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Need a Doctor!!!!

For solitaire play I've become somewhat tired of building squads and sending them into combat. They don't last long. So I'm wanting to try something in a new vein. Medical Profession! Only I want to work onboard a cruise liner, thinking I'll give Judges "Singing Star" some exercise. It will definitely need some redressing; Judges Guild didn't include a sickbay, though I have 422 staterooms to mix and match. Searching the archive gave me some good layouts of medical facilities, but I can't find anything about stores. Surely a sickbay isn't going to have a dosage of every medicine for each crewmember and passenger. Or is it that if you run out of Dramamine the unlucky patient goes into a low berth? Also, if one member of the Medical Staff gets "called up", what's he going to pack besides underwear and toothbrush? What stores are in an ambulance? How about in a M.A.S.H. unit? Please don't refer me to my family doctor. He's retired, and I can't afford the new ones.
 
Are you sure you want a list of everything carried by a paramedic ambulance or even a GP making home visits?

A sick bay won't carry every medicine let alone for each crew/passenger. Just those deemed most useful/suitable for its role.

For example my ambulance does not carry crepe bandages or anti-depressants but will carry field dressings and mini-jets of epenephrine and narcan. When stocks run low we pick up from our home station (drugs especially) but we tend to have plenty of everything except for the really critical cardiac drugs, only enough for one arrest. But then after that we need to hit the station for a calm down and a brew up anyway.
 
As for "what does a doctor pack on deployment":

+ Golfing gear. Definitly golfing gear. You never know when you get the chance to operate on the generals son and play 18 holes on Regina

+ A mobile still and a cocktail shaker

As for medication:

IRL cruise ships pack a selection of the most commonly needed medications. If a passenger needs special medication (i.e Insulin, Proznak etc) he has to bring it himself. Passengers with potential problems (Pregnants, some allergics) also have to inform the ships purser in advance so it can be decided wether to buy or store necessary gear or to refuse passage

As for the ambulance stores: Actually they carry very little in the sense of medication. Emergency stuff for re-animation (watch a show of ER/Doctor House etc), blood plasma, salt-solutions, some light pain-killers (Acetyl-Salicine Acid or similar) ( Edit: And the other stuff Border Reiver listed when he beat me posting). Ambulances perform stabilisation and transport not full surgery/healing after all. They do have quite a bit of gear from wheeled stretches to heart monitors and defibrillators to manual and electrical breathing aids. Add in Spineboards and inflateable collars/splints

As for the MASH: They are basically a mobile hospital. So except an iron lung, a child-care station and a full scale islation ward with airlocks etc. you will likely found everything you can find in a civil hospital.
 
Pharmeceutical question along the same lines. How chemically complex are the standard drugs used in common medical treatment? Could they be brought aboard in "building block" form and synthesized as needed?
 
ok here's the list.

cardiac meds box;
atropine 2x
epenephrine (1:10000) 6x
lidocaine 2x

general meds box;
nubaine x2 (being phased out)
diazepam in 3 sizes, large rectal, small rectal, an IV dosage, all x3
benzypenicillin 2x
syntometrine
epenephrine (1:1000) 2x
narcan x3
paracetamol suspension (calpol)

techie roll
salbutamol 2.5mg x8
aspirin 300mg x12
narcan x1
glucagon x2
glucose gel x2 plus plenty in the ambulance
glycerol trinitrate 2mg x12

on belt
morphine sulphate 10mg x8
metoclopromide 10mg x8
more in morphine safe on ambulance

thombolytic kit for stopping myocardial infarctions (heart attacks)

defib/ monitor acts as 12 lead ecg, o2 saturation monitor, bp monitor, respiration monitor.

blood glucose monitor, blood alcohol monitor being tested.

"D" size oxygen cylinder (330 litres), dressings, saline, giving set, sterile water, manual bp cuff, stethoscope, oral pharyngeal airways from newborn to big bugger, nasal airways the same, bag & mask, paediatric bag and mask, laryngoscope, endotracheal tubes, five sizes of cannula x2, various syringes and needles, saline flushes, macgill forceps.

The above is all carried to each job (plus a blanket).

Then the ambulance carries specialist extraction and immobilisation equipment, suction units, ventilators, oxygen, entenox, maternity equipment, infectious disease protection, cbr protection, more spares for the portable (first response) gear, splints, straps, vaccuum mattress, and much, much more.
 
Well, I printed this page of the forum, and am grateful for the insightful responses. Dr. Kildaire in space seems possible now.
I am a LBBs user, ravs, and the secret to solitaire play is....drumroll...the reaction tables!
 
For inspirational reading on the topic of Doctors In Space, try the Sector General series by James White:

Hospital Station (1962: collection of stories from "New Worlds" science fiction circa 1958-1961)
Star Surgeon (1963)
Major Operation (1971)
Ambulance Ship (1979)
Sector General (1983)
Star Healer (1985)
Code Blue - Emergency (1987)
The Genocidal Healer (1992)
The Galactic Gourmet (1996)
Final Diagnosis (1997)
Mind Changer (1998)
Double Contact (1999)

Link: Wikipedia entry on "Sector General"

Another good resource is the book "Med Ship" by Murray Leinster (Baen Books).

I've used both in my own "Medship" RPG story arc. While being a crewmember of a starfaring hospital ship might seem boring at first, there are still the usual issues to be resolved.

Best of luck!
 
Originally posted by Jeff M. Hopper:
Pharmeceutical question along the same lines. How chemically complex are the standard drugs used in common medical treatment? Could they be brought aboard in "building block" form and synthesized as needed?
It depends on the tech level your are talking about. Many current small molecule drugs could be synthesized on an aircraft carrier say if they had some labs. The major drawbacks, yields may be very low, i.e. your space for raw materials might be better spent stocking more drugs. Purity and sterility is always a question. Of course there are regulatory hurdles, what would the FDA say, and legal, potential patent infringement.


The big difficulty with small moecule drugs is not so much making them, but finding out which ones work, what are the active enantiometric forms, how much do you give, what are the side effects, etc.

At higher tech levels, I can see some stock base materials and a "synthesizer/purifier" on board some vessles. The drugs will be very exspensive but if your 4 jumps away from civilization its good to have. I'd also imagine any exploration ship with a large lab could synthesize small batches of almost any small molecule drug.... starting with compounds containing 4 carbons or less. ;) (The last bit there was the dreaded phrase in O-Chem IIRC).

It may also be in the future there will be yeast, cell lines, bacteria, etc. that can be readily genetically engineered to express the biologic (e.g., protein) or small molecule drug given food.

Just my 2 credits worht on a Sunday afternoon.
 
Each to their own, but if I had anything majorly wrong with me on a cruise liner (or on an world with a Pop less than 5), I'd want to be put in a low-berth and let some specialists figure it out...
 
Originally posted by Ptah:
It may also be in the future there will be yeast, cell lines, bacteria, etc. that can be readily genetically engineered to express the biologic (e.g., protein) or small molecule drug given food.
We are quite close to this today - that is, some drugs (especially hormones) are already manufactured by gengineered bacteria or yeast in industrial-sized bioreactors; I've seen small bioreactors as well, and technically speaking, if you have a bio-reactor (fermentor), nescery nutrients and a sample of the gengineered bacteria/yeast (capable of reproducing), you could produce the molecule in a small bio-reactor. The main problems will be having the correct organism (that is, finding the gene and inserting it to a bacteria or a yeast), start-up times (bacteria and yeast take some time - from a few hours to a few days - to grow before you have a large amount of them) and extracting and purifying the needed molecule from the bio-reactor's mix (which contains water, microorganisms, nutrients and other materials). A higher-TL, computerized system that does most of the labwork and extraction/purification would probably be able to produce a drug given a sample of the relevant gengineered bacteria strain.

More higher-TL items:

1) Synthetic plasma, which would be manufacturable in mass quantities as opposed to today's need for donors; it would possibly also be far easier to preserve than natural plasma and with no risk of carrying nasty virii (such as AIDS or hepatitis) from a donor.

2) Compact and accurate laser-scalpels, which will save the need for sterylization between uses, and could probably have variable strength (from skin-tattooing to cutting bones).

3) Biological glue (healing-stimulating at higher TLs) to replace stitching; or, atleast, bio-degradable stiching material which removes the need to remove the stitches (whih is painful) and reduce the chance of infections.

4) Another thing that could be possible to manufacture on-site at a high-enough TL are antibodies (using monoclonal techniques); with a wide enough library of hybridomas (modified white blood cells that manufacture monocloal antibodies and multiply without regulation; used today in immunological research and industry) and the needed (automated) cell-culture and antobody-extraction equipment, you coukld create various anti-toxin and anti-infectant serums (such as against snake venom). I'm not sure that I remember the science behind this correctly, though, but this seems possible IIRC.

5) Compact, computerized and automated blood-analysis systems would be very useful; while specific-test kits exist today and are quite compact, doing a full analysis requires a lab. A system (preferrably suitcase-sized, maybe smaller at higher TLs ) which would accept a blood sample and does a wide spectrum of analysis (various indicators, plus toxins or other infectants if present) would allow a doctor to make informed decisions on spot; if the system could also analyze the DNA of infecting bacteria or virii this would also make identifying drug resistant organisms (and their weaknesses) far easier.
 
Compact, computerized and automated blood-analysis systems would be very useful; while specific-test kits exist today and are quite compact, doing a full analysis requires a lab.
Actually we have a fairly compact piece of apparatus for full blood testing available now. Although most blood testng is sent to a lab with fairly rapid results if necessary, in an emergency both Accident & Emergency and the Acute Receiving Unit have their own kit. It is no bigger than 2 litres in size but uses disposable cartridges for its operation which are prohibitively expensive for general use.

Perhaps we can look to something like todays blood glucose monitor, palm sized which take a miniscule amount of blood to register and less than 20 seconds to analyze. The state of the art ones today can do glucose, ketones, alcohol and cholestrol in one quick test.
 
Originally posted by Employee 2-4601:
</font><blockquote>quote:</font><hr />Originally posted by Ptah:
It may also be in the future there will be yeast, cell lines, bacteria, etc. that can be readily genetically engineered to express the biologic (e.g., protein) or small molecule drug given food.
We are quite close to this today - that is, some drugs (especially hormones) are already manufactured by gengineered bacteria or yeast in industrial-sized bioreactors; I've seen small bioreactors as well, and technically speaking, if you have a bio-reactor (fermentor), nescery nutrients and a sample of the gengineered bacteria/yeast (capable of reproducing), you could produce the molecule in a small bio-reactor. The main problems will be having the correct organism (that is, finding the gene and inserting it to a bacteria or a yeast), start-up times (bacteria and yeast take some time - from a few hours to a few days - to grow before you have a large amount of them) and extracting and purifying the needed molecule from the bio-reactor's mix (which contains water, microorganisms, nutrients and other materials). A higher-TL, computerized system that does most of the labwork and extraction/purification would probably be able to produce a drug given a sample of the relevant gengineered bacteria strain.
</font>[/QUOTE]Yep. I'm aware of many such bacteria, yeast etc. being used today. Maybe in the future there is one cell line, yeast etc. that has been engineered to produce almost anything with DNA that can be easily modified (i.e., won't kill it). Purification and extraction are easy IF cost and doing it small scale are not problems. Bottom line, I can certainly see the "pharmacy-in-a-suit-case" If we are at TL 8, maybe it first becomes available at TL 10, byt TL 12 it is dwon to the size of a pack of cigarettes and an integral part of Battle Dress. By TL 14 it is down to the size of a credit card in volume and fully implantable in human beings, in essence providing a "back-up" immune system and pharmacy. The biological aspect and drug raw materials could even come from the person. THe device focuses on the genetic modifications needed, modifies a few cells, then grows them up or even just releases them and lets them grow and do there thing in the body. Add some senors and it's an implantable "doctor."


More higher-TL items:

1) Synthetic plasma, which would be manufacturable in mass quantities as opposed to today's need for donors; it would possibly also be far easier to preserve than natural plasma and with no risk of carrying nasty virii (such as AIDS or hepatitis) from a donor.
I'd see this one at the next TL, TL9.

2) Compact and accurate laser-scalpels, which will save the need for sterylization between uses, and could probably have variable strength (from skin-tattooing to cutting bones).
I'd see this one as son as laser weapons become available and maybe one TL earlier.

3) Biological glue (healing-stimulating at higher TLs) to replace stitching; or, atleast, bio-degradable stiching material which removes the need to remove the stitches (whih is painful) and reduce the chance of infections.
I think we have this stuff already it just may be exspensive and doctors worry about it not holding if the patient moves too much, hence opening "sutures" and the doctor to malpractice suits.
 
IMTU, if you need special medical attention, you must provide either a supply of any medication(s) or a template to allow synthesis. Most drugs normaly carried would include wide-spectrum anti-viral and anti-bacterial medications, hitting them with a shotgun approach. If more help is needed and there is no auto-doc, they go into low berth waiting for transfer to a true medical facility.
Most everything else the ship carried, would likewise be wide-spectrum drugs and/or anti-toxins, rather than for specific diseases.
Equipment wise, a synthesizer for medicines, ultra-sound scanner which could also act to break up kidney stones or the like, treatment beds ala Star Trek which are actually being seriously looked into, ie all the main indicators taken regularly and without prodding the patient awake, etc.; and of course some handy hyposprays, laser scalpels, etc..

However in all reality, I generally just say I am using a med-kit of some type or sticking the patient in an auto-doc. It doesn't however stop me from working hard to figure what it all is and/or does.
 
IMTU, here's the basic expectations for a ship's pharmacy:

Per person aboard at launch for up to 1 month expected duration:
10 doses of antihistamines (array of different ones)
10 doses of multi-action pain relievers (Muscle Relaxant analgesics... such as naproxen and/or motrin)
1 dose of narcotic
1 dose of narcan
3 doses each of 5 different antibiotic types
1 dose of stimulants (array of different types)
1 dose of depressants (array of different type)
1 dose of insulin
0.1L Sterile Saline
packed preserved blood substitute adequate to make 1L of blood substitute
1 dose of clotting agent

Note: all dosages in minimal packing, with minimal base. Yes, it makes handling a pain. But it also means that the packing volume per person is well under 2L a person... I estimate about 1L per person.

In large volumes, this can probably be down to about 0.5L a person.

I'd expect a square meter of casting material (finished surface area), per 10 persons, and similar finished area of bandaging, to be aboard.
 
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