CC Skills Medicine

**Medicine** is the science and practice of establishing the diagnosis, prognosis, treatment, and prevention of disease or correction of injury. As a function of the natural instinct of self-preservation, the study and practice of medicine is a major part of human culture, with a near-endless list of specialties.

## **Medical Skills by Training Level**

Speculation can't hope to list every specialty or sub-specialty, but will list a few common medical professions and the system-relevant sub-skills those professions would employ. For the sake of context, the following list is a rough approximation of distinct certification categories in the United States, with approximations to first responders around the world.

### **First Responder**

* Entry-level professional medical skills, usually the level of metropolitan police. At roughly 60-hours of training, this includes three sub-skills:
	+ First Aid skill rating: 14
	+ CPR+AED skill rating: 10
	+ OpPsych skill rating: 10

### **Emergency Medical Technician**

* Professional medical responders and clinicians, trained to 120+ hours depending on jurisdiction. Assumes control of an incident scene and stabilize the injured or begin assessment of the sick. EMT-B is the minimal level for combat medic classification in the US Armed Forces.
	+ First Aid skill rating: 18
	+ CPR+AED skill rating: 15
	+ OpPsych skill rating: 15

### **Paramedic**

* Professional medical responder, trained in excess of 1,000 hours.
	+ First Aid skill rating: 25
	+ CPR+AED skill rating: 15
	+ Manual Defibrillation skill rating: 28
	+ OpPsych skill rating: 25

### **Nurse**

* A four-year degree, with possibilities of specialization including neonatal, pediatric, adult-gerontology and so on.
	+ First Aid skill rating: 28
	+ CPR+AED skill rating: 15
	+ Manual Defibrillation skill rating: 30
	+ OpPsych skill rating: 20

### **Physician**

* Doctor, General Practice:
	+ First Aid skill rating: 35
	+ CPR+AED skill rating: 15
	+ Manual Defibrillation skill rating: 35
	+ OpPsych skill rating: 18

### **Specialist**

* Could be any of a hundred varieties of highly-trained medical professional, but we're assuming a surgeon here:
	+ First Aid skill rating: 40+
	+ CPR+AED skill rating: 15
	+ Manual Defibrillation skill rating: 35
	+ OpPsych skill rating: 13 (this varies per professional, but many doctors are so accustomed to the controlled environs of a medical facility that they fall apart in the field). A podiatrist would likely be very low on the field OpPsych skill, while a trauma surgeon could be upwards of 30.

## Key operationally-relevant medical skills

Somebody suffering from something would say that the study of that malady is relevant, and we acknowledge that, but for the purposes of this action-based simulation system, we're focusing on a few key skills.

* First Aid. Bleeding out is the major cause of death from traumatic injury and First Responders key skill is the recognize and safe treatment of major bleeds. This ranges from applying a band-aid (skill: 1), to applying a complex splint (skill: 12), to open-heart surgery (skill: 40).
* Cardiopulmonary resuscitation + Automated External Defibrillator (CPR+AED). These devices diagnose a sinus rhythm (electrical heart rate pattern), then automatically calculates the best possible intensity for a charge. Once the skill rating of 15 is reached, that's roughly the max in variations that can be achieved to maximize the efficiency of these live-saving devices.
* Manual external defibrillator. Used in conjunction with an electrocardiogram, which can be separate or built-in, a practitioner first diagnoses the cardiac rhythm and then manually determine the voltage and timing for the electrical shock.
* Operational Psychology, including crowd control and hazard recognition.