Surgery

READ THIS FIRST

The chart that shows what surgeries each role is qualified to perform.

Surgery/Treatment Types by Role
Treatment Type	Paramedic	Machinist	Physician	Surgeon
Bone Repair	NO	NO	YES	YES
Arterial Bleeding	NO	NO	YES	YES
Tendon Repair	NO	NO	YES	YES
Amputation	YES	YES	YES	YES
Limb Replacement	NO	YES IF MECHANICAL	NO	YES
Cavity Surgery	NO	NO	YES	YES
Foreign Body Removal	NO	YES IF MECHANICAL	YES	YES
Organ Transplant	NO	NO	NO	YES
Necrotic Limb Repair	NO	NO	NO	YES
K'ois Mycosis	NO	NO	NO	YES
Autopsy	NO	NO	YES	YES
Hardsuit Removal	YES	YES	YES	YES
Cyborgification	NO	YES	NO	YES
Plastic Surgery	NO	NO	NO	YES
Brain Repair	NO	NO	NO	YES
Eye Repair	NO	YES IF MECHANICAL	NO	YES
Heart Repair	NO	YES IF MECHANICAL	YES	YES
Lung Repair	NO	YES IF MECHANICAL	YES	YES
Liver Repair	NO	YES IF MECHANICAL	NO	YES
Kidney Repair	NO	YES IF MECHANICAL	NO	YES
Stomach Repair	NO	YES IF MECHANICAL	NO	YES
Appendix Removal	NO	NO	YES	YES

Note: Concerning the Machinist's ability to repair mechanical organs, assisted organs are included in these abilities as well.
Concerning Autopsies: While doctors theoretically may know how to perform an Autopsy, Medical staff should never be performing them, unless Investigations are absent and there are severe circumstances (code red, Command orders, etc.) and it is urgently required. In all other cases, a body with a suspicious death should be stored in the Morgue until Investigations arrives at a later time, as per Standard Operating Procedure.

A Guide to Surgery In General

All surgery requires the set of surgical instruments in the Operating Theatre, along with an operating table. In general, only Machinists, Physicians, Surgeons, and the Chief Medical Officer (if qualified) can (ICly) perform advanced surgery. Remember to let each step complete fully, else you risk harming the patient.

Abnormal Growths

Due to the limitations of the engine, k'ois mycosis, black k'ois, and parasites (like nerve flukes and heart flukes) count as another organ causing deleterious effects once they take hold in a body. To get rid of them properly, you have to remove them as you would an organ.

Ghetto Surgery

If you can't find an operating table, have no fear, there are other ways to fix people up. Any table will work! Click twice on a player with grab intent to put them in an aggressive grab and click on a table. Be sure to tell them to rest, otherwise they might automatically get back up mid-procedure. Note that you have a 1/3 chance per step to make a mistake and injure the patient rather than advancing the procedure. While tables are more available anywhere metal is on hand, deploying the patient on a roller bed is preferable with only a 1/4 chance to fail.

NOTE ABOUT GHETTO SURGERY

Performing this as a crew member and a non-antagonist one (unless the situation really calls for it. If you have any questions, you're free to ahelp it) might possibly lead to action being taken against you by the internal security team or IAA, which would result in your character in being 'fired' or disciplined.

Surgical Tools

Surgical tools are very hard to get and it is best to keep them in the operating theatre. However, if the worst happens and some tools disappear, you can order more in a surgery crate from cargo, and most can be made with an autolathe.

The following are the standard surgical tools most doctors will need:

Standard Tools:

• Scalpel
• Hemostat
• Retractors
• Circular saw
• Cautery
• Bone gel
• Bone setter
• Surgical drill
• Medical mask
• Anesthetic tank
• Autopsy scanner
• Sterile mask
• Latex gloves
• Advanced trauma kit
• Nanopaste
• MMI

Advanced Tools:

• Incision Management System
• Laser scalpel

Ghetto surgical tools:

• Cable Coil
• Glass Shard
• Wirecutters
• Crowbar
• Welding Tool
• Tape Roll
• Mousetrap
• Fork
• Cigarette
• Lighter
• Metal Rods
• Wrench
• Kitchen Knife

Infection

Wear gloves and wash your hands before every surgery. Failure to do so will result in giving your patient an infection which, if left untreated, can be deadly. Apply ointment to the afflicted areas quickly if you fail to wash your hands before starting surgery.

Prepping for Surgery

Please ensure that your patients are properly diagnosed and scanned before starting the operation, and that all medications and personnel needed for the procedure have been prepared.

1. Find a suitable operating table, unless you're willing to risk Ghetto Surgery.
2. Make sure you're wearing latex or nitrile gloves and a sterile mask.
   • (Optional) Ask the patient to strip, or clickdrag them onto your body and click on all of their items to remove them.
3. Clickdrag the patient onto the operating table or grab the patient and click on it. Alternatively, ask them to lie down on it.
   • (Optional) Buckle the patient to the operating table by clickdragging them. Unbuckle them with grab intent .
4. Check the Operating Computer to ensure the patient is positioned properly; if the monitor does not show the patient's vitals, the surgery will not work.
5. Activate the neural suppressor on the operating table. They will be unconscious in a few seconds.
6. Make sure you're set on the Help intent.
7. Use a sink to wash your hands. Unclean hands can result in an infected wound. This is treatable with ointment on the localized area.

Sedating without an operating table:

1. Place a medical mask and a anesthetic tank on an IV stand.
2. Clickdrag the IV stand onto your patient.
3. Select the medical mask, which will place it on your patient.
4. Click the IV line and open the tank valve.
5. Make sure you're set on the Help intent.
6. Use a sink to wash your hands. Unclean hands can result in an infected wound. This is treatable with ointment on the localized area.

Sedating without an IV stand:

1. Pick up a medical mask and a anesthetic tank.
2. Clickdrag their body onto yours to view their inventory. With the medical mask in your right hand, click on the "Nothing" link at the top beside "Head (Mask)". In a few seconds, you will equip them with the medical mask.
3. Place the anesthetic tank in your right hand, then click the "Nothing" link in their inventory window beside "Back" to equip it on their back.
4. A new link will appear beside the sleeping agent called "Set internals". Click on it to turn on the gas. It will force them asleep in about 5 seconds. You are now ready to proceed with surgery.
   • You may need to clickdrag their body onto yours again to refresh the window to actually see the option to enable their internals.
5. Make sure you're set on the Help intent.
6. Use a sink to wash your hands. Unclean hands can result in an infected wound. This is treatable with ointment on the localized area.

NOTE: If anyone is pulling on the patient, the surgery will not work properly! Make sure no one is pulling the patient!

Surgery List

There are many different types of surgeries out there to perform. Sometimes it will be necessary to have the patient hooked up to an IV or someone on standby to inject medications during the procedure.

Opening a Surgical Site

The first steps of most surgeries.

• NOTE: Steps 3-5 can be replaced with one use of an IMS if one is available to you. Steps 3 and 4 can be replaced with one use of a Laser Scalpel.

1. (Optional) Complete Prepping for Surgery.
2. Aim for the location in the Damage Zone.
3. Use the scalpel to create an incision.
   • If the patient is Vaurca, use the drill instead.
4. Use the hemostat to stop any potential bleeding.
5. Use your retractors to lift up the skin.

For internal work in chest and skull only:

1. Use the bone saw to cut through the bone.
2. Use your retractors to move the bone aside.

GHETTO:

• Scalpel - Knife 50%, glass shard 20%
• Laser Scalpel - Level 1 75%, Level 2 85%, Level 3 95%, energy sword 5%
• Hemostat - Cable coil 75%, mousetrap 20%
• Retractor - Crowbar 75%, fork 50%
• Surgical Saw - Hatchet 75%

Closing a Surgical Site

The final steps of most surgeries.

1. Aim for the location in the Damage Zone.

If you had to use the bone saw earlier (chest/head):

1. Use your retractors to put the bones back into place.
2. Apply bone gel to mend their ribcage/skull unless the bone was fractured during the sawing phase, in which case, conduct bone repair before continuing.

Then, after the above (or if it was not required):

1. Use the cautery to seal the incision.

GHETTO:

• Retractor - Crowbar 75%
• Bone Gel - Tape Roll 60%
• Cautery - Cigarette 75%, lighter 50%, welder 25%

Bone Repair

The mending of broken bones and fractures.

1. (Optional) Complete Prepping for Surgery.
2. Perform Opening a Surgical Site.
3. Ensure the target limb doesn't have over 30 brute damage (15 for hands and feet), otherwise the bone will break again.
4. Apply bone gel to the broken bone.
   • If you are fixing broken bones in the head or chest, apply a second smearing of bone gel.
5. Use the bone setter to set the bone in place.
6. Apply more bone gel.
7. Perform Closing a Surgical Site.

GHETTO:

• Bone Gel - Tape Roll 60%
• Bone Setter - Wrench 75%

Plastic Surgery

The altering and repair of a patient's face.

1. Aim for the patient's mouth - not head - in the Damage Zone.
2. Cut the skin with your scalpel.
3. Use your retractors to retract the skin, preparing the patients face
4. Use your hemostat to begin fixing vocal cords if needed' otherwise begin the process of fixing any other facial deformity or modification
5. Cauterize the incision with the cautery.

SHELL IPC'S ONLY BELOW!

1. Aim for the patient's mouth - not head - in the Damage Zone.
2. Cut the skin with your scalpel.
3. Use your retractors to retract the skin, preparing the patients face
4. Multi-tool to begin fixing synth voice box if needed: otherwise begin the process of fixing any other synthskin deformity or modification
5. Cauterize the incision with the cautery.

GHETTO:

• Scalpel - Knife 75%, glass shard 50%
• Retractor - Tactical Knife 75%

Arterial Bleeding and Severed Tendon Repair

Repairing damaged arteries and tendons.

1. (Optional) Complete Prepping for Surgery.
2. Perform the steps in Opening a Surgical Site.
3. Use the vascular recoupler to repair the damaged blood vessels.
4. Perform the steps in Closing a Surgical Site.

GHETTO:

• Vascular Recoupler - Cable coil 75%

Amputation

Removing a limb or a limb stump.

1. (Optional) Complete Prepping for Surgery.
2. Aim for the patient's limb using the Damage Zone.
3. Use a circular saw to amputate the limb.
4. (Optional) Conduct Bone Repair on the parent body.

GHETTO:

• Circular Saw - Hatchet 55%

Limb Replacement

Replacing missing limbs.

1. (Optional) Complete Prepping for Surgery.
2. Perform the steps in Amputation.
3. Attach the desired limb, whether it's the patient's or a robotic limb.
4. Ensure the patient is able to manipulate their new limb before releasing them.

For organic limbs, be ready to inject Thetamycin as the replacement limb is surely infected.

Internal Organ Repair

Mending organ damage. Yes, even brain damage.

1. (Optional) Complete Prepping for Surgery.
2. Aim for the chest, groin, or head in the Damage Zone.
3. Perform the steps in Opening a Surgical Site.
4. Use the appropriate mechanism to mend the organ:
   • Advanced trauma kit for organic organs.
   • Nanopaste for synthetic organs.
5. Perform the steps in Closing a Surgical Site.

GHETTO:

• ATK - Gauze 20%

Cavity Surgery

Putting things inside peoples' body cavities.

Maxiumum size of item that fits inside:

• Head - tiny
• Abdomen - small
• Chest - normal

1. Aim for the chest, abdomen or head in the Damage Zone.
2. Perform the steps in Opening a Surgical Site.
3. Use the surgical drill to prepare cavity.
4. Insert the item inside. If it caused internal bleeding, use the vascular recoupler to fix it.
5. If you decided not to put item inside, use cautery to mend the cavity wall.
6. Perform the steps in Closing a Surgical Site.

GHETTO:

• Drill - Pen 75%, metal rods 50%
• Cautery - Cigarette 75%, lighter 50%, welder 25%

Implant/Shrapnel Removal

Removing implants from the body. Also removal of things from body cavities.

1. (Optional) Complete Prepping for Surgery.
2. Aim for the implant location on the Damage Zone.
3. Perform the steps in Opening a Surgical Site.
4. Use your hemostat to extract the implant. This may take several tries.
   • Note that there is a brief period where nothing happens after you click on the patient with the hemostat. Use this time to click on the patient multiple times to queue up multiple attempts at removing implants.
5. Perform the steps in Closing a Surgical Site.

GHETTO:

• Hemostat - Wirecutters 75%, fork 20%

Organ Removal/Transplantation

Removal and re-insertion of organs. This also applies to prosthetic organs, k'ois, and parasitic infections such as heart flukes.

1. (Optional) Complete Prepping for Surgery.
2. Aim for the organ's location in the Damage Zone. (Head for brain/eyes, chest for heart/lungs, groin for appendix/kidney/liver)
3. Perform the steps in Opening a Surgical Site.

REMOVING an organ:

1. Use the scalpel. This will open up a window asking you which organ you'd like to cut loose.
2. Use the hemostat. This will open up a window asking you which loose organ you'd like to remove.
3. Dispose of the organ or store it in a freezer.

TRANSPLANTING an organ:

1. Click the patient with the organ you intent to transplant.
2. Use the vascular recoupler to reconnect the organ to the body.
3. Administer an advanced trauma kit or use nanopaste if required to repair any damage received during transport/transplantation.
4. Perform the steps in Closing a Surgical Site.

GHETTO:

• Scalpel - Kitchen knife 75%, glass shard 50%
• Hemostat - Wirecutters 75%, fork 20%
• Vascular Recoupler - Cable coil 75%

Organs may become infected after transplantation. Do not transplant organic organs that are from a different species or blood type as the patient, otherwise they will be rejected and the patient will soon die.

Additionally, K'ois is located in the chest. Black K'ois is located in the head.

Head Reattachment Surgery

Reattaching a severed head.

See limb replacement surgery.

Necrotic Limb Repair

Fixing limb necrosis mostly caused by septic infections. NOT necrotic organ repair.

1. (Optional) Complete Prepping for Surgery.
2. Aim for the necrotic area in the Damage Zone.
3. Perform the steps in Opening a Surgical Site.
4. Use the scalpel to cut away the dead flesh.
5. Use a dropper filled with Peridaxon to revive the necrotic limb.
6. Perform the steps in Closing a Surgical Site.

GHETTO:

• Scalpel - Kitchen knife 75%, glass shard 50%
• Dropper - Bottle/beaker 75%, spray bottle/bucket 50%

Autopsy

Examination of cadavers to find cause of death. See autopsy prodedures for more information.

1. Place cadaver onto the operating table.
2. Scan the cadaver with a Health Analyer to find injured locations.
3. Aim for the patient's affected area in the Damage Zone.
4. Cut the skin with your scalpel (the chest may require two cuts).
   • For Vaurca, use the surgical drill instead.
5. Use the autopsy scanner to scan the area.
6. Repeat scalpel and scan procedure for all affected areas.
7. Right click the autopsy scanner to print out autopsy data.

Hardsuit Removal

Cutting the seals on a sealed hardsuit so that it can be removed from the person wearing it.

1. Place the patient or cadaver onto the operating table. Cleanliness is not required.
2. Aim for the chest in the Damage Zone.
3. Use a plasma cutter, welding tool, or circular saw to slice the hardsuit seals open. This may take several attempts.
4. Pull the hardsuit control module off.

Extracting organs from detached body parts

Removing internal organs from parts of the body, such as heads, which are no longer attached to the rest.

1. Place the body part on any surface, or hold it in hand.
2. Use the scalpel to cut the body part open.
   • For Vaurca, use the surgical drill instead.
3. Use the retractor to crack the body part open.
4. Use the hemostat to extract an organ. Repeated applications will yield further organs, until all organs present in the body part have been removed.

Pre-Cyborgification Procedure

Preparing a brain for cyborgification. This ain't rocket surgery!

1. (Optional) Complete Prepping for Surgery.
2. Aim for the head.
3. Perform the steps in Opening a Surgical Site.
4. Use the surgical drill on the brain to prepare it for Man-Machine-Interface compatibility..

• REMOVING the brain:

1. Perform the steps in Organ Removal/Transplantation.

• KEEPING the brain:

1. Perform the steps in Closing a Surgical Site.

Medical Department
Head of Department	Chief Medical Officer
Personnel	Physician - Surgeon - Psychologist - Pharmacist - Emergency Medical Technician - Medical Intern
Useful Guides	Guide to Medicine - Guide to Surgery - Guide to Chemistry - Guide to Cadavers