You will not be able to defibrillate through EVA wear or other thick outer clothing, so be sure to remove this beforehand. (Technically, an auto-resuscitators is equipment rather than machinery since it can be picked up and moved around, but for reasons discussed below it should typically not be removed from or used outside of the ETC).

The heart can also be restarted using adrenaline, as discussed in the Chemicals section - injecting 5u (or more) adrenaline will attempt to restart the heart just as a defibrillator would, though this causes some heart damage. This can be done via adrenaline auto-injector or by syringe, if liquid adrenaline is available.

CPR can also restart a heart - however, the chances of successfully restarting the heart with CPR is slim, having a 2% - 10% chance to restart per compression depending on the rescuer's medical skill.

Note, however, that unless the underlying issues which caused the heart failure are addressed, the heart will almost immediately stop again. A heart can stop from excessive heart rate (from pain or low oxygenation), blood loss, brain damage, or heart damage - of these, only the former can be effectively treated outside of the ETC, and it is usually difficult to distinguish between them without a full body scan (not to mention that any combination of these causes can be happening at once). Therefore, restarting the heart should usually only be attempted once the patient is already in medical.

Outside the ETC, you'll instead want to focus on mitigation and stabilization while transporting your patient. This can be done via CPR and auto-compression.

To perform CPR on a patient, target the chest, head, or mouth while the patient's heart is stopped or while the patient isn't breathing. CPR consists of chest compressions (which serve to act as an external pump for the heart, temporarily enabling the patient to pump blood - one compression is sufficient to pump blood for 20 seconds, with effectiveness determined by medical skill) and mouth-to-mouth (which temporarily provide oxygenation to the patient). If you or the patient is wearing a mouth covering (or lacks a mouth or lungs), you will not be able to perform mouth-to-mouth - however, you should still attempt CPR as chest compressions are vital for patient survival. CPR can also be conducted automatically via auto-compressor (see Gearing Up) - this will perform CPR at a basic skill level, without mouth-to-mouth. This is vital for keeping an asystole patient stable during transport.

Now, for the practical part: treating your patients.

Treating Your Patients

This section will give an overarching approach for treating some of the most common conditions you'll encounter. Patients will often have more than one condition, and learning to prioritize is half the battle. Learning to juggle and quickly analyze will take time.

How Do People Die?

People die when they accumulate so much brain damage they become braindead. Your job is to slow down and interrupt this process at every step. Brain damage is caused by two things. Direct damage, and loss of blood oxygenation. The brain dies if it can't get oxygen!

Direct damage results from being shot in the head, or being poisoned, or having toxins build up in the system because all your organs failed. Loss of oxygenation is caused by not having air, heart and/or lung failure, or blood loss. The following section will try to explain common conditions in terms of the pathway of damage that can cost your patient their life in the “How Does It Kill You”, or "HDIKY" section.

That said, not everything is lethal. Don’t worry that the engineer who shows up with a burned hand will drop dead if you leave them waiting a few minutes.

Conditions

Bleeding (Internal and External)

  • Severity: High - Critical. Medications do not work without blood flow, and blood loss rapidly damages the brain. Stopping blood loss is almost always your number one priority.
  • Diagnosis: The handheld scanner will show bleeding wounds and will state if arterial (internal) bleeding is detected. Scanners will also state if major blood loss (less than 70% total volume) is detected, regardless of cause. External bleeding can also be seen visually (patient has open, bleeding wounds, patient is leaving drops of blood on the floor, etc.). Finally, blood pressure (as seen on your handheld scanner) can also provide an indication of a patient’s blood level - however, low blood pressure (especially in absence of other indications of blood loss) can also indicate heart failure.
  • Treatment: Apply an ATK or gauze to the relevant areas to seal external bleeding. Attach an IV to recover lost blood. The rate of internal bleeding can be reduced by splinting or bandaging via ATK to the relevant body part, and/or administering Inaprovaline - however, surgery is required to fix internal bleeding completely, and handheld scans do not reveal the location of IBs. Strategic Bicaridine overdoses will also fix IBs, but this should only be attempted by experienced MTs in emergency situations.
  • HDIKY: Blood carries oxygen to the brain and allows medication to circulate. Without blood, the brain cannot receive oxygen and medications cannot take effect (part of why Dexalin is ineffective for blood loss-based oxygen deprivation). Moreover, severe blood loss will damage and eventually stop the heart altogether, rapidly causing death.

Cardiac Arrest

  • Severity: Highest. Your patient will be dead in a minute without immediate action.
  • Diagnosis: Your medHUD will show a flashing red line over the patient's head. A handheld scan will show a pulse of 0BPM. Heart failure (and heart damage) is also typically coupled with low blood pressure (though low blood pressure can also indicate blood loss).
    • Note: a black HUDline indicates a patient with a cybernetic heart, or one lacking a heart entirely (that is, inorganic beings and dionaea). Such patients will have a pulse of 0BPM - this is normal, and not a cause for concern. A cybernetic heart might still fail, however - see the latter half of this section.
  • Treatment: Defibrillation, adrenaline, or CPR can restart a heart, but only if the cause of the heart failure is treated. You want to focus on mitigation and running the patient to surgery as fast as you can. Bandage any open wounds, and apply an auto-compressor to replace some of their missing heart function. Administer a shot of Inaprovaline, Tramadol, and - if you think their lungs may be damaged, or you aren’t certain one way or the other - Dexalin Plus, and, if they are missing blood, hook them up to an IV. You may attempt to restart the heart at this point with your method of choice, if you desire - if their heart stopped due to high pulse/pain/low oxygenation, this may restart it now that the patient has appropriate medication in their system (though there is no guarantee this will work). If the patient has 30% blood oxygenation at this point, then they are stable-ish - so long as they have a sufficient supply of blood and oxygen (keep them on Dexalin Plus!), remain on the auto-compressor, and are not continuing to take damage for whatever reason, you ought to be able to take them to the ETC for surgery and defibrillation safely; take them to the ETC. If not, something is wrong - they don't have enough blood, are low on oxygen, or are taking continuous damage - and the patient will die rapidly: take them to the ETC pronto, skip the scan, straight to the OR, go go go.
    • A patient with a stopped cybernetic heart is even worse off. Cybernetic hearts are harder to stop - usually, they only break after a strong electromagnetic pulse - but a stopped cybernetic heart means it’s fully broken, and it cannot be repaired, restarted, or even mitigated (autocompressors and CPRs will not work) without surgical intervention. Rush the patient to the OR immediately.
  • HDIKY: A stopped heart means no blood flow at all. No oxygen can reach the brain, and no medication can circulate. Death follows 0% blood oxygenation swiftly.

Oxygen Deprivation (from Lung Damage or Environmental Oxygen Loss)

  • Severity: High - Critical.
  • Diagnosis: Patient is gasping, coughing up blood, or unable to speak. Handheld scanner shows severe oxygen deprivation, or low blood oxygenation levels with normal blood pressure (low blood oxygenation levels with low blood pressure instead indicates blood loss and/or heart failure).
  • Treatment: If there are no underlying issues with blood loss or heart failure, Dexalin Plus will bring blood oxygenation levels up to 80%. Placing the patient on high-pressure internals (to a maximum of 64kPa) can also mitigate oxygen deprivation and further lung damage, if Dexalin Plus is unavailable. Bring patient to the ETC for full diagnostic scans and probable surgery. Note that if a patient is gasping but does not appear to have low oxygenation, their lung damage is probably only minor (or their internals tank just ran out), and they won't need immediate surgery - minor lung damage is more annoying than dangerous.
  • HDIKY: No oxygen means no oxygen to the brain.

Poisoning

  • Severity: Low - High. Very much dependent on amount of poison and how long it's gone untreated.
  • Diagnosis: Unknown substance in the bloodstream or stomach (though this may also be something innocuous, like food). Patient is dry heaving or vomiting. May be experiencing Massive Systematic Organ Failure (MSOF), if severe enough.
  • Treatment: Administer Dylovene immediately, and keep the patient on Dylovene until the poison is fully clear from their system (and after, if their liver has been damaged - it probably has been). Bring the patient to the ETC - dialyze or stomach pump the patient, if the poison hasn't already cleared from their system (and if they aren't in need of immediate surgical attention). Body scan the patient, and bring to the OR for any surgical issues.
  • HDIKY: Toxins, generally, will eat through your organs in a fairly linear fashion. The liver fails first, followed by the kidneys, then the lungs, heart, and brain - once the lungs start to fail, things spiral out of control rapidly. You want to stop this process as soon as possible.
  • Special Cases:
    • Spider Bites: Be aware that spiders often cause bleeding wounds, which should be bandaged, and also sometimes lay eggs in people, which should be surgically extracted promptly. Otherwise treat as normal.
    • Alcohol: Do not administer Tramadol or Oxycodone to a patient with alcohol in their system. Reprimand the patient for binge-drinking when they wake up.
    • Amatoxin: A delayed action toxin found in mushrooms of the Amanita genus - initially causes a moderate allergic reaction (itching, coughing, etc.) before causing rapid, severe organ damage. Dialyze quickly, before it reaches this stage.
    • Carpotoxin: Produced by the space carp found around the ship - severely interferes with blood circulation. Extremely dangerous, as it will cause the patient to quickly enter cardiac arrest and fall below the 30% oxygenation threshold, with Dexalin, CPR, and other usual treatments becoming ineffective - dialysis is the only available option, or the patient will die quickly. Inaprovaline can be used to buy yourself more time.
    • Cardio-, Pneumo-, and Neurotoxins: Some toxins skip the usual "organ chain" of damage and target the heart, lungs, or brain directly, though these are typically fairly uncommon aboard the Torch. Dialyze/stomach pump these cases as normal, but treat the patient for heart/lung/brain damage rather than liver damage.
    • Drugs: An OD should be treated the same as other poisoning cases, but in general, most recreational drugs aboard the ship aren't a cause for medical concern. You can usually tell someone is high by drooling, giggling, or a lowered pulse. Don't worry, they'll come down eventually.

Radiation Poisoning

  • Severity: Moderate - High
  • Diagnosis: Radiation visible on handheld scanner. Other symptoms of poisoning present (dry heaving, vomiting, possible MSOF). Possible hair loss.
  • Treatment: Inject Dylovene immediately, and keep the patient on Dylovene until the radiation is fully clear from their system. This prevents the worsening of organ damage. The severity of radiation poisoning is as follows:
      minor < mild < advanced < severe < extreme < acute
    • For low levels of radiation (roughly, "advanced" or less), administer Hyronalin - 5u is typically enough. Add more if the first dose fails to fully clear the patient's radiation.
    • For higher levels of radiation (roughly, "severe" or above), administer Hyronalin and Arithrazine, alongside Tricordrazine if possible (to mitigate the Arithrazine), and Tramadol if necessary. Heavy radiation is also often accompanied by burns - treat accordingly. Administer more medication if this fails to full clear the patient's radiation (you probably won't need to). Be cautious when administering more than 5u Arithrazine at a time, because it is ouchie.
  • In either case, after the radiation has cleared the patient, give the patient a body scan to check for organ damage (liver damage is probable, other damage is possible if the radiation was left untreated for a while) and genetic damage and/or mutations. Treat accordingly.
  • HDIKY: Like other sorts of poisons, radiation will chew through your liver, and eventually, the rest of your organs.

Brute-Force Trauma

  • Severity: Low - High
  • Diagnosis: Brute-Force trauma can be seen on your scanner, and to the naked eye.
  • Treatment: Note that treatment of brute-force injuries should usually wait until worse conditions are treated, as Bicaridine and Tricordrazine will prevent surgery. Bandage any bleeding wounds ASAP, though!
    • For minor injuries, administer Bicaridine and bandage the wounds with an ATK, if they haven't healed by the time you pull your ATK out. Administer more medication if needed. Tramadol can be administered for pain management, if necessary.
    • For more severe injuries, administer Bicaridine and Tramadol (and Inaprovaline if necessary to stabilize the pulse) to start, bandage the wounds with an ATK, and administer Tricordrazine via Sleeper (or, in a pinch, by drawing equal parts Inaprovaline and Dylovene into your syringe at once). Monitor patient until fully healed, administering more medication as necessary.
    • Note: Don't allow patients with extreme injuries (the handheld scanner will say "extreme damage" for the given body part) to go into surgery unless absolutely necessary. This is because the surgical incisions can push the damage over the top into irreparable territory, necessitating amputation. As stated above, treatment of brute-force injuries should usually wait, but in this case, giving 5u Bicaridine on-site or at the ETC and waiting the 30 seconds or so for it to metabolize is highly recommended.
  • HDIKY: Brute-force trauma can be painful enough to stop a heart - it also accompanies many, many other, more serious conditions.

Burns

  • Severity: Low - High
  • Diagnosis: Burns can be seen on your handheld scanner, and to the naked eye.
  • Treatment: KeloDerm is a really, really powerful. This is good for you.
    • Administer KeloDerm. For more severe burns, couple with Tramadol to prevent pain and Inaprovaline to keep their pulse down, and administer more KeloDerm as needed. Salve burns with an ABK if desired. Burns can vaporize a patient’s blood, causing blood loss but not bleeding. Administer NanoBlood if their blood pressure doesn't look good.
  • HDIKY: Burns can vaporize blood - see the section on bleeding. Burns can also be painful enough to stop a heart!

Fractures and Breaks

  • Severity: Low - Moderate
  • Diagnosis: Handheld scanner reports fractures. Patient is falling over (for a fractured leg) or dropping things in pain (for a fractured arm).
  • Treatment: Splint the limb (if possible - this only applies for arms, legs, hands, and feet) and bring the patient to the ETC for surgical repair. Note that a patient can manage with a splinted limb for a while - in an emergency, a patient with a fractured arm/leg can be splinted and allowed to resolve whatever crisis is at hand before returning to the ETC for surgical treatment.
  • HDIKY: Fractured or broken limbs can be painful and can get infected, but they are rarely fatal. A broken skull or rib cage, however, is much nastier: for one, they tend to go hand in hand with massive injuries to very important organs, and for two, the shards of bone can move around inside the patient, further damaging these organs.

Embedded Objects

  • Severity: Moderate
  • Diagnosis: Patient visibly has something sticking out of them. A foreign body is visible inside the patient on the body scanner.
  • Treatment: Bring patient to the ETC for surgical removal. Some objects - say, a machete lodged in someone's face - can be tugged out by hand (by right-clicking the patient and using the "Yank object" verb), but this is not recommended except in emergencies, as it can further injure the patient and cause arterial bleeding.
  • HDIKY: Wounds won't be able to fully heal when there's an object lodged in them. Also, ew.

Irreparable Damage and Limb Loss

  • Severity: Moderate
  • Diagnosis: Irreparable damage or stumps of limbs visible on the handheld scanner. Patient is visibly missing limbs.
  • Treatment: Treat the massive pain and blood loss the patient is almost certainly experiencing. Bring patient to the ETC for amputation (irreparable damage is, naturally, irreparable) and limb replacement.
  • HDIKY: Irreparable damage and limb loss is extremely painful, potentially causing cardiac arrest, and typically causes high levels of blood loss. A mangled stump of a limb, moreover, will typically be bleeding internally - this bleeding cannot be stopped by any means short of amputating the stump.

Mutations and Genetic Damage

  • Severity: Low
  • Diagnosis: Genetic damage is visible only in the body scanner and cryotubes, and usually only occurs as a result of radiation exposure or slime attacks. Mutations are widely varied, and also usually a result of radiation exposure. Common manifestations include unexplained blindness or deafness - these two mutations will show on the body scanner, though others might not.
  • Treatment: Genetic damage can be treated with Cryoxadone and/or Clonexadone in the cryotubes, or with Rezadone (though Rezadone is rarely produced). Mutations can be treated with Ryetalyn - any amount 1u or more should be fully effective. If the mutation seems harmless, though, feel free to ask if they'd like to keep it.
  • HDIKY: Genetic damage causes pain, which can theoretically eventually lead to cardiac arrest - typically, however, these are both relatively "safe" conditions and are unlikely to lead to complications.

Infections

  • Severity: Low
  • Diagnosis: Abnormally high body temperature (not caused by prosthetics or the like). Patient may be experiencing dizziness, migraine, if the infection is in their head. Best diagnosed via the body scanner.
  • Treatment: Administer Spaceacillin (found in the NanoMed), and monitor patient to ensure infection clears.
  • HDIKY: Infections can technically progress to the point where they're dangerous, but they essentially never do. Don't worry that much about infections.

Dislocations

  • Severity: Low
  • Diagnosis: Patient is in pain, has visibly dislocated limbs
  • Treatment: Right-click the patient and use the "Un-dislocate" verb.
  • HDIKY: N/A. Dislocations hurt, but they're not lethal! Chew out security for joint-locking their prisoners, though.

Facial Deformation

  • Severity: Lowest
  • Diagnosis: Patient is unrecognizable, even without any face coverings.
  • Treatment: Bring them to an OR for plastic surgery, preferably after things have calmed down.
  • HDIKY: N/A. A broken nose or smashed lip is not pleasant, but it will not kill a patient. Let the patient come in of their own accord, though treatment ought to wait until after any triage situations are handled.

Patient is Just a Brain

  • Severity: Highest
  • Diagnosis: You're holding a brain.
  • Treatment: Put the brain in an MMI immediately - there's an MMI in the freezer of both ORs. Run!!! Check to make sure they don't have a "Do Not MMI" in their medical records, unless you want a hefty lawsuit - otherwise, plop 'em in there. If you manage to get them in the MMI before brain death occurs, console the poor bastard, and convince the roboticist to build them an FBP. If no roboticist is available, ask the rest of engineering. Get pushy with them if you have to. Nobody wants to be stuck in a brain-jar.
  • HDIKY: Brains die pretty fast when they are outside of the body.

Organ Damage

Organ damage falls in its own, special category, and hence gets its own section. Organ damage overlaps with, is caused by, and causes the conditions above - it also tends to be more difficult to diagnose outside of the ETC. As a medical technician, you will typically be treating based on conditions rather than on organ damage - however, an understanding of the severity and treatment of organ damage is extremely helpful for the management of patients and in gauging the seriousness of any given injury.

In general: Organ damage is best treated surgically. Organ damage can also be treated via the Cryotubes, albeit slowly (especially for damage worse than minor), and all organ damage except brain damage can be treated via Peridaxon, Arithrazine, or Rezadone, though this tends to cause unwanted side effects. These methods are typically only used for minor organ damage or in triage situations, where no surgeon is available.

Certain organs can also be treated with other, more specific medications, as detailed in their respective sections.

When seriously damaged, organs can have particular statuses which will show on the body scanner output - these are usually for the surgeon to worry about:

  • Decaying: Non-functional, but still salvageable (for now) - requires surgical application of Peridaxon to fix (or can just be replaced if no Peridaxon is available). If it isn't repaired quickly, the organ will become necrotic.
  • Necrotic: Totally dead. Will require replacing via organ transplant - prepare to print out some organs with the Bioprinter and/or Prosthesis Fabricator.
  • Scarring: Scarring occurs when a badly damaged organ is repaired, or in the case of the brain, when the brain is repaired while the patient is below 60% oxygenation. Scarring reduces the overall maximum health of an organ, but isn't a health concern in and of itself - still, your surgeon should try and avoid causing it.

Diagnosis and severity of organ damage is dependent on the organ in question, and detailed in each organ's section. For a precise diagnosis, you will typically need to scan a patient in the body scanner. However, sufficient damage to any combination of organs will be visible on your handheld as "Major Systematic Organ Failure" (MSOF, for short); the severity of MSOF is, naturally, dependent on the organs in question (a decaying liver is much less dangerous than a decaying heart or lungs), but should in general always be treated with high to critical priority.

Note: If your patient is MSOF and a Unathi, they should instead be treated with highest priority, on par with cardiac arrest and extremely weak/fading brain activity. Alert your team and rush them to the OR immediately. See Robotic and Alien Patients for specifics on Unathi treatment - but in short, force-feed them any protein you have on hand (the protein bar in your emergency safety kit works), administer Dylovene, an auto-compressor, and any other relevant medication, and run like hell.

Brain Damage

  • Severity: Highest
  • Diagnosis: Precise level of brain damage shows up directly on the handheld scanner.
  • Treatment: Ultimately, every condition that can kill you leads to your brain.
    • Mitigate whatever has caused the brain damage (direct damage, oxygen deprivation, etc.) to the best of your ability on-site, as per the other sections, and rush the patient to the ETC, ASAP. If their brain activity is "extremely weak" or "fading", announce so over medical comms, and bring them directly to the OR, without stopping for a body scan.
    • Brain damage is mitigated by administering Inaprovaline, and minor brain damage can be treated with Inaprovaline alone. If they have no other issues, a patient with minor brain damage can be treated with only Inaprovaline.
    • Alkysine can treat more severe brain damage, though it requires 85% blood oxygenation in order to function.
  • HDIKY: Your brain dying means you are dead. That's it.

Heart Damage

  • Severity: High - Critical
  • Diagnosis: High pulse, low blood pressure (especially low blood pressure without any signs of blood loss). Easily confused with blood loss. For total heart failure (patient is flatlining, heart rate of 0BPM), see Cardiac Arrest.
  • Treatment: Heart damage can stem from a number of sources: blood loss, oxygen deprivation, poisoning, direct damage, and so on. Treat the source accordingly, and in any case, apply an auto-compressor and administer appropriate chemicals (namely Inaprovaline, except in Dylovene-priority cases). Rush the patient to the ETC.
  • HDIKY: Heart damage prevents blood flow, which prevents oxygen and medication from circulating. This lack of oxygen kills the brain. Moreover, sufficient heart damage will stop the heart, causing cardiac arrest.

Lung Damage (see: Oxygen Deprivation)

  • Severity: Moderate - High
  • Diagnosis: Patient is gasping, coughing up blood, or unable to speak. Handheld scanner shows severe oxygen deprivation, or low blood oxygenation levels with normal blood pressure (low blood oxygenation levels with low blood pressure instead indicates blood loss and/or heart failure).
  • Treatment: See treatment for Oxygen Deprivation. Assuming the heart and blood levels are fine, administering Dexalin Plus will bring them to at least 80% oxygenation. In lieu of Dexalin Plus or Dexalin, turn on high-pressure internals (to a maximum of 64kPa). Bring the patient to the ETC for a full scan and, likely, surgery.
  • HDIKY: Busted lungs means no oxygen means no oxygen to the brain.

Liver and Kidney Damage

  • Severity: Moderate
  • Diagnosis: Dry heaving, evidence of poisoning (unknown substances in the stomach or bloodstream) or radiation (visible directly on the handheld scanner). "MSOF" without any signs of heart, lung, or brain failure is usually indicative of liver and/or kidney damage. Kidney failure releases potassium, which also shows as an unknown substance in the bloodstream.
    • Note that kidney damage is nearly always caused by liver failure, and is treated the same in the field - thus, there is no need to diagnose them separately prior to getting a body scan.
  • Treatment: In general, administer Dylovene immediately and bring the patient to the ETC for a body scan. See to treatment for Poisoning or Radiation Poisoning as appropriate. The patient should be kept on Dylovene as long as the liver remains damaged, in order to promote liver healing and to prevent damage to other organs. Note that liver damage can be treated entirely with Dylovene, so long as the liver isn't decaying or necrotic - kidney damage requires surgical intervention or else cryogenics/chemical treatment.
  • HDIKY: The liver is the body's first line of defense against toxins and radiation alike. Once it fails, toxins will then attack organs sequentially: next the kidneys, then the lungs, then the heart, then the brain - and once the toxins hit the lungs, things start spiraling rapidly. A damaged liver or kidneys are not immediately lethal - but you want to catch it there ASAP to prevent things from getting much more complicated.

Eye, Stomach, and Appendix Damage (including Appendicitis)

  • Severity: Low
  • Diagnosis: Patient feels a stinging pain in their lower body (stomach or appendix). Patient's head hurts, patient is having trouble seeing (eyes). It's usually easier to diagnose these conditions in the body scanner.
  • Treatment: Fix via surgery or Cryotubes. An inflamed appendix must be removed, rather than repaired via surgery or Cryotubes or the like. Eye damage can be treated by administering Imidazoline as long as the eyes aren't decaying or necrotic. (Note that eye damage is different from cataracts, which are a form of mutation, and should be treated with Ryetalyn).
  • HDIKY: N/A. Save appendicitis, which can cause a massive release of toxins in the body if left untreated long enough, damage to these organs is fairly uncommon and only very rarely lethal. They occur most often with falls (any), overeating (stomach), or welding without safety gear (eyes).

Damaged Augments

  • Severity: Lowest
  • Diagnosis: Augments appear on body scanner as damaged or necrotic.
  • Treatment: Repair surgically - augments (and other mechanical parts) require nanopaste or a screwdriver to fix, so make sure your surgeon has those on-hand. Will need to be removed if necrotic, but don't need to be replaced, unlike organs.
  • HDIKY: N/A - busted augments won't work, but they're not lethal.

The above should cover most, if not all, injuries you'll see aboard the Torch. Keep in mind conditions rarely occur in isolation, and you may well run into something entirely new - we're on the frontier of space, after all. Always be ready to improvise, generalize, and prioritize.

Other Info

Surgical Support and Post-Operative Care

As a paramedic, in addition to stabilizing and transporting patients, you will also need to perform surgical support - that is, keeping patients alive and healthy while a physician performs surgery and running any tasks that need to be done in order for the surgery to be conducted smoothly. This includes:

  • Administering medication as appropriate:
    • Inaprovaline, if heart rate is unsteady, the patient is bleeding, or the patient is at risk of taking brain damage (so, almost always).
    • Tramadol, if the patient is at risk of shock - Oxycodone and/or Deletrathol if Tramadol isn't sufficient, and Deletrathol alone if the patient has alcohol in their system.
    • Dexalin or Dexalin Plus, if the patient has low oxygenation/damaged lungs.
    • Dylovene if the patient has taken liver damage, is poisoned, etc. (plus Hyronalin and/or Arithrazine if they're irradiated).
    • Do not administer Bicaridine or Tricordrazine during surgery, or mix Inaprovaline and Dylovene during surgery, as this will heal surgical incisions.
  • Hooking the patient to an IV bag, if bleeding or low on blood.
  • If the patient's heart is stopped, performing CPR and ensuring that the patient is wearing an auto-compressor.
  • If the patient's heart is stopped, restarting it (via defibrillation/adrenaline/CPR) once the underlying cause is treated.
  • Check (and double-check) that the operating table's neural suppressors are on, and the patient is unconscious.
  • Ensuring the patient's scan was pushed (if they got scanned before going to the OR).
  • Strip any bulky outerwear/voidsuits/armor/helmets in the way of surgery.
    • You may also want to strip the patient's uniform - when uncovered by clothing and exposed by surgical incision (or gaping wound), one can examine the state of organs without needing a body scan, thus allowing a surgeon to appropriately treat a patient even if you didn't get to scan them before taking them to the OR.
  • For Unathi - feeding the patient protein, so they don't starve to death during surgery.
  • Print any limbs or organs from the bioprinter or prosthesis fabricator that the surgeon will need to transplant during surgery.
    • Fleshy organs should be stored in the freezer crate if they are printed before the surgeon needs them, so they don't decay.
  • Run out and grab anything else needed for the surgery - whether that be more medication, more meat or metal for the bioprinter/prosthesis fabricator, nanopaste or a screwdriver for repairing prosthetic organs, or a whole 'nother surgical toolkit because some maniac moved the first one.

You will also likely be drafted to do post-operative care once surgery is finished, which is relatively simple:

  • Re-scan the patient to ensure there's no surgical issues remaining.
  • Treat any non-surgical issues - usually, this means Bicaridine and/or Tricordrazine to heal up the surgical incisions. Sometimes, this means a metric ton of Bicaridine and Tricordrazine (both at once will go faster) because they fell down three decks.
  • Discharge the patient once they're clear.

Robotic and Alien Patients

You will also find yourself needing to treat alien and robotic patients, on occasion - while much of the above still applies, some species have special considerations to take into account, as follows:

  • Unathi:
    • Probably the most difficult alien species to treat, and unfortunately also the most likely to wind up in medical.
    • Unathi have a powerful healing factor powered by their digestive system, and can shrug off most injuries provided ample access to protein. However, this can work against them - when Unathi starve (either because they were critically injured and their digestive system tried to heal them too hard, or because they simply haven't been eating), their body begins to digest their own organs, which will all rapidly become necrotic. This is really dangerous!
    • If you find an MSOF Unathi:
      1. Scream bloody murder over medical comms.
      2. Force-feed them protein (the protein bar in your emergency safety kit is probably the most readily-available source, but protein shakes, steak, burgers, whatever all work) - this will buy their poor organs a little more time. In the unlikely event they are conscious, give them the protein instead.
      3. Administer Dylovene and an auto-compressor (again, buying time) plus any other relevant treatments, then run like hell straight to the OR. Do not stop to scan. Hope you have a good surgeon.
      4. If the Unathi is conscious, you can ask them to turn their healing factor off prior to surgery (which yes, they can do) - otherwise, they are going to be healing constantly during surgery, which 1) will heal up surgical wounds mid-surgery and 2) will continue to chew through their protein supply and/or internal organs.
      5. Assuming they didn't/couldn't turn their healing factor off, continue force-feeding the Unathi protein throughout surgery (target their head or mouth with the protein bar/protein shake/burger while not on Help intent). Be prepared to print off a lot of replacement organs.
    • Unathi are incompatible with prosthetics and augments - when replacing their organs, you'll need to use organic replacements from the bioprinter. Be sure to have a lot of meat and/or Clonexadone on hand. Relatedly, rejecting prosthetics means Unathi cannot be MMI'd.
    • Unathi can self-heal external cuts and burns and damage to internal organs, and regenerate missing limbs. They cannot self-heal broken bones, arterial bleeding, necrotic or decaying organs, or other injuries like radiation poisoning or imbedded objects. Don't let them try to walk these things off, because they will die.
  • GAS (Giant Armoured Serpentids):
    • Medicine on hard mode because the patient may or may not maul you if you touch them.
    • GAS breath by producing produce phoron and acetone in their bodies, which they combine to form Dexalin. This phoron will show up as an unknown substance in the bloodstream - you should not dialyze a GAS just because you see this message. Look for other signs of poisoning (dry heaving, vomiting, MSOF, so on).
    • That said, poisoning is especially dangerous for GAS because they have a unique organ - the phoron storage - which can't be made with the bioprinter or prosthesis fabricator, and therefore cannot be replaced. If the phoron storage dies, a GAS will no longer be able to produce Dexalin, and will slowly suffocate to death if they don't receive an external Dexalin drip for the rest of their life. The phoron storage is attacked by toxins second after the toxin filter (the GAS equivalent of a liver), much like kidneys are in other species.
    • When doing dialysis on a GAS, make sure you keep the GAS high on Dexalin or they will suffocate.
    • GAS are too large to be pulled with ctrl + click or fit in a stasis bag/rescue bag/body bag - they must be moved with a roller bed or pull intent.
    • GAS blood does not carry oxygen (and is technically called hemolymph rather than blood) - none of the blood oxygenation effects impact GAS, and oxygenation is only dependent on their Dexalin levels. Low blood or a stopped heart is a lot less dangerous for GAS, though it'll still damage organs at random.
    • Like Unathi, GAS cannot be MMI'd - presumably because they have a distributed nervous system rather than a central brain.
    • For surgery (i.e. none of your business, but included for completeness):
      • All external parts (head, torso, arms, tail, etc.) of the GAS are encased, meaning they need to be cut open and repaired before and after surgery, just like a human chest or skull would.
      • GAS have different internal organs than humans, and many of their analogous organs are in different spots. For example: GAS's "brains" are located in their thorax (chest) - a GAS can survive decapitation, and even have its head re-attached! See the Giant Armoured Serpentid page for specifics.
  • IPCs/FBPs/Prosthetics:
    • Robotic patients are usually the job of the roboticist to deal with. If there's no roboticist available, ask a doctor (physicians are required to have Trained Complex Devices at minimum, though they might not have the OOC knowledge to deal with robots) or an engineer. Failing that, you can stick the patient in a charger while you wait for appropriate personnel to fix them, so that the patient at least remains stable. See Robotics for specifics.
  • Skrell:
    • A little more resistant to toxins and a little less resistant to alcohol, but Skrell don't have any unique medical considerations. Warble freely.
  • Dionaea:
    • Dionaea barely get injured by anything, don't have blood to lose, and more importantly, who would even beat up a diona in the first place? If you get an injured diona for whatever reason, if they have any irreparable limbs, amputate them (they'll grow back eventually) - otherwise, prescribe them a healthy dose of sunbathing by the SM and send them on their way.
  • Adherents:
    • Similar to IPCs/FBPs. Make sure the Adherent has charge, and then stick them in the mineral bath in Adherent maintenance on Deck 4 to heal. That said, you'll basically never see injured Adherents, anyways.
  • Vox:
    • Don't treat Vox.

General Tips

Finally, a few broader words of advice.

  • Stay alert and responsive. Listen to medical comms and the common radio channel for calls for help, orders, or any other signs you might be needed, keep an eye on suit sensors to see if they're flashing red, and always be ready to run.
  • Always communicate. Shout out on medical comms when you're responding to a call or if you need backup, let medical know if you're coming in with a critical patient (a shout of "EWEAK" or "MSOF" will usually do), and keep them updated on any situations you're staging. Talk to your team. They'll appreciate it.
    • In the same vein, respect your coworkers. Nobody likes a medical technician who steals patients from other medical staff or talks down to the department! Even when the other medical staff are in need of help, assistance should be offered respectfully. Don't be a dick.
    • Relatedly: if you plan to take supplies from medical outside of the norm (e.g.: MT standard gear and chemicals, as above), notify medical staff. If you take the radiation medicine on an away-mission and the doctors don’t know to restock, they are left in a very bad position if the ship is hit with a rad storm, etc.
  • Your safety comes first! Stay back from active combat, don’t head into a depressurized area without a voidsuit (don’t vent the hallway either, check the airlocks), don’t rush in to a fire or any other situation you’re not equipped for. And please, don’t chase down bad guys — you’re not security. You will just look like a tool.
  • Follow triage - but ensure you don't get tunnel-vision on one patient. Treat and stabilize critical patients first, then other seriously injured, then moderate, etc. — you may need to bounce between multiple patients to ensure they don’t worsen. In an extreme triage situation, however, you may not be able to save everyone — run damage control, and save who you can.
  • Prisoners have a right to medical care - you do, in fact, need to treat them. That said, if you need to choose between saving a crew member and saving a hostile attacker, save the crew member first. Despite all the shit security may talk, your crew members usually don't want you dead, unlike hostile boarders! That typically earns the crew some priority.
    • Relatedly: this should probably go without saying, but if someone is an active threat, do not treat them until after they are incapacitated and cuffed.
  • Patients are people too. Talk to them. Obviously, don't mince words if someone's hacking their lungs up, but if someone comes to the ETC complaining about stomach cramps, don't wordlessly grab them and drag them to the body scanner - ask them politely to follow you, inform them about their condition and their options, and when they're recovering in post-op, let them rest if they need to.
    • At the same time, don't keep people trapped in the ETC longer than they have to be, especially if they have somewhere to be - especially in a crisis, and especially if they are emergency personnel responding to said crisis. Many people don't want to be in medical any longer than they have to.