A practical guide to being a medic

In this guide I give you a crash course to the medical system, how to give first aid (useful to any class), and what's expected of the ships medic. You should at least have done the tutorial to be acquainted with the basic interface and concepts. Do understand that the medic is not a beginner friendly class, because half of being a competent medic is knowing the medical system inside out, and the other half of it is tightly managing some of the ships scarcest and most valuable resources. However, this guide will also help you if you are not the medic and just want to know how to quickly patch up someone.

0 - First Aid, and Items that everyone should carry at all times

Whether you are the ship's doctor or not, or just a random mechanic wanting to be able to give first aid, you will always want to carry some basic medical supplies on you, in order to save lives and patch people up quickly.

The most important medical items you should always carry on you if you, in order of importance, are

- Bandages or Plastiseal
- Morphine, and
- Saline. (a distant third)
The fourth tool in your arsenal is not an item, but an ability: CPR

In practical terms there is little difference between bandages and plastiseal, but plastiseal is better and more abundant. Why those three items exactly? Actual emergency situations are most often going to be one of the following, and you need to be able to handle them:

1. A person is bleeding out rapidly
2. A person has taken enough damage to go unconscious

Both of these situations will quickly lead to the death of a person if left untreated. Every other situation is not an emergency that requires first aid. If a person is dead, they do not require medical attention. If they are not currently in the process of dying, they do not need first aid. Most afflictions either cure themselves over time, or can be cured by a person lying in a bed for a while, or they can be cured by a stations doctor for a small fee. They are not time critical and you need to triage the ones who need help immediately vs the ones that can wait until later, and the ones that you cannot save.

Some emergencies (Husk infections, Poisonings) require swift, but not immediate attention, and due to their rarity and predictability, they are not covered by "First Aid", and treating them should be left to actual medical professionals, who can go to their cabinet and acquire the appropriate medication.

1. A person is bleeding out rapidly
(From encountering a mudraptor or being shot at, for example.)
If a person is bleeding, they gain the "Blood loss" affliction, which may eventually kill them. Your goal is to stop the bleeding, with bandages or plastiseal, but bleeds can be numerous and require many bandages to treat, so you should consider injecting them with Saline to gain some time. their health interface will most likely be cluttered up with various smaller afflictions. You may want to inject them with a morphine to quickly de-clutter their afflictions, to see quickly where the bleeding is. Then, treat the real, life-threatening problem: The Bleeding. Apply bandage/plastiseal to the specific extremities that have the "bleeding" affliction. If you do not carry bandages, you will, most likely, at some point simply bleed out.

2. A person has taken enough damage to go unconscious
If a person has taken enough damage to pass out, they will stop breathing. Lacking oxygen can quickly keep a person on the ground with more force than even the wounds will. To counteract this, you need to perform CPR. CPR will reduce the "Low Oxygen" affliction, keeping the person alive and giving you the time you need to treat the real issues, doing the actual treatment - This is when you apply morphine, bandages and saline as appropriate.

CPR can be performed and works even if the person does not have access to oxygen. However, if the primary reason for the person to fall unconscious was the lack of oxygen in the first place, they will quickly fall unconscious again. CPR will be less effective and even cause damage if performed by someone with a low medical skill (under 20).

I - Medic Essential Items

As the ships actual doctor, you are expected to be able to do more than just deliver basic first aid. You are the person who can be guaranteed to be actually wearing the health scanner and thus quickly figure out what is happening. Here are the essential items you need to have, if not on your person, at least in reach and well stocked:

1. Health Scanner. The health scanner is an item every medic spawns with and allows you to quickly diagnose several afflictions at a distance, giving you more time to make the right decisions when seconds count. The health scanner also sees through people wearing masks wearing wrong ID cards. Always wear it. Even if you are not a doctor, you probably want a health scanner, it is easily the most useful item overall to wear on your head, letting you immediately detect impostors and husk infections in others. You can craft this in the normal fabricator from common materials.

2. Antibiotics (ABX) allow you to quickly and cheaply remove husk infections. Husk infection lurks behind every corner on Europa, and your crewmates love to get themselves bit. Antibiotics cause serious organ damage, while only removing about 20% or so of husk infection, so you definitely want a high medical skill to use them, because you will need at least 2-3 injections to cure a person of the husk parasite if you don't get to them immediately. Keep the rare and expensive calyxanide around for the serious cases with >60% progress in the husk infection, because the sheer amount of ABX required to cure them would likely kill them, forcing you to spend additional morphine to keep them alive. Antibiotics are found on wrecks and can be deconstructed from antibiotic slime, found in caves.

3. Anaparalyzant. Circuitous to craft by yourself, but found in relative abundance on Thalamus ships and other wrecks. Whenever your crew has an encounter with a Thalamus and does not manage to nuke it from long distance, you will likely require Anaparalyzant. Leukocytes will give people they hit Paralysis, which slows them down, eventually to the point where they are stunned and stop breathing. With a high CPR skill you can keep them alive indefinitely in this state. Always keep plenty of Anaparalyzant around, and have it ready when going against a Thalamus. The Thalamus is also the only source for adrenaline glands, the only source for Adrenaline in the wild, which is an essential ingredient for making Fentanyl.

4. Stabilozine. The primary reason why you want to loot every hammerhead, giant spineling and brood mother. Almost every poison, radiation sickness, and even drug withdrawal and drunkenness can be fixed with liberal use of stabilozine. And that is not to speak of its purpose in genetics where it is needed to purify genes. You do not need to keep 15 different antidotes around - Instead, be ready to inject people with heaps of stabilozine, that you keep around instead. And yell at your captain to let you loot those hammerheads for their swim bladders.

II - Nice To Have Items

"Nice to have", but not essential are the following:

- Deusizine: The most high level medical item to craft, it can bring the almost dead back to life, and is the ideal thing to put in PUCS suits and Medical Auto-Injectors. It is however extremely expensive to craft, requiring liquid oxygenite (from oxygenite shards) in addition to the already expensive fentanyl and antibiotic glue. If you can acquire a good stockpile of this stuff, make sure every crew member on your ship always carries one or two Deusizine, because it will allow even people with no medical skill to instantly and quickly bring back downed comrades.
- Hyperzine: The ultimate stimulant, made from combining meth and steroids, Hyperzine turns anyone into a combat machine, reducing their incoming damage while increasing their running speed and melee damage.
- Combat stimulants: A talent item made from relatively hard to find sulfurite shards, it is even more powerful than Deusizine in its ability to bring back the dead and keep them fighting - but much more difficult to acquire.
- Medical Auto-Injectors: Given that every engineer seems to beeline for the the PUCS suit, there is an apparent degree of redundancy with the Medical Auto-Injector, which offers the same functionality - automatically injecting a medical item once the wearers health has gone down to below 50%. But Auto-Injectors are still very good, you can wear them at the same time as a PUCS suit, and keep Hyperzine in one, and Combat Stimulants or Deusizine in the other, and have them both be automatically injected when stuff goes sideways. Furthermore, PUCS are difficult and expensive to make, and have the downside of everyone having to wear a PUCS constantly, while Auto-Injectors are cheap and easy. Use them, they are good.
- Tonic Liquid: Made from ingredients that otherwise do not have much purpose, Tonic Liquid is an easy to use cure-all for smaller injuries, curing 12% of internal damage over the course of a minute, and makes various buffs last longer. Make use of it when opiate stocks are low.
- Cigars: A talent item produced by the captain, the Cigar is the best way to remove psychosis, and the only way to remove Reapers Tax. Make sure your captain gets this talent (it is much more useful than the alternate talent) and until you get your hands on some Cigars, you may want to keep some Haloperidol around to treat severe cases of psychosis.

III - Not so good items

The following things are things that may seem good reading their description, but really are not. The only purpose these items have is for crafting or selling. Keep them away from your crew.

- Fentanyl: Fentanyl is very powerful but also highly addictive and poisonous, especially if your medical skill is below 72. Once you reach that level you may want to replace your personal morphine stacks with Fentanyl, but for the love of god keep Fentanyl away from the filthy hands of your untrained crewmen - in their hands you should treat it as a poison. Declare it contraband and have them hand it over at gunpoint. You, however need Fentanyl for crafting other items. You find the Adrenaline Glands in Thalamus organs only, and Ethanol can be deconstructed from yeast plants, found in caves.
- Opium: 2 Opium turn into 1 Morphine, and 1 Morphine is stronger than 2 Opium. If 1 Opium would fix you where 1 Morphine would be overkill, you probably should just prescribe some bed rest instead. Turn that opium into Morphine and don't look back. Poppy plants can be found in caves.
- Antibiotic Glue: Plastiseal is simply good enough, and much cheaper, and does not run the danger of causing organ damage. Antibiotic Glue is good as an ingredient for Deusizine. Keep away from crew members, they absolutely will kill each other with it.
- Poisons: There is no purpose to keeping poisons around unless you want to grief your crew. They are useless against monsters because they either do not act fast enough or simply do nothing at all. Sell them as soon as you can.
- Antidotes: Stabilozine fixes almost everything and is cheap and easy to find. You don't need these.
- Raptor Bane: Simply not worth using over a real gun even if you know you are going against Mudraptors. Don't bother growing Raptor Bane, grow Tobacco for cigars if anything.
- Pomegrenade Extract: Weaker than Tonic Liquid, and much more annoying to make. It heals an abysmally small amount, abysmally slowly. Just lie in bed if you consider this as an option for healing. Don't bother growing Pomegrenades, grow Tobacco for cigars if anything.
- Blood Packs: In practical terms, Blood Packs do the same thing as Saline. So deconstruct all those blood packs, get the Saline, plus free Alien Blood (for laser weapons crafting) and free Stabilozine on top.
- Pressure Stabilizers (APS): They are not bad, they are just not very good either. They only last a short time, and the time window to refresh them while in pressurized water is short. Only use them if you want to trick your security into getting themselves killed telling them they could use the Bandolier instead of a diving suit, then watch them die from overpressure because their APS ran out in a critical moment.
- Endocrine Boosters: Sometimes called the most OP item in the game, they are ludicrously expensive to make in terms of resources, and most talents that you can get with them simply aren't very good. They are similar to the APS - they are a toy, not actually useful, but this time with the purpose of when you want to figure out how overpowered a single person can get.
- Compound N: While ostensibly a formidable explosive, it has a weakness not shared by UEX, C-4 and Frag grenades, which are your usual railgun shell fillers: Compound N will explode if anything nearby explodes, similar to IC-4. This makes loading up railgun shells with Compound N highly dangerous to the gunnery crew. Volatile Compound N explodes after an amount of time by itself, and is only good for griefing.

IV - Managing Ship Supplies

You're the ships doctor, so get yourself a gun as soon as possible. Shoot anyone who tries to steal your medical supplies with a few educational bullets. If guns are in low supply, you can use a syringe gun with chloral hydrate and put handcuffs on them. If they are larping as an "opiate addict", just save yourself the trouble and kill them instead. They are wasting essential ship resources. Do not let them.

As the ship's doctor, it is your job to make sure you, your ship, and your crew have the medical equipment that you need. Yell at your captain to make him buy supplies, and yell at him to stop at wrecks and caves. Craft bandages into plastiseal and opium into morphine to make them more effective. If your medical fabricator isn't churning out medical supplies around the clock, you are failing at your job.

Morphine (and its base, Opium) will most often be in short supply. Guard the Morphine supplies jealously and aggressively. If morphine stocks are low, keep it to yourself - You can get more bang for the buck out of it than your untrained crewmates. But if your Morphine stock is abundant, make sure everyone has some, so they can quickly cure injuries in the field without requiring your intervention, leaving you with more time to craft more supplies!

Most of your medical supplies will come from buying them at stations early in a campaign, while later on, as outposts become rarer, you have to rely on what you can find: Finished medical goods from wrecks, plants from caves, and swim bladders from hammerheads, crawler mothers and giant spinelings. Some useful materials will come from minerals that you mine. Adrenaline glands, a vital ingredient for Fentanyl, can only be found in Thalamus organs.

The most scarce resources are alien materials - Oxygenite and Sulfurite in particular. A mechanic with the Scrap Savant skill can turn random scrap he finds into these. You can find plenty of small alien artifacts in alien ruins, which deconstruct into these, even more so with talent points in the xenologist tree. Finally, abyss islands are loaded with alien materials, and you should encourage your captain to seek them out once your crew is confident in its ability to take on abyssal creatures.

V - Genes and the Scientist Talent Tree.

With the Scientist talent tree, you as a medic are the primary handler of genes. You require an ample supply of stabilozine to process unidentified genetic materials. If you want to dabble with genes at all, I recommend you beeline your talents for the advanced gene splicer before you start injecting people with genes. With simple gene splicers your options are much more limited and you will lose a good gene you used in them once you replace them with advanced gene splicers. I consider the Scientist talent tree easily the most useful medic talent tree.

The single most important and most useful gene is the Hammerhead Matriarch gene, because it will save you a lot of medical supplies in the long run. Never combine the Hammerhead Matriarch genes with anything for fear of tainting, not even other Hammerhead Matriarch genes. Instead, make sure as many people in your crew have at least low level Hammerhead Matriarch genes as you can, it will greatly increase their survivability and reduce the amount of medical supplies you and your crew need in your day to day.

With advanced gene splicers, you can make sure as many people as possible have at least some Hammerhead Matriarch regeneration going, and then experiment with the second gene slot. But avoid tainting matriarch genes at all costs, don't even combine them with each other. 2 people with 13% regeneration are far more useful than 1 person with even 100% regeneration.

Most of the other genes range from completely useless to marginally useful. Having a mudraptor beak might be funny, but it's just not useful. A moloch gene for maybe 10% more damage resistance or a crawler gene for maybe 23% more swim speed are useful, but not essential to survival in any way.

One other gene deserves special mention, and that is the Husk gene. The Husk gene lets you be infected with the Husk, but without actually dying and losing your character. The Husk gene is like a whole bunch of genes combined into one, including the Hammerhead Matriarch gene, insofar that it gives you regeneration in addition to bleeding immunity. Especially when it is a high level gene, it becomes incredibly potent. However, you trade with it your ability to speak in game, which has more consequences than you might think. You can no longer give commands to bots, or use the status screen to call out damage, for example. A captain can no longer use his entire "Shipmaster" crew buff talent tree!

As for the geneticist talents other than the Advanced Gene Splicer: Gene therapists 25% potency increase to medication you apply is too good not to take, and Pressure Stabilizers are bad. "Gene Harvester" gives you random gene drops from random critters your crew kills, this translates into more chances at Matriarch Genes, and is thus the better option than a slight increase in the probability your gene recombination attempts do not produce tainted material.

VI - Xenologist Talent Tree

Very little needs to be said about the Xenologist Talent Tree. It lets you find bonus alien materials and artifacts when you pilfer alien ruins, and gives you bonuses to using alien pistols or deconstructing alien artifacts.

Notable with the "Alien Hoarder" talent is that the "8% bonus damage for each alien artifact you are carrying" does not count the alien pistol and the energy cells. You need to carry "Alien Curios" or some such. "The Atmos Machine" makes sure you will almost never run out of energy cells, as alien artifacts sometimes deconstruct into other artifacts, alien pistols, ancient weapons, and alien energy cells. Note that the "Atmos Machine" description is misleading, it spawns those artifacts in addition to what the artifact normally would deconstruct into.

I do consider the Xenologist the weakest talent tree of the medic, because it is so focused on alien ruins, while at the same time not really helping you deal with guardians. The alien pistols do burn damage which the guardians have minimally a 75% damage reduction against. An autoshotgun-carrying, high level security officer is far better at clearing out a ruin than you are.

Final words

There, now you know everything you need not to suck as a medic. But to be able to quickly save lives, you will need a lot of practice and experience. Being a good medic is easily the most challenging job on a submarine in terms of both overall knowledge, and split-second decisions that have to be made.

Special mention to Ironic_and_Dead who created a video guide on the various afflictions and medical items. Watch it for a more in-depth evaluation of the medical system in Barotrauma.

Two corrections to the video (which is from 2021):
1. Burn damage is no longer cured by opiates. But instead, it slowly cures by itself. It can be treated with bandages.
2. Steroids used to be the best medical item because they straight up added health, and could thus "bring back the dead", but they no longer do that. Use deusizine or combat stimulants for the same purpose instead. Steroids (And Hyperzine) now have a damage resistance instead of a health bonus.

[borzoi_07]

Can you make a guide for Neurotrauma ?

[LitLCappnPaxtonFttl]

/sticker Headcrab Surprised

[LitLCappnPaxtonFttl]

what did the marker say?
/sticker G-man

[Gman]

Thx for the guide! ive been nervous about taking the medical role on subs cause i had no idea what i was doing. but this guide definitely gave me a lot of info!

[catmanmlio]

Thanks for the guide, i am doing the campaign solo with bots, Real helpful so I cna get the most bang for my buck with medical items

Also Deusizine, indeed a life saver

[Terragen]

Are you not aware that some afflictions scale to vitality?

[Corrupted]

There is no meaningful difference between "Retroactive damage resistance" and "Health increase"

[Terragen]

and again for anyone who is a visual person, here's an image that might help explain it:

https://barotraumagame.com/wiki/File:Testing-vigor-functionality.png

[Terragen]

It's a common misconception that steroids increased vitality which is an understandable mistake given that they remove significant damage so *appear* to increase vitality, but that's not what was happening.

Just to clarify, "retroactive" means it is affecting conditions in the past. So previously the damage resistance would apply to damage you had already taken so if you had taken 50 vitality of damage and later applied a damage resist of 50% then suddenly that 50 damage you had already taken became 25 damage (so it would appear your vitality was increasing when it was actually damage disappearing, hence people mistakenly thinking it was adding vitality when it wasn't.)

Now it is NOT retroactive so behaves as you'd expect - damage resistance only "resists" damage that is suffered AFTER it has applied which is why you can no longer get an unconscious person to stand up simply by injecting 'roids or 'zine.

Hope that helps make sense of it!

[Corrupted]

Steroids used to give you straight +400 health, which was helpful if you were at -50 health (dying) because you'd immediately get back up at 75% (~350) health, it didn't "retroactively apply damage resistance", that doesn't even make sense. What would however happen was that if you, say, took 200% damage while under the effects of steroids, eventually you'd just fall to 0 and you'd start dying as the steroids wore off.