Some medical questions

[ThePiachu]

So I'm learning how to play a doctor. I have figured most of the basics out, but I'm having problems treating the following:

- Mild internal brute damage - brain damage, etc.
- Whether to treat brute damage first, or do surgery first
- How to deal with oxygen damage - just use drugs, or is there some surgery for that?
- Health analyser finding unknown substances in blood, but full scanner not picking up anything

Any advice would be helpful.

Also, any other medical tricks I should know about?

[Brotemis]

Brain damage has a specific drug that does the healing for it listed on the wiki if I rember right. As far as internal damage goes, it varies whether it's a broken groin or punctured lung. In most cases, you'll want something to stop internal bleeding long enough to operate or inaprov to keep critical patients stable.

Unless the patient is dieing from blood loss, overdose, or oxygen loss, always do surgery first and give medication to heal after if time allows, otherwise triage fills up with patients who need surgery and you fall behind.

Unknown substances aren't worrying usually unless the patient is overdosing. Take steps to prevent further toxin damage and then keep an eye on the patient

I forgot to add that concerning oxygen damage, it could be from a certain chemical that causes oxygen loss directly, but more normally from a punctured lung. In some cases, in oxygen damage that does not go away, it is a heart problem.

[Hughgent]

Ah, Medbay is a rewarding career.

Internal organ damage is mostly fixed through surgery. that would be this surgery. wiki/Surgery#Internal_Organs_Surgery. HOWEVER, brain/eye damage should be treated by Alkysine/Imidazoline respectively as it's MUCH faster than the surgery required. Check the Chemistry wiki for recipies or ask the person making chems to whip some up. wiki/Chem_Guide

I have a strong preference to treat the brute damage FIRST. this is because if they have more than 35 ish brute damage to the location, the bone will automatically break again. HOWEVER, if you give them some bicardine before the surgery, they should heal enough during that this won't be an issue.

the CAUSE of oxygen damage is one of two causes usually. they have low blood or they have Heart/Lung damage. Low blood is fixed by transfusing blood via IV, and the organ damage is dealt with via organ surgery. should you complete the surgery, and they still have the oxygen damage, it will fix itself on it's own relatively quickly. Yes, Dexalin or Dexalin Plus will "fix" oxygen damage. but those are only temporary solutions.

Unknown substances are not usually a problem unless they have toxin damage. if they have toxin damage WITHOUT liver/Kidney/Appendix damage then they've got a poison in them and should have dialysis performed on them via the sleepers. Remember to remove and splash the full beakers on the ground after doing dialysis.

[DefinitelyAlone0309]

So I'm learning how to play a doctor. I have figured most of the basics out, but I'm having problems treating the following:

- Mild internal brute damage - brain damage, etc.
- Whether to treat brute damage first, or do surgery first
- How to deal with oxygen damage - just use drugs, or is there some surgery for that?
- Health analyser finding unknown substances in blood, but full scanner not picking up anything

Any advice would be helpful.

Also, any other medical tricks I should know about?

- Mild internal brain/eye damage can be fixed with Imidazoline, or Alkysine, both of which can be made in chem lab

- Doesn't hurt to just pop a Bicard pill into your patient before a surgery if you're that worried about the brute damage

- Oxygen damage, if it's not related to anything, can just be fixed with Dexalin or Dexalin Plus, or you can just leave it be and it'll heal itself. If it's low blood, then grab the patient some Iron pills and/or attach an IV drip to them. If it's organ damage, well then you do the Organ Damage : wiki/Surgery#Internal_Organs_Surgery

- "Unknown substances in blood" can be ignored most of the time, if they're not dragging any other symptoms with them.

[CSolaris]

Also, any other medical tricks I should know about?

- Use the cryotubes. Even if you don't have a special mix, the standard cryoxadone is enough to stabilize people if you're getting swamped.

- Also, paying attention to the logs helps you figure out what could possibly be wrong with them without having to stuff them in a scanner.

- "x gasps for air!" or "x coughs up blood!" is your cue to go straight into organ repair surgery and hit 'em with that ATK (advanced trauma kit). This is usually a ruptured lung or something else in the chest that'll quickly drain someone's health. "x yells like an idiot!" is usually an indicator for brain damage which, like everyone else has said before me, can be treated to a certain extent using Alkysine.

- If you're running triage, don't be a dickhead and just leave people outside the OTs without scanning them first.

- If you've got the time, prep a smoke purge kit (potassium + phosphorus in one bottle, sugar in another (can interchange sugar with either potassium or phosphorus)) to quickly treat ODs without having to use the dialysis machine - wear a gas mask because it's possible to be affected by the medications in the smoke purge.

- Don't throw empty bloodbags in the disposals, a lot of new doctors will toss them out without knowing that they can be refilled like the medicine bottles / auto injectors from the dispensers.

- Defibs reset the 5 minute timer on a dead person, so don't panic if someone dies on you. Just give them the pills necessary (or purge them if necessary), defib them and then go from there or stick them in the cryotubes.

- If all the OTs are in use, pull up a rollerbed and operate in an OT anyway. Sometimes the campaign goes to shit and the Medbay quickly fills up. Don't wander around waiting for an OT to open up, either begin triage or pull up next to a surgical tray and get to work - just remember to give spaceacillin or disinfect after every procedure otherwise you risk necrosis or infection.

- Don't be afraid to ask for help, as someone who plays primarily doctor / CMO, I'd much rather you ask me for help so I can walk you through it rather than you freaking out when your patient dies and making things significantly worse.

- Learn chemistry. Personally, although it's not super math convenient, I go with 15u dosages. 15u is a generous, yet still safe, dose that'll last long enough for an injured person to be transported back to the Almayer from the field.

- Don't be afraid to call the MPs on someone if they're making things difficult for you.

[Rohesie]

- Health analyser finding unknown substances in blood, but full scanner not picking up anything

People have answered simply for you not to worry, but that is not a very satisfactory answer, now is it? There's a list of substances that will show in your scanner, telling you the concentration so you can know if the patient suffers an OD, such as Bicaridine, Tramadol and others meds. Whenever a substance is not on that list it will appear as an 'unknown substance'. This can range from the very benign hot coco, to a very dangerous space drugs OD or toxins. You'll have to know if it's something to worry about or not by the consequences. Those overdoses will tend to cause toxin damage and possibly organ failure.

Any advice would be helpful.

Also, any other medical tricks I should know about?

CSolaris is a great doctor, so you can't go wrong on his advice. I have a ton, but I'd then write a whole book, so I'll just keep it at a few:
- Never have the autodoc idle, and never use it in automatic mode. It's more often than not faster than conventional surgery, lets the patient be awake so they can keep chatting, and keeps you free to deal with other patients. Automatic mode doesn't fix organ damage and is considerably slower.
- A large amount of patients has heart damage because they were defib'ed. Organ damage is the most frequently missed by doctors. Double-check your patient for it before you release.
- As a doctor you'll be receiving lots of stasis bags and possibly roller beds. However, those are limited in number. Remember to toss them back on the dropship so the medics can get them back. That will make their job so much easier.

If you have any specific questions, feel free to send a message out or in the game.

[DefinitelyAlone0309]

Also, any other medical tricks I should know about?

1. Don't ever be on anything other than Help Intent. If you're in medbay and you're not on Help Intent, punch yourself. If you find any person in medbay that's not on Help Intent, punch that idiot and patch them up right after yelling in their face for them to switch back to help intent in LOOC (don't actually do this though, but you get the general idea).

2. If you see anyone, and I do mean ANYONE, dragging a roller bed/body bag/stasis bag. you run the heck out of the path (unless you're carrying one yourself). If it's not a roller bed, you can shuffle through them to speed them up. If you or they are not on Help Intent, check tip number 1.

3. Have a Space Cleaner in one of your pocket, ALWAYS. I don't give a damn about those fancy medical pouches, that Space Cleaner will 1. Help you quickly clean yourself before/after every surgeries (like seriously, one spray with the bottle and you're good); or 2. Help you clean up some random blood/dirt on the floor, tidying up Medbay. Don't even be afraid of it running out, since you can quickly fill it with your friendly neighborhood Spiderman chemist.

4. Git gud at chemistry. No, I don't mean that you have to be the one who fill out medics' requests before their first deployment, though it'd be great if you can reach that point. I'm talking about making chem for yourself. Simple stuff like ImiAlky, TriBicard, KeloDerm, Iron/IronSugar and Dex Plus will help you out GREATLY in terms of healing people.

5. Kits, injectors, bottles, splints, blood bags can all be restocked in their appropriate vendors. So, either you stay a good boy and just restock whey you're out of those, or be a naughty one and multiply the hell out of those things sans injectors, blood bags (but seriously, you'll never need that many blood bags) and bottles. Pill bottles, sadly, can't be restocked normally with the vendors, because that's the job of chemists.

6. Notice the little things, and scan a lot with the HF2. If a patient, seemingly fine, is getting increasing oxy/toxin damage; chances are they have organ damage. If a patient's oxygen damage suddenly shoots up from 0 to 100, they have ruptured lungs, and you'll need some Oxycodone injectors to do the surgeries to fix their lungs, since internals won't work on them (need clarification on this though). If you see results of unknown broken bones, either ask your patient themselves, or watch for the part that has the most brute damage.

7. IB surgeries don't actually require you to open their ribcage/skull. I know, I was bamboozled by the wiki too.

8. Learn how to do multiple surgeries. ie : Fix a person with IB + Organ damage + broken bones, all in the chest, by going IMS -> Fix-O-vein -> Bone Gel -> Bone Setter -> Bone Saw -> Retractor -> Advanced Trauma Kit -> Retractor -> Bone Gel -> Cautery.

9. Try to have a system between you and other doctors every round, if possible. Have one dude on triage and scanning duty, one dude on recovery and assisting duty, the rest on surgeries ....

10. If any researcher steals your bluespace beaker from the lower chemistry lab, you use mean words to yell at them until they give it back. I don't care if they're the better chemist, or if you'll never touch chem. The bluespace beaker should be in a place where all medbay staff can grab, and not in their little autism lounge. Researchers can have all the large beakers if they wish, just not the bluespace.

Any other things you want to know, you're welcome to PM me on the forum or just try and catch when I play Researcher/Doctor and ask me.

[spookydonut]

Autodoc automatic mode is for when the patient has more problems than time left to for you to select the relevant surgeries and bypass the time sink that is stabilising them.
It hurts me when people say never use automatic mode, it has its place and you're not using it to its full potential if you never use it like that.
Common situation:
A flood of wounded comes in with a mixture of marines close to death and dead but defibable (and the usual flood of low priority stable cases like missing limbs and breaks)
The autodoc can quickly take a near death patient off your hands with a quick scan and hitting the automatic button.
Always keep in mind that stabilising eats up a lot of time and you should do everything you can to mutlitask.
Cryo tubes can effectively stabilise 4 patients at once while you deal with 5th by hand, the autodoc takes another patient off your hands.
Don't let medics take all the stasis bags from medbay either, a stasis bag can keep a critical marine alive while you deal with a bunch of defibs, important because there's nothing you can do to hit pause on a defib able marine other than successfully defibbing them every 4ish minutes.
On the topic of cryo tubes the best mixture is 50/50 cryo/clonex which you can make in about 2 minutes.
Take the 4 beakers with 30u of cryox and dump them all into the bluespace. Add 10u phoron and 40u sodium. You'll now have 80u cryox and 80u clonex and roughly 8u phoron. Put the bluespace in the chemmaster and pull the phoron out as a single pill and stick it back in the phoron beaker. Either add 80u of filler chems or just divide it 4 ways back into the small beakers.
Set the coolers both to a out 20-30k and Max power, it'll take maybe 15 mins to get to that temp then they'll switch off and use no power. Always leave them on Max power as in normal use the cryo tube coolant can rise in temp quite quickly and you need to keep as big a buffer of 'cold' as you can.
If anyone except the cmo or a doctor with the cmos approval messes with the coolers have them arrested by the mps, especially the ce, if they interfere with your ability to treat marines thats disorderly conduct and if they are doing their job by keeping the reactors running the power use will never be an issue (neglect of duty if they aren't doing their job)

[DefinitelyAlone0309]

Add 10u phoron and 40u bicardine

Bicard ? Don't you mean Sodium ?

[spookydonut]

Bicard ? Don't you mean Sodium ?

I did, yes. I was confusing it with peri

[Rohesie]

Autodoc automatic mode is for when the patient has more problems than time left to for you to select the relevant surgeries and bypass the time sink that is stabilising them.
It hurts me when people say never use automatic mode, it has its place and you're not using it to its full potential if you never use it like that.
Common situation:
A flood of wounded comes in with a mixture of marines close to death and dead but defibable (and the usual flood of low priority stable cases like missing limbs and breaks)
The autodoc can quickly take a near death patient off your hands with a quick scan and hitting the automatic button.
Always keep in mind that stabilising eats up a lot of time and you should do everything you can to mutlitask.

In my experience what takes long is to defib back from high damage. Stabilizing, on the other hand, is quicker.
The automatic mode is too slow and won't fix organ damage. And a quick scan will show you the patient's problems and allow you to set up what they need in manual mode.
Hell, in manual you can even choose to only deal with the serious conditions, such as organ damage, internal bleeding or crippling lack of blood. Leave the broken bones and disfigured faces for later.
Now, if you set it on automatic and do have a flood of patient you have disabled the autodoc for further use for a long time.
A manual-mode one can spite out stabilized patients providing health in a industrial scale.

Take the 4 beakers with 30u of cryox and dump them all into the bluespace. Add 10u phoron and 40u sodium. You'll now have 80u cryox and 80u clonex and roughly 8u phoron. Put the bluespace in the chemmaster and pull the phoron out as a single pill and stick it back in the phoron beaker. Either add 80u of filler chems or just divide it 4 ways back into the small beakers.

Alternatively take the bluespace beaker, add 10 phoron, put it in the machine, output 40 oxygen, 20 water, 20 oxygen and 60 sodium. Remove the remaining phoron and you now have 120 clonexadone. Fill the beakers which are already at half-capacity with cryox and you have a 30-30 clonex cryox mix.

Less steps involved.

[spookydonut]

In my experience what takes long is to defib back from high damage. Stabilizing, on the other hand, is quicker.
The automatic mode is too slow and won't fix organ damage. And a quick scan will show you the patient's problems and allow you to set up what they need in manual mode.
Hell, in manual you can even choose to only deal with the serious conditions, such as organ damage, internal bleeding or crippling lack of blood. Leave the broken bones and disfigured faces for later.
Now, if you set it on automatic and do have a flood of patient you have disabled the autodoc for further use for a long time.
A manual-mode one can spite out stabilized patients providing health in a industrial scale.

You've completely missed my point.

[Rohesie]

You've completely missed my point.

Oh? Care to elaborate? Perhaps give a specific scenario in where the autodoc on automatic mode is superior?

[Omicega]

I have to agree with Vader, I have no idea why anyone would ever use the automatic mode. Stabilising a patient (assuming they're not on 300+ damage) takes seconds at most - worst case scenario it's something like inap, peri, QC, bic/kelo then defib - then all you have to do is chuck them in the scanner and manual mode them like you would literally anyone else. It doesn't take any significant amount of time to run manual mode because you can simply click the same things for literally every patient you come across (IB, organs, brute, burn, bones, shrapnel, eyes will cover 90% or more of patients), and stabilising a patient to go into the autodoc is, like I said, super quick and easy if you have more than five minutes' experience with the medical system.

[spookydonut]

Automatic mode isn't as slow as people think it is, and again you're missing my point about time management.

[TheDonkified]

I think the bigger question is how big is the difference in treatment with automatic mode vs manual mode. Also, do autodocs act as stasis bags when they are activated, or does automatic mode focus on treating the life threatening wounds first while treating accumulated damage?

I see your point though how putting someone in the autodoc in automatic mode saves the time and effort trying to stabilize them and has the autodoc do it for you while also treating their wounds, instead of wasting time picking every surgery in the autodoc risking their dying.

[Omicega]

I am not missing your point unless what Donkified suggests turns out to be the case and the autodoc works as a kind of stasis bag in automatic mode. Even then, I struggle to see any point in using it - it is super easy to stabilise even the most fucked up patients in literal seconds and then shove them into manual mode.

[ChiefAmir]

OFF TOPIC:
I am reading this thread during my med school neuroanatomy class. Does this count as studying??

---

Back on topic:
Quick disclaimer: I haven't played the doctor role on CM, but I do main medics and I have played as a surgeon/doctor on Bay/SEV Torch.

• Don't ignore stasis bags. I've seen many a doctor ignore stasis bags in the medbay and prioritize marines yelling about fractured feet or hands.

• While you should stabilize SSD patients to the point where they survivie, don't spend a lot of resources on them (QC and peridaxon them if appropriate and pop them in a stasis bag for later). Focus on non-SSD patients to get those players back in the round.

It''s not fun lying around in a stasis bag in medbay for half an hour while doctors ignore you and and fully heal SSD marines.

[Rohesie]

Last round we had around three crabbed marines and a Runner came through vents and killed one doc first and then the CMO. They both had over 200 brute and IB/broken bones. The usual deal. The first I patched, gave inaprov and quickclot, defib'ed, tossed into the scanner, tossed into the autodoc, manual mode, IB surgery, broken bone surgery, go to the next patient. The second I patched, gave the same pills, it took like three or four defibs, same deal, toss into manual autodoc. Then I was freed to deal with the crabbed patients along with the recovering doctors.

If I had tossed the first into automatic mode I'd likely have been unable to toss the second. You say it's not so slower. I fully disagree. It feels infinitely slower, and it gets stuck doing irrelevant, non-vital surgeries. Such as face reconstruction, eye damage and the likes.

I understand the idea of using it as a stabilizer. I just don't think it's worth the cost. The extra 5 seconds it takes you to scan a body and set the surgeries are completely worth the shorter working time of the machine.

Also, manual-mode autodoc fixes damage and acts as a stasis bag so to say, as well. That is not a monopoly of automatic mode.

[CSolaris]

I also find that the auto doc on auto mode is more time consuming than either putting it on manual and selecting each one / operating yourself. I was watching the round Lydia is speaking of and they had 4+ doctors from what I saw, so putting using automatic mode would have been much slower than having someone open a marine up and get to work. Sure the auto doc might be able to stabilize the marine as it goes, but popping a few pills into a marine does just as much, and an experienced doctor player can patch up a marine faster than you'd think it would take.

Give me a marine that's squanched up and give a marine that's equally as squanched to the auto doc on auto mode. 9/10 i'll be done before the auto doc and working on the next marine.