Winning a battle and coming up on top is one thing, surviving your wounds afterwards is another.
This guide is to prepare you in understanding the mechanics of Health, Wounds, First-aid, Clinical Treatment, and Surgery. (And some extra tips)
THIS GUIDE IS FRESH , May be incomplete or wrong in some areas. Feel free to comment.
On the far left side of your in-game screen, you should see your character doll, this is useful for interacting with your own character and others alike.
However, be mindful that there are no clothing or armor obstructing the limb when you try to examine it.
Beside the character doll, you should see a heart icon not far from the doll, this is your health examination button.
This is extremely useful to examine your conditions without taking off your clothing to examine wounds or embedded objects.
IMPORTANT: On the left side of your screen you will also see a word, defaulted to "feint". Most medicine happens on the 'weak' intent, simply click it and select the weak intent. THIS IS ESPECIALLY IMPORTANT FOR SURGERY, AS YOU WILL STAB A PATIENT.
A character's maximum blood level is 1000, your blood can regenerate from drinking water or resting over time.
Now say you were ambushed by a lone volf, you managed to kill/run away, now you are suffering from heavy bleeding from the attack.
The bloodlevel pool will start to decrease by the amount of bloodloss rate every wound have.
Meaning you can get away with 3 clotted slash wound on your chest for a good amount of time.
But you won't go very far with a crit aortic bleeding with a bleedrate of 60 untended.
When a bodypart gets injured from damages from any source; (Blunt, Sharp, Fire, etc...)
Your character will sustain pain, and pain can affect certain actions like climbing, running and even stun you from time to time.
You can see your character doll has color changes to red on said damaged bodyparts, it is crucial to identify the type of wounds you have been afflicted of.
If you plan to get hurt or expected to get injured while by yourself or in a part without a knowledgeable healer, stocking up on first-aid supplies is not a bad idea.
Both Feldshers and Physickers are equipped with a surgery bag that holds all the advanced medical tools. Spare tools are stored in the clinic and Feldsher's private surgery area. These tools are costly to replace so it is best to take care of it.
Many injuries exist in the city of Vanderlin. This is section going to be an extensive crash course on almost all of them
Injury glossary in order of appearance
A hematoma is the fancy term for a bad bruise. Hematomas are clotted blood under the skin normally purple and blue. Hematomas are non-life threats and only massive hematomas have minor bleeding.
Slash wounds can be caused by any weapons or items that has Cut/Chop intents or slash damages, this can be prevented by wearing armor that has slash protections.
Slash wounds can vary from small slash, slash, and gruesome slash. With each wound level have different pain and bleed rate.
Puncture wounds can be caused by any sharp piercing weapons that has Stab intent or long range weapons like crossbow and bow, this can be prevented by wearing armor that has pierce/stab protections.
Puncture wounds can vary from small puncture, puncture and gaping puncture.
Bite wounds are just like any other injury. Bite wounds bleed and can vary all the way to gruesome. The real detriment of a bite wound, is disease spread. Things like licanthropy and the deadite parasite. That will be discussed later.
Open arteries are by far the worst brute injury you can have. Like in real life, you can bleed to death in a matter of minutes. The Aortic artery is in your chest and spans down and up the body. This is one of the most important, as it carries fresh oxygenated blood from the heart to the rest of the body. The Carotid artery carries blood to the brain, and is necessary for life.
In order of importance, from top being most important.
Disembowelment involves the spilling of one's organs from the abdominal cavity. Disembowelment causes massive blood loss and loss of organs vital to the body's function. Fixed through surgical intervention.
These include:
These organs will fall out onto the ground and need to be brought in by whoever rescues them.
When a limb recieves damage, there is a threshold it will go under. Beyond this threshold there is a chance it will fly off. It leaves a bleeding stump causing MASSIVE blood loss. Same thing applies for decapitation.
Rest and/or surgical wound treatment.
Surgical tools become embedded objects
Scalpel > Forcep > Needle (Mend wounds basic, adv, and expert is the BEST choice as it heals all wounds, works on whole body from one site) > Forcep to remove the other forcep > Needle stitch incision
Simply stitch with a needle. The minor bleeding after sewing doesn't matter as it will heal relatively quick. For laymen, a makeshift needle works or a temporary wrap with cloth.
Loss of a body part leads to a bloody stump being left behind that needs to be sewn shut. Reattachment just requires holding the limb and targeting the missing area and clicking the patient to reattach. The limb will still have ALL injuries inflicted upon it before amputation.
Requires all three organs from the time of injury to be returned to the physician (Liver, Stomach, Intestines). It is recommended you first stitch the wound shut. Then continue with a new surgery.
Surgical tools become embedded objects
Scalpel on the chest > Forcep > Speculum > Implant organs > Forcep to remove all tools > Needle to stitch incision
Will be expanded upon with more hands-on experience.
Burns, for all intents and purposes, are some of the simplest injuries. All burns are extremely painful and pain is the number one problem for such and ailment.
Can heal with sleep or with a wound mending surgical treatment.
Surgical tools become embedded objects
Scalpel > Forcep > Needle (Mend wounds basic, adv, and expert is the BEST choice as it heals all wounds, works on whole body from one site) > Forcep to remove the other forcep > Needle stitch incision
Caused by severe trauma of any type, fractures cause the effected limb to lose integrity. This means for most it will be unusable. For the ribs and skull they are debilitatingly painful. Neck fractures and pelvis fractures can lead to tetraplegia and paraplegia. Fractures in Vanderlin are always displaced and closed fractures, meaning they are completely snapped and require surgery.
All fractures require the same surgical treatment.
Surgical tools become embedded objects
Scalpel > Forcep > Speculum > Bone Setter > Forcep to remove imbedded objects > Needle to seal incision
Also caused by various types of trauma, primarily beggars falling off rooftops, dislocations also cause loss of limb usage. Other than appendages, the head can also become dislocated, leading to tetraplegia. These can be treated with surgical or physical intervention.
Select weak intent>grab>grab effected limb
Surgical tools become embedded objects
Scalpel > Forcep > Speculum > Bone Setter > Forcep to remove imbedded object > Needle to seal incision.
Various types:
Lower body or upper body paralysis most of the time caused by pelvis fractures.
Full body paralysis, all limbs and body parts have lost voluntary movement. Sometimes the ability to speak is lost too.
Paralysis requires treatment of a bone structure that has inhibited the spinal cord, just like treating a bone fracture.
Surgical tools become embedded objects
Scalpel > Forcep > Speculum > Bone Setter > Forcep to remove imbedded object > Needle to seal incision.
Anemia is lack of blood in the body.
Ranges from:
Little Anemic -> Anemic -> Very Anemic -> Extremely Anemic
Anemia is not very concerning, at least at the lower intensities. Very anemic is going to start causing lower levels of consciousness, AKA patients going in and out of consciousness. Extreme Anemia is THE most important, as after a period of lack of treatment, the patient will be unconscious and will die as the body fails to compensate and the organs shutdown
For very anemic and below, sleep is sometimes effective. For ALL anemia hydration with water is the most effective treatment and is one of the only things to treat extreme anemia before a person shuts down.
Poisoning is invisible to the physician by all formal examinations. They rely on purely visual ques. Poisoning greatly depends on the agent. Some people drop dead immediately and some take a while. Jacksberries are the most common form of poisoning.
Symptoms of poisoning:
Examination of patients now shows a 'toxin' value, making it easier for a physician to see poisoning more easily.
Leech treatment is effective, as it sucks the bad, poisoned blood out. A physician's surgical bag contains "The Parasite" which is a special "leech" bred and domesticated for this purpose and is highly effective.
Remember to remove it after the treatment.
Diseases are planned to be expanded upon in the future. Right now, two exist: Lycanthropy & Deaditism.
Leads to someone turning into a werewolf. Spreads from bite wounds.
Leads to someone turning into a Deadite when dead. Highly hostile and deadly. Spreads from bite wounds. A physician needs to be aware of possible infection for rapid treatment and to keep themselves safe.
If the body is captured "alive" the church can cleanse the individual of the ailment.
Same as with Deaditism, but the patient has to be in human form.
Needs to be verified.
When a patient dies, they are not gone forever. A Priest(ess) or acolyte of Astrata can revive a corpse if it is not missing vital parts. If you feed a dead patient water, it will not fix the anemia until the body is revived.
If someone has been dead for too long, or a limb has been deattached for too long, the part/person will begin to rot. Again, the church can fix necrosis with their powers.
Mainly for letting out your inner-Rimworlder, there is a couple reasons you would want to harvest an organ.
Scalpel -> Forceps -> Speculum -> Forceps and manipulate organs -> Replace an organ if applicable
Some people will request an eye change, you would do surgery on either eye itself.
Scalpel -> Forceps -> Speculum -> Saw -> Scalpel to cut the remaining flesh.
If you are morally dubious enough, the keep may request a surgical bone breaking as punishment for a crime.
Scalpel -> Forcep -> Speculum -> Saw -> Forcep to remove tools -> Needle to stitch shut.
Physickers and Feldshers operate very often by themselves, and even when they are all together, in many situations they are still understaffed. You don't have to have formal triage if you don't want to, but try to keep it in the back of your mind. Everyone's definition of a "Mass Casualty Incident" will be different depending on their skill level. General rule of thumb, if you have more than one patient then you need to start prioritizing.
Here is a triage guide if you wish to use it:
Those without bleeding wounds, Those with minor bleeds, Those with little anemia. Any amount of brute or burn damage is not a life threat by itself, so they are stable even if they have 200 brute. If a patient has damage, is not bleeding, and has fractures and paraplegia, They fall into this category.
Those with basic anemia to very anemic. Those with decent amounts of basic bleeding wounds. And any other injuries that could develope into life threats quickly. Only paralysis that applies to this section is Tetraplegia, due to how much danger it leaves someone to.
Arterial bleeds, Infection from Lycanthropy/Deaditism, amputation leading to bleeding stumps.
This category is to be left to non-physician or non-healer individuals as they are already dead and no amount of emergency care is going to help them.
This is a very basic list, and you are encouraged to either use common sense in these situations or modify this to your skill level.
In situations like keep sieges and similar incidents, a physician is an under-equipped and under-trained fighter. A physician relies upon not being a target so they can do their job. Avoid conflict and do not pick sides. This is not a requirement, but still a useful tip.
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