Trauma medical

src/design-proposals/TraumaMed.md

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+# Trauma Med
+
+| Designers | Implemented | GitHub Links |
+|---|---|---|
+| Scrambleking | :x: No | TBD |
+
+
+## Overview
+
+Trauma-Med is a combined forensic and treatment system with a focus on medical care.
+
+The document leans heavily on attrition, medical treatments, and works within our current damage system.
+
+## Background
+
+Cybermed is no longer being developed, we now have nu-body.
+
+This doc is designed to work alongside, but not require, https://github.com/funky-station/docs/pull/114.
+Specifically the "treated" there would be directly connected to the treatment of Traumas here.
+
+This document draws upon sources such as Casualties Unknown, Operation, and some old flashgames for inspiration.
+
+This document does not implement diseases, though it recommends designing areas for such systems to fit in upon implementation.
+
+## Features to be added
+
+### Trauma
+Traumas occur on the instance of a damage. For instance when you are shot with a gun, you gain one bullet wound trauma.
+The trauma persists until "treated".
+These traumas, depending on the source, can also trigger different versions of said trauma requiring separate treatments (bullet passes through, vs hitting an organ vs bullet gets lodged in).
+While afflicted by a trauma, the associated damage cannot be healed by (standard) chemicals, requiring more in-depth medical care to be able to recover the health loss.
+
+Some traumas depending on severity may only partially stop healing (such as a 10 damage injury naturally healing to 5), while some may heal naturally on their own (such as a 1 damage papercut self-healing).
+This is not defined by the severity of the trauma, but by the trauma itself.
+
+Additionally traumas should roll according to the damage dealt after resistances, so the injury to an unarmoured person should be much more severe than a jumpsuit.
+
+#### Un/Defined Traumas
+
+Defined damages are damages that are explicitly defined in what Trauma they may produce in addition to further effects they may have.
+These can be specific to the involved trauma (such as barotrauma), or be categorised under a group of traumas (such as bullet wounds) or another such group.
+There are also undefined Traumas, intended for interactions with systems that have yet to gain their own identified traumas.
+
+##### Categorised/Instance Traumas
+
+Instance traumas involve a scale for how severe of an outcome they may produce based off of the damage given.
+As an example, a gunshot that deals less than 10 damage is more likely to leave a "bullet in" trauma than an antimaterial rifle shot, which might leave a "gaping bullet wound" that is harder to fix than a regular "bullet wound".
+These are tracked separately, and 2 wounds of the same severity (such as a 5 and 10 damage small bullet wound) would require the same level of treatment but each would track how much healing they are blocking separately.
+
+##### Stacking Traumas
+
+Stacking traumas consist of damages such as organ damage, pressure damage, being at a bad temperature for too long and the like.
+These do not require separate treatments as they all count as the same damage source, though with enough severity they may require a more intense method of treatment.
+As an example, being in a slightly too hot room for a moment may only require some ointment, but walking through the burnchamber nude would require surgery and likely advanced chemical treatment.
+
+##### Undefined Traumas
+
+Undefined traumas are a catch all for damage sources that do not define what trauma they may inflict. 
+As an example, if you make an icicle gun and don't define it, it will deal "unidentified piercing trauma" and "Unidentified Cold Trauma" which counts as a stacking trauma source.
+Additionally some damage may only be partially defined for their traumas such as defining the icicle as a "bullet trauma category" but with "unidentified cold" with it, or even a more unique trauma that covers 2 damages.
+
+Of note: Metashielded topics should not be noted past what is within the trauma type, and descriptions of traumas should generally be vague.
+A cosmic cultist sword may cause "A Sword Wound Covered in Frostbite" but it wont cause "A Cosmic Cult Sword Wound" trauma.
+
+##### Secondary Traumas
+
+Secondary traumas are most commonly associated with Organ, bone, or Limb damage.
+These traumas would have a chance to roll both for general damage of a given type (breaking bones with blunt) and for specific Trauma sources (The Bone Breaker Gun TM).
+Secondary Traumas all come with secondary effects, such as a broken bone causing a slowdown in movement, accidentally dropping items, or something else similar.
+
+#### Treated traumas
+
+Treated traumas continue to exist until fully healed, acting as evidence of treatment.
+The treatment of trauma will instantly heal a portion of the damage inflicted from the trauma, though it will still require time, sped up through chemicals, to heal fully.
+
+#### Trauma Timers
+
+Certain traumas may have timers innately on them that worsens the injury with time, or else festers causing the need for additional medical care.
+This is intended to work with a proper disease system, but without the implementation of one it can simply provide poison damage on the wound, requiring cleaning or even more advanced processes to heal.
+
+This system also works to staunch bleeding by having a "fresh" wound bleed as it slowly clots on an individual level.
+
+#### Trauma Locations
+
+Each time a trauma is inflicted it will roll a location between the head, torso, arms, or legs.
+This system will primarily be used in trauma identification as expanded on later, but will also exist to allow for more secondary trauma effects depending on location, and additionally work as a tie-in for future surgical systems.
+
+### Identifying Trauma
+
+Identification of trauma comes in 3 forms, with increasing levels of effort to perform.
+
+1. Basic Inspection
+Basic inspection is essentially what we currently have with the shift-click to see health system, only identifying the surface level wounds when not covered (such as by an EVA suit).
+Each Trauma would have an associated clothing that will cause it to be hidden, such as gloves hiding arm wounds, shoes hiding leg wounds, and shirts hiding torso wounds.
+
+2. Medical Inspection
+Medical inspection opens a proper body-UI via a medical scanner to show injuries in given locations.
+This UI can then be used to determine optimal treatment methods by clicking on wounds listed by location (or visually shown should it prove viable).
+This method of inspection will also hide injuries depending on clothing.
+Using this method should also suggest the possibility of internal trauma, though not explicitly what it is.
+
+3. Advanced Medical Inspection
+Advanced medical inspections can be done via the use of additional tools such as the stethoscope and provide further information on internal trauma.
+
+4. Mechanical Inspection
+Mechanical Inspections are done via a proper scanning machine.
+These take time to proceed and are most often used to identify internal traumas such as damaged organs, lodged bullets or broken bones.
+
+### Treatment
+
+There are 3 stages of treatment implementation intended with this document for treatment.
+With the exception of chemical treatments, each injury must be individually treated.
+As an example, if someone has 3 bullet wounds you should be applying 3 bandages to treat them all.
+
+1. Raw/Topicals
+
+Raw treatment methods heal traumas without the need for surgical intervention.
+Many traumas will be satisfied with this level of treatment, but for heavier or more complicated injuries will require surgical treatment, or even possibly chemical.
+
+2. Surgical
+
+When Raw Treatment is not enough, surgical treatment will be required.
+Surgical treatment involves a larger step by step process that results in additional traumas that must then be further tended to by Raw/Topical methods.
+A barebones implementation would be fairly similar to shitmed in implementation working through a UI menu for specific treatments, but would be intended to work as a Minigame-style surgery system in it's full form.
+
+3. Chemical
+
+Normal use of chemicals within this system hastens recovery post-treatment.
+Some traumas (See Organs, Toxin Damage, Genetic Damage) require chemicals to heal, but these are rare and expensive.
+Exotic style chemicals may be able to treat traumas directly, but these would be prohibitively expensive.
+
+#### Interaction Type
+
+Interaction types are how players will interact with the treatment system in game.
+
+1. Do-after
+
+Do after systems are simple "click button to do things" as they are now.
+Some treatment methods (such as applying ointment) may be left at this degree of healing, while other treatments are planned to be further expanded into "Minigame" treatments.
+
+2. Minigame
+
+Minigame treatment is intended as the final stage of implementation.
+Done entirely through UI this would involve such methods as "pulling glass shards out", "Taking a bullet out of a wound", "Stitching the wound" and "surgical" treatments.
+
+#### Treatment Types
+
+1.  Full Treatment
+
+In the case of a bullet-in injury, a full treatment may require taking out the bullet, staunching the additional bleeding, then applying a bandage.
+This would allow the wound to fully heal over time, though use of better or worse tools may affect the natural healing speed, or if they are bad enough cause damage and/or count as partial treatment.
+
+As an example, using cloth or hand-crafted bandages may inflect "poison" upon the patient, possibly rolling diseases should such a system be implemented.
+
+2.  Partial Treatment
+
+In the case of the same bullet-in injury, you may chose to simply wrap the wound with a bandage, allowing the wound to partially heal from the injury. 
+
+### Organs, Toxin Damadge, Genetic Damadge
+
+With the existence of nubody systems the possibility of organ damage becomes an option for use.
+Generally organ damage will result in the connected system causing continual issues (such as a lung injury causing a growing airloss and speech issues)
+Organ health and organ Trauma should be dealt with the same as body health and body trauma, where they are separate systems that work together.
+In order to repair organ health (before surgical replacements) you utilise chemicals to regenerate the affected organ through cryogenics.
+With the addition of surgery it will primarily be done surgically with replacement organs that themselves come with compatibility trauma, suppressed through chems (though expensive cryogenic cures will still exist).
+
+Additionally "Toxins" (Poison and Radiation) as a damage will affect organs directly, and require Mechanical Inspection in order to identify proper treatment.
+Genetic damage on the other hand will be removed as a damage type and be changed to an effect-only trauma.
+Genetic Trauma will cause continual damage to internal organs until treated through advanced methods, effectively working as a continual cancer/virus within the body to support it being a meta-level punishment.
+
+### Species specific trauma
+Certain species require separate trauma tables from standard species, such as arachnids exoskeleton. 
+Initially implementation with these species may not be as perfect as is ideal, however depending on the species they should be able to roll on an according trauma table as would be appropriate for their physiology.
+In the case of no species specific trauma table however it should always default to a standard table.
+
+In some cases trauma may entirely not function as a system *stares at slimes*.
+These species can initially function with the standard trauma rules, but should be worked with to create a system connected to the trauma tables, even if it involves a blanket table override for each damage type.
+In the case of slimes, having specific chem metabolism with regen and additional hunger requirements may satisfy this.
+They should still roll on tables, but Slime Trauma is likely to look entirely different from every other species.
+
+#### Borgs
+That's right, I'm including borgs in this.
+Borgs, while being relatively simple to repair can also easily be included in this system, and identification only has to be at a surface level.
+Their repair methods will of course not be the same as standard treatment, but there is no reason why a borg beaten by a toolbox should be repaired with a welder. 
+As such they *too* will get their own trauma tables, with such treatment as "banging back the metal" and "replacing sheets".
+The largest difference in treatment is that borg-treatment will immediately heal them instead of requiring additional recovery time.
+
+### Death, CPR, and Airloss
+
+As with the current system, the body must be healed below their death threshold to be revived, requiring CPR to recover that state and assist in fixing traumas associated with Airloss such as "hypoxia".
+
+### Antagonists
+Antagonists still need a way to heal, and existing measures can still be used within the current system, though with some changes.
+
+1. Passive healing sources
+Current passive healing sources such as the BC pylon can still be used to heal trauma, and over the course of healing may automatically reduce the severity of trauma, or eventually completely negate them.
+They do not however "treat" them
+
+2. Active healing sources
+Active healing sources (like if we gave a person a colossus type heal) will have to be balanced on a case by case basis, but until they are they can be assumed to automatically heal everything within the damage range of the heal.
+
+3. Healing Chems
+For Nuclear operatives, syndicate agents, and other non-magical roles, a big source of antag-based healing will come from "advanced interdyne chems" or a similar equivalent which will be able to bypass the majority of trauma treatment.
+
+## Game Design Rationale
+
+Each level of this system is meant to provide more immersion and layers to the world's medical and health systems, slowing down treatment and making it more indepth and engaging to those interacting with it.
+Additionally this system forces combatants to actually heal between engagements instead of slapping 2 bandages on themselves and calling it good, making attrition without proper preparedness to be a far greater issue.
+Lastly it means that people cannot simply ignore injuries, and are far more likely to avoid combat when able to so that they don't have to go to medical for treatment.
+
+## Roundflow & Player interaction
+
+Over the course of a round this will create a *vastly* more complete triage system within the game, encouraging the proper use of medical supplies creating a more noticeable gameplay loop than just "oh yea bandage me so I can run right back in."
+
+Ideally this results in the following styles of interaction:
+1. A gunfight occurs
+A security officer is downed and 2 civilians are hit.
+The officer is bandaged by the paramedic to staunch the bleeding as a priority patient, and given a stabilising medication.
+The civilians are healed if they are in a dangerous situation, if not they head to medical.
+At medical the officer is checked for secondary injuries as they have sustained the most damage
+The Civilians are given a basic once over to see if they have taken any secondary injuries, and are either taken in for better care, or given some chems to heal the remainder of the damage.
+The Officer having bullets lodged in themselves has to have them removed, along with having to be given some chemicals to deal with minor organ damage as they leave.
+They spend some time recovering in the ward before heading back out.
+
+2. 
+The syndicate heads to mains to heal themselves after the fight.
+After getting to a quiet room they lather on some ointment on their burns, it's not perfect but it'll let them hide the pain and start healing.
+They then wear additional clothing to hide their injuries and identity as they head back to work, pretending like nothing happened.
+
+## Administrative & Server Rule Impact (if applicable)
+
+This is likely to have an effect on powergaming rulings around med-huds becoming much more strict as it becomes possible to hide your wounds through clothing.
+Additionally a general look at powergaming around randomly holding topicals will need to be reviewed.
+
+# Technical Considerations
+
+There are many technical and performance issues with this implementation as it is wide reaching.
+First is the implementation of a damage handling system that works between the entity taking damage and the actual health of the entity itself, along with the timer systems inherent in that.
+Trauma itself could probably be handled through Components given to entities accordingly, but would then require the ability to stack components accordingly.
+The UI need is vast, even if the current scanner UI is mostly re-used a full implementation would require much more effort than the current system, especially if you include "treatment minigames".
+Prediction in the system will also have to be accounted for, perhaps using an RNG for each character that is initialised on spawn, and synched with client whenever the body is inhabited.
+
+