Editing Health care

{{Quality|Fine}}

[[File:hospital_preview.png|right]]A '''hospital''' [[location]] allows [[wound]]ed dwarves to rest and receive care and treatment. Hospitals use any [[bed]]s, [[Table]]s, [[traction bench]]es, and [[container]]s that have been built within the zone. The hospital will requisition [[thread]], [[cloth]], [[splint]]s, [[crutch]]es, [[Gypsum plaster|plaster powder]] (for casts), [[bucket]]s, and [[soap]] for medical use. These will be stored within the hospital's containers; you may adjust the desired quantities.

'''Doctors''' are dwarves assigned to any of the four doctoring occupations: [[diagnostician|diagnosis]], [[surgeon|surgery]], [[bone doctor|setting bones]], and doctor, which does all of the above. All doctors in the fortress operate under the instruction of the [[chief medical dwarf]], an appointed [[noble]]. Doctors perform their medical procedures on a dwarf only after treatment has been prescribed by a diagnostician. Doctors do not (yet; one must use [[DFHack]] in the interim) perform any healthcare on animals. Suturing and wound dressing are done by orderlies, but their quality is not impacted by any skills, so having all dwarves assigned to it has no negative effect.

 

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

Hospitals are designated as [[locations]]. Designate any zone except a bedroom in the usual way, then select the Add Location button (plus sign) and select Hospital. Any amount of zones can be added to the hospital in the same way, selecting the existing hospital name instead of clicking "new hospital" at the top of the menu. Select the view location button (magnifying glass) allows you to check the equipment and medical supplies missing/available to your hospital.

* Place enough [[bed]]s in that zone to ensure you can keep all wounded dwarves in the hospital. Dwarves can lie on the ground instead of in beds if none are available, but this is not ideal.

* Place at least one [[table]] ({{Menu icon|b|f|t|sep=-}}) for surgeons to perform surgery on. Adjacency to beds makes it easier to move a patient for surgery. You may perform surgery without tables; it will be messier.

* Place one or more [[traction bench]]es ({{Menu icon|b|f|T|sep=-}}) to handle compound fractures when the dwarf requires "immobilization."

* Place [[container]]s ({{Menu icon|b|f|h|sep=-}}) to store medical supplies reserved for hospital use. Once placed, dwarves will start stocking the hospital with medical supplies, you can track their progress and change storage limits in the zone's 'Set Hospital Information' menu. A small hospital can manage with two containers, while a fully-fledged fortress with an adventurous military may need as many as eight. (Containers are not strictly necessary; doctors can and will use supplies from anywhere, but dedicated hospital containers allow you to earmark some supplies for medical use - for example, to prevent the auto-looming of ''every'' last thread.)

Medical Staff:  

* Assign dwarves to one of the doctoring occupations and they will do them once work details have been updated. You might want to set several dwarves to be dedicated doctors, with diagnosis labor well-covered - 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 who is assigned as a doctor or diagnoser can diagnose dwarves.  Once a patient is diagnosed, you can see on the individual health screen what procedures are needed, for example, washing or suturing. Low-skilled diagnosers may miss syndromes, so if you're having an epidemic of [[forgotten beast|flesh melting extract]], it may be best to only have your best diagnosers on duty.

There are four skilled [[doctor]]ing labors and two unskilled supporting hauling labors involved in healthcare.

| Determines what procedures (of the other four) are necessary. Bad diagnosers might miss [[syndrome|syndromes]] others won't.

| Repair internal organ damage, excise necrotic tissue or serious injuries to muscle, bones. Good surgeons cause less bleeding in their operations.

| Stops serious bleeding. Part of the default '''orderly''' work detail.

| Finalizes closed wounds for healing. Part of the default '''orderly''' work detail.

| Hauls wounded units to the hospital. Part of the default '''orderly''' work detail.

| Gives food/water to patients/prisoners. Part of the default '''orderly''' work detail.

With a chief medical dwarf appointed, you can view your dwarves' health using {{k|w}} for wounds section.  

* '''Bones''' can be set and treated by bone doctors using thread and cloth (for minor fractures), splints and casts, or traction benches, depending on severity. [[Body_token#GRASP|Grasping]] is often impaired during healing. The {{DFtext|Immobilization Request}} status tag is an indication that a splint or plaster cast is required. Multiple overlapping and compound fractures require a surgeon. Typically caused by [[attack_types#Blunt_weapons|blunt]] trauma.

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. The creature that caused the infection will be credited for the kill.

[[File:Hospital information v50.03.png|thumb|In-game hospital information summary]]

It is constructed in the [[mechanic's workshop]], and requires a [[table]], a [[mechanism]], and a [[rope]] or a [[chain]] to construct. The [[quality]] of each component is not reflected in the quality of the traction bench, and only the [[material]] of the table is used as the material for the bench. "Recycling" low-quality, low-value components into high-quality traction benches can provide a modest increase in [[value]]. Note that if any [[Stockpile|stockpiles]] have been linked to "Give" to the workshop, all of the resources needed to construct the traction bench must be found in the linked piles (e.g., linking only a stone stockpile may prevent access to the necessary tables/ropes/chains).

Splints, applied by a bone doctor, immobilize limbs that have sustained bone fractures, allowing them to heal. Dwarves will '''not''' be able to leave the hospital and resume their normal duties until the broken limb is fully healed. {{verify}}

They can be made out of one [[wood]] at the [[carpenter's workshop]] or one metal [[bar]] at the [[metalsmith's forge]] or the [[magma forge]]. Splints are inferior to plaster casts, as while they are easier to obtain and prepare, they do not allow movement while healing (which can take months). Splints are categorized as [[finished goods]].

*[[Bed]]s are used by patients to rest. Placing beds at the corners of a hospital will help ensure the wounded are brought to a tile that has a bed.

* You may wish to consider individual rooms for each bed if you find your doctors are choosing to treat Urist McPaperCut over Urist McBloodFountainTheGushing. A locked door minimizes the mess, and thereby infection and allows you to prioritize. Plus, necrotizing flesh can generate lots of [[miasma]], which a closed door will stop.

* To prevent the usage of adamantine thread, store no thread in hospital settings and instead have a stockpile of non-metal thread in the hospital while additionally having a manager order to make 1 wafer when you have 1 adamantine thread.

Dwarves will prefer to store and use the most expensive thread and cloth – yes, that includes special "[[raw adamantine|exotic]]" strands, which you may want to forbid during medical emergencies.