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MEDICAL 101: DOCTORING FOR DUMMIES


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Hi all. I've finally decided to pull my finger out and write a guide on each of the jobs within medical, in the hopes of giving everyone who wants to play it a better understanding of your job within medical, the gear you should be carrying, and tips on how to make it easier. First off, a huge thank you to @Roostercat, @kermitand @BravoBohemia/CoolSortieBro for reading this, adding and just putting up with me stressing over this for the past few days.

Each job will be listed with recommended gear and knowledge. KEEP IN MIND, THE BELOW IS JUST A SUGGESTION IN ORDER TO MAKE YOUR TIME IN MEDICAL LESS FRUSTRATING AND MORE ENJOYABLE. OF COURSE, PLAY AT YOUR OWN PACE AND DO WHATEVER BRINGS YOU JOY. THIS IS JUST A GUIDE.

 

BASIC KNOWLEDGE:

Spoiler

Basic knowledge of medical is our medical system, as of 24/11/2022 is BrainMed, where in toxin damage is converted to organ damage, bleeding reduces total blood oxygenation (BO), which, when falling past below 85%, slowly starts to decay the brain. Cutoff for losing spontaneous circulation and breathing is 20% brain activity. It's difficult but NOT impossible to recover oxygenation enough to escape this stage without brain surgery, since being in cardiac arrest caps BO at 30%. Keep a low-dose alkysine drip attached to your patient and continue administering CPR. Ensure that your patient will have adequate oxygenation (>85%) when they do eventually regain a pulse. This means repairing the heart and lungs, and/or replacing lost blood volume as needed. If your patient is holding at 30% oxygenation with CPR, then it's just a matter of time until that window of opportunity presents itself and you can recover them. Oxygenation <40% causes the brain to rack up damage much faster. <30%, moreso. Brain death is total death. Once the brain is dead, that character is removed from the round and CANNOT be brought back to life. WE DO NOT HAVE DEFIBS OR CLONING. For more information on Blood Oxygenation and Brain Activity, check the Tips and Tricks portion of this guide,

The CMC also works differently from other servers. Ours does not show PointMed damage, it shows heart rate, pulse, temperature and location, if people have suit sensors maximised. Normal readings show as green across the board. When a heart rate begins to spike (or drop due to some drugs), it shows as blue. An alarming heart rate will show as a brilliant orange and someone who is actively having a heart attack (also called flatlining, asystole, or McFuckingDying), or dead, will show as red. People with fake hearts, IPCs and Dionae will show up with N/A on their heart rates, so don't panic if you see that.

 

HYPOSPRAYS:

Spoiler

Hyposprays are the best way one should be injecting chemicals into patients. They are found in the equipment storage area. They are immensely helpful, as they can load up fifteen units of chemicals that can be administered in 5, 10 or 15 increments. They are much safer than syringes, as syringes carry a risk of infecting patients. Syringes inject in four seconds, hyposprays inject in three. Infection risk is present with repeated injections, increasing with every use.

As part of basic medical training, all jobs in medical would have had basic courses on how to use these, and as such, all jobs should use them.

The Premium Hypospray holds up to 30 units, all of which can be injected immediately, unless armour is in the way. Only the CMO has one of these, but they can be sold by merchants rarely.

 

NANOMEDS:

Spoiler

Nanomeds have basics that everyone should be using. The basic chems from the nanomeds are listed below. A more refined list of chemicals will be found under the Pharmacist tab of this document:

  •  Inaprovaline: little blue bottle. Best chem in the game. Will help normalize a patient's pulse, which means they won't start having a heart attack, reduce the rate of bleeding by 20%, increase BA when BO is over 85%, but only when BA is at 69% (nice) or more. It also acts as a mild painkiller, and also allows people to breathe (if they're able) without a pulse, and it also slows the rate of brain decay from low oxy.
    • When a patients pulse is elevated, they continue to bleed, but harder. Slowing the bleed rate is essential in ensuring your patient survives.
  •  Dylovene: one of the green bottles on the nanomeds. Reduces toxin damage in a person brought on by greimorian toxins, minorly fixes the liver. Acts as an antitoxin for all things that give the toxin affect, IE: Toxin (from the nanomeds), Greimorian toxins (though its SUPER important to dialysis this first), and other, less legal things. It can also be used to treat hallucinations and drowsiness, to a degree. TIP: Inaprovaline and Dylovene can be mixed together to make Tricordrazine, a basic, heals minor brute and burn damage, drug. Medibots will also inject 15u of this into a patient.
  •  Perconol: one of the pink bottles. Basic painkiller. Good for stabilising heart rate, reducing patient moaning/crying
  •  Thetamycin: Another green bottle. NEEDED for infections brought on by burns not salves in time, wounds left open too long, surgeons not closing surgical sites and syringe use. A minimum 10u in a patient's body is recommended to remove infections. 
  •  Coagzolug: Slows all bleeding to a greater degree than inaprovaline while also slowing the rate of arterial bleeds. A must for responders (more info below).
  •  Health Scanners. These are vital for everyone and everyone in medical should have one. Once used on someone, it shows everything that you need to know on how to fix someone. More on health scanners above. If you do not want to carry this on your person, your PDA should have a program that allows it to scan patients just like a hand scanner would. Simply access your PDA and click the Health Analyzer program, then click on a patient with the PDA in your hand.

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This is a healthy human. Nothing wrong with them. Note the brain activity and blood oxygenation. These are extremely important to know and be aware of.

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Oh no, now there are burns. Note the lack of blood oxygenation and the dropping brain activity as a result. Unsalved burns typically cause infections, which can kill if not treated correctly and in a timely manner.

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Oh man, now he’s BLEEDING. Bleeding can be stopped by using gauze, or advanced trauma kits. If bleeding doesn’t stop, patients blood oxygenation can drop and thus, brain activity can drop. Its highly recommended by first responders to stop the bleeding before moving a patient.

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(The blood oxygenation is dropping due to the bleeding not stopping. This not only makes a horrible mess but is very dangerous for the patient.)

The brain activity will drop to 69% with this loss of blood oxygenation. Blood oxygenation can be restored by shoving iron pills in someone's face, doing a blood transfusion (IVs set to 5+), or saline injection (IVs set to about 0.8), or even just getting the patient to eat something meaty can help. It also restores slowly over time, though it is far too slow to save someone’s life in an emergency.

Things that restore brain activity, once blood oxygenation is above 85% are inaprovaline, at 69% BA and above, or alkysine at ANY BA, though its recommended for <69%. Alkysine can be injected via IV drip at any amount less than 1.5 units a second. This means you can set the IV to 0.02, use barely any Alkysine, and get the same result. You can also administer Alkysine via a dropper set to 1-2 units and squirted into the eyes. Another way is for surgeons to pop the skull and massage an ATK into the brain, though this may leave scarring if blood oxygenation is below 60%. More on organ scarring under the Surgeon tab.

  • - Breath Analyzers: Someone sat next to a scrubber and have no idea what they inhaled? Breath analyzer can discover what damage a person has to their lungs, if any.

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A minor amount of lung damage. This can be fixed with Pneumalin inhalers, or Peridaxon if the damage is minor.

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This is very bad. Fix this!

To get someone breathing again, you have a few options: 

Connect them to artificial air by dragging the sprite of the IV stand onto their character and selecting the mask option to apply a medical mask to them and open the valve by clicking on the IV stand once more (keep in mind this will not work if they have any item in their face slot, so make sure to remove these)

Toggle on the EPP function of the stabilizer harness by using it in hand and then putting it on the patient by accessing your inventory. You will not be able to place the harness on the patient if they have any items in their suit slot nor will the mask be able to deploy if they have an item in their face slot as stated above.

Simply click on their sprite with empty hands, no face mask, and help intent to begin performing mouth to mouth. This is the simplest and easiest method but will prevent you from doing anything else while you are providing air. All of these options are only temporary and will merely bridge the gap to getting someone breathing on their own once more.

  • - Beakers. There are small beakers within the Nanomeds. These can be used to mix inaprovaline and dylovene together to make tricordrazine, a basic chem, if there’s no pharmacists. They can also be used to melt down various pill form chemicals found around medical by putting at least one unit of water into the beaker, then plopping the pills in.

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One Inaprovaline and one Dylovene makes two Tricordrazine.

  • - Advanced Trauma Kits (ATK) and Advanced Burn Kits (ABK): These two things are amazing, and should be used over gauze and ointment at all times if you are medical. Advanced Burn Kits also sterilize burn wounds, leading to less needing of thetamycin.

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Each has 5 uses. You can also use other, partially used ones to refresh your uses. IE: You have one use left, but someone dropped one with 3 on the ground? Yay, now you have one with 4. Cyborg players should keep this in mind as well for refreshing your own stacks.

 

LOCATIONS:

Spoiler

A vast majority of the gear needed for EVERY role is located in the main Medical Equipment storage on Deck 3, just near the stairs.

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A bit dark in here...

The lockers contain various things, such as scrubs, caps, labcoats, headsets, a box of gloves and two types of HUDS. HUDS are HIGHLY recommended, as they allow you to view the medical records, physical status and, most importantly, the pulse of everyone on the goddamn ship. Medical HUDs are also available from the loadout in various forms. One is an augment, located in the AUGMENTS tab on the loadout.

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Keep in mind, these augments will only work if you have the appropriate access level to use them, medical intern or above. The augment costs one point. Another option is the glasses one, if your character is opposed to augmented HUD. This is located in the GLASSES AND EYEWEAR section of the loadout, and can only be picked if you are on duty as a medical intern or above, or have the access of them. The Medical Hud selection costs one point.

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Another thing that can be found in the loadout is Medical Pouches and Medical Webbing.

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Both of these will add five slots to your uniform slot and are highly recommended, and only cost one point. You cannot have both.

NANOMEDS are located in three locations around medical: Near the Medical Equipment storage in Deck 3, Near the ORs and in the GTR.

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If these ever run out of things, you can call a janitor, and they can restock it. Shock horror, I know.

 

MEDICAL INTERN:

THIS JOB IS HIGHLY RECOMMENDED IF YOU ARE NEW TO MEDICAL AND HAVE NO CLUE WHAT YOU'RE DOING.

Spoiler

The baby medical role. As an intern, you may be brand new to the game or brand new to medical. Either way, welcome to medical. Interns are medical residents from wherever, attempting to further their knowledge of whatever their desired profession may be. Responders, Physicians, Surgeons and Pharmacists can all learn from intern before integrating into those roles. If there is a CMO on duty and you've mentioned what you're interested in learning, either ask to be attached to someone of that job, or a CMO might do it for you. Interns of specific jobs should review the list of items for each role below and figure out where they're located.

Don't be afraid to ask questions on what things are and what they do, its better to ask now while you have no clue what you're doing, rather than in your full job where people expect you to know what you're doing. This doesn't mean don't go into those jobs if you don't know everything. Everyone learns new things every day.

 

FIRST RESPONDER:

Spoiler

Congratulations, you've picked the most popular role as of writing this guide. As a responder, you are expected to be the first on the scene to stabilise all patients. THIS DOES NOT MEAN FIGHTING ANTAGS OR GETTING IN THE WAY OF SHOTS. YOU WILL GET BWOINKED FOR THAT.

An important distinction to remember is that first responders are paramedics and emergency medical technicians, not doctors or surgeons. Your job is triage and stabilization, not so much treatment. Given that you are always going to be the first member of the medical department to interact with a patient (or more often than not, patients) it is often on you to make the determining call who gets priority on care, or who gets care at all. There will be many a round where you will need to leave someone at the scene in order to transport another patient, and yes, that includes the worst case scenario of leaving someone to die. All these factors lead to first responder easily being the most stressful medical role that will have your hair greying in a matter of months. A strong knowledge of the intricacies of the medical system as well as the layout of the entire map is strongly recommended before stepping into these boots. A link to the map layout can be found here: https://map.aurorastation.org

Gear for a first responder includes:

  • Hypospray
  • Handheld Scanner

  • MedHud

  • Inflatables

  • Stasis Bag(s)

    • These bags will provide a 20x stasis factor to any one inside, much like the sleepers and stasis beds Will eventually run out of power and go from a baby blue color to gray. Little more than a fancy body bag at this point. 

  • Roller bed (can also fit on the suit slot of the RIG if the RIG is fully deployed).

  • Stabiliser harness

    • Every harness starts will a full battery and a partially filled tank that will provide roughly four to five minutes of CPR and mouth to mouth, more than enough time to get a patient back to proper medical care

      Refilling the tank can be done by applying a screwdriver to the harness itself and then using a wrench to pull the tank free

      Recharging the cell can be done by dropping the entire harness into a standard recharger or by using a crowbar to free the cell and using a cell charger.

  • Red first aid kit (each FR slot will spawn with one of these and an additional three are available throughout medical)

    • Contains 3 ATKs, 2 ABKs, one stack of splints, and one inaprovaline pen.

  • Belt for more storage. Most responders will devote their belt to chemical storage but feel free to place whatever you like in here.
  • Handheld radio
  • GPS
  • Chemicals!
    • The basic load out is as follows: one bottle of inaprovaline, one bottle of dylovene, one bottle of perconol, one bottle of coagzulug.

      If you need to make space, it’s recommended to leave the coagzulug bottle at home as you will likely never need more than five units at a time. 

      At least one coagzulug auto injector and one syringe, both are available in the medication closet in the Responder bay.

The list above is generally regarded as the must have items to perform your job effectively as a responder, however there are a few additional items you can take to make your duties as a two legged ambulance that much more effective.

  • Pneumalin inhaler
    • Two are available in the stabiliser closet to the left of the cryo-tubes at the start of every round.
  • Adrenaline autoinjector
    • Only available if a pharmacist (or a very loving CMO) is around, will make recovering a patient from a flatline that much easier.
  • Blood bag
    • Blood bags can be attached to your gurney before starting a line on a patient, allowing you to keep them topped up while transporting back to medical.
    • Right clicking on blood bags will allow you to set their transfer rate; you’ll generally want this maxed out.

    • Blood bags can also be used in the hand as well in a pinch, offering an opportunity to provide blood with no other equipment on hand.

  • Breath Analyzer

  • Empty Syringe

    • By selecting the upper torso on grab (yellow) intent and clicking on a patient with the syringe, you can perform a needle decompression, known by many as a lung jab to quickly get their lungs back in working order.

  • Stethoscope

    • Makes you look like you know what you’re doing

    • Allows you to easily determine if someone is breathing or not.

    • This can be attached to your uniform as an accessory to save space and be used automatically anytime you shift-click another player by using the “Toggle-Examination-Mode” verb while equipped.

  • Penlight

    • Used by targeting the eyes and clicking on a patient while on help intent

    • Allows you to diagnose a variety of issues if you know what each flavor text it returns means

      • 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 the point of repair.

    • Due to a bug in the code, the penlight will not work if the patient is handcuffed or buckled to a gurney or chair.

  • Medical webbing or medical drop pouches

Finally, the piece de resistance of first responder equipment, the rescue hardsuit. This magically collapsing space suit will very quickly become your best friend anytime the rubber meets the road as it provides everything you might need in an easy to use package:

  • Built in hypo-spray, MedHud, and handheld scanner
  • Jetpack
  • Fully sealed internals
  • Leg actuators for surviving falls, covering distances faster, and leaping from one deck to the next.

Additionally, the rescue rig does provide a minute amount of both brute and burn damage to keep you alive when the bullets start to fly; as well as complete and total radiation shielding for when those annoying rad-storms decide to ruin your coffee run.

The rescue rig is not without downsides however, the biggest being that you cannot wear a backpack while it is on your body. You can still carry your bag in hand but this leaves you down one appendage when it comes to treatment time. Additionally, while the hardsuit is activated you cannot have any items in your hand, face, or outerwear slots which means you’ll have to strip your jacket, gloves, and cigarette before you can fully seal the suit. Additionally, your jetpack will use the oxygen in your internals tank as propellant so jet around sparingly if you don’t want to be sucking vacuum mid rescue.

The RIG is access locked to First Responders and CMO's.

 

PHYSICIAN:

Spoiler

The GTR is your home. This is where you take patients from the first responders, throw them into the scanner, figure out what the booboos are, and fix them. If there are no surgeons on, you are also permitted to do basic surgery, but keep to the list here: https://wiki.aurorastation.org/index.php?title=Surgery

Keep in mind, the graph at the top of the page may be changed at any time, so its good to keep track of it.

You administer more complicated drugs than FRs, insert IVs and generally try to get people on their feet without needing surgery, if appropriate. Knowledge of how to stabilise someone (read: bringing them to 100% BO and BA) is highly recommended here, as well as knowledge on what the recommended cryo temperature is, IV rate for blood, saline and alkysine is. Again, ask your pharmacists if you don't know/aren't sure.

Your gear will likely include:

  • Hypospray
  • Handheld scanner
  • HUD, either.
  • Gloves
  • Mask
  • Stethoscope
  • Belt full of more complicated drugs, such as peridaxon, dexalin plus, alkysine. Anything else, you can beg from your pharmacist/generous CMO.

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How the GTR should look after a basic setup. Remember to set those IVs!

 

SURGEON:

Spoiler

As a surgeon, your home is the ORs. You are the only role, aside from the CMO, allowed to do brain surgery and plastic surgery. You are permitted to do all surgeries, from amputations to plastic surgery.

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You live here during canon rounds. I'm not kidding.

Your kit likely won't differ much from a Physicians kit, and if there are no physicians, you may be expected to do their job.

Keep in mind that, despite having similar qualifications relevant to the physician, your role is to use the OR, and theirs is to handle GTR. You can handle GTR patients when needed, but do not overstep your lane. Ensure that there are no physicians available or simply ask if they are alright with you taking a patient. Communication is everything!

A guide to surgeries can be found here: https://wiki.aurorastation.org/index.php?title=Surgery

 

PHARMACIST:

Spoiler

Pharmacist can be a demanding role as you’ll have all the other roles within Medical appearing at your window requesting certain chemicals while you’re still busy making your usual line-up of chemicals. You will also be extremely popular with everyone in medical, due to the medicines you make being a rather fundamental part of getting people back on their feet.

You can fix people up, but it’s rather a last ditch effort kind of thing. You cannot do surgery, but you know everything that every chemical does, and can fix people that way, if needed.

The list of all the drugs we have in the game (barring a few), can be found here: https://wiki.aurorastation.org/index.php?title=Guide_to_Chemistry

A fantastic chem guide has already been written as well, by the amazing @VisVirific, in order to help assist pharmacists, interns, and would be pharmacists in concocting medication:
https://forums.aurorastation.org/topic/14079-a-general-chemistry-guide-11012021-update/

 

PSYCH:

Spoiler

As the ship’s Psychiatrist/Psychologist, it’s your job to deal with the various mentally deranged and troubled personnel that the SCC saw fit to employ. This role is largely roleplay based, so don’t go into it expecting a wealth of mechanics, because there simply aren’t that many.

You have your office and some various nick nacks that might make your experience a little more engaging, but the main point of it is to get patients in to talk to them.

Responsibility wise, keep in mind that a psychologist is trained in mental healing, not physical. This means your psychologist should not do any GTR work and should not do any operations. The only exceptions to this are bandaging and salving basic wounds and maybe administering some chemicals. Leave the hard stuff to the Physicians and Surgeons and only step in to help if medical is short handed.

One of the pitfalls of this role is not finding people to sit down and talk to in the first place. That being said, its highly encouraged you get out and talk to people yourself! PDA people with problematic records and ask if they would like a chat, offer to counsel security’s prisoner, lead a class on breathing exercises in the holodeck, something.

More often than not nobody will explicitly seek out a psyche for roleplay, just one of the unfortunate realities of the role. Getting out there and showing what you are about will only make people more receptive towards sitting and spending time in your office.

 

TIPS AND TRICKS:

Spoiler
  • Stasis Beds
    • Two of these located in the ICU that are turned on by alt-clicking on their sprite
    • Provide a constant 15x stasis while allowing you to continue administering care
      • Keep in mind, this stasis factor will also cause any chemicals in the bloodstream to metabolize slower, medicines and poisons alike

  • Lung Jabs

    • As stated previously in the first responder portion of this guide, a needle decompression is a wonderful method to get someone’s lungs back in working order from any state

    • Jabbing someone with a needle will reset their lung’s damage state to minor no matter its current condition and leave them with a small puncture wound in their breathing bags that will prevent you from repeating the procedure until the lung is fully repaired

      • This will also reset a patient's blood oxygenation to 100% provided they have the blood volume to support it.

  • Cryo Tubes

    • Arguably the best way to treat a massively wounded patient if you have the time to wait. Depending on the temperature and cryo mix, the tubes will take anywhere from a few minutes to the heat death of the universe to get a patient fully patched up

    • Cryo tubes will treat all injuries other than arterial bleeds and fractures, including organ and genetic damage and are a great option if other avenues of treatment are unavailable

  • Heart damage

    • If a patient has heart damage, it's quite noticeable if you stick an IV into them and their blood oxy doesn't raise, or if you scan them with the handheld and the blood oxy says something silly like, 67.666% or something. Try getting some adipencema into them, if possible. Otherwise, physicians and surgeons may have to pop them open to heal the heart.

  • Sleepers

    • Sleepers are extremely important if you wish to save nanomed chemicals, as they can inject 5 or 10 units of Inaprovaline, Soporific, Perconol, Dylovene and Dexalin. They can also be used to siphon greimorian toxin from your patients body, should they get bit.

      • The siphoning of toxins from patients bit by greimorians is very important, otherwise it can lead to MSOF and death.

  • Blood Oxygenation (BO) and Brain Activity (BA), how they will murder your face. (Thank you, @Sheeplets)
    • <85% BO goes down to 69% BA.
    • <70% BO goes down to 49% BA.
    • <60% BO goes down to 29% BA.
    • <30% BO goes down to 0% BA and kills you.

TREATING VAURCA:

Spoiler

A lot of the stuff covered in this particular part of the guide has already been written by another fantastic medical player, @Pedantic. Check out their guide here: https://forums.aurorastation.org/topic/15803-vaurca-med-for-dummies-like-me/

The important thing to remember about treating vaurca is:

  • Do not give them Dexalin or Dexalin plus.
  • Do not give them any nutriment based food.
  • K'ois and sulfur pills will save them.

Again, please keep in mind that this is JUST A GUIDE. If you have questions on ANYTHING medical related, the server does have a departmental discord that can be used for questions, ideas, updates and so on to help get you going. https://discord.gg/pUCE3Ay

Please have fun, and I will try to update this whenever it's needed.

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I used to play medical a lot a few years back. I've been trying to get back into it, but I'm having to adjust to changes and additions, like the stasis beds and the complex IVs. I appreciate the rundown, because I've found myself blanking out during rounds and uncertain what to do with patients, especially the really messed up ones who need their everything fixed. Though I imagine that's a universal problem.

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I think it's personally, very poor form for paramedics to be taking butazolene or dermaine. Maybe if there's no one in the GTR, but if there's a physician then  those wounds won't kill you as long as you bandage, salve and treat for pain. Encouraging FRs to carry non-emergency, if-i-don't-give-this-to-him-he'll-die chems not only make it more likely for them to step into the GTR, but infringes upon the physician's job. If there's a FR, physician and surgeon, and someone comes in with broken bones and brute damage from gunshot wounds and the FR already gave butazoline, they may as well be wheeled directly to the OR because there's nothing for the physician to do except for maybe getting a scan and making sure they're on an IV.

in my opinion, i think what separates a good FR player from a great FR player is being able to understand that just because you can treat near everything barring surgery (not including fringe cases like damaged eyes, etc), doesn't mean you should. it's important to make sure you're leaving stuff for GTR.

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10 hours ago, Faye &lt;3 said:

in my opinion, i think what separates a good FR player from a great FR player is being able to understand that just because you can treat near everything barring surgery (not including fringe cases like damaged eyes, etc), doesn't mean you should.

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100% This yeah. First Responders are better when they chill and let the doctors have their moments, but it's a thin line to walk and depends a lot on the team and how confident you are in letting someone die sometimes.

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