QND Medical Drama

[kilemall]

This is a Quick and Dirty medical drama set of rules, using a version of 68A and something like CT damage resolution, to provide color and visualization to medical situations and drama for the Medic to handle. Feel free to translate into the system variation of your choice.

Part I- Combat and Accident Damage

This part includes combat damage and damage sustained from an accident- vehicle, a fall, construction/mining/demolitions, etc.

Each of the attributes corresponds to 1-3 major body systems-

STR= Muscle/bone, Cardiovascular System
DEX= Nervous System, Coordination/Fine Motor Control, Movement, Senses
END= Digestive, Respiratory, Immune Systems, Skin
INT= Brain, problem-solving
EDU= Brain, memory

A damage result can therefore be described from which attribute was affected, and affects and treatment extrapolated.

Consider instituting a hit location system for more descriptive/task drama.

On each die roll of 6 applied to STR, a bone is broken and likely a limb is unusable, or the rib cage cracked. For the same 6 result for DEX, the skull is fractured or the spine damaged. Extrapolate from the attribute and general severity of the damage result.

If any one of STR, DEX or END drops to zero, in addition to the initial unconsciousness in case of first damage, checks must be rolled against an immediate medical emergency.

Roll 2d6 three times, one for each physical attribute- if the roll is greater then the attribute, there is an emergency occurring associated with that attribute. Note the zeroed out attribute will automatically have an emergency, but other attributes can be affected that have not taken damage.

STR emergency- Bleeding out, heart attack
DEX emergency- Brain trauma, spinal cord, hydrostatic shock
END emergency- Respiratory arrest/failure, organ failure

A stabilization roll is required, one for each attribute in emergency.

The roll difficulty is determined by how many attributes are at zero- 6+ for one attribute, 8+ for two attributes, 10+ for all three with the patient being technically dead.

Apply Medical skill as a plus, possibly TL (see optional below).

Stabilization takes ten minutes. For each attribute not stabilized, the patient now starts taking a point of damage every ten minutes applied to that attribute first then others, and a fresh round of attribute failure checks need to be rolled for any attributes not at zero.

If DEX is at zero, damage starts being applied to INT and EDU each, one point per minute past the first ten minutes. When INT reaches zero, brain death has occurred and for all intents and purposes the character is gone.

Once stabilization is achieved, the normal rules apply to the character's attributes re: averaged or minimal values.

If the skin is broken (virtually guaranteed in the case of combat damage), an infection roll against END is required after the first 12 hours. If infection occurs, the same 1 point damage rule per 12 hours and 68A difficulty treating it applies.

 

[atpollard]

Pretty slick. I may have to see if I can find a place to use it in my PbP.

 

[kilemall]

(Optional Crunchier Damage Rules)


Recovery
In the case of serious wounding (two zeroed attributes) or near death (three), surgeries and regimens will likely be required to allow attributes to start recovering past attribute value 1.

A procedure is done per attribute on the 68A scale of difficulty. If the roll fails, an emergency occurs with that attribute and the patient must be re-stabilized. A surgeon (Medic-3, DEX 8+) is required.

The difficulty level drops for each attribute that has been successfully treated for recovery.

In most cases the patient by now has been moved to a facility or craft with a surgery and treatment ward, and so the medical skill, possibly facility modifiers should be higher then where stabilization occurred.

Fast drug must not be used until all three attributes are set to recover.

If INT/EDU took hits, they do not count as an attribute difficulty increase, but the roll to recover them is determined by the current difficulty level from the physical attributes. Normally the physical work is done and then recovering INT/EDU is addressed.


Consciousness & Coherence
If a patient is conscious or regains consciousness after a serious injury (two attributes down), roll a check against INT and EDU.

If the INT result fails, the character is incoherent or unresponsive. If INT succeeds but EDU fails, the character is lucid and can answer basic status questions, but cannot provide memory or factual answers.

This may be important for a character who wants/needs to convey critical information before death occurs.



Tech Level Counts
The base TL of the kit and/or facility counts- a higher tech treatment may virtually ensure survival for anything short of physical destruction, and a primitive facility may lose a person that would otherwise be saved.

Apply TL-7 as a DM on the 68A rolls.

DMs apply for less then optimal facilities available-

-1 DM for aid stations, paramedic level ambulances, commercial starship medical bay
-2 DM for field treatment, medkit only

If that is unpalatable, then treat TL as one would an attribute and use something like

TL 0-1 -3
TL 2-3 -2
TL 4-5 -1
TL 6-8 0
TL 9-10 +1
TL 11-12 +2
TL 13+ +3

 

[kilemall]

Part II- Illness

Illness may occur at any time. Urban areas are a disease risk factor due to higher populations with more contact, plague situations, environmental triggered illness (allergy to cancer), parasites, or exploration of new areas/planets where risks are unknown and immunity may not exist.

Referees should probably refrain from rolling against disease regularly unless it promotes the story or highlights the environment- example, no regular 'wandering disease' checks, but stepping onto a planet with a tainted atmosphere and no filter should virtually guarantee a check.

Don't forget to consider passengers on a merchant run, those medics are required crew for a reason.

Random Illness
Roll against END- if higher then END, the illness is contracted.
Roll 1d6 on the following table

1-2 Infectious Disease
3- Food Illness
4- Environmental Trigger
5- Parasite
6- Illness (non-infectious)

This determination is useful for description, but also risk- any other of the same party exposed to this vector should undergo a roll.

Roll incubation/onset-

Roll 2d6 and multiply each die result against each other yielding a time interval value range of 1-36. Roll against the below for time interval.

1-seconds
2-minutes
3-hours
4-days
5-weeks
6-years

At onset, roll 1d6 damage- on a 6 roll another die, etc.

Roll 1d6 to determine damage apply time range, divide by this number per time interval (example, illness has 12 hour onset, damage is 3 points, 1d6 roll for apply result is 4, so 1 point is applied every 4 hours).

Alternatively roll separately for damage interval- heart attacks for instance could be argued to have an onset of years and damage interval in minutes.

Apply damage as per combat. The broken bone/fractured skull rule generally does not apply.

Most illnesses are temporary and not life-threatening- bedrest and normal palliative care will do.

In the case of more serious illnesses, especially that zero out attributes, the stabilization and optional recovery rules would apply- possibly without treatment to arrest the illness, the damage continues even past the damage rolls above.

Diagnosis for serious illnesses are also needed in order to begin effective treatment- for random diseases roll 1d6 to determine difficulty, 1-2 6+ 3-4 8+ 5-6 10+

Medical skill and possibly TL mods apply.

An incorrect diagnosis means the illness is not being treated and progresses as though no intervention has occurred.



Designer Illnesses
Consider having a set of illnesses already defined, possibly with unusual properties and difficult cures. They can even be an impetus for adventure, to find a cure for a plague or a character trying to get treatment for a years-long fatal disease/parasite.



Procyon Boneworms
The boneworms extract the calcium out of bones, leaving them brittle- effectively a parasitic-induced osteoporosis. STR is damaged initially as applied full force will break bones- if left untreated, DEX and END can be damaged too as spinal columns can break down and bone marrow destruction saps the immune and energy functionality due to reduced blood supply.

Vector- Parasite
Onset- 9 weeks
Damage- 3d6 STR first
Damage interval- 2 weeks per point
Diagnosis Difficulty- A+
Treatment/cure- Drug Talligen to kill the boneworms, extreme calcium regimen to rebuild bone at lower TLs, Fast Drug or regen treatment at higher TLs, treatment for complications.


Spinal Hammer Fever
A radmutated bacteria that was first observed at Perde Station, it is attracted to and feeds on spinal fluid, ultimately creating painful pressure on the spinal cord that feels like hammers are hitting it. The symptoms are unique and thus the disease is readily diagnosed.

Generally the immune system will fight this off quickly, it's primary risk is it's rapid onset and disabling nature. Since it affects DEX and without warning, many vehicle crashes have proven to be caused by this disease.

This is an illness highly linked with space stations, the bacteria gets into improperly treated water, so both drinking water and fruit/vegetables can be vectors.

Vector- Food Illness
Onset- 24 hours
Damage- 2d6 DEX first
Damage interval- 5 seconds per point
Diagnosis Difficulty- 6+
Treatment/cure- Specialized antibiotic Hydrax to kill the bacteria, bedrest, possibly Fast drug for more rapid replenishment of spinal fluid.


VID (Vegan Immune Disorder)
An immunity virus that sets the body's own immune system against itself, the severity of the disease is determined by how high the patient's END is. It is the ubiquitous severe flu of the far future.

Vector- Infectious Disease
Onset- 6 days
Damage- Points=END
Damage interval- 1 point every 12 hours
Diagnosis Difficulty- 6+
Treatment/cure- No cure, as the virus rapidly evolves to evade developed vaccines or drugs, at end of point damage/illness the patient's immune system will recognize and fight it off- until the next mutation comes along.. A controversial treatment is to suppress the immune system until the disease runs it's course. This option is promising but dangerous.

 

[kilemall]

(Optional Crunchier Illness Mechanics)

Preventive Diagnosis/Treatment
If a diagnostic session is conducted between an illness being contracted and it's onset, it is possible it will be diagnosed ahead of time and preventive treatment performed, avoiding the risk and damage of the illness itself if possible.

The diagnosis difficulty in this case is predicated on the thoroughness of the diagnosis procedures themselves, rather then the illness difficulty itself. DMs can be applied for hard illnesses to spot at referee discretion.

Basic checkup- 30Cr- diagnosis chance A+ .
Yearly Physical w/ Tests- 300 Cr- diagnosis chance 8+ .
Thorough Medical Workup- 3000 Cr-diagnosis chance 6+ .





Immunity/Vulnerability

The body will develop immunity to most any disease or trigger eventually. However, it can also have continuing vulnerabilities.

At the end of an illness, a roll of END or less is a successful adaptation of the body to the trigger, parasite or disease and a roll for the specific illness in the future can be avoided or given DMs to succeed.

People with low END may have to 'catch' it several times in order to build immunity.

However, on a natural 2 the patient's body is vulnerable to future attacks of this specific illness.

This would be equivalent to a continuing allergy, either food or environmental, or recurring bouts of a disease.

If exposure occurs there should be DMs to increase the chance of the illness occurring, or even automatically inducing the disease.

In either case, of immunity or vulnerability, the illness along with it's effects and the patient's relationship to it should be noted on the character sheet.

 

[Whipsnade]

Kilemall, please please please please PLEASE write this all up in a single document which can then be posted to the site's File Library. This material is too good to be lost in the forums.

Also, I'm sure Jeff would love to publish the material in and issue of Freelance Traveller. In fact, the subject of the material might give Jeff a reason to publish a medical-themed issue.

Thanks again for all of this.

 

[aramis]

Pretty slick. I may have to see if I can find a place to use it in my PbP.

The DGP articles do the same thing with damage to Int and Edu...

 

[kilemall]

Kilemall, please please please please PLEASE write this all up in a single document which can then be posted to the site's File Library. This material is too good to be lost in the forums.

Also, I'm sure Jeff would love to publish the material in and issue of Freelance Traveller. In fact, the subject of the material might give Jeff a reason to publish a medical-themed issue.

Thanks again for all of this.

Not done yet.

Part III.

 

[kilemall]

The DGP articles do the same thing with damage to Int and Edu...

Never saw it.

As I recall the Talsorian Friday Night Firefight had a similar mechanic, it was very important to get that flying ambulance to show up and save you, so that's probably what triggered my thinking of it.

The INT/EDU confusion/memory loss thing is more off LBB8 Robots then anything else.

 

[kilemall]

Part III- Long Term Effects

Attribute Loss
Most illnesses and minor accidents are either a nuisance, a continuing burden to fight, or a temporarily debilitating experience.

However, serious combat wounds, accidents or illnesses can be a very important event with consequences.

If a patient sustained a serious wound or worse, two attributes zeroed out minimum, a long term effect must be checked for.

As the patient heals, a final check for full rehab and recovery must be made.

Full recovery is 8+ for two attributes zeroed, A+ for three attributes. INT and EDU do not count against this roll.

Medical skill of the attending physician is applied. The previous optional TL rules are highly recommended to apply as well.

If full recovery is not achieved, an aging roll must be made against each and every attribute that was damaged. This includes INT and EDU if they took damage.

The aging rolls are as per the next roll on the aging table for that attribute that the character would be eligible for, even if they are too young right now for aging.

Loss of attribute is 1, unless the character is of advanced age, then some of the aging rolls lose 2.

The losses are permanent.

Processes such as a physical fitness regimen can regain attributes using the new values as the baseline.

Options to recover or improve attritubes by exotic surgeries, regen therapies, genetic replacements or prosthetic cybernetics are possible and are the realm of the referee.



Mustering Out
A service, government or for-profit organization must balance the needs and goals of that organization and stakeholders with motivating personnel to do the right thing and take risks as needed, and supporting them within reason.

However, if personnel are less capable or an ongoing risk, the organization may choose to terminate service involuntarily.

Determine how many attributes were permanently lost in long term damage aging.

Roll 1d6. If the roll is equal to or less then the number of attributes reduced, the character is mustered out.



(Optional Harsh Long Term Effect)

Aging Roll
Instead of rolling the above, a simplified process could be applied.

If the character patient suffered a serious or worse wound, add up all the damage points incurred and subtract the endurance before damage applied.

This number is the number of years the character has aged. Note the new physical age on the character sheet.

If aging rolls are triggered, roll them.

If the character is active service, the new age of the character applies to maximum terms (but the character does not get pension or other benefits to compensate).

 

[kilemall]

A nice little add-on to this would be illnesses. The dangers of Travelling include this sort of risk, and think of your ship medic, has to have something to do then be an overpaid steward.

 

[kilemall]

Thinking of making this a permanent file.

Looked over the JTAS Medical stuff again. I still like mine better, but I am missing treatment costs.

 

[kilemall]

Note, you can use the disease section to 'build' a poison, animal/plant delivered or ingested, or artificially made.