• Realistic use of medicine in DayZRP


    Sofie

    Old version with comments and questions.

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    With a realistic survivor game comes a very important medical role, just as important as it would be in a real zombie apocalypse. With few resources available and little knowledge among the remaining population, it is something you should be expected to roleplay. This guide is, above anything else, made to give everyone an overlook of the most common medical conditions that others might expect them to roleplay. This includes deciding what injury your character has, how to describe it and roleplay out the related symptoms. All this information can be found under "how to act". If you want to learn how to treat the most common conditions because it is knowledge that your character would possess, you find the necessary information bellow "what to do". Information from this guide should not be tested in real life.

     

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    USEFUL TOOLS

    Many prefer using search engines while they are roleplaying to search up symptoms and diagnosis. I recommend that you use BMJ Best Practice and UpToDate. How to use them are described in this post.

     

    THIS IS NOT GENERAL KNOWLEDGE

    Most survivors do not have all this knowledge. Only use what would be relevant for your character to know. However, knowing how to roleplay symptoms of diseases and injuries you want is important to know.

     

    RULES ALWAYS APPLY

    Remember the rules when you do medical roleplay! You can't decide for someone what they suffer from, so make sure to always ask //OOC what you see when you examine them.

     
     

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    MEDICAL EQUIPMENT

    Epinephrine

    Morphine

    Blood bags

    Saline

    Charcoal Tablets

     

    INJURIES AND DISEASES

    Cuts

    Infected wounds

    Gun wounds

    Broken bones

    Cholera

    Hypothermia

    Hyperthermia

    Kuru

    Diabetes Mellitus Type 1

    Methanol Poisoning

     

    MEDICAL PROCEDURES

    Amputation

     

    INTERVIEW

    Kenji - Kenji Oshiro

    Thejackfish - Jack Fisher

    Dr Brandon - Brandon Tallent

    Helena - Hope Pisces

     

    SCENARIOS

    1. Doctor scenario

    2. Death scenario

    3. Non-immune getting infected scenario

     

    CONCLUSION

     

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    Medicine is a science of uncertainty and an art of probability.

     


     

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    Epinephrine

    Epinephrine as an injection like we see it in the game and is used to treat life-threatening allergic reactions caused by insect bites or stings, medications, food, latex or other causes. Or as most of us know it, something you inject into an unconscious person. Epinephrine is also known as adrenaline and has an important effect on the body as a hormone. Playing a big role in the fight-or-flight response by increasing blood flow to muscles, the output of the heart, pupil dilation and blood sugar. Simply making you into a "superhuman" that can handle a lot more stress.

    Spoiler

    How to use it:

    • Epinephrine injections come as a pre-filled automatic injection device containing a solution to inject under the skin or into the muscle on the outer side of the thigh. If necessary in an emergency, the injection can go through clothing.

    • It is normally injected at the first sign of an allergic reaction, where the symptoms of this include closing of the airways, hoarseness, itching, swelling, skin redness, fast heartbeat, weak pulse, confusion, stomach pain and, at last, the only symptom in the game; a loss of consciousness.

    • Even if in reality it would be normal to inject the dose into the person when it is feeling the first symptoms, the game does not give us this opportunity. Plus falling unconscious in the game is often caused by a blood loss or a hard hit to the head, where no allergic reactions have the blame.

    • Still, the epinephrine is used to quickly get someone on their feet again, which we can give adrenaline credit for, making their heart beat faster and their fight for survival stronger.

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    Morphine

    Morphine injections is a medication used to treat severe pain by reacting on certain centers of the brain to give you pain relief. This equipment is what most people use when they get the "my arm is hurting" message on their screen, which there is no problem with. Just know that taking a dose of morphine would not fix a fracture on its own, only hide the pain for a while. Too much morphine can also kill you, where a dose over 200 mg is considered to be lethal for an average person. However, even a dose of 60 mg can cause coma or death. Since a morphine injection in the game is 10 mg, you would only need to take 6 to do an overdose.

    Spoiler

    How to use it:

    • Morphine injections come as a pre-filled automatic injection device that you inject into a muscle or under the skin.

    • Before penetrating your skin with the injection needle, it is important to clean the injection site with rubbing alcohol over it.

    • It is also important to change the location of the injection site with each dose to avoid problem areas under the skin.

     

    How to act:

    Morphine might give you nausea which is not dangerous and can be treated by just laying down, not moving your head for 1 to 2 hours. If your body is used to using morphine you might get symptoms such as restlessness, watery eyes, widened pupils, sweating, and a runny nose. It is also important to keep in mind that the more you use the medicine, the less it will work the next time.

     

    Blood bags (blood test kit + IV)

    Like the name indicates, this is basically bags filled with human blood that has a two-way roleplay possibility; where you have to first get the blood from someone and then transfer it into another person. The blood is given intravenously, which means you need to use an IV to give it correctly. However, because people have different blood types you can't simply accept a blood transfusion from anyone. Accepting the wrong blood type or blood from someone with a disease might cause death - as further described under "how to act".

    Spoiler

    What do to:

    In the game we can use blood testing kits to test our blood by taking a small sample. The blood testing kit contains a card with 4 marked areas that you first wet with sterile water. You then pierce the person you are testings skin on their finger and take a blood sample on each of the marked circles and spread it out. The blood will dry and react by coagulating or not at all (the blood types coagulates differently). With the blood test kit comes a manyal with pictures showing which blood type your four circles match with. There are 8 types of blood: O+, O-, A+, A-, B+, B-, AB+ and AB-, where you need the same blood type as yourself. However, there are some exceptions:

     

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    Taking blood from someone always comes with a risk. First of all, you pierce their skin with a needle that goes directly into their blood stream, if this is not done under clean conditions infections may occur. Therefore, make sure to clean the skin and use a sterile needle, this also goes for transferring blood to someone. Secondly, the person losing blood will have a drop in blood pressure and will feel the symptoms from this, if they originally were not healthy enough to donate blood can a blood loss like this be dangerous.

     

    How to act:

    Like said before, donating blood will give you a drop in blood pressure and you will feel the symptoms from this like cool, clammy skin, dizziness and weakness, a fast and weak pulse, paleness, trouble breathing. Getting back to your normal blood level will realistically take around a month. therefore, make sure to eat well and stay hydrated during this period. Vitamins would also help in reality. All these symptoms also go for blood losses that come from injuries or other diseases!

     

    Saline

    The cells in our bodies are bathed in a watery fluid that contains primary sodium and chloride ions. These ions play a vital role in maintaining proper fluid balance and keeping our tissues hydrated. Sodium is also involved in many cell processes such as muscle contraction, transmission of nerve impulses and kidney function while chlorides are responsible for maintaining the acid-base balance. Therefore to sustain life, it's very important to maintain these ions within a narrow range.

    Spoiler

    How to use it:

    • Saline is used intravenously and, therefore, IV is also needed to do these procedures.

    • Using sterile equipment and being good with hygiene is just as important here.

    • Saline is used on people in danger of developing dehydration because they cannot take fluids orally.

    • It is said that sodium raises the blood pressure, something that is useful in times when a blood loss have decreased it.

     

    Charcoal tablets

    Charcoal tablets come in small packages and is easily taken orally to treat a drug overdose or food poisoning. Charcoal is made from coal or woon and binds to drugs and toxins so that the body can get rid of these unwanted substances before they hurt you. They are easily taken by swallowing them with water. But they do have two side effects that you might want to roleplay out; your tongue can get a black colour for a short period of time, and it might also give you diarrhea and cause you to vomit.

     

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    Cuts

    Every wound is different. If a person has been axed down in his back or scarred on his arm, these two injuries demand different types of care. I will only explain how to do first aid to stop the bleeding and prevent death caused by blood loss - or like we do in the game; pressing F and bandaging someone.

    Spoiler

    What to do:

    If you come across a person that has, let's say, a deep cut on their wrist that is bleeding furiously. The first thing you should do that kinda speaks for itself, is to calm the person down so their pulse slows down ((If they have a high pulse the blood will be pumped faster out into their limbs, causing only for the bleeding to increase)). Raise the wounded arm above the person's head and search for their pulse under their bicep, there is the main vein going there that you can block by putting enough pressure on it, this will decrease the bleeding. If the patient is awake you can ask them to do all this while you focus on the bandaging. What I see many series do is gently wrapping the bandage over the bleeding wound, something that will NOT help (The Walking Dead disappoints me here). What you should do is use as much bandage as possible and stuff it all into the wound, something that will cause the person wounded a lot of pain, but is necessary to clog all the small veins inside the flesh that is bleeding. When the wound is filled up with bandage, wrap the bandage tight first around the wound, then up covering the fingers, before bandaging down the arm to the elbow/shoulder ((this prevent the body from pumping blood into the arm)). The bandage should be wrapped using a fishbone pattern so they won't slide apart. This method also goes for any other libs on the body.

     

    Honey treatment

    Sterile honey can be used to treat wounds because it makes the bacteria "eat itself to death" with a big enough amount, the wound heals faster, prevent bad smell, causes less scarring and neutralize. It's a simple and easy way to treat infected wounds as well as just normal cuts.

     

    How to act:

    There is no secret that having your skin cut open is painful, and will even make the most badass people complain. Like any other injury, I'm writing about below the body will release adrenaline when you are hurt. This hormone have effects on your body that you can feel - faster heart beat, heavier breathing, sweat, more awake and so on. If the cut is deep and the bleeding serious, then you will probably loose a lot of blood before getting the wound bandaged which will be showed to you in the game by getting a greyer screen. While having this grey screen you should roleplay out the typical symptoms of a blood loss. Blood pressure will fall because of your heart having less blood to pump around, which will make you dizzy. You will feel tired, short of breath and turn pale. ((If you eventually die from blood loss, it's because the body's oxygen supply drastically reduces the number of oxygen-carrying red blood cells is decreased, something that will lead to a heart attack or a stroke)).

     

    Infected wounds

    Infected wounds would probably be the most common cause of death in the apocalyptic world. After getting injuries like cuts or bullet wounds, the chances of it getting infected are quite large. Especially if the tool that was used to rip open the skin is dirty and rusty. Infections can also happen if you penetrate the skin with thin needles, so make sure to keep this in mind when you take epinephrine, morphine, saline and use blood bags.

    Spoiler

    What to do:

    Injected wounds are treated differently after how severe they are and by their location. It is important to clean a fresh wound, using soap and water to wash away germs and decrease the risk for infection, even better is using sterile water or germ killing solutions like alcohol. Any objects should be removed from the wound with surgical cleaning, and dead or infected tissue in the wound should be removed Pockets of pus should be drained and the wound should be packed with saline-soaked bandage before placing wrapping dry bandage around it like I wrote how to do under "cuts".

     

    It is important to clean and change the bandage on a regular basis. This is done simply by removing the old bandage and packing, wash the wound, clean it and put on new bandage with saline-soaked bandage. It may take from days to moths before the wound is clear of infection and finally heal normally. Using antibiotics will also help fight or prevent an infection caused by bacteria.

     

    Honey treatment

    Sterile honey can be used to treat wounds because it makes the bacteria "eat itself to death" with a big enough amount, the wound heals faster, prevent bad smell, causes less scarring and neutralize. It's a simple and easy way to treat infected wounds as well as just normal cuts.

     

    How to act:

    An infection can come from as little as a simple cut to the finger, so you should always be prepared that this is something that you most likely will roleplay out. If you are cut up by a dirty/rusty object, then you will most likely have an infected wound, where there are a few symptoms you should know to act out. The skin around the wound will turn red and it will smell really badly along with being sore to touch even in the areas around it, along with being warmer to touch. You will most likely get a fever and feel dizzy with a faster heartbeat.

     

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    Gun wounds

    Bullets are composed of a casing enclosing an explosive power charge, which will force the end projectile element out at high speeds, depending on the ammunition and type of gun. The most important factors in causing significant injury or death are the bullets placement and projectile path.

    Firstly, the projectile crushes structures along its path, similar to a knife would do. This will cause shearing and compression, sometimes tearing structures apart, doing great damage. Soft tissue can collapse when punctured by a bullet, also if the projectile is deformed and fragmented it can cause greater damage to tissue that is not even in its pathway. Lastly also for the wound to be infected by bacteria is something that you have to worry about.

    Spoiler

    What to do:

    When faced with a gunshot wound there is several things we need to think about. What type of weapon was used is one of them; the severity of a gun wound will vary if it's caused by a small handgun, a shotgun or a high-powered rifle. Also it is important to know that the bullet will most likely go through the body, so you need to also focus you aid care on the exit wound of the bullet. Lastly you need to think about what organs that can have been damaged from the bullet. If it's a simple gun wound to a limb then it should in most cases only need good medical care, but sometimes professional help is needed to remove the bullet or any dead tissue that may occur. Gunshot wounds are an open portal to your inner tissues, which mean you are in great danger of a dangerous bacteria infection, therefore taking antibiotics is a clever move. Wounds caused by dirty bullets are also in many cases causing tetanus, so I hope for your characters sake that their tetanus cover is up-to-date so they avoid this problem (new dose needs to be taken every 10th year).

     

    How to act:

    Pretty similar to how you would react getting cut (read on "cuts")

     

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    The first picture shows the entrance wound from a large-caliber .45 handgun. While the other wound from a medium-caliber 9 mm.

     

    Broken bones

    Broken bones are quite common among players that are fun to play out, but it can get even more fun by making it a bit descriptive. Fractures can range in severity and recovering time, where some of them are minor only causing you not to be able to use guns while others can be life-threatening. Improper treatment of fractures can even lead to debilitating changes to the body's strength and mobility - meaning its an open door to drastically changing you characters health. We separate fractures into two categories:

        1. Simple fractures (closed) are bones that remain within the body and do not penetrate the skin

        2. Compound fractures (open) are broken bones that penetrate through the skin and expose the bone and deep tissues to an exterior environment. These are considered much more serious than simple fractures because they may be complicated be deep infections if bacteria enter the body through the wound.

    Spoiler

    What to do:

    The period immediately after a bone fracture is critical for the proper repair of the bone and healing of the affected tissues. Bones begin to heal very quickly after a fracture and the bone tissue will knit together with any nearby bone fragments to form a callus of cartilage and eventually new bone tissue. The goal for the bone healing is to reach a proper union of the fractured bone pieces that restores the original bone anatomy and restores full function to the muscles and joints that move the bone.

     

    Sign and symptoms of broken limbs are swelling, bruising or tenderness. If the injured part is difficult to move or hurts when moving, being touched or bearing weight it's most likely a broken bone. The first thing you should do is stop bleedings if there is any (look at the information about cuts). The best thing an unprofessional can do finding someone with a broken bone is to apply a splint to the area above and below the fracture sites and bring them to a professional.

     

    These professionals are those who roleplay as doctors. The first step for them is to try and figure out what type of fracture and the degree of displacement and misalignment the patient is suffering from, something that might be difficult without an X-ray. The first goal in treatment is to see that bone ends that abut each other are in alignment so that, when the fracture heals, the bone will retain its previous shape. Displaces bone ends are manually maneuvered back into position. It is also important to check for blood circulation, something you simply do by pressing firmly over the skin beyond the fracture site. It should first blanch white then pink up in about two seconds. Signs that circulation is inadequate include pale or blue skin, numbness or tingling and a loss of pulse. This is all caused by the bone putting pressure on veins and nerves that goes down the leg, and can be fixed manually by adjusting the bone. But it can also be a damage that was caused by the bone breaking, hopefully it fix itself. An arm may heal in a month, but a leg may take up to half a year, but of course this has to adjust to the game.

     

    How to act:

    It's not a mystery that breaking a bone hurts like hell. Your broken limb will not be as movable and will hurt when used, fingers will be numb and you will most likely just hold it as still as possible. Some fractures are not as easy to diagnose, and you might be able to move around like before, only feeling the pain, like if it's a fracture on a rib. If you have a broken bone and try to move, this might do more damage and rip up veins and nerves, therefore there is a bad side about continuing to use your broken limbs and not getting treatment right away.

     

    Cholera

    Cholera is an infectious disease that causes severe watery diarrhea, which can lead to dehydration and even death if untreated. It is caused by eating food or drinking water containing the bacterium called vibrio cholera. When a person consumes this, the bacteria release a toxin in the intestines that produces severe diarrhea.

    Spoiler

    What to do:

    Cholera is highly treatable but because dehydration happens quickly, it's important to treat the disease as fast as possible. Hydration is the best treatment for getting dehydrated by cholera. But to kill the bacteria consuming antibiotics is the best thing to do. You can also take charcoal tablets since they binds the toxin that the bacteria produces (read about charcoal tablets above).

     

    How to act:

    Symptoms of cholera can begin as soon as a few hours or as long as five days after infection. In worst cases the infected has severe diarrhea and vomits, which quickly leads to dehydration. Other symptoms is also a rapid heart rate, loss of skin elasticity, dry mouth, throat, nose and eyelids, low blood pressure, thirst, muscle cramps and nausea (which is the symptom we experience in the game).

     
     

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    Hypothermia

    Hypothermia is a potentially dangerous drop in body temperature, usually caused by exposure to cold temperatures, something that happens to our characters when we run around with wet clothing in the cold environment of Chernarous. Normal body temperature is 37 celsius (98,6 Fahrenheit), while with hypothermia the temperature drops below 35 celsius (95 Fahrenheit) and with a severe cause of hypothermia the temperature can drop to 28 celsius (82 Fahrenheit) or lower.

    ((The hypothalamus is the brain's temperature control center and trigger processes that heat and cool the body. During cold temperature exposure, shivering is a protective response to produce heat through muscle activity, another process is blood vessels temporarily narrow in the outer parts of the body, so that blood won't go to the limbs - cool down - then go back to the inner body. Normally the heart and liver produce most of your body heat, but when the core body temperature cools these organs produce less heat and "shut down" to preserve heat and protect the brain. Really low body temperature can slow brain activity, breathing and heart rate)). Confusion can set in, weakening a person's ability to understand what's happening and to make intelligent choices to get to safety.

    Spoiler

    What to do:

    Recognizing the symptoms is the first step in diagnosing hypothermia. Thermometers that are available in the game can detect low core body temperatures and confirm the diagnoses. The best thing you can do for yourself or any other person with hypothermia is to remove the wet clothes and put on warm dry ones. Protect them against rain and make them a warm fire. Other helpful items for warming can be heat packs or warm water bottles (difficult to get that last one in the game), placing these on the torso, armpits, neck and groin. Drink something warm, but avoid alcohol and caffeine.

     

    How to act:

    Like described above shivering is a natural symptom to freezing. You will also have a slow, shallow breathing, feel confused and experience memory loss. Quickly be exhausted and will struggle to talk while you stumble around with a loss of coordination. The pulse will be slow and weak.

     

    Hyperthermia

    Hyperthermia occurs when a person body temperature rises and remains above the normal 37 celsius (98,6 Fahrenheit.) This normally occurs during the heat of summer and is therefore not so common in the cold environment of Chernarous. But if you enjoy fire-RP or ghillies you might have experienced this.

    In hot weather or during activity the body perspires. As this perspiration evaporates from the skin the body is cooled. If challenged by long periods of intense heat, the body may lose its ability to respond efficiently. In other words, hyperthermia occurs when body metabolic heat production or environmental heat load exceeds normal heat loss capacity or when there is impaired heat loss.

    There are different types of hyperthermia where heat stroke is the most severe one. This happens when the body is no longer able to regulate its internal temperature, which is quite dangerous. The body temperature may be over 40,5 celsius (105 Fahrenheit), heat that damages the brain and other organs. Another form of hyperthermia is heat exhaustion where the person experiences weakness, nausea, vomiting, headache, muscle cramps and profuse sweating. Other forms are heat cramps, which are involuntary spasms of large muscle grounds, and heat syncope, which is fainting or lightheadedness. Also, heat rash may occur as a prickly/itchy feeling on the skin with red bumps.

    Spoiler

    What to do:

    If someone is exhibiting signs of heat stroke (symptoms are bellow), treatment should be done immediately. Thermometers that are available in the game can detect low core body temperatures and confirm the diagnoses. Get the victim away from whatever that warms them, take their clothing off and encourage them to lay down in water and rest until they cool down. Make sure they get enough fluids but avoid giving them alcohol and caffeine.

     

    How to act:

    Symptoms of hyperthermia vary after which form you have. Generally, they are muscle cramps, fatigue, dizziness, headache, nausea, vomiting, and weakness. The heartbeat might be stronger and she skin can be reddened, sweating is normal. Confusion and mental changes may develop, and seizures can occur with brain damage. It will end in coma and death if not treated.

     

    Kuru

    Kuru is an extremely rare and fatal nervous system disease. It has similarities with the Creutzfeldt-Jakob disease (CJD) and BSE, and it can spread through cannibalism. 40 years ago kuru killed almost ten percent of a small tribe in New Guinea, where the disease spread because of the people performing cannibalism during funeral rituals. The name kuru translates to shiver or trembling in fear and has no known cure and is generally fatal within one year. You can contract the disease by eating an infected brain or coming into contact with open wounds or sores.

    Malformed proteins known as prions cause Kuru. They make the body's natural proteins change shape and create lumps in the brain where cells die, in Kurus case brain cells. Kuru is a spongiform disease, which cause sponge-like holes in the brain and are fatal.

    Spoiler

    What to do:

    First of all, what not to do! We all know that your character starts laughing and crying randomly after you have eaten human meat, as this is one of the symptoms the game have included. But if you ever encounter someone who shows any of the symptoms listed bellow or just the mood changing, it is VERY IMPORTANT that you don't roleplay out that you know it's Kuru! Except if you have experienced it being linked with cannibals before or is some kind of scientist. Best thing to do when people burst out in tears is to link it with something else they have experienced or told  you to ease their roleplay. Example if they are hurt you can comfort them that the pain will go away etc. If the cannibal is so talented that they roleplay out the rest of the symptoms as well, you are of course allowed to wonder why they are acting so strange.

     

    How to act:

    Kuru is characterised by difficulty walking, swallowing and chewing, slurred speech, moodiness, pain in the legs and arms and a loss of coordination and muscle twitching. And of course, the symptom we see in game; random laughing and crying. Because of difficulties swallowing and chewing starvation might occur.

    It is important to know that if you wish to consume human flesh you have to accept the consequences, therefore, many people who roleplay as cannibals just 'act' like they consume it by writing *eating the flesh* etc. But if you can't help yourself, you need to know how to act. Remember that you most likely don't know what Kuru is, like the others. Even if you know you consumed human meat you might not know that's the reason for you to get these symptoms. Also, when you burst into tears because of the mood changing it is best to also roleplay them out. If you start crying then act sad and find up a reason why, even if it's just your characters mind that is stressed.

     
     

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    Diabetes Mellitus Type 1

    For those of you that don't know, there is 2 types of diabetes mellitus and I'm just going to quickly explain why I'm focusing on type 1. In common for them both is that the person that have this disease will have a high glucose level in their blood because their cells are not able to take it from the blood - which is used as fuel to produce ATP = energy - something that might be a fatal. The reason their cells are not functioning properly is because of insulin / the receptors not doing their job. A type 2 diabetic used to be called "age diabetes" because mostly old people got it, but because of the bad lifestyle, many people have it have now affected younger people. There is a clear link between being overweight and having type 2 diabetes. Where a bad lifestyle over time cause the cells receptors to badly react to insulin, a hormone that tells the cells to take up glucose. Why I'm saying that this type of diabetes is not as important is because with a change of lifestyle (no smoking, healthy diet, activity) that can be enough to prevent the disease from being dangerous. And considering our characters runs around and don't eat much, this will not be so common.

    Type 1 diabetes, on the other hand, is more dangerous. This is a disease that may affect anyone, but most people that get the disease have it before they are 35 years old. This disease shows symptoms quickly and the only way to prevent death is to take insulin, which the patient have to continue doing for their entire life. That's why I'm recommending people to try this disease out on their characters.

    Spoiler

    How to act:

    Type 1 diabetes is a disease with high demands for self-treatment. It's a chronic disease that will never stop that you must take daily responsibility for. Symptoms that show that you might develop diabetes type 1 is a powerful thirst, having to go to the toilet often, an increase or decrease in appetite and weight loss. Since glucose is the only form of energy the brain and red blood cells can use, it is important that the body can turn fatty acids into glucose. This is done with ketoacidosis. Which is a process that produces ketone bodies that will lower the pH of the body and dehydrate the patient even more. This makes the patient's breath smell like acetone, which smells like nail polish remover.

     

    Type 1 diabetics don't produce ANY insulin = 0 glucose, and therefore depend on insulin to be given as medicine. The amount of insulin needed depends on the persons body, activity and diet. To measure the amount a carb-to-insulin ratio is used, where you devide 450 by the total daily dose of insulin. The result is the grams of carbohydrate that are approximatelycovered by 1 unit of insulin. This may sound confusing, but lets say your character takes 30 units a day, then her carb-to-insulin ratio will be 1 unit of insulin for every 15 grams of carbohydrate. In conclusion this means you should use the epipen every time you have a meal and can adjust the dose after what you had to eat.

     

    I recommend using the epinephrine in game as a 'fake insulin', and remember that you can cancel the animation and that you might have to inform ** that it is insulin so people don't comment on it being epinephrine. The first thing you do with the insulin pen is to remove the protective cap, roll it between your hands a few times (don't shake), chose dose, inject it into your lower belly area (some more details + varies from type of pen). If that was not clear enough, here is a video showing you how.

     

    Insulin is a medication that would not be easy to find in an apocolypse. Therefore it would be realistic for a diabetic in-game to deal with high blood by doing activities. Constant high blood sugar over longer periods of time will cause organ failiures, worse eyesight and less sensitivty in feet and hands, which can be roleplayed.

     

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    Methanol Poisoning

    Poisoning is a great way to kill someone and get away with it. Just keep in mind that you will always have to get perma rights from the person if you expect them to die from your "assassination". Also, you are not allowed to poison someone's food or drinks without permission first, even if it does not kill them (unless KOS rights, but I have never seen anyone win a gunfight by sneaking gasoline into someone's water bottles).

    Methanol poisoning is one of the ways you can poison someone from what you can easily find around you in Chernarus. It is difficult to separate between the "harmless" ethanol that people drink at parties and methanol which can be deadly. In many cases, there can also be a mixture of the two types of alcohol. Becuase of these reasons, methanol poisoning is something that is in real life is very common when people try to produce their own alcohol. But you can also find it in industry buildings since it is commonly used as a solvent. It can also be found in ordinary houses in copy machine coloring, car products and in some types of fuel.

    Spoiler

    How to treat it:

    Most medical professions will know how to treat this, so if you are roleplaying a doctor pay attention! If you suspect methanol poisoning you can treat the patient with ethanol. Ethanol will prevent decomposition of methanol to formic acid, a substance that is poisonous to the body since it provides an excess of acid in the body, which can harm eyes, optic nerves and the brain. Ethanol and methanol are broken down by the same enzyme and will therefore compete for the active site. However, the enzymes affinity towards ethanol will be greater, which leads to smaller amounts of methanol to convert into harmful substances. Most of the methanol will instead be excreted in it's original harmless form trough the urine and exhalation.

     

    How to act when poisoned:

    Only shortly after intake, you can feel stomach pain and nausea. However, strong symptoms come late, often 10 to 30 hours after intake when there has been formed enough formic acid to produce symptoms (depends on how concentrated the fluid was with methanol). Symptoms are headache, confusion, nausea, stomach pain, visual disturbances, blurred vision and blind spots, struggle to breathe. If it goes untreated it can lead to coma, unconsciousness, respiratory- and cardiac arrest. Those who survive may have damaged their nervous system or become blind.

     

    [Image: 100px-Methanol-3D-vdW.png]

     

    [Image: 5e20b6ae265d4fa1abb37a8596686a17.png] [Image: f51cb90d561c1c8accc7097bb5734a95.png] [Image: 895b5fbed072dc2a361b15fdebbdc1bf.png]

     

     

    [Image: DWJyo4o.gif]

    "An activity directed at or performed on an individual with the object of improving health, treating disease or injury, or making a diagnosis."

     

    Amputation

    There are many reasons for an amputation to be necessary. The most common are poor circulation because of damage or narrowing of the arteries (peripheral arterial disease). Without adequate blood blow the body's cells can not get the oxygen and nutrients they need to survive. As a result, the affected tissue begins to die and infection may set in. Other reasons to amputate can be because of a severe injury (crushed limbs or serious burns), cancerous tumour in the bone or muscle of the limb, serious infections that do not get better with antibiotics or other treatment, thickening of nerve tissue (neuroma) and frostbite.

    Before going for this procedure, it is important to keep in mind that not only is the procedure even difficult to do properly for the best surgeon in the world during an apocalypse with little equipment, so it would be impossible for someone with no medical experience to do. Also if you decide to get your arm amputated you have to always type *arm is missing* in text chat and probably deal with a lot of questions. You will also most likely only be able to use a pistol as a firearm. If you go as far as amputating your leg, well I guess you can figure out how difficult that will be to roleplay...

    Spoiler

    Procedure

    The procedure of an amputation is not as easy as people think and do require much from the person that is going to do it. An amputation is normally done under general anesthesia (the patient is asleep) or with spinal anesthesia (numbs the body from the waist down). The surgeon that does the work removes all damaged tissue while leaving as much healthy tissue as possible. Before the procedure the surgeon use methods to determine if tissue is rescuable by checking for pulse, compare skin temperatures of the affected limb with those of a healthy limb, looking for redness in the skin and of course checking if the skin near the site is still sensitive to touch (do this before giving spinal anesthesia). During the procedure, the surgeon will remove dead tissue and crushed bones, smoothen uneven areas of bone, seal off blood vessels and nerves and cut and shape muscles so that the stump/end of the limb will be able to have an artificial limb attached to it. After doing this, the surgeon sews the skin together unless there might have to be done more work later.

     

    However, in DayZRP, we don't aalwayshave the equipment to do this properly. The best thing to do then is to give the patient some alcohol (ethanol will make it less painful) and have a few strong people to hold them down as someone else saw their limb off and follow up with using hot metal to burn the veins close so the patient won't bleed to death or get infections as easily.

     

    There is actually a saying between medical staff that as long as the patient is screaming, they are at least not dead.

     

    Recovery

    An amputation usually requires a hospital stay for at least a week, depending on the surgery and complications (which limb it is, extremity and the patient's general health). After the surgery changing the bandages on the wound is important, and lots of painkillers will also be necessary. It can also be smart to take something to help prevent infection. Ideally, the wound should fully heal in about four to eight weeks, but the physical and emotional adjustment to losing a limb can be a long process.

     

    Phantom Limb

    A phantom limb is the sensation that an amputated or missing limb is still attached to the body and is moving appropriately with the other body parts. Approximately 5 - 10 % of individuals with an amputation experience this, and the majority of the sensations are painful. The missing limb often feels shorter and may feel as if it is in a distorted and painful position. Occasionally, the pain can be made worse by stress, anxiety and weather changes (I know, weird right?). The frequency and intensity of attacks usually decline with time.

     

    [Image: 209ebc2041c96d6f14eb02a70bd21015.png] [Image: 647ce45060115e3b401e0783d17b4653.png]

     


     

    [Image: ht0Jx7J.gif]

    To get the roleplaying point of view even more in focus, I wish to interview experienced medical roleplayers to get their opinion on the subject. Asking four relevant questions about common mistakes, difficulties and tips for the rest of us to learn from. If you think that your opinion might fit well into this thread, please sign up for an interview!

     

    Kenji - Kenji Oshiro

    27.12.15

    Spoiler

    What's the most common mistakes roleplayers do when they play out an injury or disease?

    They seem to underestimate the injuries they want to RP out. For instance the effect of a pass through gun shot. Like if you get shot in the arm and is still able to aim a rifle. This image bellow shows a bullet going through ballistics gel. As you can see the cavity is big and will have the same effect of your muscle, damaging your arm so much that using it shortly after would be unrealistic.

     

    [Image: GELS01_Ballistic%20Gelatin.jpg]

     

    What's the most difficult thing about role playing as a doctor?

    Doing on the fly research. You really need a second monitor to do quick searches all the while not letting your Rp drop silent. Secondly is the fact that you can not power game injury. You have to //OOC ask everything. You can not just say oh yeah you have an infection in your arm and I have to amputate. It is up to the player what injury they want. Also what I consider a don`t, is walking around in scrubs all day. You play a doctor, and a doctor would keep the clothes he works on patients with separate and clean and he would have a second set for day to day wear.

     

    Do you have any tips for those who want to roleplay as doctors?

    1. Do your homework. You don`t want to treat someone in a way that would not help. If that person has any medical knowledge he will notice this. People will notice and appreciate a well thought out character / realistic character.

    2. Try to talk while emoting by double tapping caps to keep RP going.

    3. You are not a doctor if you are a medic, nurse or a medicine student. Your character would know this, and the knowledge your character possesses should be acted out accordingly. For instance, my character would know the basics outside his field but nothing more. Example: he could identify different infections and give the appropriate antibiotics, and he could patch up wounds. But injuries that require more advanced treatment he could not do. Like brain damage severe internal injury ect. ect.

     

    Do you have any tips for those who roleplay as patients?

    Know the injury you want to RP out. And Rp out the pain of pulling out a bullet or getting the wound cleaned with alcohol. Because the doctor can not power game your injury, so the guy who is playing the doctor can not say "oh you got shot in the side so you have internal bleeding" since that would be power gaming. It is good for the doctors immersion if the person that wants to RP out an injury did a bit of homework and the RP will be accurate realistic and more enjoyable for all involved.

     

    Jackfish - Jack Fisher

    01.02.16

    Spoiler

    What's the most common mistakes roleplayers do when they play out an injury or disease?

    They act like its nothing. if they got a broken leg and I/someone gives them a morphine they act like nothing happened. In a real situation it wouldn't be that easy.

     

    What's the most difficult thing about role playing as a doctor?

    Being as neutral as possible. I think doctors should help everyone in need (they also signed up for that). Fisher is trying to do that but it isn't easy.

     

    Do you have any tips for those who want to roleplay as doctors?

    Try to get some medical knowledge. Read this thread or read on the internet.

     

    Do you have any tips for those who roleplay as patients?

    Try to roleplay it out more realistically. If you can't do that because you don't want to walk the whole time then do it if there are people around. If people see you act like a patient.

     

    Dr Brandon - Dr Brandon Tallent

    02.02.16

    Spoiler

    What's the most common mistakes roleplayers do when they play out an injury or disease?

    One thing I notice quite a lot is how people react to wounds and disease. I either get someone who is shrugging off gun shots, who's overacting after I make a small incision in the arm, or someone who seems to feel no pain even though they were just shot with a .308 round. OH! And I can't forget the person that is slowly dying of Cholera. That is black and white in there screen with the shakes but can still run and shoot with not trouble at all. Those are my favourite. I can only dream of what kind of super solider training they went through.

     

    What's the most difficult thing about role playing as a doctor?

    I would say the hardest part is being a "Doctor" is people assume you know everything. They assume you can fix everything. When in fact. My doctor character does not know everything. He can't fix everything. He is a man with basic medical understanding. He can't tell you why you have irregular heart beats, he can't tell you if your mental alright. Being the Doctor is hard because there is so much that can go wrong with the human body and it's almost impossible to know every little bit of medical knowledge. That is why it is hard to be a Doctor. There is so much unknown that people expect you to know.

     

    Do you have any tips for those who want to roleplay as doctors?

    First off. Be patient. You're dealing with human beings. Humans are known to be emotional. Especially when their life is on the line. You need to be able to calm patients down and take control of the situation.  Otherwise, you could lose a life.

    Second off. Do a little research. You're a Doctor. People look to you for answers. Unlike my character, you will probably be specialised in something. For instance, Physiatrist specialises in physical medicine and rehabilitation. A cardiologist specialises in diseases of the heart and blood vessels. Do a little research into what that means. Find out how they help people. Be a little prepared. It could come in handy.

     

    Do you have any tips for those who roleplay as patients?

    Same as with the Doctor. Be Patient. Being a Doctor isn't easy. Some of us aren't that fast. I know for a fact I am very slow at typing. Like painfully slow. Oh and secondly. Rp out Injures and Illness out a bit better. Just ask yourself questions. If I was sick in real life. Would I be able to run this far? If I got shot in the arm would I be able to shot as well? If I broke my legs and have a splint on. Would I be able to run that well? Just little questions like that can make your RP go from ok to amazing!

     

    Oh! Side note for everyone. Doctor or not. Have fun with this! This is a roleplaying game. We are meant to have fun!

     

    Pisces - Hope Pisces

    24.05.16

    Spoiler

    What's the most common mistakes roleplayers do when they play out an injury or disease?

    I think sometimes they don't research what makes sense afterward or can affect them mentally or physically in the future.

     

    What's the most difficult thing about role playing as a doctor?

    I feel as if sometimes I do repetitive roleplay that isn't as descriptive so I try pushing myself to be more descriptive or take a lot longer for the medical RP to help the person enjoy it more to show I'm doing my best not to write the same thing over and over and over again.

     

    Do you have any tips for those who want to roleplay as doctors?

    We're generally not going to know everything and don't worry, it's alright. This is a roleplay server, something where you can make things up. Don't do it if you think people are going to judge you for it because you're doing the best to your ability. If you don't know something search the symptoms on google whilst you RP like sometimes I do on my IPod. Doctor's can specialize in a certain thing and I think it's tough when everyone IC thinks you have the capability of knowing everything.

     

    Do you have any tips for those who roleplay as patients?

    I know myself personally and a few RP sessions as my Dr character that people like to make things dramatic. Sometimes though you need to think before you do it and think "Does this actually make sense? If I was shot in the toe would I start to cough blood like it was vomit?" Sometimes it's best to just stick to one injury i.e being shot in the leg can damage tendons and boning in the leg depending where it is located and you will have difficulty to walk properly for a very long time.

     

    [Image: da03ee6a26f583145cad3fd2ecf33859.png] [Image: dbe813d4edd234d68b3e2e7f61290fa2.png]

     

     


     

    [Image: mtgAvgk.gif]

    No matter how many times you read this guide and feel like you are ready for taking the part of being a doctor or patient, you never know what you might face in game. This test will be an attempt to maybe make it a little bit easier for you. Facing you with some of the scenarios that you will soon experience on the servers, but also things that you should know to avoid getting into reports.

    The questions and scenarios will be presented before every spoiler that contains the answer or suggestion to what you could do. Keep in mind that the suggestions are not what you have to do, only a suggestion. You have to do what fits your character and the situation best.

     

    Doctor scenario

    You meet a man asking if anyone knows a doctor, so you claim that you are qualified to perform whatever help he needs. He explains to you that he have been shot in the shoulder and have had no medical treatment since it only happened an hour ago. The man takes his shirt off for you to examine the wound.

    Spoiler
    1. The man has already told you he was shot in the shoulder. What can you do to get more information about his wounds?

    Whenever you examine someone's injuries you should always ask OOCly what you see. The person might have already planned how serious they wish the injury to be, and the worst thing you can do is just sew it up before asking.

     

    2. The man shot has no plans for his wound, he just wanted roleplay and is not able to answer any of your questions. What would you do?

    This is very common. Many people have not searched for the symptoms or effects of their injuries, leaving them clueless what to act out or type back to you when you ask OOCly. The best thing to do now is to roleplay out from the information already given to you. It would be a rule break making the injuries worse than they are since that would be metagaming. Therefore, the best thing you can do is just give him a basic treatment, even if it wouldn't be the amazing medical roleplay that you could have given.

     

    3. The man tells you OOCly that a bullet has punctured his lung, but you have no clue how to fix a punctured lung. How can you still provide good RP?

    This is not even an injury I have written about in this thread. The reason for this is that if I were to write about every injury specifically that everyone has ever roleplayed, this guide would have broken the forums. Instead, you can have an extra monitor next to you where you can google how to treat a punctured lung. Hopefully, the injury is treatable, if not you should check out the next question.

     

    4. The man claims OOCly that he needs you to replace his lungs with animal lungs (something unrealistic). How do you deal with this when you know it's not doable even in real life at a sterile hospital with the best surgeons in the world?

    People love to take medical roleplay as far as they can. Sadly this happens way to often and people get away with it. We can't expect people to know everything about what's realistic to do and not, but you should not encourage it by performing this unrealistic procedure. In this situation, I would suggest explaining to the man IC that you would not be able to do it with the lack of equipment and knowledge and that you think no one else would be able to either.

     

    5. As you are explaining that you can't help, another man comes along and explains that he can do it right now in the middle of nowhere. What can you do in a situation like this?

    It's always difficult playing the realistic doctor that has to be a buzz killer and saying that some things are impossible. The best thing you can do at this point is to try and speak with the other doctor, say that you think it will kill the man to even try. If they don't listen and you think it's bad roleplay, then don't waste your time and stick around.

     

    Death scenario

    You have been in a gunfight and died from being shot in the head because of the game mechanics. However, you don't want to perma your character.

    Spoiler
    1. How do you roleplay this out without breaking the "New Life" rule?

    When being killed, the new life rule says that you are not allowed to remember events that lead up to the death unless the people responsible give you permission. Something that is very common if someone dies by accident or if the people who killed you want to see what your character would do. But sometimes you die in a firefight or to someone who don't wish for you to remember them. That also meaning that you can't remember what happen to you in the first place that made you end up on the coast (where we spawn). People do this differently, but most common are the excuse that you got medical care there or made your way there to avoid danger.

     

    2. The injury is something you wish to roleplay out. How can you explain why you are hurt and still alive?

    Sometimes it's difficult to know where you have been shot/stabbed etc. It would be realistic for you to play some kind of injury. In this case, being shot in the head would realistically be deadly. However, you are allowed to make up an excuse that it only hurt your face, just passed your eardrums knocking you unconscious or hit you somewhere that wouldn't be as deadly. These are also good reasons to why you don't remember the event that leads up to you ending up on the coast.

     

    3. You spawn on the coast and meet someone while you don't have any gear at all. How can you let this not affect the quailty of the roleplay?

    This happens often and the people that meet you know exactly why you have no gear and is running around on the coast. Therefore, most people will be nice to you and not ask any questions that put you in a tricky situation. But if they ask you can make up an excuse. Maybe you don't remember anything that has happened, or maybe you are afraid to be too greedy with things because of past experiences.

     

    Non-immune getting infected scenario

    You are roleplaying a character and you wish for it to be non-immune so you can roleplay dying from getting infected by the virus.

    Spoiler

    1. How can you be alive so long after the outbreak when you are not immune to the virus?

    The virus is very resistant and has wiped out most of the world's population, meaning that its a miracle that you have not yet been infected by it when you are non-immune. However, since it has been allowed to roleplay being a non-immune, you need to come up with a good excuse for you being alive. One good excuse is that you have been keeping yourself away from everyone else, never been in contact with an infected and have always eaten and drank from clean sources since this is possible.

     

    2. You begin to interact with people. How can immune people be a source of infection to you?

    Immune people are not carriers of the virus in a sense that their body fluids will not spread the virus like an infected would. However, it is stated in the lore that the virus can hitchhike on things like water, food and even clothes. So even if the immune person's body is not a source of infection, they can still be a danger to you if they, let's say have been fighting a zombie and gotten their blood spilled over them.

     

    3. It's time for you to roleplay getting infected. What sources can you get infected from?

    There are many ways you can get infected by the virus. Most used is getting scratched or bitten by a zombie. But the virus in its natural form (outside a host) can actually stay alive and be active for a period of days or weeks (depending on the climate). Therefore, you can also get infected by consuming contaminated water and food. The virus can even survive on surfaces, but this is very rare.

     

    4. Regretting infecting yourself, you wish to develop a cure that will save your life. How much time do you have and is this possible?

    After getting infected the lore state that it takes 3 days normally for a person to turn. Many people have roleplayed trying to find a cure, but so far no cures are allowed to work since the game won't stop being a zombie game just because you roleplay finding a cure. If you decide to get infected as a non-immune person you have to go trough with it. The virus has a 100% mortality rate, so when you are infected you will die from it.

     

    Have any scenarios that you would like to share? Any suggestions to solutions you can do if faced with the ones above? Please leave a comment or PM.

     

    [Image: a2603e8e02596dbbc48aa2e1325cc109.png] [Image: 315fb6ef3099288687d05d09c94bf0d3.png] [Image: 14574ca3c6ce0c7d724303aa5b883a6e.png]

    2




    User Feedback


    Chief

    Posted

    This a seriously detailed and informative guide, too bad its kind of out of the way in the guides section :(

    Ill reference this for newcomers that come my way for sure!

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    3 minutes ago, Chief said:

    This a seriously detailed and informative guide, too bad its kind of out of the way in the guides section :(

    Ill reference this for newcomers that come my way for sure!

    1

    Thank you so much, Chief. I guess that's just the new forum. Not much we can do except what you mention. I appreciate it.

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    On 4.1.2017 at 9:08 AM, Nolan said:

    It's a nice guide.

    Thanks, Nolan. I try :$

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