Guide to Wound Tending

This page needs to be reviewed/updated.

REASON: Check the contents of this page
PRIORITY: Not defined

The Basics

Bobmed is a port of the work of Ryll-Ryll on TG station. Currently this is only my spin on his work, and if i failed to answer something here, https://tgstation13.org/wiki/Guide_to_Wounds will probably have you covered.

This guide assumes you know the general basics of medicine. If you don't, please follow the yogstation guide, since it most closely resembles our medicine, and if you have any doubts not explained here, please ask mentors and fellow players for help!

• Limbs are separated. Arms and hands are no longer fused together like a fucking abomination and will be wounded separately. To remove a hand from an arm, you can simply cut it with a sharp object, assuming it has been dismembered. Other limb mechanics follow as normal.
• Limbs can be wounded. Wounds are treated differently depending on type, severity, and location.
• Wounds have different severities. It progresses like this: Trivial, moderate, severe, critical.
• Armor protects from wounds not based on their brute/burn value, but rather on a specific "wound" value.
• Dismemberment is no longer pure RNG. Limbs can only be dismembered if the skin, muscle and bone are mangled, unless the weapon overrides these mechanics and simply delimbs without any checks (this can happen with the crucible and the executioner sword). Dismemberment is highly lethal, because it applies a very severe wound on the parent bodypart that is hard to cure and bleeds a lot (assuming the bodypart is a right hand, the parent bodypart is the right arm). The skin of a limb is considered mangled if the limb has a slash/pierce wound of moderate severity or above. The muscle is considered mangled if the limb has a slash/pierce wound of severe severity or above. The bone is considered mangled if the limb has a blunt wound of severity severe or above. You do not need to use multiple types of weapons to cause dismemberment, as if the muscle is already mangled then the limb will start rolling (inefficiently) for blunt wounds. Therefore, with enough effort, you can always delimb a damaged limb.
• Blood loss is limb and wound based. Limbs will only bleed if they are wounded, and bleeding is only stopped on a limb-by-limb basis. If a patient has two wounds, you need to gauze both to stop the bleeding.
• The cryo cell is not a cure all. It will not cure wounds of severity above moderate, and it will take an horrendous amount of cryoxadone/pyroxadone as well as time to cure moderate and below wounds. Use cryo cells to treat base damage, but you should cure wounds via other means.

The tools

The health analyzer has 3 functions: Scanning normal damage, scanning wounds, and scanning chemicals. ALWAYS carry one as a doctor, since it will tell you EXACTLY how to deal with any kind of wound with very explicit and verbose text. Got it?

Surgery is common and very necessary. The computer will tell you exactly each step once you start a surgery on a patient, so just follow it thoroughly, don't be a bumbling idiot. Surgery requires the patient to be anesthized in some form, or it will be very likely to fail on each step and mutilate your patient - the most common ways to anesthize are: Nitrogen tank + mask, miner's salve and morphine.

And finally, DO NOT ATTEMPT SELF SURGERY, IT NEVER ENDS WELL.

To treat wounds, you will need chems. Here is a comprehensive list:

• • Corticosteroids: Treats scars. Can be made with: 10 blood, 10 oxygen, 10 water, 10 bicaridine (20u)
  • Fibrin: Treats any kind of wound by reducing bleeding and doing effects based on the wound type. Won't cure wounds right away, but are a life saving grace to reduce their effects and severity while you deal with the other problems the patient has. Application should be done via patch, splashing it on the patient like a complete asshole, or squishing it via a bottle of space cleaner or with any spray thing. 10 blood, 10 oxygen, 10 water, 10 bicaridine (20u)
  • Biomeat: This is used to create biomass for cloning. Normal slabs of meat only give 50 biomass, biomeat slabs give 100 (for comparison, you need 300 biomass to clone a single person). 8 blood, 10 cryoxadone, 20 synthflesh, 2 nutriment (1 slab)

Blunt

Blunt wounds are caused by, blunt weapons like batons and baseball bats. These wounds currently are all related to bones, but most of the time they are not highly lethal (in a short period of time) and should not be prioritized over other injuries. Dislocations are the moderate wound and can be easily fixed with a bone setter, or simply grabbing the patient and helpfully interacting with the dislocated limb. If you are the victim, you can also do a far cry move and relocate your limbs manually - this may hurt you, and it is recommended for someone else to relocate the limb, although the bone setter has no differences between applying on yourself or someone else. To relocate your own limb, simply examine yourself and click on the highlighted wound text. All limbs can be dislocated, except the head. Bone gel can be used to cure even the worst fractures, but it takes time, is painful and is not as efficient as actual surgery.

Additional: Contrary to what you might believe, fractures do not cause organ damage (yet). They impact performance and usability of the limb, but as stated before, are not extremely lethal in a short period of time.

Burn

Burn wounds are normally caused by lasers and fire. These wounds are bad because they can very quickly progress and get worse, and on top of that they have a nasty nasty tendency to get infected. To treat these wounds, you need to use regenerative mesh and medicine that treats burn damage. To avoid the limb getting infected and septic, use spaceacilin, sterilizine and alcohol, as well as proper gauze. The wound will only go away once it's "destroyed flesh" is reduced to 0 along with the infection, you cannot just cure it while it's septic. Septic limbs will not only become unusable, but also cause toxin damage over time and make the limb much more susceptible to dismemberment (REALLY bad). To top it off, limbs with burn wounds are more vulnerable to all types of damage, so curing burns should be prioritized if the patient has no critical slash or pierce wounds. If the wound proves too hard to treat via the aforementioned methods, use surgery.

Slash

Slash wounds are normal caused by sharp weaponry of all kinds. These wounds are pretty common and not very hard to treat, but high severity ones may prove to be extremely lethal very quickly mostly due to blood loss. To treat these, you have two options: Cauterization and suturing. Suturing tends to be more effective and is thus recommended, but any item that has burning properties can potentially be used to treat a slash wound (even an energy gun!). Slash wounds are only cured once all of their bleeding is completely stopped, and if they are severe they can be demoted to lower wounds when treated instead of being simply done with. If the wound is very severe and treating it proves to be ineffective, go to the surgery room.

Additional: As an EMT, do not drag patients across the station completely carefree. This will only cause tons of bleeding to the patient and worsen the situation. Use roller beds, chairs, anything but dragging the miserable body across the floor like the maniac you are. To top it off: Corpses will clot bleeding over time and thus bleed less and "cure" over time. You still shouldn't drag corpses on the floor like a maniac.

Pierce

Pierce wounds are very similar in function to slash wounds, and are normally caused by bullets or spiky things. Most of the information above applies, really. Not much else to say.

Dismemberment

Dismemberment is pretty much a variation of a critical slash wound. Just treat it VERY quickly, the only caveat is that you aim at the parent limb (interpret it as healing the stump) instead of the lost limb. If you are able to just attach the lost limb right away, good, because attaching the appropriate limb will instantaneously remove the dismemberment wound.

• If someone has completely lost a limb, you can bug science to research a limb grower to replace it... or you can harvest limbs from humanized monkeys or just get them a cybernetic one from robotics.

Embedding

Embedding has been reworked. This is mostly a nice thing for coders since the code is way better and more comprehensible, but the practical effects for players are:

• • Bullet shrapnels can embed
  • Some things can embed without being harmful and damaging over time
  • Some things can embed and not ever fall off without intervention, be it surgery or far crying it off
  • Some things can embed and are completely impossible to be removed without surgery

If a patient comes up to you full of embedded buckshot because security used the shotgun you know why: straight to surgery. You can use the "remove embedded object" surgery to remove every single embedded thingie in a given limb, the operation does not need to be repeated, just like organ manipulation you stay on the removal step (until there is nothing to remove or you close the surgery).

Scars

Limbs can get scarred. Any wound when cured will leave a scar. Scars can be treated with corticosteroids, and they can be hidden by clothing that covers the bodypart they are on. Like mentioned above, scars currently can be treated with corticosteroids.

• Scars are purely visual, and do not impact you in any purpose beyond identification

Cloning

Cloning takes biomass. For this, you need to get meat slabs and slap them on the pod respective pod. Not only that, but cloning takes 1000 credits and 300 biomass a person, and is therefore very costly. Always avoid cloning when it is not necessary, treat your patients best you can. If the medbay budget cannot support a cloning process and you direly need to clone someone, get a card with an associated bank account and change the paying account of the cloning computer.

Warning: Changing the paying account requires the ID and password of the bank account (if applicable). If you fail to input those 3 times, you will be set to arrest and security will be alerted. Don't commit bank fraud!

Surgery changes

All surgeries that create incisions will also cause bleeding as long as that incision is left open,incisions are usually patched up with a cauterizer , but if it doesn't work use a suture.

Organ manipulation now allows for organ healing , chronic organs can be revived using Sterilizer spray , and then further healed using Synthflesh spray(The most effective) , or sutures/regenerative meshes.

Mein lieben!

The health analyzer will be able to tell you when an organ is significantly damaged or just completely rancid. To fix this situation, here is the easy solution:

• Organ manipulation surgery on the limb the damaged organs are located on.
• If the organs are completely rancid, apply sterilizine/spaceacilin/space cleaner via any kind of reagent holder, otherwise skip to the next step.
• Apply synthflesh with any kind of reagent holder OR use bruise packs/ointment/regenerative mesh/sutures to heal the organs.

This is of course the lazy way and only works with fully organic organs, but it is efficient and very quick.

• Other alternatives are:
  • Organ harvesting monkeys
  • Replacing rancid organs with cybernetic ones from science

The snowflakes

Not every wound type applies to every species. Only organic species with skin can have scars, so insectoids and IPCs are completely off.

Any synthetic species will receive every type of wound described above, but the treatments are different (still detailed by the health analyzer) and the wounds have different effects. For this reason, medical doctors are not expected to treat them - These should be handled by robotics instead. If you bring a synthetic person that is pleading for their life to robotics but the roboticist refuses to help, do the following:

• • Pass a link to this guide via LOOC
  • Report this behavior to the admins

Being malicious

So you want to be very very evil huh? Here are a few tips:

• • Dislocated limbs can be "untreated". Simply aggressive grab and harm intent interact with the affected limb, this will start a loop of you trying to break the poor victim's limb.
  • Higher force means higher severity of wounds. DPS is no longer such a deciding factor in combat, as it might be more effective to give someone a very deep cut than several small ones.
  • Buckshot rounds embed quite easily, and .38 revolvers can use DumDum rounds (gotten via cargo or research) that ALWAYS embed, at the cost of damage.
  • Burn wounds are the best at making limbs more vulnerable, because a charred limb will receive increased damage from all sources. An energy gun is great for softening up your target!
  • Breaking bones on the head can cause brain traumas very easily, which only go away when the wound is cured. These traumas are always bad ones.
  • Armor is limb based. If somebody is wearing an armor vest and helmet, it is much more effective to aim for say, their hands!

I don't get it!

Use the health analyzer to get info for each wound, ask for help in LOOC by your fellow crewmembers, ask for helps on mentorhelp, and if desperate ask for help in OOC without breaking metagaming rules.