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Author Topic: Hospitals: Very dangerous and to be avoided at all costs?  (Read 10913 times)

Jacko13

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Hospitals: Very dangerous and to be avoided at all costs?
« on: April 25, 2012, 11:02:52 am »

I am on fortress no 8 at the moment (the others were victims of my failure to grasp the learning curve with DF) and this one has survived several sieges and reached a level of stability were I am not frantically trying to survive by fingernails.  Hence I decided at long last to invest some time and energy in a Hospital.  At long last I have soap, secure water a CMD (Chief Medical Dwarf) and all the other necessary kit. 

Yet I feel like I am losing more dwarfs to injuries than I did without it??  Minor injuries got operated on (by master surgeon as far as I can tell) and then promptly succumbed to infection and death. From a hurt finger no less in the case of my legendary Milita commander!!!! Am tempted to go back to go back to avoiding them like the plague (hospitals that is)...  Am I missing something?
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Corai

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Re: Hospitals: Very dangerous and to be avoided at all costs?
« Reply #1 on: April 25, 2012, 11:04:21 am »

Okay Urist, keep putting the poison in, soon they will be-oh damn they see me.

They likely treat it but dont remove the infected part. Thus the infection stays, I think a full recovery needs 5 doctors with each of the skills.
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CognitiveDissonance

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Re: Hospitals: Very dangerous and to be avoided at all costs?
« Reply #2 on: April 25, 2012, 11:53:38 am »

Hospitals are complicated, but I don't believe they usually make injuries any worse - at worst, they provide a centralized place for your dwarves to die.

They can facilitate recovery from anything, but you pretty much HAVE to have it fully supplied with the following:

- Chief Medical Dwarf, with the Diagnosing skill enabled. For large forts, I suggest disabling all other labours for this dwarf.
- Dwarves with all other healthcare labour options enabled - wound cleaning, suturing, surgery, bone setting. Once more, it's a good idea to have dedicated dwarves for this.

- The hospital needs to have beds, chests/boxes/bags, table(s), traction bench and a source of clean water
- For supplies, you need to have thread, cloth, buckets, splints, crutches, soap and gypsum plaster

Clean water is IMPORTANT - if you are using a well, it has to draw water from a source 2z deep, or a moving water source. If the source is 1z deep still water, it will be stagnant and/or laced with contaminants. In that case, cleaning the dwarves' wounds with this can make it worse.

To check, use (t) to view the components of a well, and examine the bucket. It should contain the water. If it's stagnant or laced with mud (or worse), you need to rebuild the well.

I have had dwarves survive the loss of two limbs and breakage of everything else. (a really unfortunate incident with a giant eagle) That particular dwarf became a farmer :)

EDIT: One thing to be aware of is that hospitals can also be a spread vector for contaminant fluids, such as the stuff produced by certain underground beasts that I forget. Those dwarves, regretfully, should not usually be allowed back into your fortress - unless you have a decontaminating chamber available.
« Last Edit: April 25, 2012, 11:56:51 am by CognitiveDissonance »
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Dekon

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Re: Hospitals: Very dangerous and to be avoided at all costs?
« Reply #3 on: April 25, 2012, 11:58:33 am »

^

Yeah.  OP, if your dwarves are dying like crazy after medical treatment, it's likely because their wounds are being cleaned with stagnant water. There's currently a very serious bug with that that causes stagnant water to be almost impossible to deal with.  If a tile is labeled as stagnant, any water that touches it - and all water touching that - will instantly become stagnant.  Even flowing rivers or oceans. 

This can be fixed with DFhack.  After you start the program, type 'liquids', then 'wclean', then 'block'.  Then, on DF, hit k, and just start going over your entire water system - switching back to DFhack and hitting enter, then back to DF, move the cursor ten spaces or so, then back to DFhack, hit enter, back to DF, etc.

It's time consuming and annoying, but it's the only way to deal with stagnant water.  To clarify, you have to do this with EVERY water tile that shouldn't be stagnant.  In addition, you have to make sure all the walls get it to (the block covers a 16x16 area, and cleans that area).  You also have to make sure to drain any murky pools whose walls are touching your clean water source, as those will always become stagnant again, and if the walls of a murky pool are shared with a freshwater source, the freshwater source will become stagnant as well.

It's a serious, serious, serious pain in the ass.
« Last Edit: April 25, 2012, 12:01:30 pm by Dekon »
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CognitiveDissonance

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Re: Hospitals: Very dangerous and to be avoided at all costs?
« Reply #4 on: April 25, 2012, 12:05:57 pm »

As I posted in the other thread, you can actually fix Stagnant water with some diversion. There is a bug feature right now that water sources can be irreversibly contaminated with "stagnate". You fix this by creating a new cistern (dig it out of the ground fresh) and ensuring that water can ONLY enter it via a pump.
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greycat

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Re: Hospitals: Very dangerous and to be avoided at all costs?
« Reply #5 on: April 25, 2012, 12:20:22 pm »

The CMD does not have to diagnose dwarves.  Really, I don't know how this rumor got started, but it needs to end.  Any diagnostician can perform the diagnosis.  If you want to minimize the time to treatment, make lots of dwarves with the Diagnosis labor enabled.  I like to make 3-4 "doctor dwarves" with all healthcare labors enabled, and hauling disabled.  This generally gives me prompt diagnoses and treatments.  Skill level does not appear to be relevant.  Traits like "enjoys helping others" may be important, however.

Stagnant water in a well is a non-issue for me.  Make soap -- lots of it.  I haven't seen a dwarf die of infection in ages.
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Hyndis

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Re: Hospitals: Very dangerous and to be avoided at all costs?
« Reply #6 on: April 25, 2012, 12:21:42 pm »

As I posted in the other thread, you can actually fix Stagnant water with some diversion. There is a bug feature right now that water sources can be irreversibly contaminated with "stagnate". You fix this by creating a new cistern (dig it out of the ground fresh) and ensuring that water can ONLY enter it via a pump.

Yes, and its the same method you use to make drinkable water from salt water. Work the same way.

Pumps and lined cisterns are wonderful things.
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Soulbourne

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Re: Hospitals: Very dangerous and to be avoided at all costs?
« Reply #7 on: April 26, 2012, 12:46:03 pm »

A question, if my cistern is 1-z level deep in some parts(An old habit from 40d I have is I like to make my cistern an artificial lake cavern), will that mean it will become stagnant/muddy water?  Assuming I carefully drew it from a clean water brook.
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Garath

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Re: Hospitals: Very dangerous and to be avoided at all costs?
« Reply #8 on: April 26, 2012, 01:05:19 pm »

not stagnant but the water will be muddy
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Soulbourne

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Re: Hospitals: Very dangerous and to be avoided at all costs?
« Reply #9 on: April 26, 2012, 01:08:16 pm »

Right, thanks.  And if I draw it from a square multiple levels deep will it be muddy if other areas at 1-z level, or is it only squares that are right on top?  If it's the first, gonna need to get my miners to dig fast while the water slowly streams across the map into my cistern >.>
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i2amroy

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Re: Hospitals: Very dangerous and to be avoided at all costs?
« Reply #10 on: April 26, 2012, 01:09:39 pm »

Actually cleaning with water will never make the chance of a wound being infected worse (unless there is a syndrome causing material in the water potentially). It will always decrease the chance, it's just that if you clean with muddy or stagnant water the amount that it decreases the chance is much smaller. Really the key to keeping your dwarves form being infected is to get some soap in your hospital. Cleaning with soap and water (even muddy or stagnant) reduces the chance of infection by much more then without the soap, extremely reducing the chance of death by infection.
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Jacko13

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Re: Hospitals: Very dangerous and to be avoided at all costs?
« Reply #11 on: April 26, 2012, 01:11:19 pm »

My new well is drawing from two z levels and producing clean water. The same pool was producing dodgy water from a 1z level tile.  Slightly strange but it seems to work.
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Soulbourne

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Re: Hospitals: Very dangerous and to be avoided at all costs?
« Reply #12 on: April 26, 2012, 01:17:57 pm »

Yay for sediment mapping!  *Goes to have a few extra channels dug while the water crosses the map through the underground aqueduct*

Thanks.
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Nonsequitorian

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Re: Hospitals: Very dangerous and to be avoided at all costs?
« Reply #13 on: April 26, 2012, 01:57:22 pm »

I thought this thread was gonna be like one of those over-dramatic news reports. UP NEXT: Are elves sleeping with your wife? STAY TUNED TO FIND OUT!

nightwhips

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Re: Hospitals: Very dangerous and to be avoided at all costs?
« Reply #14 on: April 26, 2012, 02:27:17 pm »

I thought this thread was gonna be like one of those over-dramatic news reports. UP NEXT: Are elves sleeping with your wife? STAY TUNED TO FIND OUT!

IS YOUR MAYOR A VAMPIRE??? We investigate!
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