How do you handle surgery?

[FraNe91]

Hey guys I have a question for you!

How do you handle surgery?

Let's say the medic makes a surgery skill check on a patient. He either succeeds, but the total HP gained is not enough for one char to get back to its maximum, or he fails and the patient loses char points but not enough to die.
Do you allow another roll? How many?

Last time it happened we rolled for how many hours the medic would resist (we rolled 5) and every our we allows him to roll for surgery.
Within two rolls the medic succeeded in stabilizing the patient. If he had not after 5 rolls, if he wanted to continue he should have done an Endurance check with increased difficulty.
But I see this too easy...

After some thought I came to this:

The medic rolls how many hours he'll spend (and he's allowed to increase the time to get a bonus), and does a single surgery check.
If he does not stabilize the patient, he will roll again for the time spent and will do another skill check.
He can perform without malus as many hours as his Endurance char score, after that he gets a negative DM (-1 for every hour more than his End score?).

What do you think?
What should happen if with the second time roll the total is higher than the medic Endurance?

Otherwise, how do you handle it?

Thanks!

 

[Matt Wilson]

If something changes in the situation, a new approach, new tools available, new help, etc, then it might make sense to make another go of it. But otherwise, the surgery attempt should mean you've done all you can for the patient.

 

[FraNe91]

If something changes in the situation, a new approach, new tools available, new help, etc, then it might make sense to make another go of it. But otherwise, the surgery attempt should mean you've done all you can for the patient.

This would mean, if you go by the book, that the patient is dead for sure. Am I right?

Well, If you thing about how other skills work, that's just right probably... one single try, nothing otherwise.
In this case I think the Medic should probably try to take its time increasing the chance, and asking the aid of other medics (maybe they give him a bonus to the roll equal to their Medic skill).

Would you allow a different Medic to try after the first?

 

[Matt Wilson]

I'm trying to imagine a situation where a medic is trying to revive someone, and another medic is standing near saying, "I'll give it a try if you can't resuscitate her." The second medic should be assisting, not waiting for a turn.

 

[CosmicGamer]

Note: The following is based on 1st edition

I understand where MW is coming from. Allowing multiple tries also might result in something odd like the first surgery not going well because of a poor roll of the dice so someone grabs a nurse "here, you try now".

In real life people do undergo multiple operations for various reasons.

Is there anything in the rules that specifically says that a patient can't undergo multiple surgeries?

"Once one characteristic is back to its maximum level the patient can benefit from medical care."
One could read it as implying a patient may need surgeries until they get one characteristic returned to it's maximum level because only then can the patient benefit from bed rest and regular medical care for recovering.

 

[FraNe91]

Would you allow a different Medic to try after the first?

I'm trying to imagine a situation where a medic is trying to revive someone, and another medic is standing near saying, "I'll give it a try if you can't resuscitate her."

:lol: :mrgreen:

Actually, my idea was more like CosmicGamer's:

In real life people do undergo multiple operations for various reasons.

Is there anything in the rules that specifically says that a patient can't undergo multiple surgeries?

"Once one characteristic is back to its maximum level the patient can benefit from medical care."
One could read it as implying a patient may need surgeries until they get one characteristic returned to it's maximum level because only then can the patient benefit from bed rest and regular medical care for recovering.

About this:

The second medic should be assisting [...]

Maybe a task chain? But who rolls first? The surgeon with highest Medic, and his roll influences the others?
Or maybe they all roll and the sum of their effect is the total effect?

 

[CosmicGamer]

A task chain is essentially the same as summing up the effects of the rolls. From a mechanics standpoint, I don't believe it matters who goes first. Wouldn't the end result be the same? I'd go with what seams right for role playing. However, a task chain could end very badly if both people end up with negative effect.

Personally I'd go with page 49 (1st edition core) situational modifiers and call the surgical assistant a "competent aid" for a +1DM and better chance of getting a positive effect that will help the patient. In support of what I said above, this section says "Characters can choose instead to use riskier task chains to give other characters bigger Dice Modifiers". Possible bigger positive and possible bigger negative

 

[Reynard]

And this is why surgical theaters have a team of 'competent aids' assisting the surgeon making the procedure more successful. Supporting personnel with low skill should always use the competent aid rule but if you have two (or more) people with good skills then task chaining makes more sense. There's no reason two or more qualified professionals can't use their full skills on the same problem especially life threatening situations.

A competent aid should have at least Skill-0 otherwise they should use Task chaining with the -3 penalty for, as you guess, incompetence.

 

[FraNe91]

A task chain is essentially the same as summing up the effects of the rolls.

Not exactly, for example if your fellow Medic rolls 11 (Effect +3) with the task chain you get +1 instead of a plain +3.

if you have two (or more) people with good skills then task chaining makes more sense.

The chances the surgical assistant fumbles the roll are much higher than giving you +2 with a task chain (the required Effect of on his roll is +6), on the contrary if you just choose the situational modifier you get a +1 for free.
Even with a +4 DM the average roll of 2d6+4 is 11, which gives you +1 only on a task chain.
I do not see this a very convenient choice...

 

[ShawnDriscoll]

Hey guys I have a question for you!

How do you handle surgery?

Depends on the surgery that's needed. If there is another character around that is trained, they can "prep" for surgery. What DM they get can be applied to the doctor character's surgery roll. Players that are role-playing such situations well will have all kinds of options they can roll for. No role-playing simple means the players look for a ruling in the book somewhere, and the surgery attempt becomes a binary outcome with not much to work from other than the patient lived/died. If the patient can't recover from surgery, then it was meant to be.

 

[CosmicGamer]

A task chain is essentially the same as summing up the effects of the rolls.

Not exactly, for example if your fellow Medic rolls 11 (Effect +3) with the task chain you get +1 instead of a plain +3.

I don't follow; please elaborate.

 

[FraNe91]

A task chain is essentially the same as summing up the effects of the rolls.

Not exactly, for example if your fellow Medic rolls 11 (Effect +3) with the task chain you get +1 instead of a plain +3.

I don't follow; please elaborate.

In task chains you do not simply use the Effect of the previous roll as a DM to the second.
There is a table (in page 51 of the CRB) where depending on the previous roll Effect you have a different DM to the next one:

Previous Check      New DM
Effect -6 or less   -3
Effect -2 to -5     -2
Effect -1           -1
Effect 0            +0
Effect 1 to 5       +1
Effect 6 or more    +2

As you can see, if the previous roll Effect is between +1 and +5 you only get +1 on the next roll.

This is not the same as using the previous roll Effect as a DM, which is more powerful.

I hope I explained myself better.

 

[CosmicGamer]

Thanks. I'd forgotten about that table since a task chain rarely comes up in our play.

 

[dna]

How i handle Surgery.

1) what is the base line of the patent? (DM on how bad they are and this can change)
2) what is the goal of the surgery ? (DM on what are you trying to do? remove bullet, arrow, spear? or just stabilize the patent to get better medical care? harder = neg DM simple = + DM) Note: doing small steps is easier but takes longer than a skilled surgeon doing the full operation in a hi tech medical suite)
3) situation Modifiers - Are you still in combat? (= neg DM) or are you in a 5 star Tech 15 medical suite (+DM) (high tech doc with low tech tools or low tech doc with high tech tools - neg DM)
4) Task Chain, and good Role playing. - someone using anesthesia machine, or just a bottle of whiskey? task, assistants, ect. (example Human surgeon working on a vargr with a vet tech standing by, Vet tech, who is not skilled in surgery, but knows the physiology and can offer advice and direction to the surgeon, such as "giving Tylenol to dogs is very bad", giving the bonus to the Dr attempting the Surgery.

5) success = goal of #2 has been met, failure by 1 = success, but will still need additional medical care (Patent is stable enough to move and minutes of life has become hours = free retry), Failure = lower base line (patent is not any better and perhaps worse based on situation), critical failure patent is much worse off (your attempt did more harm than good, lower base line and hit points).

6) retries - to retry you must change something, try a simpler goal (change remove bullet to stabilize pt and slow bleeding.), change situation (the ambulance has arrived, or you got the pt to a hospital), change Task chain, (a new lead surgeon has arrived on scene or a low tech medic takes over to stabilize patent with low tech tools. etc)