Surgery and you or How I learned to love IMS

[nerocavalier]

Probably isn't needed but I'm making this for future reference. Surgery shouldn't take long. Everything that's striked through is outdated information. The average marine with three broken bones, and internal organ damage should at worst take five minutes. It takes four steps to stop someone from dying of them now.

But how do I surgery, you may ask.
It's a simple, repetitive affair. Sure, the steps may look daunting but if you can do it once and you can do it ten more times and get faster.

First things first, grab your patient with grab intent and click on the adv. scanner. With the new update, medHUDs allow you to see the scans if you examine them. Examine them before you scan them since some people usually get scanned and then just stand by the scanner.

Before the surgery, click on the surgery table with anesthetic tank in hand. Now once there, plop your patient onto the surgery table and buckle them to it to turn on the anesthetics. Just spray yourself with the spray bottle.

If you've followed these steps, congratulations! You've put on anesthetic tank, mask, cleaned yourself, and even put them under in ten seconds or less and in a fluid motion to boot.

Surgery Steps
Bone Repair: Aim at said location. Scalpel, hemostat, retractor, bone gel, bonesetter, cautery. Replace the first three surgery steps with the Incision management system. If brute damage > 40, the bone will break again.
Note: I recommend giving them 30u of tricordrazine before surgery.

Facial Reconstruction: Aim at mouth. Scalpel, hemostat, retractor, cautery.
Note: This surgery is something I always do to pad out surgery time plus my OCD demands it. It takes like 20 seconds max.


Shrapnel Removal: Aim at location. Scalpel, hemostat, retractor, (circular saw then retractor if chest or head), hemostat, (retractor then bone gel if chest or head), cautery. Replace the first three surgery steps with the Incision management system.

Larva Removal: Aim at chest. Scalpel, retractor, circular saw, retractor, hemostat,, retractor, bone gel, cautery. Replace the first three surgery steps with the Incision management system.

Eye Repair: Aim at eyes. Scalpel, retractor, hemostat, cautery.

Fixing Organs: Aim at said location. Scalpel, hemostat, retractor, (circular saw then retractor if chest or head), adv. trauma kit, (retractor then bone gel if chest or head), cautery.
Replace the first three surgery steps with the Incision management system.

Limb Reattachment: Print out said limb right arm for right hand and so on. Aim at what they're missing. Scalpel, retractor, cautery, and robotic limb.

Internal Bleeding: Aim at necessary location. Scalpel, hemostat, retractor, fixovein, cautery. Replace the first three surgery steps with the Incision management system.

Once you're finished, pick up whatever was on their back click on the mask once and double click the tank twice. Now they're all set to go if everything was done properly and you just have to shake them up and kick them out.

But Nero, I've seen people do surgery lightning fast! How do I do it faster?
Leave surgery tray on table and take out the tools for the next two steps then use them.

To skip washing your hands, spray yourself with a space cleaner bottle or stuff a spaceacillin pill down their throat. Alternatively, fill a hypospray with spaceacillin and jab them once.

Remember to combine surgeries. There's no need for you to cauterize someone after taking out shrapnel and cutting them up again to fix their bones.
Example: Urist McInPain has a broken chest, larva, ruptured lungs and internal bleeding. Aim at chest. IMS, saw, retractor, hemostat, adv. trauma kit, fixovein, retractor, bone gel, bone gel, bone setter, and cautery.

In this situation, remember to apply peridaxon so they don't die.

No Adv. Scanner!
Well, for one, don't panic. First, see if you can get your patient or their medics to tell you what's wrong. If you get a good answer, do surgery. If not, just scan them and assume that the splints are over a broken bone.

Any broken limbs will show up on your analyzer. Fix them, then scan again. If no broken bones are still detected, then let them go, if there are, move on to the next step.

Ok, now look at them. If it says "brain damage detected" or they're talking like "Unknown as Urist McInjured" then their head is broken. Fix it. Fix their face if you have time.

If those things aren't there, check to see if they have minor oxygen loss at a stable blood level, if so fix their chest.

If they have minor toxins damage, fix their groin.
This is also how you diagnose people in FOB surgery.

Transporting tools 101
Surgical trays are still a thing. Grab them.

Field surgery and you or OH GOD WHERE DID MARINES G-
Congratulations on being selected as the expendable doctor sent down to support the marines. Most likely, marines will throw up some tables and call it a day for your defences. Yeah, no.

Here are some things you'll need. A WeylandMed, surgery tools, a roller bed, and an IV if you're feeling like dragging stuff around. Find a MT or Engi and ask them to wrench the WeylandMed, and pull it around with you. If you're asking how to transport your tools, scroll back up and read Transporting tools 101. Normally, you'd have to bring down pills and so on but with the advent of the WeylandMed, not anymore! Get a space cleaner bottle if you want to clean yourself, otherwise get ready to give marines spaceacillin.

Ideally, you won't need a helmet but knowing marines, you probably will need one. Go get a helmet. Since you're not allowed to have a rifle or shotgun or smg, ask for a pistol or a revolver if you want. It won't do anything for you but hey, nice to have. (Not really).

Once planetside, look for the most secure place where xenos won't barge in and elope with you. Preferably close to a LZ so you can stuff injured marines that don't have limbs and so on back onto the Almayer.

Leave the WeylandMed close to you, drop the roller bed and wait for marines to trickle in wounded and dying. Remember to remind marines to come to you and also remember to ask if any have larva. Apply peridaxon and quickclot as needed to stop marines from dying as you do surgery.

Now do surgery. Yeah, that's pretty much it. Send up wounded if there's already one-two injured waiting for you to finish a surgery because really, the other doctors would want something to do too.

Go up and read No. Adv. Scanner! if you don't know how to figure out where marines are broken.
Also for field surgery it goes. Stretcher > Table for better chances.

Basic triage: Larva > Defibbable Marines > Ruptured Lungs > Everyone else.
If you have any information and or complaints, share it below. Keep in mind that I randomly made this on mobile because I was bored.

[Imperator_Titan]

I haven't ever been a doctor, but I might now try it since I couldn't be bothered to read up on what every single item does. Thanks, really helpful guide.

[xeno366]

Make more info about field surgery please.





THANKS

[Feweh]

Stickied

[nerocavalier]

Make more info about field surgery please.

Done.

[Katsukai]

There is an bug regarding bone surgery, if you only use bone gel only once after bone settler step. The affecting limb won't function and will show on adv scanner that he/she has no broken bones. So always use bone gel twice on each step.

[nerocavalier]

There is an bug regarding bone surgery, if you only use bone gel only once after bone settler step. The affecting limb won't function and will show on adv scanner that he/she has no broken bones. So always use bone gel twice on each step.

I'm fairly certain that they had some other broken bone in their system because not once have I ever encountered that problem.

Occasionally, the bone breaks again because the brute damage is over 40 but never because I didn't apply bone gel twice. And if it's a bug, why haven't you reported it in the bugs section?

[Katsukai]

Had a mod pming me why I had 3 patients with non functioning hands while they all seemed fine on adv scanner, the reason we discovered is that I forgot to apply bone gel twice every step.

[nerocavalier]

Had a mod pming me why I had 3 patients with non functioning hands while they all seemed fine on adv scanner, the reason we discovered is that I forgot to apply bone gel twice every step.

Which mod?

[Katsukai]

Which mod?

Can't remember been a week ago, when this happened could be Jay.

[Wubs4Scrubs]

How many uses can you get out of the laser scalpel before you have to let it recharge? I had a moment a few weeks ago where a patient had a few separate broken limbs and needs a few surgeries to fix them up. After the first couple the laser scalpel stopped functioning and gave a pop up about it sputtering before failing the surgery step. I tried examining it to see if it has any charge indication but as far as I could tell it was all guesswork.

[EXOTICISME]

You forgot the step where you threaten marines who stay in medbay with two quickcloth, god i hate them, if they are not hurt or have something important to do just GTFO from medbay

[nerocavalier]

How many uses can you get out of the laser scalpel before you have to let it recharge? I had a moment a few weeks ago where a patient had a few separate broken limbs and needs a few surgeries to fix them up. After the first couple the laser scalpel stopped functioning and gave a pop up about it sputtering before failing the surgery step. I tried examining it to see if it has any charge indication but as far as I could tell it was all guesswork.

It's RNG. Sometimes, it works smoothly without any errors, other times it really wants to kill this one marine. My rule of thumb is that if it messes up twice, I'm going back to normal scalpel.

[spicemoron]

I recommend giving them 30u of tricordrazine before surgery.

Or just give em bicard since it heals faster, or give em both, assuming you made yourself the right pills.

[nerocavalier]

Or just give em bicard since it heals faster, or give em both, assuming you made yourself the right pills.

Ease of access, really. There's tricordrazine autoinjectors inside of the surgery rooms and all you have to do is pop two and get to work.

[Swagile]

Been using the oxy method and its superior than using anesthetics.

The time it takes to put on / off shit, turn on / off internals is better spent popping 15u into a dude with a hypospray and doing surgery; its faster even if they flinch since they get like 0.1 damage per flinch or something like that.

[Terran]

Add the fact that you can do multiple same surgeries. For example, a patient has 2 broken legs or 2 patients have a lavra inside. You can repair 2 legs at once. Aim left leg, make incision, aim right leg, incision, hemostat, left leg hemostat, retractor... And to do 2 lavra-removal surgeries you need to put 1 patient on operating table and second on ordinary table. Then do the same surgeries on each. By you need to wait for ending of a step on one infected before starting it on the other.

[Swagile]

Multiple surgeries is currently bugged due to the "You need to target the original limb you were working on!" spamming you (even when you don't aim for any other limbs), so I don't advise doing it.

[Terran]

I said, you have to wait for a step on 1 surgery to end.

[Szunti]

Only engineers can move vendors.

Can standards unwrench and move vendors and machines? No. Engineers should be doing that.

[nerocavalier]

Only engineers can move vendors.

Note the dates. Either way, changed.

[nerocavalier]

Updated.

[Bulaven]

We've come a long way from IMS being rare and highly sought after... And from those awful laser scalpels.

[nerocavalier]

Updated and removed the crossed through stuff.

[AcuteCircle]

This is a nice guide. The other day I saw a poor marine being operated on by a guy still using scalpels...
Also! The surgery steps remove heads:
Aim at head -> IMS -> Accidently put the IMS away 0.001 seconds before it finishes -> Bone saw