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, and lungs.
 * Arms: Connected to the torso. Contains bones.
 * Hands: Connected to the arms. Contains bones.
 * Lower Body: Contains the pelvis, stomach, 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.

If a substance has already been metabolized, it will not show up on scans; but drawing and analyzing a blood sample with the chemical analyzer can identify it. This is relevant if you need to know how the damage was done, especially if the threat still exists and you may have more patients with the same problem.

=Equipment= At the beginning of each shift, you should gather your equipment. Keep with you anything that you will need often (like your hypospray or your HUD), anything that you might need immediately and not have time to run and get (like a stabilizer harness or a bottle of inaprovaline), and (for first responders) anything you might need to use in the field (roller bed, crowbar).

Drugs
Visit the Guide to Chemistry to get a good idea of what each medicine can do.

The most used medications are:
 * 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.
 * 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.

Tools
Medicine depends heavily on the tools available.

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 by cold, heat, or electricty. 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.

Advanced Burn Kit
Advanced burn kits treat burns, speeding healing and preventing infection if used soon after the burns are inflicted. Each advanced burn kit stack includes five applications.

They are a more effective version of Ointment. They can be found in the vendors in Medical; most Medical personnel are issued a first-aid kit that contains advanced burn kits.

Advanced Trauma Kit
Advanced trauma kits treat brute damage, speeding healing and preventing infection. Applying an ATK stops bleeding (though not internal bleeding). They are also used in surgery to repair organs.

They are a more effective version of the roll of gauze. They can be found in the vendors in Medical; most Medical personnel are issued a first-aid kit that contains advanced trauma kits. Advanced trauma kits are also found on trays of surgical tools in the operating rooms.

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.

Dropper
Used to measure out small amounts of reagents; right-click to set transfer amount. Can be used to administer medication through the eyes.

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.

Hypospray
Reusable, self-sterilizing syringe. Holds 15u. Pour medication into it and click on the patient to inject 5u. The CMO is issued an advanced hypospray.

Penlight
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.

Medical Belt
A medical belt stores medication bottles and small medical tools. Has seven slots.

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.

Roller bed
A roller bed transports patients safely without having to drag them (which causes more injury) or carry 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.

A vitals monitor can be attached to a roller bed. It displays consciousness status, brain activity, blood pressure, blood oxygen, and blood volume.

Stabilizer Harness
Put this on a patient (in the suit slot) and it will automatically perform CPR if the patient's heart or breathing stops. Each stabilizer harness contains a battery and air tank, which can run out of charge or air and need charging or filling.

Stethoscope
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 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.

Splints
Used to stabilize a fractured limb. Hold the splint, aim at the fractured body part, and click on the patient. Will also slow internal bleeding in limbs.

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 (or cell charge for IPCs), blood pressure, blood oxygen (displayed as a rough estimate of normal, low, or dangerously low), and body temperature.

Stasis Bag
A stasis bag is used to transport critical patients. These bags completely halt the progression of all damage and can protect the patient from a vacuum, but there's no air supply and the stasis effect degrades with use. A light on the bag indicates the stasis level.

Syringe
A syringe to extract medicines and inject them into the patient. Holds 15u; right-click to change transfer amount from 1 to 15 units. Can fit on your ear.

Syringes come sterile and capped. Re-using a syringe on more than one patient raises the risk of infection.

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.

Body Scanner
A CT and MRI scanner shoved into one futuristic bed and console, and so much more! Can diagnose pretty much anything wrong with a patient.

A body scanner:
 * Shows how much blood the patient has and how well-oxygenated it is.
 * Identifies reagents in the stomach and bloodstream.
 * Analyzes each body part for damage, fractures, bleeding, implants, and foreign bodies.
 * Detects organ damage.
 * Detects infection, radiation, and paralysis.
 * Prints out a summary for the physician. If the patient will need surgery, print one out and hand it to the surgeon. They contain confidential health information, so file reports in the filing cabinet behind the reception desk, or shred them before discarding.

A typical body scan looks like this:

Cryo Tubes
Cryo tubes are used to administer cataleptinol, cryoxadone, and conexadone, which only work at temperatures under 170 degrees Kelvin. One unit of medicine taken from the tube's beaker is multiplied into ten units inside the patient. Cryo tubes can be used to put a patient into stasis, slowing all bodily functions--including slowing internal bleeding and the progress of infections.

How to Set Up
To prepare the cryo tube:
 * Place one beaker of medication into each tube (pick them up and click on the tube).
 * Turn on the gas coolers.
 * Go into the cooler room, which is next to the cryo tubes, and click on each cooler to bring up the interface.
 * Turn the power on.
 * Set the temperature. The higher the temperature, the more quickly medication works; the lower, the more effective stasis works. 120 degrees Kelvin is a good standard setting.

IV Drip
The IV stand transfers reagents from a container into a patient's bloodstream, and can serve as an oxygen tank or ventilator. They are wheeled and can be dragged around. IVs should be stocked with a blood bag (or other reagent container), an oxygen tank, and a breath mask.

To use an IV, click on the IV and drag it to the patient, then choose whether to hook up the needle or the breath mask.

Alt-click menu:
 * Transfer rate. Sets how many units per tick the IV stand will inject.
 * Remove container.
 * Remove tank.
 * Remove breath mask.

Right-click menu:
 * Transfer rate
 * Toggle EPP (positive pressure; breathes for the patient out of the attached tank.)
 * Toggle mode (Inject or Take Blood)
 * Toggle stop (Whether the IV will automatically stop injecting blood when the patient's blood volume is full)
 * Open/Close valve (Open the tank valve and start administering oxygen)

Sleeper
Sleepers are used to administer basic medications, perform dialysis, pump the stomach, and put a patient in stasis. The display shows basic patient vitals.

Allows the injection of:
 * Dylovene
 * Inaprovaline
 * Soporific
 * Perconol
 * Dexalin

Advanced Tools
These tools are generally obtained from either Ops or Research.
 * [[File:BluespaceBeaker.gif]]Bluespace Beaker: Holds 300u. Very useful for chemistry.
 * [[File:InhalerBS.png]]Bluespace Inhaler Cartridge: 60u cartridge. Bigger is better... right? (No. No, it is not.)
 * [[File:Combatinhaler.png]]Combat Inhaler: Administers the entire contents of the inhaler at once. Use with care!
 * [[File:Noreact.gif]]Cryostasis Beaker: Reagents won't mix or react inside this beaker, but it can only hold 60u.
 * [[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:Inhalercart.png]]Large Inhaler Cartridge: 30u cartridge for inhalers. Double the capacity of the small cartridges that show up in chemistry.
 * [[File:Laserscalp.png]]Laser Scalpel: Cauterizes an incision automatically; no need to stop bleeding with the hemostat afterward.
 * [[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:Powercell.png]]Super Capacity/Hyper Capacity Power Cells: Install them in the RIG. Leg actuators are fun!
 * Upgrades. Engineering or Research can upgrade your machinery.

=Procedures=

Syringes.pngtions
Equipment used: Syringe, hypospray, rapid hypospray, IV, autoinjector.

Medicine is injected into the bloodstream to be metabolized immediately at full effect. Set Help intent, aim at the body part you wish to inject into, and click on the patient. Medicine must be injected into an organic limb that is not covered with armor. If the patient is wearing a voidsuit, the injection will take longer because you have to use an access port.

An IV drip is used to inject medication continuously.

Autoinjectors work quickly and can be used by unskilled crew. Autoinjectors can be opened with a screwdriver and the contents poured out and replaced; used autoinjectors can be opened with a screwdriver and refilled. To close, click on the autoinjector in hand. Autoinjectors are best used for rescue medications like adrenaline, inaprovaline, and coagzolug.

Pillbottle.png
Pills are taken orally. They can be taken by unskilled patients (or fed to patients by aiming at the mouth and clicking on the patient); but they metabolize at half the effect of injections. Pills cannot be taken while wearing a mask or EVA gear.

Liquid medication can also be taken orally.

Autoinhaler.pngation
Inhalers administer medication to the lungs. Most medications (with a few exceptions, such as dexalin) work at 75% effectiveness when inhaled; a few must be inhaled to work at all. Autoinhalers can be opened with a screwdriver and the contents poured out and replaced. Used autoinjectors can be opened with a screwdriver, refilled, and closed (click on the inhaler in hand to close it). Specialized inhalers with larger cartridges are available. Autoinhalers and inhalers can be used by unskilled crew.

Eye drops
Reagents can be administered to the eyes via a dropper (available from vendors). Aim at your patient's eyes, set your intent to Grab, and click on the patient. Oculine eye drops are a common treatment for eyes damaged by welding without protection.

Traumakit.pngal Applications
Gauze, ointment, and trauma and burn kits treat injury to the skin.

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 (click and drag).
 * Set the drip rate with right-click on the IV. For blood, set the drip rate to 5.
 * Monitor the patient's blood oxygen levels and pulse via health analyzer.
 * If an IV drip is not available, injecting the patient with blood by syringe or hypospray 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
If incompatible blood is administered to a patient, it will cause poisoning in the form of a rejection reaction.

Blood from one species is never compatible with another species, even if it shares the same color. The pre-loaded blood bags in the Treatment Center storage closet contain processed 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 that follows 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, it cannot pump blood to the brain, which begins to die. Extend their life by performing CPR. Every time you perform CPR on a patient, it gives them one breath as long as their lungs are working, circulates blood a little no matter what state heart is in, and may restart their heart. It's normal for ribs to crack while you are doing CPR.

CPR only works on patients in cardiac arrest. When doing CPR, you have the options to do just chest compressions, or full CPR (chest compressions and rescue breathing). To do CPR, empty your hands, set your intent to Help, click on the patient, and choose which type of CPR you want. If you are doing rescue breathing, both you and the patient must not be wearing anything that covers the mouth. Both of you must remain still for CPR to work. Once you have started CPR, you can continue indefinitely until the patient's heart restarts.

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.

Stabilizing Patients
A patient is stable when their blood is oxygenated, their heart is beating steadily, their blood volume is good, and their brain function is not degrading. Stabilizing patients is the primary goal of the First Responder.

To stabilize a patient:
 * If the patient's heart has stopped, treat for cardiac arrest.
 * Inject Inaprovaline to support brain function and steady heartbeat.
 * Stop bleeding with an Advanced Trauma Kit. For internal bleeding, administer Coagzolug and hurry to the surgeon.
 * If the patient's blood oxygen level is low, treat for hypoxia.
 * If the patient has lung damage, administer Dexalin or Dexalin Plus.
 * If the patient has suffered blood loss, administer a blood transfusion.
 * Splint fractured limbs, or put your patient on a roller bed to keep them from moving.
 * Treat burns with an Advanced Burn Kit to prevent infection.
 * If the patient has been poisoned or irradiated, but is otherwise stable and does not need inaprovaline, administer dylovene to slow the damage.
 * If the patient has an infection, administer thetamycin; if you have none with you, administer dylovene and painkillers and get them to Medbay.

Some patients will be impossible to stabilize completely:
 * A combination of damage to the heart and lungs can make it impossible to raise the patient's blood oxygen level. Dexalin (Plus) doesn't work if the heart is not beating to circulate the artificially oxygenated blood. For these patients, apply a stabilizer harness or do CPR and rush them to Medbay, where they can be treated with surgery or organ-repair medication.
 * If a patient's heart is damaged and their brain function is low (<20%), their blood circulation may be too poor for alkysine to work. Rush them to the operating room; treating their heart and brain directly may be their only chance. Continue stabilizing them while the surgeon is operating.
 * Internal bleeding cannot be entirely stopped without surgery. Coagzolug or a bicaridine overdose will slow it. Attach an IV, hope the blood transfusion keeps up with the blood loss, and hurry them to a surgeon.
 * Patients with extreme blood loss may be suffering too badly from hypoxia for a blood transfusion--even from multiple IVs--to restore their blood volume in time to save their life. These patients should be surgically treated for brain damage simultaneously with the blood transfusions.

Surgery
See Surgery. Required for:
 * Repairing fractures
 * Stopping arterial bleeding
 * Removing foreign objects
 * Organ transplants
 * Removing necrotic tissue
 * Plastic surgery
 * Appendicitis
 * Cyborgification
 * Amputations

Organ damage can be treated with medication, but surgery may be faster or more efficient, or may be the only option in the absence of a pharmacist. Simple operations can be done by a physician; more complex ones require a surgeon. Operations involving cybernetic parts can be done by a mechanist. A first responder is not trained to do surgery, but may assist in the operating room to keep a patient stable while the surgeon works.

=Common Diseases & Injuries= These are by no means the only ailments you will see, but they're a start.

Blood Loss

 * For external bleeding cases:
 * Pressure: If you have no medical equipment, apply direct pressure to slow bleeding. Establish a grab, switch to help intent, target the bleeding body part, and click on the patient. This slows, but does not stop, bleeding as long as neither you nor the patient move. If you are bleeding, help intent click the limb and you will begin applying pressure.
 * Gauze: Basic treatment. Stops bleeding and speeds healing.
 * Advanced Trauma Kit: Stops bleeding, speeds healing, disinfects, and immediately heals a small amount of damage.


 * For internal bleeding (IB) cases:
 * Cryogenics: Placing a patient with internal bleeding into a (correctly set up) 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 poison the patient, but it may clot internal bleeding. Generally a last resort if none of the other methods are available.
 * Coagzolug: Coagzolug slows bleeding, buying you more time to treat a patient. Overdoses at 10u.

Once you have stopped the bleeding, work to raise the patient's blood volume.
 * Iron: Must be ingested in order to work. Replenishes 8u of blood per unit. Vaurca patients need sulfur instead; Skrell patients need copper.
 * Nutriment: Must be ingested. Replenishes 4u of blood per unit.
 * Protein: Protein is found in meat, eggs, tofu, and seafood. Must be ingested. Replenishes 4u of blood per unit.
 * 20/20/20 Pills: Iron, nutriment, and protein in a pill, 20 units each for a total of 60. With three separate reagents, these pills can replenish blood rather quickly. Best given on a mostly-empty stomach.
 * Blood transfusion: Blood bags hold 200u of blood (a little less than half a patient's total blood volume). Use the IV drip to administer.
 * IV Drip with Saline Plus: Administering 1.5u/tick of Saline Plus will rapidly replenish their blood and works for all species.

Symptoms of blood loss:
 * <85% blood volume:
 * Brain damage begins.
 * Patient feels dizzy and pale.
 * Alkysine and inaprovaline no longer heal brain tissue.


 * <70% blood volume causes all the above and:
 * Health scanner shows severe blood loss.
 * Cloudy vision.
 * Brain damage increases.
 * Pulse quickens.


 * <60% blood volume causes all the above and:
 * Unconsciousness.
 * Surgical brain repair may cause scarring.
 * Pulse quickens.
 * Brain damage increases.


 * <30% blood volume causes all the above and:
 * Ventricular fibrillation.
 * Cardiac arrest.
 * Massive brain damage.

Brute Damage
Brute damage covers cuts, bruises, punctures, and other physical trauma, caused by being hit with something, being dragged with open wounds, slamming into walls, depressurization, etc. High brute damage can cause a fracture or even amputate the limb entirely. Brute damage causes pain.

To treat:
 * Gauze: Heals 4 brute per wound. Stops bleeding.
 * Advanced Trauma Kits: Heals 8 brute per wound. Stops bleeding and disinfects.
 * Bicaridine: Heals 5 brute per unit. Overdoses at 20u.
 * Butazoline: Heals 8 brute per unit. Overdoses at 15u.
 * Tricordrazine: Heals 3 brute and burn per unit. Overdoses at 30u.
 * Mixing Bicaridine and Butazoline causes genetic damage. Mixing either with tricordrazine is safe.

Burns
Burns are usually caused by fire, extreme cold, lasers, and electrocution. Extreme burn injury can vaporize a limb entirely. Burns are easily infected. Large or severe burns cause blood loss. Burns cause severe pain.

To treat:
 * Ointment: Heals 4 burn per wound. Disinfects.
 * Advanced Burn Kits: heals 8 burn per wound. Disinfects.
 * Kelotane: Heals 6 burn per unit. Overdoses at 20u. Does not disinfect wounds.
 * Dermaline: Heals 12 burn per unit. Overdoses at 15u. Does not disinfect wounds.
 * Tricordrazine: Heals 3 brute and burn per unit. Overdoses at 30u.
 * Mixing Kelotane and Dermaline causes genetic damage. Mixing either with tricordrazine is safe.

Cardiac Arrest
Cardiac arrest is indicated by a flat line 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, the heart will stop again.
 * Administer inaprovaline to slow brain damage and stabilize the pulse.
 * Adrenaline can restart the heart if the blood is oxygenated. Before administering, check the patient's respiration.
 * 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 indefinitely. Even if CPR does not restart the patient's heart, it will slow brain damage.

Dislocations
The patient's bone has gone out of joint; functions like a fracture. To fix a dislocation, right-click on the patient and click on "Undislocate joint". If there are multiple dislocations, a prompt will appear asking which limb you would like to relocate. Be aware that this is painful for the patient, and should not be attempted by unskilled crew in non-emergency situations.

Foreign Bodies
Most foreign bodies, whether bullets, shrapnel, an alien parasite, or a bomb, require surgery to remove. If the object is large enough--such as a knife or a fire axe--it may be removed by simply yanking it out by right-clicking on the patient. This is dangerous because it will cause more damage to the body part and is likely to cause bleeding--possibly internal bleeding--but in an emergency, or within easy reach of a surgeon, removing a foreign object this way is an option.

Fractures
Fractures are caused by brute damage to a body part. They range in severity from hairline to fracture to broken. If not stabilized, fractures can cause damage to the organ in that body part.


 * Splints: A splint keeps a fractured bone in place and prevents it from damaging adjacent tissue. Splints can be applied to arms, legs, hands, and feet.
 * Wheelchairs: A patient with a broken leg or foot can sit in a wheelchair to recover their mobility. Pushing a wheelchair works the same as walking.
 * Bed Rest: If your patient has a fractured skull, ribs, or pelvis, splinting is impossible, and moving around will injure them further. Put them on a roller bed and tell them to stay there and wait for the surgeon.
 * Surgery is the only way to repair fractures.

Genetic Damage
Genetic damage is dealt by radiation, slime digestion, or coming out of a stasis bag. It can be diagnosed with a body scanner.

To treat:
 * Cryoxadone: Heals genetic damage if administered at 170 Kelvin or lower (generally in a cryo tube).
 * Clonexadone: Works like cryoxadone, but faster.
 * Cryo-Mix: A 1:1 mix of Cryoxadone and Clonexadone.
 * Rezadone: Heals genetic damage without the need for cold temperatures. Overdoses at 20u, though 10u may induce dizziness.

Hypoxia
Hypoxia is low oxygen in the blood. The blood oxygen reading on your handheld health scanner represents low blood oxygen from all causes, including low blood oxygen, blood loss, and damage to the heart. If you can rule out cardiac damage or blood loss, a low blood oxygen reading means hypoxia.

To treat:
 * 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.
 * Administer Inaprovaline to slow brain damage from hypoxia.
 * 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. Dexalin forces oxygenation to 50% and overdoses at 20u; Dexalin Plus forces oxygenation to 80% and overdoses at 15u.
 * Administer Pneumalin to treat lung damage, or perform surgery.
 * If the patient is not breathing and you do not have an IV stand with oxygen tank and mask, do CPR (Full CPR, with rescue breathing) or put them in a stabilizer harness.

Infection
Infections start when a wound isn't treated and disinfected in time. A hand scanner will not detect an infection, but will detect the fever that results from infections. If left alone, infections can rapidly kill a patient. Diagnose infections with the body scanner.

Levels of infection:
 * 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.

The following are some symptoms of infection based on where it's located:
 * 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
 * Pyelonephritis (Kidneys)
 * L1: Lower back pain
 * L2: Malaise
 * Pyogenic Abscess (Liver)
 * L1: Right-sided abdominal pain
 * L2: Poor blood filtration; toxins build up
 * Pneumonia (Lungs)
 * L1: Coughing
 * L2: Shortness of breath; hypoxia
 * Staph Infection (Arms, legs, hands, feet)
 * L1: Pain
 * L2: Sharp pain temporarily disables limb

To treat:
 * Administer Thetamycin and monitor the patient. Having at least 5u of thetamycin in the bloodstream prevents infections from spreading to nearby body parts. Do not put the patient in the recovery room; they need constant watching. Use the ICU or GTR.
 * Leporazine reduces fevers.
 * Administer painkillers to prevent the patient from going into shock due to pain.
 * If an organ is infected, treat the patient for the symptoms of organ failure.
 * If the patient's infection is causing toxins to build up in the blood, administer dylovene.
 * Gangrenous limbs should be treated with necrotic limb repair. If no surgeon is available, amputation is an option.
 * Organ necrosis needs to be treated with a transplant.

Mental Illness & Trauma
Mental illness is primarily role-played.
 * Psychiatrists/Psychologists specialize in treating mental illness. Psychiatrists specialize in medical treatment for mental illness; psychologists and counselors specialize in therapy.
 * All characters with a Medical Doctorate degree are qualified to diagnose mental illness and prescribe medication, but it's not their specialty.
 * Surgeons are trained in neurosurgery and can treat brain damage caused by trauma, toxins, or oxygen deprivation.
 * Chemists/Pharmacists can synthesize psychiatric medication and understand how it works, but they cannot prescribe it. A doctor must prescribe the medication for the patient.
 * Occasionally, mental illness may cause a patient to become violent or suicidal. Use the least amount of force necessary to keep the patient safe; restraint is highly traumatic and should only be used in an emergency.

Radiation
Radiation exposure is caused by radioactive reagents, being in an unshielded area during a radiation storm, or certain artifacts. A hand scanner detects radiation exposure; body scanners show it more precisely.

Radiation causes damage similar to toxins, eventually damaging the liver and causing vomiting. Patients may lose their hair and feel weak and dizzy.

To treat:
 * Hyronalin: Heals 30 radiation per unit. Overdoses at 20u.
 * Arithrazine: Heals 70 radiation, but causes mild brute damage. Overdoses at 20u.
 * If neither hyronalin nor arithrazine are available, keep the patient on dylovene and monitor them. Radiation decreases naturally over time; dylovene prevents further damage.

Organ Damage
Organ damage is caused by physical trauma, poisons, or moving around with broken bones in the same body part as the organ. Most organs die at 30 damage; a dead organ must be replaced. Brain damage causes death at 100 damage rather than 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 heals the brain of minor damage. Overdoses at 20u.
 * Dylovene: A green medicine heals minor liver damage. Overdoses at 20u.

Toxin Exposure
Poisons tend to show up as unidentified chemicals in a patient's bloodstream via a health analyzer. Some poisons target specific organs, bypassing the liver; general poisons must damage the liver before they can start damaging other organs.

Patients who have been poisoned may report stomach pain and vomiting. If the liver has been damaged or the poison targets a different organ, they will show signs of organ damage. Patients who have ingested acid will also have burns.

To treat:
 * Remove toxins from the stomach via the sleeper's stomach pump option.
 * Remove toxins from the blood via the sleeper's dialysis option. This will also remove beneficial reagents and some blood.
 * 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.
 * Taking a blood sample for analysis with a chemical analyzer can identify the poison in the patient's blood, which might help you treat it.
 * Dylovene: Protects the liver against damage from toxins. Overdoses at 20u.
 * Fluvectionem: Removes all other chemicals reagents from the bloodstream, but causes mild liver damage. Overdoses at 20u.
 * Pulmodeiectionem: Causes the patient to cough up any reagents in their lungs when inhaled. Overdoses at 10u.
 * Treat for organ damage, burns, blood loss, or any other damage the toxin may have done.

=Medbay Operations=

Layout

 * Exam room: Used for private, non-emergency checkups.
 * Morgue Lift: Goes down to the morgue; used to transport bodies.
 * OR 1 and OR 2: For surgeries. Refrigerated back room includes lockers with monkey cubes and blood.
 * Atrium: Open to the upstairs level. Park waiting surgical patients here.
 * Psychology: For mental health counseling.
 * ICU: For patients with non-surgical problems that need constant monitoring.
 * GTR: General treatment area. Patients come here at intake.
 * Pharmacy: Makes medication.
 * Cryo: For cryo treatment. Back room includes air compressors and air tanks.
 * First Responder: Equipment, lockers, and ready room for first responders. Includes a charger for mechs.
 * Reception: Intake; seating for doctors awaiting patients and patients awaiting doctors.


 * Staff room: Usually unused, but there if you need a private moment.
 * CMO's office: CMO's private space. Home to Crusher, the Medbay cat.
 * Isolation: Used to treat patients with contagious conditions.
 * Equipment room: Lockers for doctors and surgeons. Extra hyposprays, belts, HUDs, and other useful items.
 * Shower: Useful to keep clean after one has been covered in blood.
 * Atrium: Open to the downstairs.
 * Briefing: Medbay staff report here at the beginning of a shift.
 * Recovery: For patients who need rest and time, but not monitoring.

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
Medical personnel are divided into specialties. Ideally, everyone should keep to their own specialty, transferring patients between them as needed.


 * The Chief Medical Officer organizes the efforts of the Medbay staff and interfaces with Command. Depending on their background, they may also function as a physician or surgeon.
 * First Responders primarily work in the field, retrieving patients, stabilizing them, and bringing them back to Medical and to the Physicians. In multiple casualty situations, first responders perform triage.
 * Physicians diagnose and treat patients in Medbay. When their patients need surgery, they should hand them off to the surgeons; when they need counseling, they should hand them off to the psychologist. Physicians can prescribe medication.
 * Surgeons specialize in surgery. They may be assisted in surgery by a Physician or First Responder who keeps the patient stable while they work.
 * Machinists perform surgeries that involve installing or repairing prosthetics and artificial organs.
 * Pharmacists make medication, and know how to administer it. They do not prescribe medication directly; rather, they supply medication to the first responder, physician, surgeon, and psychologist.
 * Psychologists specialize in counseling, including both mental illness and counseling for those who are dealing with stress or simply need advice. They can prescribe psychiatric medication to patients.

When job slots are empty, or when Medical is overwhelmed with work, personnel may find themselves covering for one another:
 * Physicians and Surgeons may function as First Responders.
 * First Responders may administer medication, monitor patients, take scans, and treat patients in the GTU.
 * Physicians may do simple surgeries. In an emergency, a first responder may perform an amputation or do a needle thoracotamy for a collapsed lung.
 * Pharmacists and Psychologists may perform first aid, administer prescribed medication, and take body scans for the physician or surgeon.
 * Research scientists trained in chemistry can provide medication.
 * Anyone--including non-Medical crew--can perform CPR, use an autoinjector or autoinhaler, apply bandages and ointment, or grind or dissolve pills into liquid medication.
 * Machinists may perform simple surgeries.

=Xenomedicine= Medical staff are required to learn the anatomy and physiology of all species they can expect to encounter. Depending on your own species, you may be more or less familiar with any given species. These statistics use humans as a baseline.

Human

 * Blood Volume: 560
 * Primitive Form: Monkey

Skrell

 * Primitive Form: Neaera
 * Less resistant to alcohol.
 * Less stamina.
 * Faster running speed.
 * Immune to slipping.

Unathi

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

Tajara

 * Slightly higher brute damage.
 * Primitive Form: Farwa
 * Low alcohol tolerance.
 * Faster walking speed.
 * Less stamina and running speed, but faster stamina recovery.
 * Fall damage is halved.

Tajara: Zhan-Khazan

 * Slightly higher brute damage than base Tajara.
 * Slower walking speed.
 * Slower running speed, but more stamina.
 * Resistant to cold.
 * Tolerant to alcohol.

Tajara: M'sai

 * Significantly higher brute damage than base Tajara.
 * Faster walking speed.
 * Faster running speed, but less stamina.

Dionaea

 * 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 poisons Diona.
 * Arithrazine severely poisons Diona.
 * Does not bleed.
 * Immune to slipping.
 * Immune to infections.
 * Immune to low pressure.
 * 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.
 * Nutriment (normal food) is toxic.
 * 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.