v0.31 Talk:Health care

Bugs fixed in the current version

Just because it was true a version ago doesn't mean it's true now. Here are some bygone issues of Dwarven Healthcare:

~~People have reported mixed results with bandaging wounds.~~ Fix listed: ^v0.31.04 ^Bug:474.
~~Surgery will never complete if the Surgeon cannot lift his patient.~~ Fix listed: ^v0.31.07 ^Bug:318.
~~Patients requiring traction benches will never use them.~~ Fix listed: ^v0.31.07 ^Bug:1244.
~~Some wounds may heal before treatment, preventing the surgery job from completing, making your dwarf invalid forever.~~ Fix listed: ^v0.31.04 ^Bug:168.
~~Traction bench is broken.~~ Fix listed: ^v0.31.08 ^Bug:1244.
~~Bone setting is broken.~~ Fix listed: ^v0.31.08 ^Bug:1244.
~~Wounded dwarves in hospital but not in beds die of thirst~~ Fix listed: ^v0.31.08 ^Bug:1035.
~~Bone doctors cannot fill buckets to apply plaster casts, instead standing next to the water source holding a bucket indefinitely.~~ "Fix listed: ^v0.31.19 ^Bug:2627 ".

Rest to death

Be aware that once you have a hospital zone defined - all your injured dwarves will immediately run there at top speed and start to "Rest" there. "Rest" job can not be interrupted by any other job because a resting dwarf gains "unconscious" state. If you have no uninjured dwarves to bring food and water all patients will eventually get thirsty and dehydrate to death. Insanity breaks the "rest" job and the mad dwarf will wake up and wander around but it isn't helping.

If all your dwarves are injured to some extent - don't designate hospital zones.

Not sure if this is still an issue. But if it is, a workaround I've used in the past is to deconstruct the bed the Unconscious dwarf is on. This will wake them up and hopefully convince them to go seek food/drink.--EvilGrin 20:06, 4 August 2010 (UTC)

You can also use the zone remover to remove the hospital. Hopefully the dwarfs will wake up and go get themselves a drink. This is a way to run a part-time hospital if you have no water supply at all. 220.253.87.249 08:53, 31 December 2010 (UTC) someguy

Starving to death in the hospital?

I had a few injured dwarves; they ended up starving to death in the hospital while a surgeon tried to perform surgery. Do I need to put food stockpiles in the hospital? Does it need a well? --Bombcar 16:46, 3 April 2010 (UTC)

Were all your other dwarves busy? As "bring food/water to injured" is like a well job and will only occur when no other order is deemed more important.Kenji 03 11:24, 5 April 2010 (UTC)

There was a bug. See "Wounded dwarves in hospital but not in beds die of thirst" at ^Bug:1035. The dwarves were dying because without a "Bed" they were not hitting the "Rest" state and the dwarves were never brought food.--Falldog 01:42, 8 July 2010 (UTC)

Splints, crutches and buckets no longer stored

I had a hospital zone with everything stored but plaster. I removed all the containers and took away the hospital zone. Then I made the zone again, put all the containers back. Those three items didn't come back. I replaced the hospital zone and it's still not stocking them again. Richards 12:16, 13 July 2010 (UTC)

Nearby pond/pool of water

I think it's very important to make note that a pond or pool be located inside or at least in a room adjacent to the hospital. See my user page if you want details, but the basics is that doctors (and possibly other dwarves) will run to the nearest water source to clean an injured/resting dwarf if they're dirty/muddy/bloody/whatever. The problem is both sieges and distance. During a siege, your doctor's going to get killed, plain and simple. Yeah, other dwarves will get killed bringing water to dwarves, too, so it's important anyway. Another thing is distance. Say you have a bloody dwarf with a badly dented chest, and another dwarf with a mangled, broken head gushing blood. For whatever reason, your doctor decides to diagnose Urist McDentedChest first. The next course of action is cleaning. Your doctor then grabs the nearest bucket from your hospital coffers, runs up the stairs to the nearest murky pool, brook, or river and halfway back to the fortress gate, UristMcGushingBloodOutHisHeadHemorrhage bleeds to death.

On another note, dwarves do seem to clot very well now compared to old 40d. UristMcGushingHead in my fort has stopped bleeding, and even gone from extreme pain to faint to pale, and now he's back to only fainting, but if you go into battle with multiple wounded dwarves, you're going to have your doctors making multiple runs outside. Inside water needs to be made an important point. With the irrigation technique required at the moment, it shouldn't be too hard to explain since a similar technique is used. --Ryun 21:51, 3 April 2010 (UTC)

        Would a well suffice?

It should, but I have not yet gotten to the point of making a well so I can't say I've tested it. With the abundance of underground pools, it shouldn't be difficult to make. I had suggested a pool initially because they would be easy to set up (except a little difficult to get full) for a new fort. I assume they should, anyhow. Once I bend my head around the technique of getting down to those pools multiple z-levels below, I'll test it.

After several stupid mining errors ("Let's use the channel ramps to mine instead of digging out the topmost staircase and get stuck forever!") it appears that wells do indeed work for supplying dwarves water. However, I would like a recommendation that the hospital is put on the z-level as closest as possible to an underground pool if that is the water source. Dwarves take a fairly long time to get water when the distance the bucket must travel exceeds greater than 3 z-levels. Prep with multiple wells as well, of course, especially if you must place the well a long distance from the water source.--Ryun 22:03, 13 April 2010 (UTC)

I chose to run stream water down to my hospital. I channeled out a cistern one level deeper than the hospital level, connected diagonally to a shaft that ran to the stream. The diagonal connection kills the water pressure. I crossed my fingers, channeled out the last tile connecting the shaft to the stream, and it worked perfectly, so I permitted use of the door to the cistern. (I've not flooded a fort since the Second Magma Incident of 2007.)
—0x517A5D 06:11, 18 April 2010 (UTC)

A well works fine. Sadly my dwarves don't use my bewdiful balineae right across from the hospital to fill buckets. Maybe because of all the soap in the water. (Okay, I'll be honest, never seen a dwarf with soap there, but they do get nice thoughts from 'having a bath') --Old Ancient 20:27, 18 April 2010 (UTC)

A well works for cleaning patients and giving them water, but if Urist McBonedoctor needs water for plaster casts, he'll stand by the well with an empty bucket and do nothing. This happened in v0.31.10 at a well inside the hospital and at a well outside the hospital.

My well goes 14 z-levels down, but channeling a single tile to designate pond keeps it filled. It does get contaminated with mud, but no patients have died of infections. Every dwarf in the upper fort still uses it to get clean, and gets a happy bath thought.Uzu Bash 13:30, 13 October 2010 (UTC)

Traction bench bug?

My medical dwarves seem unable to move patients onto the traction bench. I've seen mine spend most of a year on "Place In Traction", standing over the victim, not accomplishing anything. --DarthCloakedDwarf 05:09, 18 April 2010 (UTC)

I cannot confirm, for I have not even seen any of my hospital workers (with surgery enabled) use the things, and all the wounded recover just fine, regardless. --Bronzebeard 00:11, 1 May 2010 (UTC)

i had the same "place on traction bench" problem; my doctor was stood over the patient for what seemed like an eternity with that job description, but nothing was happening. as he started to starve himself, i removed the traction bench and he went to get some grub. i then tried the bench in a different position (away from any walls), but that didnt work either; had the same job, both in the same positions, but nothing was happening... i've ended up just scrapping the traction bench altogether, and have had no problems since :]--DJ Devil 02:20, 1 June 2010 (UTC)

If playing on a Save made prior to .08 remove every traction bench and every table, everywhere on the map. This will remove the medical dwarves from the stalled loop that happens when they are unable to lift a patient and carry him to surgery. As of .08, the surgeons will be able to carry new patients if they are not already stuck in the loop. --Falldog 04:28, 21 June 2010 (UTC)

* Dwarves without a depot will steal hospital items and store them once a trade caravan arrives.

what does this mean?

I guess it refers to the more general bug of dwarves not respecting property of caravans in some situations; supposedly they will steal food and booze if there's none in the fortress piles and they r hungry. So in this case they try to fulfill the thread, cloth and so on requests, ordered in the hospital H menu. Haven't encountered this myself though. --92.202.18.240 20:33, 27 April 2010 (UTC)

I've seen it happen with dwarves who do have a valid depot. As soon as I opened the gates to let the caravan in, they stole everything the hospital needed from the caravan. 64.255.180.66 02:23, 5 August 2010 (UTC)

Surgery bugged?

It worked fine for me: it took a heckuva long time because my surgeon was incompetent; several surgery jobs and some ancillary damage later, rediagnosis - no more surgery required! So it looks like a bad surgeon will take lots of attempts to get there but will eventually succeed. soundandfury 22:55, 5 May 2010 (UTC)

Surgery Workaround Suggestions

if a dwarf is left lying on a table due to interrupted surgery, and is not 'resting' (i.e. is hungry or thirsty) but has not been moved back to bed, it may be necessary to destroy the bed the dwarf had been resting in. This will cause someone to recover him to a new hospital bed.

if a doctor keeps attempting surgery on a table then moving the patient without doing anything, remove ALL tables and force the surgery in a bed, seems to be an issue with the Surgery Cancelled: Patient is Not Resting – unsigned comment by 27.33.150.75

Hospital beds

I had a soldier who required suturing and since suturing is bugged, he never healed. Despite doing his duty and fighting, he kept returning to the hospital, showing rest instead of sleep, racking up bad thoughts from not being in his room and bed and possibly didn't even eat or drink, only getting what others brought him. So I thought, meh, remove the beds. this made him sleep on the floor in the hospital. So eventually I removed the hospital and in no time he is back to ecstatic, sleeping in his room, eating in the hall, making new friends, taking a bath. His wound and the suture and dressing requests are still there and are performed (to no avail) in his room.

My recommendation for now (31.04 should fix some hospital bugs): Don't have a hospital and first check if doctors work fine without it. --92.202.10.116

'Clean Patient'

What labour relates to this? ..awh, he just died of infection.. but for future use, does anyone know? is it an automatic part of the diagnosis progress, done by the diagnostician? is it done by anyone with a healthcare skill? and can we have the answer on the page, please?--DJ Devil 19:40, 26 May 2010 (UTC)

It makes sense that wound dressing wound be part of this, but you'd have to check, it might just be cleaning skill. Ya need soap btw. 71.134.230.146 04:55, 31 May 2010 (UTC)

'need' is such a false word. it's not 'need'-ed. it just helps fight infection, so i'm told. i still havent made any, though :p nor plan on it. ^-^ and i think it's part of the diagnosis progress, but i've not had much injury of late, and i only have one specialized doctor with all the relative labours enabled, so my guess is as good as anyone's ^-^ i shall change some labours during the next megabeast attack and try to pin it to one of them (or all of them?)--DJ Devil 02:27, 1 June 2010 (UTC)

It's not part of diagnosis, because I just saw it done by a dwarf set to do all the other healthcare jobs. It appeared to be done with just soap. There might have been a bucket of water involved, couldn't quite see. 81.131.64.136 20:48, 1 May 2011 (UTC)

Two dwarves in one bed?

I was trying to ignore all the injured dwarves in my fortress for awhile, but it wasn't doing to well for me, so i opened a hospital. then 2 dwarves immediately went (as patients)and started resting in the same bed. what the deuce? – unsigned comment by Dudemcman

At a loose guess, they both detected the same bed at the same time, and didn't detect each other heading for it.

Were the two dwarves married to each other, or romantically involved? 21:37, 2 August 2010 (UTC)

--DeMatt 19:11, 3 June 2010 (UTC)

Bug: overlapping office with hospital zone prevents bag/chest filling

I had a hospital zone with 10 chests, and my dwarves would not put anything in them- cloth, thread, splints, etc. This was because my Chief Medical Dwarf's office overlapped the hospital. Once I deconstructed his office chair, dwarves came to fill the hospital chests with supplies.--208.81.12.34 14:03, 3 June 2010 (UTC)

Worth noting that this shouldn't come up too often, since the CMD doesn't require an office (although yes, I realize in early forts it's common for one dwarf to take many if not most of the noble positions, so a CMD might need an office for another position. Still, better to build it away from the hospital from day one, since the bookkeeper or manager's desk will probably be handed over to the first migrant with higher admin skills anyway) 218.186.8.234 08:08, 12 September 2011 (UTC)

Single hospital versus multiple hospitals

So... after I've gotten the hang of actually building a hospital, I've been wondering. Can multiple dwarves work in the same hospital simultaneously, so you can store all the supplies in one central location? Or is it better for efficiency to have several small but fully-equipped hospitals, so that each hospital can have a doctor working in it? --DeMatt 19:14, 3 June 2010 (UTC)

Well, after watching two dwarves get simultaneously patched up in the same mini-hospital (ignoring the others), I'm fairly sure that multiple hospitals offer no benefit over singletons. Besides being able to locate them in different spots, that is. --DeMatt 23:46, 6 June 2010 (UTC)

Which medical skills affect outcome?

Do we know whether skill levels at wound dressing, suturing, surgery, etc. affect the chance of a successful outcome? The articles on these skills didn't mention. I think I remember Toady's devlog talking about dabbling surgeons being bad at surgery? -- Creidieki 15:59, 16 June 2010 (UTC)

Whats the deal with rot?

In the latest version .10 I've been pretty satisfied with healthcare; seems far more efficient and I even saw a cast get applied once (still won't show up in hospital information though); however, my surgeons seem incapable of dealing with rot. One of my militia commanders has a rotten lower arm from a forgotten beast attack, and every time my accomplished surgeon performs surgery he then "excises rotten tissue"; and when that is completed I can see what was listed as "advanced rot" is now "minor rot". However the wounded dwarf then requires another diagnosis and while my surgeon continues surgery the rot advances to moderate then back to advanced. At which point the surgeon excises rotten tissue and the loops begins anew. I thought it kinda useful for training up my surgeon, but really wtf is going on? Looks like I have to wall off another hospital patient so they can die suffering and save my doctors time and all my supplies of soap (they re-clean the patient after every tissue excision).

How do I get rot off of my adventurer?

The same way you perform surgery on yourself in the real world. You don't. --TomiTapio 14:18, 5 August 2010 (UTC)

That may be true for dwarf fortress, but hardly the real world: http://en.wikipedia.org/wiki/Leonid_Rogozov#Antarctic_service --213.103.212.251 23:19, 10 August 2011 (UTC)

How do I get my doctor to apply a cast?

If your doctor is stuck trying to fill a bucket with water while applying cast you can use the following workaround.

Create a pond zone
Allow a dwarf to fill a bucket with water
Forbid the filled bucket and remove the pond
Claim the bucket
Forbid and reclaim the bucket the doctor is using

The doctor should now return the cloth and plaster to a stockpile and restart the apply cast job; this time using the bucket filled with water. Tested in v0.31.12. --Kaustic 13:13, 12 August 2010 (UTC)

Slightly different method

Almost the same as above.

Make the pit two tiles deep.
Build a well on top of the pit.
Make a pump continuously pump 7/7 water from the lower tile of the pit into the upper part of the pit. (waterwheel + pump = perpetual motion) NOTE: not strictly needed, a constant water input and a constant drain will suffice in any way, but that's the easiest one.
Once every few minutes, the water level will drop below 7/7 and a dwarf will be assigned to "fill pond" before the water level returns to 7/7. The dwarf will take a bucket of water to the well, and drop it, since the well is already full.
IF this bucket is the nearest bucket available to the hospital, the next time the bone doctor requires one, he will take this one.
ELSE you will still have to forbid the bone doctor's empty bucket.

Critical points:

It is currently unclear what factors in the chance of getting a dwarf to fill the invalid pond. For me it happens once every few minutes, which is not enough when you have many broken dwarves.

Easier method

If the health of the injured dwarf can afford it follow this steps:

Look for the dwarf that need the cast applied. Make sure it is the one the doctor is filling the bucket for.
Remove his bed.
Profit

The medic will turn his back on this job and move on. Risky if your dwarf is in the brink of death but worth it.

Infection can be healed

Should it be mentioned in the article that infected wounds can actually heal? One of my dwarves had both upper legs broken and smashed open. They became infected short time later. After a quarter year, the infections vanished. --Blur 21:31, 14 August 2010 (UTC)

I too can confirm that I have had a dwarf heal from infected wounds. This dwarf had 2 smashed bones which were cleaned with water then set, and about a month after he got out of bed he was completely healed. UberNube 13:29, 23 August 2010 (UTC)

"Forbidden" Bolts not being removed from injured dwarves bodies?

OK, please forgive me for asking what may just be a newb question. I just realized (after 2 game years) that one of my axedwarfs wasn't healing because the bolts that had shot him were never removed because, apparently, they were forbidden thanks to the default forbidding of ammo after it has been shot. Is this a new phenomenon, or just something I never thought of before... --98.185.254.172 00:13, 18 August 2010 (UTC)

It was like that in 40d as well. The typical solution is to go into the dwarf's inventory, and un-forbid the bolt and mark it for Dumping. Someone should come along to dump the bolt then (assuming you have an active dump zone somewhere, and the refuse labors enabled), which will allow the wound to properly heal.

Bit too expensive sutures?

After a heated battle with a forgotten beast, one of my dwarves got wounded perhaps everywhere in his body. Checking his treatment history, I noticed that the doctors were using ADAMANTITE sutures. I'd rather go for some less-important material, so is there any way to select what kind of sutures are used? --Aavemursu

I think if you put the container with the casts on a stockpile you can view the contents and then dump the adamantine casts. Not a pretty fix but it should work.--71.59.132.217 14:55, 2 September 2010 (UTC)

medical officer

The chief isn't the only one who can diagnose for treatment, I have two other doctors with diagnosis job enabled, and they seem to screw off less often so they tend to be the ones to do it. It looks like the position only enables the health overview in z-menus. Uzu Bash 03:21, 13 October 2010 (UTC)

Order of medicine

I've finally had my first injury in v0.31, after about 5 years: a broken foot, and a broken rib. The diagnosis set up requirements for suture, bone setting, wound dressing and immobilization, so I made sure all the appropriate doctors were on call for the job.

It appears that the jobs are scheduled strictly in the order they appear in the health screen, from left to right: suture, then bone-setting, then wound dressing (twice), then the plaster cast. Now that all those jobs are done, I guess someone will eventually get around to addressing the infection that set in during all that. Jobs to give water and food were interspersed as needed, and I suspect the medical jobs were deferred at those times.

If others can confirm this strict order, I think it'd be useful info for the article. Hv 09:00, 19 October 2010 (UTC)

My Chief Medical Dwarf seems to have a bit of trouble with prioritization. A group of dwarves got ambushed by some goblin archers a while back. I managed to run them off and haul my dead, dying, and wounded dwarves to the morgue and hospital. I only had one doctor at the time, and he took the better part of a year fixing this one guy who got his legs torn up by the arrows. Funny thing was, Urist McBloodfountain in the adjacent bed had been SHOT in the HEART. Checking his screen would bring up, "Heart has been broken and is gouting Urist McBloodfountains blood" meaning that I wasn't mistaken. He still had the silver arrow in his upper chest, too. I guess my elite emergency medical team managed to drag his sieve of a body back to the hospital before he bleed out in the field, and being in bed at the hospital prevents bleeding out from older wounds. ANYWAYS, is there a way to increase prioritization for medical treatment, and does bleeding really stop in the hospital, or was mine a fluke?

Which medical skills produce better results when higher?

For example

Diagnosis (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
Wound Dressing (Wound Dresser) This is also used pretty often; any wound seems to need it
Suturing (Suturer) Fairly common; most open wounds (from cutting) seem to need it?
Surgery (Surgeon) Somewhat less common; amongst others, wounds to organs seem to require it
Setting Bones (Bone Doctor) This is obviously needed for broken bones, but perhaps not for all?

Does a higher diagnosis skill affect the actual diagnosis? Or speed of it? What does a higher wound dressing skill do? And so on. If you're making a starting dwarf a doctor, what skills does he actually need? Is he just as effective if he's a novice in all skills?--Richards 03:26, 25 November 2010 (UTC)

Bad surgery skill can kill the patient with additional blood loss. Other skills seem to only affect the speed for now. (A dwarf with 20 medium wounds may very well die waiting for 20 separate successive "suture" jobs and of 5 simultaneously wounded dwarfs 1 will not get diagnosed in time.) My dabbling doctors repaired quite a number of nasty compound fractures and the like with total patient recovery where nerves were not touched. No medical skill can produce a masterwork patient.--Another 14:32, 25 November 2010 (UTC)

Can you run a hospital with no water?

Can you run a hospital with no water? It seems like the dwarfs just go there and die of dehydration. No water, no hospital? – unsigned comment by 220.253.94.158

No water means dwarves can't provide drinks to thirsty invalids (or prisoners). No water means doctors can't clean their patients. No water means doctors can't make casts (not that they realistically CAN right now). So that's correct - no water, no hospital. --DeMatt 02:17, 21 December 2010 (UTC)

Easy cleaning of patients and doctors

Channel out a trench in front of the hospital doors, make it into a pond, and get the dwarfs to fill it to 2/7 or 3/7, but no higher. When somebody drags an injured dwarf into the hospital, the patient is cleaned automatically by being dragged through the trench. This also cleans doctors entering the hospital.

This also helps with the soap bug if you make it so the soap is in the hospital, and the well is outside past a washing trench. A dwarf goes to the hospital to get soap, then cancels washing because she can't reach the area. But the dwarf has already been cleaned by walking through the washing trench, so at least they'll be happy and clean after that.

That would be a trench full of stagnant water, because it's a pond and ponds are automatically stagnant, right? By the way, is it possible to identify water as stagnant or non-stagnant by any means other than waiting for water to be brought to a thirsty patient and looking at the water in the bucket? 81.131.64.136 20:51, 1 May 2011 (UTC)

I suspect it makes no difference whether the water in the trench is stagnant or not. I've never seen a dwarf or animal covered in "stagnant water", only plain water coverings, and nothing else (any blood, etc, coverings drop wherever the water covering occurred) And in any case, it's not a pond, it's (usually) dug stone or dirt. I suspect you're confusing game-map surface ponds (i.e. "murky pools") with designated pond-zones, which is what I believe the OP was referring to when they said "make it into a pond". 218.186.8.234 08:08, 12 September 2011 (UTC)

Surgery interruption

Had my surgeon interrupt his surgery task a couple of times. The cause turned out to be people coming by and pulling the patient off the table with a "Recover Wounded" task.. right out from under the doctor's nose! Turning off the "recover wounded" labor on all the doctors and nurses and locking the hospital doors should solve that problem (uninstalling any tables may also, since it forces the doc to do the surgery with the patient still in bed), but still... all these hospital bugs-easily-surmountable-by-constant-unending-intensive-micromanagement-failing-which-dwarves-die are really starting to annoy me.. version is .31.16. 202.156.10.234 06:35, 18 January 2011 (UTC)

Dwarves resting

I made a hospital and put a few beds in it- And after a few minutes there are 2 pages of dwarves "Resting" even thought i've checked their health problems and theres nothing listed. I tried removing the hospital zone to no avail.... There seems to be one square where a ton of dwarves are sleeping on the floor...