v0.31:Health care

xTATTEREDx · +FINE+ · *SUPERIOR* · ≡EXCEPTIONAL≡ · ☼MASTERWORK☼

v50.14 · v0.47 · v0.34 · v0.31.25 · v0.28 · v0.23

This article is about an older version of DF.

Hospitals are a Template:L designated via the Template:L. Hospitals use any beds, tables, traction benches, and boxes/bags that are within these zones. You may also alter how much Template:L, Template:L, Template:Ls, Template:Les, Template:L for casts, Template:Ls, and Template:L hospitals use.

Doctors are dwarves assigned to any of the five medical labors; dressing wounds, diagnosis, surgery, setting bones, and suturing. All doctors in the fortress operate under the instruction of the Template:L, an appointed Template:L. Doctors perform medicine on a dwarf only after treatment has been prescribed by a diagnostician. Doctors do not perform any healthcare on animals, despite injured animals "requesting" diagnosis in the Template:L.

All beds within a hospital zone are automatically Hospital beds, where injured dwarves will go to recuperate. Tired healthy dwarves will occasionally camp there too if the hospital is close, even if they have their own bed.

Medical Skills

There are five doctor skills - how critical they are is unclear at the moment, but from Toady's pre-release comments we can assume they are moderately important to the healing process.

Skill (& Profession)

Template:L (Diagnostician) This skill is used at the start of the treatment of every wounded; used a lot and also needed by your chief medical dwarf
Template:L (Wound Dresser) This is also used pretty often; any wound seems to need it
Template:L (Suturer) Fairly common; most open wounds (from cutting) seem to need it?
Template:L (Surgeon) Somewhat less common; amongst others, wounds to organs seem to require it
Template:L (Bone Doctor) This is obviously needed for broken bones, but perhaps not for all?

Non-doctor labors

"Non"-doctors have 2 Template:Ls that contribute to healthcare:

Feed Patients/Prisoners
Recover Wounded

Note that these are not Template:Ls - they do not cause experience gain, but merely are activities that can be turned on/off for each dwarf. By default, all dwarfs start with these labors designated.

Setting up a Hospital

You must have assigned a Chief Medical Dwarf to diagnose patients. Without a diagnosis, patients cannot be treated. If they cannot be treated, they will occupy the hospital area until they die, performing no function. (Any dwarf with the Diagnosis labor enabled can diagnose dwarves, but the Chief Medical Dwarf may impact the diagnosis job creation.)
Ensure your doctors have their respective healthcare labors enabled through v-p-l in order to handle treatments.
Hit i and set up a hospital zone for the area you plan on having your hospital in. Be sure "Hospital" is highlighted.
Place enough beds in that zone to ensure you can keep all wounded dwarves in the hospital, plus a few spare that will be occupied by lazy couch-surfers.
Build at least four containers (b-h) to store hospital supplies.
Build tables (b-t) for surgeons to perform surgery on. You may perform surgery without tables; it will be more messy.
- Place the tables right next to the beds, or you will get "cancels surgery, patient not resting" spam, as moving the sleeping patient more than one square from the bed to the table wakes up the patient [1]
Build one (or more) traction benches to handle compound fractures when the dwarf requires "immobilization."

Broken bones

Broken bones require additional medical peripherals/devices to be properly treated.

Traction Benches

A traction bench is used by a Template:L in a Template:L to immobilize a dwarf that has sustained complex or overlapping fractures.

It is constructed in the Template:L, and requires a Template:L, a Template:L, and a Template:L to construct.

Casts

Casts are made out of Template:L and are used to keep broken bones in their proper place until healed. To store it in a hospital, create a stockpile with furniture/siege ammo enabled, metals allowed (is this needed?), core and total quality all allowed, material plant cloth, and boxes and bags individually selected. Gypsum plaster under "other stones" should also be selected. Applying a cast also requires a bucket and cloth, and a water source.

Plaster powder is produced at a Template:L or Template:L from Template:L, Template:L, Template:L, or Template:L and an empty Template:L by a dwarf with the furnace operator skill enabled. They can also be bought at embark for 3 points per unit, with each unit coming with a free Template:L.

Crutches

Crutches are represented with the symbol ┬ .

A dwarf that needs to use a crutch/crutches will gain experience in the Crutch Walking skill, which Toady has stated will reduce the speed penalty for having to use crutches. Presumably, at legendary, they will move just as fast as without crutches. Testing remains to be seen whether using crutches causes any other penalties that this skill might reduce.

See Also:

Template:L

Infection

Every open wound can become infected. Infections may heal over time, however, many dwarves will die due to infection, often months after the actual wounding

Causes of infection include:

No cleaning of the wounds
Cleaning with water from a stagnant water source
Cleaning without soap
Medical operation from unskilled doctors ^[Verify]
Bad luck

Tips for an Effective Hospital

Regularly use (i-H) to examine your hospital stockpile. Ensure your hospital is well-stocked. If you run out of materials regularly, increase the limits.
It is possible to do without soap in the hospital stockpile. Choosing to do so, however, increases the risk of infection, which most likely will kill your dwarf. Consult the Template:L page to understand that industry. Bring a 2 lye on embark for easy soap.
Put a well inside the hospital for maximum efficiency. Doctors need to wash regularly, and clean water reduces infection.
Do not place chairs next your surgery tables. A chair is an invitation for rat-roast eating freeloaders to block the medical process.
Consider making use of burrows to ensure your healthcare workers stay in the area.
You may wish to consider individual rooms for each bed if you find your doctors are choosing to treat Urist McScratched over Urist McBloodFountainTheGushing. A locked door minimizes the mess and thereby infection and allows you to prioritize.
The Chief Medical Dwarf should be kept unbusy and near the hospital, as no treatment will begin until he has diagnosed them.
- Yes, expecting him to also treat dwarves is a distraction. When you have multiple dwarves needing a diagnosis, the other medical dwarves cannot start work until he has finished.
Create "nurses" by setting dwarves to only use the Recover Wounded, Bring Food and Water labors.
- It is important not to distract doctors from treating patients.
- "Give food" and "Give water" are low priority jobs, so it is entirely possible for a patient to starve to death if no one ever gets "unbusy" enough to bring them food.
- Similarly, it is important not to put your doctors at risk by recovering wounded in the middle of a battle—if they become injured, they cannot treat themselves.
You can select nurses who enjoy helping people to give them good thoughts. This helps prevent dwarves that hate bringing others food from receiving unhappy thoughts for being "forced" to.
Consult the talk page where past bugs are detailed. Healthcare started out with many bugs. Some of those bugs may no longer be valid.

Dwarves will prefer to store and use the most expensive thread and cloth. Yes, that includes adamantine strands. Fortunately, adamantine is not nearly as useful in DF2010 as it used to be; this would have been crippling in 40d.

Bugs

Items linking to a bug on the bug tracker are accurate as of ^v0.31.08. Older bugs should be removed or tagged with the version they were fixed in.

If a dwarf gets stuck in surgery or is never properly treated, you can re-injure them to get the attention of Dwarven Healthcare, e.g. by causing a Template:L. This will cause a new diagnosis to be made and may free the invalid. If he is stuck in a bed, you can sometimes remove the bed the dwarf is resting in to get him to leave the hospital. However, when a dwarf seems to be "stuck" in a bed, they may be resting because of a severe infection, and forcing him or her out into the world will result in them succumbing to it.
Gypsum powder is not stored at the hospital. ^Bug:194
Bone doctors cannot fill buckets to apply plaster casts, instead standing next to the water source holding a bucket indefinitely. If an already-full bucket of water is available somewhere in the fortress, forbidding all empty buckets will allow the cast to be made. ^Bug:2627
Dwarves with healthcare jobs will use the closest supplies to do their work, even if they are not stored in the hospital. ^Bug:287
The hospital allocates as many of a material as possible (enough to fill all chests in the hospital) whenever the material is understocked by any amount. ^Bug:191
The quality and value of a finished traction bench doesn't account for all of the inputs used to make it. ^[Verify]
Dwarves will steal items from the caravan and store them in hospital.
For whatever reason, Dwarves will never, EVER be assigned crutches. No matter what. It doesn't matter what labors are or aren't assigned, where your crutches are or aren't kept, whether they're stored in Template:Ls built in the hospital or in stockpiles placed within the hospital, whether the crutches are masterworks or just tack, or what other injuries the dwarves do or do not have. What this means, in practical gameplay terms, is that a dwarf with a broken leg will recover once the leg is set with gypsum plaster - but a dwarf with motor nerve damage, or a missing limb, will remain a bed-ridden invalid for the rest of their miserable life. No known workaround, save for Template:L.
In some circumstances, patients in surgery will have Recover Wounded jobs scheduled for them, resulting in the surgery being repeatedly interrupted by helpful dwarves moving them from the surgery table to a bed. Coping strategies include disabling Recover Wounded on all dwarves and locking the hospital doors.^Bug:3755