Guide to Medicine

Your job as a member of the medical staff is to keep your patients alive.

If the patient's brain is alive, the patient is alive.

If the patient's brain dies, they are dead and can never be brought back.

Therefore, your main goal is to protect the patient's brain. Everything else is secondary.

=Anatomy= The body is composed of body parts connected to one another; each body part can contain bones and/or organs. If a body part is damaged, any organs or bones within may also be damaged.
 * Head: Contains the skull, brain, and eyes.
 * Torso: Contains the ribs, heart, stomach, and lungs.
 * Arms: Connected to the torso. Contains bones.
 * Hands: Connected to the arms. Contains bones.
 * Lower Body: Contains the pelvis, liver, kidneys, and appendix.
 * Legs: Connected to the lower body. Contains bones.
 * Feet: Connected to the legs. Contains bones.

Organs interact with one another:
 * The heart pumps blood to the other organs, most importantly the brain. If it does not pump, the brain cannot access oxygen from the blood and begins to die.
 * The lungs oxygenate the blood. If the blood is not oxygenated, it is useless to the brain, which begins to die.
 * The liver protects the other organs from being damaged by generalized toxins. The more it is damaged, the more toxins can damage the other organs. Damaged organs cannot function as well.
 * The stomach receives and processes reagents which may help or harm the other organs.
 * Any body part that becomes infected or gangrenous will release toxins, damaging other organs.

Brain
The more damaged the brain is, the closer to death the patient gets. Therefore, the more an injury harms the other organs' ability to support the brain, the more urgent it is.


 * Symptoms of Damage: Headaches, blurred vision, dizziness, fainting, paralysis.
 * Causes of Damage: Trauma, low oxygen, toxins.
 * Repair: Medication and organ repair surgery.

The brain starts out with an integrity of 100%. Brain injury lowers that number. If brain integrity reaches 0%, your patient is brain dead. There's no coming back from brain death.

Low oxygen
The brain gets its oxygen from the blood. Blood oxygenation below 85% will start to damage the brain; blood oxygenation below 40% damages the brain at a faster rate.

Direct Harm
If the head is damaged, the brain may be damaged. Beyond the obvious burns, bullets, and bludgeons, the brain can also be damaged if someone moves around with a broken skull or an object lodged in their head.

Toxins
Even if the brain gets plenty of oxygenated blood, organ-damaging toxins will still harm it. Some toxins damage the brain directly, bypassing the liver and kidneys.

Treating Brain Damage

 * Stabilize the patient.
 * If toxins in the body are damaging the brain, remove them.
 * Repair other organs. If the other organs cannot support the brain, the brain will continue to degrade.
 * Repair the brain.
 * Mild brain damage will resolve with restoration of blood flow and inaprovaline.
 * Moderate brain damage can be treated with Alkysine or Peridaxon.
 * Moderate to severe brain damage can be treated with surgery. Be aware that if you have not re-established blood flow to the brain, repairing the brain directly with surgery can cause scarring. This weakens the brain, making it more vulnerable to injury in the future.

Heart
The heart keeps your blood flowing. If blood doesn't flow, oxygen doesn't reach the other organs; if the brain doesn't get oxygen, it gets damaged.


 * Symptoms of Damage: Low blood oxygen, sharp chest pain, weak or high pulse rate.
 * Causes of Damage: Chest trauma, damage from a high pulse rate, lung injury, brain damage, toxins and some drugs.
 * Repair: Perform Surgery or administer Peridaxon or Adipemcina.

When the patient's heart stops, it's called Cardiac arrest.

The patient's heart rate helps indicate their physical health.

Lungs
Provides oxygen to the bloodstream. Damage increases the air pressure needed to sustain optimal oxygenation.
 * Symptoms of Damage: Hypoxia, gasping, sharp chest pain, coughing up blood, weak respiration upon examination with a stethoscope.
 * Causes of Damage: Over/underpressurized atmosphere, phoron exposure, general organ damage, trauma to the chest.
 * Treatment: Peridaxon, Pneumalin, organ Surgery, emergency reinflation via pen or syringe (in case of collapsed lung and no doctors).

The patient's blood oxygen level helps indicate their physical health.

Liver
The first line of defense against poisons, the liver reduces intoxication and prevents other organs from taking damage from poisons as long as it's still working.
 * Symptoms of Damage: Vomiting, other organs taking damage from general toxins.
 * Causes of Damage: High level of toxin damage, heavy alcohol consumption, direct trauma to the lower body.
 * Treatment: Dylovene (at 10 liver damage and below); surgery; Peridaxon.

Toxins damage the liver first, then the kidneys; the more damaged these organs are, the more the toxins will get through to damage other organs, including the brain.

Eyes
Provides sight.
 * Symptoms of Damage: Blurry vision, no vision, sharp head pain, damaged/unresponsive pupils upon examination with a pen light.
 * Causes of Damage: Welding without protection, phoron exposure, physical trauma.
 * Treatment: Oculine, Peridaxon, or surgery.

Kidneys
Filters your blood.
 * Symptoms of Damage: Phosphorus buildup in the bloodstream and eventual phosphorus poisoning.
 * Causes of Damage: Physical trauma, toxin damage to organs.
 * Treatment: Peridaxon or surgery.

Appendix
Serves no function other than to get infected and make you miserable.
 * Symptoms of Damage: Pain, fever.
 * Causes of Damage: Appendicitis, direct trauma to the lower body.
 * Treatment: Surgical removal.

=Vital Signs= Vital signs are measurable things that tell you what's wrong with your patient, so you can treat it.

Blood oxygen
Your patient's blood oxygenation is a number from 0-100% which can be checked with a health scanner or body scanner. An estimate of blood oxygenation is visible over sensors.

Causes of low blood oxygenation include:
 * There is not enough blood in the bloodstream. Restore blood volume with IV drips.
 * The blood is not carrying oxygen. Either the lungs are damaged, or there is not enough oxygen in the air around the patient. If the lungs are damaged, Dexalin (Plus) can bypass the lungs and provide oxygen to the blood directly.
 * Blood is not being pumped effectively because the heart is damaged, or has stopped. This causes low oxygenation even with working lungs and 100% blood volume.

Pulse
Monitor pulse rate with a medical scanner, or over sensors if they are enabled. The pulse can also be taken manually with a right-click menu item.

If the pulse rate is low, the patient is likely under the influence of a sedative, or has a low body temperature.

A high pulse rate can be caused by low blood oxygen, severe pain, or various chemicals. It is more dangerous than a low pulse rate.
 * Above 150 BPM, the heart begins to accumulate damage. A damaged heart causes reduced blood oxygenation until healed.
 * Above 250 BPM, the heart may stop.

Patients in severe pain may go into shock, which can cause the heart to stop. Lower their pulse rate with Inaprovaline and/or Perconol/Mortaphenyl/Oxycomorphine.

Breathing
Check your patient's breathing by examining them.

If a patient is gasping for breath, they have Hypoxia.

Body Temperature
A patient's body temperature shows up on suit sensors, health scanner, and body scanner.

A low temperature indicates hypothermia or exposure to substances that lower the body temperature.

A high temperature indicates heat stroke (such as from exposure to very hot air or fire), infection, or exposure to substances that raise body temperature.

Be aware that different species have different normal body temperatures.

Reagents Present
Reagents in a patient's body may be found in the stomach, bloodstream, or lungs. A health scanner will show the presence of medication and non-medical substances in the blood or stomach, but not the lungs; a breath scanner can be used to check the lungs. A body scanner shows which substances are present more precisely. Reagents can be removed from the blood via dialysis, from the stomach via a stomach pump, or from the lungs by administering Pulmodeiectionem.

=Equipment=

[[File:Bottles.gif]]Drugs
Visit the Guide to Chemistry to get a good idea of what each medicine can do.

The most used medications are: Mortaphenyl/Perconol are painkillers. Mortaphenyl reduces severe pain, but causes drowsiness and dizziness; it is available from the pharmacy or in pill form from some of the first aid wall lockers in Medical. Perconol reduces mild pain, but without causing intoxication; it is available from Medical vending machines.
 * Inaprovaline, available from Medical vending machines and in the autoinjector issued to each crew member in their emergency box. Probably the most important single medication, inaprovaline stabilizes heart rate, slows brain damage (and helps heal mild brain damage if the blood is fully oxygenated), and reduces pain. If in doubt, inject inaprovaline.
 * Dexalin Plus/Dexalin oxygenate the blood, even if the lungs are not working. Dexalin Plus, available from the pharmacy, raises blood oxygen higher than Dexalin, available from low-oxygen first aid kits.
 * Dylovene, available from Medical vending machines, toxin first-aid kits, and in pill form in some wall lockers. Dylovene buys you time when treating poisoning by protecting the liver from damage and healing mild liver damage. However, it mixes with Inaprovaline to create Tricordrazine. Inject both, and you'll have the benefits of neither.
 * Butazoline/Bicaridine/Tricordrazine, in order of decreasing effectiveness, are used to heal physical damage, including bruises and cuts. Butazoline and bicaridine can be obtained from the pharmacy; Tricordrazine is made by mixing dylovene and inaprovaline in equal parts.
 * Dermaline/Kelotane/Tricordrazine, in order of decreasing effectiveness, heal burns. Dermaline is available from the pharmacy; kelotane can be found in burn first-aid kits; tricordrazine can be made by mixing dylovene and inaprovaline in equal parts.

Physical Exam
Without tools, or in the field, you may use your eyes and hands to examine a patient.
 * Examining - Examining is simply done by shift clicking the patient, or using the right-click context menu and clicking Examine.
 * Bleeding
 * Bleeding cut on limb - They're obviously bleeding from the limb in question.
 * Blood soaking under clothing - They are bleeding under the clothing in question. For uniforms this can mean their upper or lower body.
 * Brute Damage
 * Bruise - Patient was attacked with a blunt object. Ranges from tiny to monumental.
 * Cut - Patient was attacked with a sharp object. Ranges from scabs to massive flesh wounds. High chance of bleeding.
 * Puncture - Patient was likely shot. Ranges from punctures to gaping holes. High chance of bleeding.
 * Burn Damage - Patient was burned, either from fire/freezing temperatures or electrocution. Ranges from skins to carbonized limbs.


 * Grabbing - Grab examines are done by grabbing someone and clicking on them with the grab in hand on help intent. You do not need to let go and grab again when switching which limb to examine.
 * Wounds - Will inform you of any burns and bruises on the target limb. See above.
 * Bones - Will inform you if the patient's limb is broken or not.
 * Skin
 * Reddened and Warm - Patient has a septic infection on the limb in question.
 * Unhealthy Discoloration - Patient has high toxins.
 * Unusually Pale - Patient has moderate hypoxia.
 * Decaying Limb - Patient's limb is necrotic.

Suit Sensors
Uniform jumpsuits and civilian clothes contain sensors that report vital signs to monitors in Medical and to the PDAs issued to Medical staff. Crew can set their sensors to off (no information), binary (alive or dead), vital signs, or vital signs and position. Vital signs displayed on sensors are pulse, blood oxygen (displayed as a rough estimate of normal, low, or dangerously low), blood pressure, and body temperature.

[[File:Healthanalyzer.png]]Health Scanner
A handheld health analyzer reads vital signs better than suit sensors, but not as well as the full-body scanner. To use, hold in your hand and click on your patient. Vital signs are color-coded green (normal), yellow (abnormal), and red (critical).

Readings include:
 * Brain activity, from 0-100%.
 * Pulse rate in beats per minute.
 * Blood pressure.
 * Blood oxygenation, from 0-100%.
 * Body temperature.
 * Severe organ damage.
 * Presence or absence of life-threatening pain.
 * Radiation level, from none to extreme.
 * Burns and brute damage for each body part.
 * Presence or absence of broken bones, but not their location.
 * Presence or absence of internal bleeding, but not its location.
 * Reagents present in the blood. Only medical reagents are identified.
 * Presence or absence of reagents in the stomach.

The handheld health analyzer will not detect infections, mild organ damage, dislocations, eye damage, genetic damage, or reagents in the lungs.

Breathanalyzer.pngh Analyzer
The breath analyzer tests lung function and detects reagents in the lungs, including alcohol in the patient's blood.


 * Oxygen Levels: Whether the lungs are processing oxygen. Different from blood oxygen.
 * Lung Health: Whether lungs are damaged; whether a lung is ruptured (pneumothorax).
 * BAC: How much alcohol has made its way into the blood, usually from drinking alcoholic drinks. Extreme BAC (.12 or more) is associated with alcohol poisoning.

Zeng-Hu Body Scanner
Functions as a portable body scanner and prints out a report identical to the body scanner's report. One is issued to the CMO.

[[File:Rollerbed.png]]Roller bed
A roller bed to transport patients safely without dragging them (which causes more injury) or carrying them (which is slow). Put the bed down by holding it in your hand and clicking on the floor where you want it. Ctrl+click the bed, then click-drag a patient onto the bed and you can start running without having to hunt for pixels to pull it. Can fit on the suit storage slot of the Rescue RIG.

Stethoscope.pngoscope
The stethoscope monitors the heart and lungs. Aiming at the chest and clicking the patient with a stethoscope in hand will tell you about their heart and lungs. The stethoscope can also be attached to your jumpsuit.
 * Heart
 * Weak/odd heartbeat - Heart damage or severe hypoxia.
 * No heartbeat - The patient is dead, or they have a synthetic heart. Or they're playing possum.
 * Lungs
 * Wheezing/gurgling - Lung damage or severe hypoxia.
 * No breathing - Dead patient, or no lungs.

Penlight.pngght
The penlight diagnoses problems with the eyes. Aiming at the eyes and clicking the patient with a penlight in hand will tell you about their eyes.
 * Their eyes narrow - Patient's eyes are fine and functioning normally.
 * Visible damage - Self explanatory.
 * Slow reaction - Blurry vision.
 * Delay between both eyes - Brain damage.
 * Pinpointed pupils - Opiates.
 * Dilated pupils - Other recreational drugs.
 * Glowing - Patient has a mutation.
 * No reaction - The patient is dead or their eyes are damaged beyond function.

[[File:MedGlasses.png]]Medical HUD
Wearing a medical HUD displays your patient's pulse line above their heads. If you are wearing a HUD, you can examine a patient to view their records, add comments to their record, or add a physical status like "SSD" or "Deceased".


 * A patient with a green line and a steady pulse line has a healthy beats per minute (BPM).
 * A patient with yellow, rapidly pulsing line has an elevated pulse; this means their heart is beating rapidly, probably due to pain or hypoxia.
 * A patient with a red, flickering line has a rapid, weak heart rate. They are going into shock.
 * A patient with a flat, flashing red line is in cardiac arrest. They need immediate attention.
 * A patient with a blue line and slowed heartbeat has a lowered BPM. This is generally caused by recreational drugs and sedatives.
 * A patient with a black line has no heart activity at all. They are either dead, have an artificial heart, or are from a species that does not have a heart.

[[File:Medicalbelt.png]]Medical Belt
A medical belt stores medication bottles and small medical tools. Has seven slots.

[[File:Stasis_Bag_Folded.png]]Stasis Bag
A stasis bag is used to transport critical patients. These bags completely halt the progression of all damage, but they also deal genetic and oxy damage, meaning time is still of concern.

[[File:Syringes.png]]Syringe
A syringe to extract said medicines. Holds 15u and draws/injects by 5u with each click. Can fit on your ear.

*[[File:Traumakit.png]][[File:Burnkit.png]] Trauma & Burn Kits
Advanced trauma and burn kits to help with brute and burn wounds respectively, along with disinfecting them. Typically found in the advanced kit that you spawn with.

IVDrip.png Drip
Speaking of IVs and blood bags, you should probably know how to use them, since blood loss sucks so bad, it's also bad by extension to not know the primary method of treating it. IVs are just objects you can pull around that transfer reagents from a container - preferably blood bags - into a patient's bloodstream via needle. This can be accomplished by clickdragging the IV onto the patient to hook them up. Here are a few features of the IV, most accessed via right-click context menu: Additionally, blood bags can have their displayed type determined by using a pen on the bag.
 * Injects and draws blood. The drawing mode will ping once the patient reaches 90% blood volume.
 * Transfer rate can be adjusted between 0.001 and 4 units per second, important for IB cases.
 * Fits reagent containers, and is not actually limited to blood bags, good for keeping someone sustained on a medicine.

[[File:Bscanner.gif]][[File:Bscanner_console.gif]]Body Scanner
Pretty much a CT and MRI scanner shoved into one futuristic bed and console, and so much more! This is probably one of the most vital pieces of equipment for Medical as it can diagnose pretty much anything wrong with a patient. Some things it can do are, but not limited to:
 * Provide information on all of the damage types.
 * How much blood the patient has.
 * Show what reagents are in the stomach/blood stream, and how much there is.
 * Give a detailed analysis of each limb, including fractures, internal bleeding, the presence of implants, and if there are foreign bodies in the limb.
 * Print condensed information to hand to a physician in the event the patient requires surgery. These should probably go into the filing cabinet behind reception.

Essentially a stationary and much bigger health analyzer. This section will cover what the screen will look like and what you can derive from it.

As you can see, this provides much more information, probably the most sought after info being anything below the Body Status heading.
 * Overall Health
 * Name: Just the name of the patient and their current state. Conscious, unconscious, dead.
 * Species: The species of the patient. See below for how each race reacts differently to treatments.
 * Health: The real overall health of the patient. 100 is perfect health, -100 is dead.
 * => Damage: The four main types of damage that can be pulled from a health analyzer.
 * Radiation Level: How many rads the patient has soaked. See Radiation Damage above.
 * Genetic Damage: How much the patient's skin is falling off.
 * Estimated Brain Damage: How much organ damage has been dealt to the brain.
 * Estimated Paralysis Level: How much time is left until the patient wakes up/can move.
 * Body Temperature: Temperature measured in Kelvin and estimated in Celsius.
 * Viral Status: Tells whether or not a pathogen has been detected.
 * Blood Status
 * Blood Level: How much blood the patient has.
 * => Reagent: How much of a certain reagent there is in the blood stream. Other is pretty much anything that isn't already on the list, which can represent either good or bad reagents.
 * Body Status
 * Organ: Tells how much burn and brute damage an organ/limb has, as well as information about it if applicable.
 * Actions
 * Print Report: Will print out a page of what you already saw on screen. Best done when the patient has fractures or organ damage. Printed reports that are no longer being used should be placed in the filing cabinet behind the reception desk.

[[File:Sleeper.gif]][[File:Console.gif]]Sleeper
Next are sleepers, beds that specialize in treating most side effects of trauma, but are otherwise an endless reservoir of some basic medicines. Some features of the sleeper are:
 * Gives estimated readout of patient's health by means of number values and colored bar graphs.
 * Allows the injection of:
 * Dylovene
 * Inaprovaline
 * Soporific
 * Perconol
 * Dexalin
 * Can conduct dialysis on a patient to remove anything that isn't blood (such as toxins, but medicines are included in this) from their blood stream.

[[File:Cryo.gif]]Cryo Tubes
A true marvel of Medical are its cryogenic tubes, allowing the use of certain medicines that can only be used at sub-zero temperatures, namely Cryoxadone and Clonexadone, which are both capable of healing lots of damage over time. If not for healing genetic damage, it should be noted that one unit of medicine taken from the tube's beaker is multiplied into ten units inside the patient! It can also halt bleeding (including internal) and halt the symptoms/damage of infection.

[[File:Freezer.gif]]How to Set Up
While a nice piece of equipment indeed, it requires some prep in order to use it to its full capacity, namely putting the beakers in and setting the gas cooler. Placing the beakers inside the cryo tube is as simple as taking the beakers on the table in hand and clicking on the tubes with them. As for the gas coolers, head to the freezer room, which is the room past the south-most door in the GTR. The coolers are on the north end of the room, just click on them and set the temperature between 10 and 80 Kelvin, though no lower or higher. Too low could draw a lot of unnecessary power, while setting it too high may slow down how fast the medicine inside the patient can work. Generally 63 Kelvin is the desired temperature.

Advanced Tools

 * [[File:Scalpmanager.png]]Incision Management System (IMS): Requires high tier research and diamonds, but this tool is invaluable to have. One click can create an incision, clamp bleeders, and retract the skin at the same time!
 * [[File:Laserscalp.png]]Laser Scalpel: Different versions depending on what's available to Research, but this basically works as a scalpel and hemostat combined when opening an incision.
 * [[File:BluespaceBeaker.gif]]Bluespace Beaker: Requires diamonds but is immensely useful for chemistry, holding 300u as opposed to its non-bluespace counterpart which can only hold 120u.
 * [[File:Noreact.gif]]Cryostasis Beaker: Reagents won't mix or react inside this beaker, but it can only hold 60u. Not very useful outside of easier grenade production.
 * [[File:Combatinhaler.png]]Combat Inhaler: An inhaler capable of dumping all of the contents of a cartridge into the patient's lungs. Use with care!
 * [[File:Inhalercart.png]]Large Inhaler Cartridge: 30u cartridge for inhalers. Double the capacity of the small cartridges that show up in chemistry.
 * [[File:InhalerBS.png]]Bluespace Inhaler Cartridge: 60u cartridge, bigger is better obviously.
 * [[File:BluespaceBeaker.gif]]Bluespace Beaker: Requires diamonds but is immensely useful for chemistry, holding 300u as opposed to its non-bluespace counterpart which can only hold 120u.
 * [[File:Noreact.gif]]Cryostasis Beaker: Reagents won't mix or react inside this beaker, but it can only hold 60u. Not very useful outside of easier grenade production.
 * [[File:Combatinhaler.png]]Combat Inhaler: An inhaler capable of dumping all of the contents of a cartridge into the patient's lungs. Use with care!
 * [[File:Inhalercart.png]]Large Inhaler Cartridge: 30u cartridge for inhalers. Double the capacity of the small cartridges that show up in chemistry.
 * [[File:InhalerBS.png]]Bluespace Inhaler Cartridge: 60u cartridge, bigger is better obviously.
 * [[File:Powercell.png]]Super Capacity/Hyper Capacity Power Cells: Pretty much just the RIG benefits from a bigger cell, but hey, leg actuators are fun to use!
 * [[File:Medibot.gif]]Medibots: Either helpful, annoying, or totally useless. Swiping your ID over it will unlock its maintenance panel, allowing you to alter a few options. One option that should be turned on is to report treatments over HUD, while one option that should be turned off is the medibot's speaker as leaving it on will just let it fill up your chat log with nonsense. Probably the most important feature is allowing it to draw from a beaker that you can insert, allowing you to make custom mixes. Unfortunately the bot cannot tell the difference between any of the damage types, only treating a patient once their overall health reaches a certain threshold, therefore take care to not load in medicines that the patient can easily overdose on.
 * [[File:Freezer.gif]]Gas Cooler: Upgrading the gas cooler will allow it to cool the gasses for cryo quicker.

=Procedures=

Stabilizing Patients

 * Inaprovaline slows brain damage from low oxygen.
 * A Blood or Saline Plus IV restores blood volume.
 * Dexalin and Dexalin Plus partially oxygenate the blood if the lungs are failing.
 * To restart a heart that has stopped, perform CPR, apply a stabilizer harness, or administer adrenaline.

Blood Transfusion
If a patient has lost a large amount of blood, they will require a blood transfusion to allow for full circulation and prevent further brain damage.


 * Prepare an IVdrip.png‎‎ IV drip with a Bloodbag.png‎‎ blood bag containing an appropriate blood type (see below). If the chemist has made some, you should use Saline Plus, which is more efficient and works for all blood types.
 * Ensure that the IV drip is in Inject mode.
 * Attach the IV drip to the patient.
 * Set the drip rate with right-click on the IV.
 * Monitor the patient's blood oxygen levels and pulse via health analyzer.


 * If an IV drip is not available, injecting the patient with blood from a syringe is a workable, if a slow and cumbersome, option.
 * Iron, nutriment, and protein speed up the patient's natural recovery of lost blood. If your patient is Skrell, they need copper rather than iron; if your patient is Vaurca, they need sulfur rather than iron.

Blood Compatibility
It's important to use right type, so bad things won't happen.

Blood between two different species is never compatible, even if it shares the same color. The pre-loaded blood bags in the Treatment Center storage closet contain a special kind of O-negative which can be given to any patient regardless of species without fear of rejection, but donated blood should be reserved for members of the same species.

If there is no O-negative blood available, and no precise blood type match as an alternative, look for a replacement by these rules:
 * Negative can take only negative.
 * All types can take O.
 * A can take A.
 * B can take B.
 * AB can take A and B.
 * O can take only O.

CPR
If a patient's heart has stopped, there's no blood flow going to the brain. This can quickly result in brain death, and obviously should be corrected as quickly as possible, as mentioned above. However, if, for some reason, immediate resuscitation is not possible, CPR is a good way to extend a patient's life. Every time you perform CPR on a patient, it counts as one breath if their lungs are properly working, it circulates blood a little no matter what state heart is in, and with some luck, you might be able to restart their heart. Don't be afraid to crack some ribs while you're at it; remember, if they died with ribs intact, you didn't try hard enough!

CPR consists of two parts - the chest compressions to kickstart the heart and the mouth to mouth resuscitation to give them air. To perform CPR on a patient, they must be in cardiac arrest, and for the mouth-to-mouth part, neither of you can be wearing a mask or other mouth covering. Click on the patient with an empty hand in to perform CPR. This requires both of you to remain still for a short period. This can be repeated as many times as necessary until treatment can be administered.

Blood Loss
Blood carries oxygen to various areas in the body of a patient, and without oxygenation (whether by lack of air or lack of blood, in this case) the patient will slowly decline in health until they die, therefore stopping bleeding is your top priority, and should be treated as a critical injury. For low blood levels, administering Dexalin will help with the oxy damage resulting from blood loss, and will help alleviate the risk of brain damage as a result. Critical blood levels, however, will result in massive spikes of hypoxia and annoying toxins. Blood loss also results in losing lots of nutrition. Symptoms of blood loss can be found below: Treatment to stop bleeding is listed below: Once the bleeding has ceased, you will have to help the patient raise their blood count. The following are some methods to assist with that:
 * 89% of original blood volume/501u and lower:
 * Low blood oxygenation - Visible on your hand scanner.
 * Patient feels dizzy - They will state vocally that they feel dizzy/faint.
 * Patient rapidly becomes hungry - Low blood generates hunger. Oddly enough, the nutrition used doesn't correlate to the amount of blood regenerated.
 * 60% of original blood volume/336u and lower:
 * Patient feels extremely dizzy - Emphasis on extremely.
 * Patient has trouble seeing - Cloudy vision and having a hard time keeping their eyes open.
 * Patient is unconscious - Not enough blood to keep them conscious, which means they can't tell you about their peril.
 * Increasing oxygen damage - Determined with the analyzer, but the prompt above will probably tell you that before you read their damage.
 * Pale skin - As a result of high oxygen damage, determined by examining with a grab.
 * 40% of original blood volume/224u and lower:
 * Aggressive oxygen damage - At this point, the oxyloss will start escalating quickly.
 * Increasing toxin damage - Assuming the patient survives to this point without dying, toxins will begin to manifest.
 * 21% of original blood volume/122u and lower:
 * Huge spike in toxins - Like, 300 damage or so.
 * Death.
 * For external bleeding cases:
 * Pressure: Getting an aggressive grab and help intent clicking the limb with the grab in hand will apply pressure to the wound, slowing the bleeding, but not stopping it entirely. If you are bleeding, help intent click the limb and you will begin applying pressure. This should only be used if you have nothing to treat the bleeding and are waiting on someone else to bring gauze/ATKs.
 * Gauze: This is the most basic item in medical to treat cuts and lacerations provided you have enough of it.
 * Advanced Trauma Kit: ATKs are better than gauze as they can disinfect the wound when it's used, and instantly heals 8 brute damage per wound.
 * For internal bleeding (IB) cases:
 * Cryogenics: Placing a patient with internal bleeding into a (correctly setup) cryo tube will both halt (not fix) the bleeding and stop it from getting worse. This is a temporary solution.
 * Bicaridine and Inaprovaline: These two medicines together (they have to be together, not separate) will prevent the internal bleeding from worsening, but will not halt the bleeding.
 * Surgery: The main method of treating internal bleeding is through surgery by means of the Fix'O'Vein.
 * Bicaridine: Overdosing Bicaridine (30u) will, of course, deal toxins to the patient, but it may clot internal bleeding. Generally a last resort if none of the other methods are available.
 * Coagzolug: Coagzolug can help slow bleeding, buying you more time to treat a patient. Overdoses at 10u.
 * Dexalin/Dexalin Plus: Will assist in oxygenating the blood, helping to prevent potential brain damage.
 * Iron: A simple reagent that must be ingested in order to work. Replenishes 8u of blood per unit.
 * Nutriment: Basic nutrients. Must be ingested. Replenishes 4u of blood per unit.
 * Protein: Animal proteins found in meat. Must be ingested. Replenishes 4u of blood per unit.
 * 20 Iron, 20 Nutriment, 20 Protein: The three reagents mentioned above in one 60u pill, which can replenish blood rather quickly as there are three separate reagents.
 * IV Drip with compatible blood: Bloodbags can hold 200u of blood (a little less than half a patient's total blood volume) and is generally a fast method of replacing blood.
 * IV Drip with Saline Plus: Administering 1.5u/tick of Saline Plus will rapidly replenish their blood and works for all species.

Syringes.pngtions
Syringe, hypospray, rapid hypospray, IV This is the most common, quickest, and effective way to administer treatments to patients, involving medicine being injected straight into the bloodstream to be metabolized immediately at full effect. Injecting the patient is usually left unhindered unless they are wearing armor devoid of an injection port, something that voidsuits and hardsuits possess. Generally when you read about the effects of medicine, it's implied that those are the results you will get if you inject it into the patient. Note: Syringes spawn with a cap which keeps them uninfected. Using the same syringe over and over will increase the risk of infection and will pass viruses from one patient to the other. Use new ones! Hyposprays can be found in the medical doctor lockers in the medical sub-level. They act like syringes without the risk of causing infection upon re-use.

Pillbottle.png
Pills are the second most common way to administer medicines, which are taken orally and metabolize at half effect in comparison to injection. Pills are mostly used for low-priority treatments or prescriptions, and are best shoved down the victim's throat whether they like it or not given to the patient along with instruction to swallow it. A patient wearing anything that covers the mouth will obviously be unable to take pills, making them unideal for patients in EVA gear.

Autoinhaler.pngation
Inhalers are a recent addition to the medical side of Aurora, and medicines from inhalers are obviously inhaled into the lungs. All medicines - save for a few such as Dexalin - are 3/4 as effective as injecting when inhaled, which is a quarter above pills at least. Autoinhalers found in aid kits come with 5u of Dexalin, but the contents can be removed/replaced by using a syringe on the inhaler. Non-expendable variants can be found in the CMO's office and in chemistry equipment lockers, along with small 15u cartridges that can be filled with whatever.

Traumakit.pngal Applications
This mostly applies to bandages and ointment, kits and equipment that you can use on a patient from the get-go. While we do not have medicinal patches, we do have trauma and burn kits for basic wound treatment, as well as for sealing bleeding and disinfecting wounds.

Cryo Treatment
Cryo is all about suspending someone in animation and healing them to boot! If someone is in a pretty bad way, tossing them into a (correctly set up) cryo tube will heal some types of damage and slow down other types of damage, sort of like a big stasis bag.


 * Cryo tanks function only below 170K.
 * The lower the temperature of the bath, the more effective the stasis function is.
 * The higher the temperature of the bath, the more effective the healing function is.

Surgery
=Common Diseases & Injuries=

Cardiac Arrest
Cardiac arrest is indicated by a flatline on your medical HUD. It will quickly lead to brain death as the brain is deprived of oxygen.

If someone is in cardiac arrest, they are priority number one.


 * If you are ever in doubt what to do, put the patient into a stasis bag. You can scan them with your health analyzer and inject them with a syringe even if the bag is closed.
 * Apply CPR or put a stabilizer harness on the patient. Sometimes this can restart the heart on its own; but if the cause of the cardiac arrest is still there, it will stop again.
 * Adrenaline can restart the heart if the blood is oxygenated. Before administering, check the patient's respiration.
 * Administer inaprovaline to slow brain damage and stabilize the pulse.
 * If the patient is in severe pain, administer painkillers.
 * If the patient has low blood volume, get some blood into them with IV drips.
 * If the lungs are damaged, administer Dexalin or Dexalin Plus after restarting the heart.
 * If the lungs are undamaged but blood oxygen is low, they may have a damaged heart; treat for cardiac damage.
 * If you are non-medical, the patient is already in surgery, or you just can't get a doctor, administer CPR. Even if CPR does not restart the patient's heart, it will slow brain damage.

Hypoxia

 * Make sure the patient has access to oxygen. If the patient is wearing internals, make sure that the air tank is full and switched on; empty internals will suffocate your patient.
 * Connect the patient to high-pressure oxygen via an IV stand with attached oxygen tank and mask.
 * Administer Dexalin or Dexalin Plus. These put oxygen into the blood directly, and do not work if the heart is not pumping blood.
 * Administer Pneumalin to treat lung damage, or perform surgery.

Suffocation damage, like Toxin damage, isn't a real damage, but a general term for low blood oxygenation, seen via health analyzer. It may be caused by blood loss, damaged lungs or heart or lack of oxygen in the environment. Treatment for hypoxia on its own is listed below:
 * CPR: Time to put those first aid courses to use! As long as you and your patient aren't wearing anything that covers the face you'll be able to perform CPR to keep the patient alive for a bit longer by clicking them on help intent. This procedure must be repeated consistently in order to be effective.
 * Inaprovaline: A cyan colored medicine which doesn't actually heal hypoxia, but instead halts any further damage, and mildly kills pain. Overdoses at 20u.
 * Dexalin: A blue colored medicine which forces blood oxygenation up to 50%. Overdoses at 20u.
 * Dexalin Plus: A blue colored medicine which forces blood oxygenation up to 80%. Overdoses at 15u.

Infection
Infections sprout when a wound isn't treated and disinfected in time, and is accompanied by a fever (check temperature). If left alone, infections can rapidly kill a patient, even exponentially if it's bad enough. Infections are commonly identified by means of the body scanner. The following are the levels of infection: The following are some symptoms of infection based on where it's located: L2 infections and lower require only 15u of Thetamycin and monitoring. Having at least 5u of Thetamycin in the bloodstream will also prevent infections from spreading from one limb to another. Leporazine is also capable of staving off fevers. L3 infections require far more Thetamycin. Regardless, immediately pairing with Dylovene and Tricordrazine to accompany the high toxins is a good idea. The following will go over further necessary treatments:
 * L1 (Mild): Pain messages and the start of fever.
 * L2 (Acute): More pain messages, infection becomes more prevalent and visible.
 * L3 (GANGRENE): Beginning of lethal toxins, organ death, and necrosis.
 * Meningitis (Brain)
 * L1: Stiff neck
 * L2: Severe headache (+1 confusion at random intervals)
 * Conjunctivitis (Eyes)
 * L1: Itchy eyes
 * L2: Blurred vision (+10 eye_blurry at random intervals)
 * Endocarditis (Heart)
 * L1: Chest tightness
 * L2: Chest pain (+25 halloss)
 * Pyelonephritis (Kidneys)
 * L1: Lower back pain
 * L2: Malaise
 * Pyogenic Abscess (Liver)
 * L1: Right side abdomen pain
 * L2: Poor blood filtration (toxins buildup)
 * Pneumonia (Lungs)
 * L1: Coughing
 * L2: Shortness of breath (+30 oxyloss)
 * Staph Infection (All external limbs)
 * L1: Pain notificiation
 * L2: Sharp pain temporarily disables limb
 * Limb gangrene:
 * Conduct necrotic limb repair.
 * Organ necrosis:
 * Request a replacement synthetic organ from Research immediately.
 * Remove the organ via surgery and replace it with the synthetic counterpart.
 * If the brain or heart is necrotic, the patient will need to be constantly supervised and treated to prevent death.

Brute Damage
Cuts, lacerations, and bruising all make up the red descriptions on the health analyzer, normally caused by physical trauma such as punching, getting hit with something, being dragged with open wounds, slamming into walls, depressurization, etc. Sometimes high brute values may break bones, which will require Surgery, or the limb may even become dismembered! Treatment for brute damage on its own is listed below:
 * Gauze: Heals 4 brute per wound. Stops bleeding.
 * Advanced Trauma Kits: Heals 8 brute per wound. Stops bleeding and also disinfects wounds if applied early.
 * Bicaridine: A red colored medicine which heals 5 brute per unit, meaning a full syringe will heal 75 brute damage. Overdoses at 20u.
 * Butazoline: A red colored medicine which heals 8 brute per unit, meaning a full syringe will heal 120 brute damage. Overdoses at 15u.
 * Tricordrazine: A purple medicine that heals all underlined damage, healing 3 damage per unit. Overdoses at 30u.
 * Do not mix Bicaridine and Butazoline, as this will result in the patient taking high levels of genetic damage.

Burn Damage
Skins, burns, and scars make up the yellow descriptions on the health analyzer, normally caused by intense temperatures such as fire, extremely cold temperatures, lasers, and electrocution. Exceptionally high burn values may vaporize a limb, and can cause blood loss. Burns are easily infected. Massive amounts of burn damage may cause your character to be 'husked'. Treatment for burn damage on its own is listed below:
 * Ointment: Heals 4 burn per wound. Disinfects wounds.
 * Advanced Burn Kits: Essentially the burn variant of ATKs. Primarily used to disinfect burn wounds.
 * Kelotane: A yellow colored medicine which heals 6 burn per unit, meaning a full syringe will heal 90 burn damage. Overdoses at 20u.
 * Dermaline: An orange-yellow colored medicine which heals 12 burn per unit. Overdoses at 15u.
 * Tricordrazine: A purple medicine that heals all underlined damage, healing 3 damage per unit. Overdoses at 30u.
 * Do not mix Kelotane and Dermaline, as this will result in the patient taking high levels of genetic damage.

Radiation
Damage dealt by exposure to the Supermatter, being injected with radioactive reagents, being in unshielded areas during a radiation storm, or destroying/activating particular artifacts make up radiation damage. A hand scanner will detect radiation exposure, but a body scanner is needed to determine its extent. Treatment for radiation damage is listed below:
 * Hyronalin: A green medicine which heals 30 radiation per unit, albeit slowly, but does not heal the resulting damage of radiation. Overdoses at 20u.
 * Arithrazine: A green medicine which heals 70 radiation, albeit slowly, but has the side effect of dealing some brute damage. Overdoses at 20u.

Genetic Damage
Damage dealt by radiation, slime digestion, or coming out of a stasis bag, which the health analyzer can only determine by means of a red prompt, requiring a body scanner for a precise measurement of genetic damage. Treatment for genetic damage is listed below:
 * Cryoxadone: A pale blue medicine which heals the above damage including genetic damage, but requires that the body be cooled to 170 Kelvin or lower, usually by means of cryo cells.
 * Clonexadone: A pale blue medicine which works exactly the same as Cryoxadone, but does everything faster.
 * Cryo-Mix: A 1:1 mix of Cryoxadone and Clonexadone, works much like KeloDerm in that the two medicines work separately, therefore faster.
 * Rezadone: A green medicine which heals genetic damage without the need for cold temperatures. Overdoses at 20u, though 10u may induce dizziness.

Organ Damage
Damage represented on the body scanner that corresponds with the trauma inflicted on organs, either by certain poisons, severe physical trauma, bones moving in the area organs are present (lower body, chest, head), or certain items necessary for function being absent. An organ is considered dead at 30 damage. The mostly deadly form of organ damage is brain damage, which leads to death at 100 damage instead of 30. Treatment for organ damage is listed below:
 * Peridaxon: A purple medicine which heals 1 organ damage per unit, and heals all internal organs. Overdoses at 10u.
 * Alkysine: A yellow medicine which heals 30 organ damage per unit, but only heals the brain. Overdoses at 10u.
 * Oculine: A pale lavender medicine which heals 5 organ damage per unit, but only heals the eyes. Overdoses at 20u.
 * Adipemcina: A green medicine which heals 2 organ damage per unit, but only heals the heart. Overdoses at 20u.
 * Pneumalin: A purple medicine which heals 1.5 organ damage per unit, but only heals the lungs, and only when inhaled. Overdoses at 15u.
 * Inaprovaline: A blue medicine which heals the brain if it's below minor damage. Overdoses at 20u.

Fractures
Bones fractures can be separated by three identifications: hairline, fracture, and broken. These three different types of fractures no longer play any part mechanically, though from an RP standpoint, hairline is the least severe while broken is the most severe (and therefore painful). Fractures can, however, deal damage to organs if they move around. Treatment for fractures is listed below: Broken bones must be repaired surgically.
 * Splints: A half-cast that keeps the fractured bone in place and prevents it from moving. This is a temporary remedy, and requires the following to actually treat...
 * Surgery: By means of bone gel and bone setter, a fracture can be mended rather quickly.

Dislocations
Not actually a fracture or even a problem related to surgery, but it will function as a fracture in that the limb will become incapacitated. Fixing it simply requires that you stand next to the patient and use the 'Undislocate-Joint' verb. If there are multiple dislocations, a prompt will appear asking which limb you would like to relocate.

Mental Trauma

 * All characters with a Medical Doctorate degree are capable of diagnosing mental trauma, as well as prescribing medication for their diagnosis.
 * Surgery trained Medical personnel are fully capable of Neuro-surgery where necessary to treat mental trauma.
 * Chemists/Pharmacists are fully capable of synthesizing mental medication, but they cannot diagnose mental trauma, or prescribe medicine.
 * Psychiatrists/Psychologists are the foremost experts on this type of illness, they are the only capable of advanced treatment (Hypnosis, Crystal Therapy, and Isolation) and they should be the first to treat mental trauma when available.

Toxin Exposure
While Toxin damage isn't technically damage in the sense Brute or Burn damage are, toxins can pose issues to treatment. They are most commonly identified as unidentified chemicals in a patient's bloodstream via a health analyzer. Treatment for toxins is listed below:
 * Dylovene: A green colored medicine which protects the liver against damage from toxins. Overdoses at 20u.
 * Fluvectionem: A dark purple colored medicine which removes all other chemicals reagents from the bloodstream, but causes mild liver damage. Overdoses at 20u.
 * Pulmodeiectionem: A dark purple colored medicine which causes the patient to cough up any reagents in their lungs when inhaled. Overdoses at 10u.
 * Dialysis or stomach pumps can be performed using the sleepers found in the GTR or ICU. This is a fast and certain way to remove toxins from a patient's bloodstream or stomach respectively.


 * Use the Dialysis function in the sleeper to remove toxins from the blood, or the Stomach Pump function to remove toxins from the stomach. If the toxins have already been metabolized (i.e., are no longer in the blood or the stomach), they have done their damage and cannot be removed.

=Medbay Operations=

Triage
Triage is a word for priority regarding patients. When there are multiple patients and not enough medical personnel, who do you treat first? Triage helps you make that decision while saving the highest number of patients.

A person dies when their brain dies, which usually happens when their brain is starved of oxygen. People who are low on blood or who have weak heartbeat or respiration are at a greater risk of dying than people with broken legs. Work your way down, treating critical first, and saving those who can wait for last. When a critical patient is stabilized, move on to another patient.

As a medic, you have the ability to apply triage tags to your patients, which show up on medical HUDs. From highest to lowest priority:
 * Red tag: Needs resuscitation. Most urgent. Patient has no heartbeat, or an extremely rapid and weak heartbeat; patient is not breathing; arterial bleeding; very low blood volume. Patient is unstable and getting worse.
 * Yellow tag: Urgent. Unconscious, rapid heart rate, bleeding, severe pain.
 * Green tag: Serious. Broken bones, bullet removals, minor organ damage. Stable patients go here.
 * Blue tag: Walking wounded. Facial reconstruction, eye damage, bruises and cuts.
 * Black tag: Dead, or dying and cannot be saved with the resources available.

Division of Labor
=Xenomedicine= Some races react a bit differently to medicine so it's important to become familiar with how some may fare. For the purpose of this section, Humans will be used as the base species for comparison. Subtypes will only mention differences in comparison to their parent species.

Human

 * Normal brute damage.
 * Normal burn damage.
 * Blood Volume: 560
 * Primitive Form: Monkey

Skrell

 * Normal brute damage.
 * Normal burn damage.
 * Primitive Form: Neaera
 * Less resistant to alcohol.
 * Less stamina but faster running.
 * Immune to slipping.

Unathi

 * Slightly lower brute damage.
 * Normal burn damage.
 * Primitive Form: Stok
 * All Alcohol (Ethanol) is toxic.
 * Can drink Butanol as an Alcohol (Ethanol) substitute.
 * Less stamina but faster running.
 * Slower walking speed.

Tajara

 * Slightly higher brute damage.
 * Normal burn damage.
 * Primitive Form: Farwa
 * Less resistant to alcohol.
 * Faster walking speed.
 * Less stamina and running speed, but faster stamina recovery.
 * Damage from falling is halved.

Zhan-Khazan

 * Slightly higher brute damage.
 * Normal burn damage.
 * Slower walking speed.
 * Slower running speed, but more stamina.
 * Resistant to cold.
 * Tolerant to alcohol.

M'sai

 * Significantly higher brute damage.
 * Normal burn damage.
 * Faster walking speed.
 * Faster running speed, but less stamina.

Dionaea

 * Normal brute damage.
 * Normal burn damage.
 * Primitive Form: Diona Nymph
 * Regenerates health and nutriment when in light or in radiation.
 * Most reagents have little to no effect on a Diona.
 * Plant-B-Gone severely poisons a Diona.
 * Hyronalin deals toxins.
 * Arithrazine deals major toxins.
 * Does not bleed.
 * Immune to slipping.
 * Immune to infections.
 * Immune to decompression.
 * Resistant to electrocution.
 * Resistant to high temperatures.
 * Breaks into nymphs upon death.
 * Very slow movement speed.

Vaurca Worker

 * Significantly lower brute damage.
 * Significantly higher burn damage.
 * Significantly higher toxin damage.
 * Significantly lower Oxygen damage.
 * Significantly lower Radiation damage.
 * Primitive Form: V'krexi
 * Breathes phoron.
 * Possesses two hearts.
 * Has an implant that stores phoron.
 * Have other robotic implants.
 * Has their own private Hivechat channel.
 * Most surgeries require using the surgical drill instead of a scalpel.
 * Can safely eat non-sterile K'ois.
 * Normal food deals toxins.
 * Immune to decompression.
 * Immune to slipping.
 * Resistant to alcohol.
 * Slower walking speed.
 * Slower running and less stamina recovery, but more stamina.

Vaurca Warrior

 * Significantly lower brute damage.
 * Slightly higher burn damage.
 * Normal Oxygen damage.
 * Significantly lower radiation damage.
 * Normal walking speed.
 * Faster running and more stamina.