Emergency Medical Operations

At first glance, it might appear that the Nova class USS Solstice is under-equipped for medical support. While the nominal mission of the medical department is to provide health care for the ship's crew and attached personnel, this is a relatively small task considering the standard long-term crew complement of about a Ninety individuals. However, the Medical department must also be capable of responding to a wide range of medical and emergency situations. These scenarios include emergencies on other spacecraft, planetary disasters, and bacteriologic and other exobiological threats, as well as crises involving nonhumanoid patients.

One of the key provisions for emergency preparedness is the requirement that at least 40% of crew and attached personnel be cross-trained for various secondary assignments including emergency medical, triage, and other disaster response functions. (Other nonmedical support secondary assignments include Engineering and Security duties.) Yellow and Red Alert protocols call for cross-trained personnel with noncritical primary assignments to be available for their secondary assignments as necessary.

Emergency medical facilities are designed to significantly increase the patient-load capacity of the Nova sickbay. Depending on the severity and patient load, different options are available. Large numbers of patients can be handled by emergency conversion of one of the shuttlebays into triage and treatment centers. The main shuttlebay is equipped with five portable emergency hospital modules, which can be set up in the flight deck area, providing up to two triage and surgery wards.

An additional emergency patient care modules can provide up to twenty-five intensive-care beds and 150 medium-care beds. These emergency care facilities are equipped for full biohazard protocol, minimizing exposure risk to Solstice personnel.

Additionally, Shuttlebay includes hardware for shortterm conversion to Class H, K, or L environmental conditions, intended for nonhumanoid populations. Note that the use of shuttlebay facilities for medical service will necessarily impact shuttlecraft launch and recovery operations, a factor that can be significant during evacuation scenarios. For this reason, large-scale evacuation involving shuttlecraft support will generally make use of sickbay and other facilities first, before shuttlebay conversion procedures are invoked.

Fewer numbers of patients can be handled by conversion of other facilities. Quarters on Decks 3 and 4 are convertible to medical intensive-care use, and utility hookups to those compartments include biomedical telemetry links and medical gas connections. The ship's cargo bays, gymnasiums, and other recreational facilities can also be converted to emergency medical use. All of these compartments are stocked with medical conversion kits, which provide necessary hardware and standard medical supplies. Additionally, during noncrisis situations, The Holodeck can be converted to patient care use. While this is a very convenient procedure, it is also very energy-intensive and is not normally employed for long-term care or during alert situations.

Supplementing emergency medical supplies, contingency preparedness scenarios include provisions for large-scale replication of supplies and hardware. Nevertheless, because energy availability for replication may be severely limited during crisis situations, emergency plans are designed to depend primarily upon the use of stored supplies.

A typical emergency situation might be a case where a severe explosion has injured 50 crew members on a starship. The Solstice medical department response might be as follows:

* After the determination of the existence of the emergency situation, the Chief Medical Officer would receive a report from the Main Bridge. The CMO would consult with the Commanding Officer as well as the Security Officer to determine that the accident site is sufficiently safe for Solstice personnel to transport over. Such determination would generally be based on sensor scans of the accident site.
* A survey and triage team would then be transported to the accident site. The CMO would normally lead this team, evaluating the extent of casualties and on-site requirements. Simultaneously, the medical staff on the Solstice would be preparing sickbay and secondary treatment areas for the imminent arrival of patients.
* At the accident site, the triage team would separate patients into one of three categories:
	+ Individuals whose injuries are not immediately life threatening and do not require immediate transport to the ship
	+ Individuals whose injuries are severe enough to require immediate attention but can be successfully treated,
	+ Individuals whose injuries are so severe that they are beyond help.

Individuals in the second category are prioritized for transport to the ship. The triage team does not administer any actual patient care (except for airway management) because to do so would slow triage processing to an unacceptable rate.

The CMO may opt to supplement the on-site triage team with an on-site treatment team, although treatment in a controlled on-ship environment is usually preferred.

Using all personnel transporters aboard the Solstice, a maximum of approximately 300 individuals per hour can be evacuated to the ship. If the number of casualties is relatively small, site-to-site transport can be used to beam the patients directly to the on-board treatment area.

Otherwise, patients are beamed only to the transporter rooms and then shuttled to the treatment area by gurney. This is because site to-site transport effectively halves the capacity of the transporter system.

While on-site triage is underway, conversion of secondary treatment areas would be prepared, using medical conversion kits. For major disasters, hospital and emergency patient care modules can be deployed, providing full-scale surgical and intensive-care facilities. If necessary, these conversions can include complete biohazard protocols.

Once patients are received onboard, treatment teams would include all available medical staff. The medical staff would be supplemented as needed by additional cross-trained personnel from other departments.