Hands-on Checks
Four checks are not a progress bar. You do them yourself: feel for the pulse, watch the chest, listen with the stethoscope, scan with the ultrasound. What you find is what goes on the chart, count wrong and nothing is recorded.
Pick them in Patient Care like any other tool. The chart hides while a check is open.
💓 Pulse check
No item needed. 3 seconds without the minigame.
- Hold the left mouse button and press where the pulse is, the wrist on a patient who is still up, the neck beside the windpipe on one who is down. Move slowly until you feel it beat.
- Tap SPACE with every beat you feel. Keep your fingers where they are.
- Felt nothing? Press N for no pulse.
| You get it right when | |
|---|---|
| Your count is within 20% of the real rate | |
| You press N and there really is no pulse | Start CPR |
Low blood pressure makes the pulse faint and harder to find. A patient in cardiac arrest has no pulse to feel, even with a rhythm on the monitor.
The chart shows the pulse as Normal, Rapid, Slow, Weak, Thready or Absent.
Bystanders use the same check through Check Pulse on a downed player.
😮💨 Airway & breathing
No item needed. 4 seconds without the minigame. Reveals the airway and the breathing rate.
- Tilt the head back with W / S until it is in the sniffing position, and hold it there.
- Watch the chest for 15 seconds and tap SPACE every time it rises. The count is multiplied by four.
- Not breathing? Press N.
Whatever is in the airway is heard as soon as you open it, gurgling (water), stridor (swelling or injury), or blocked. Your breath count may be off by 6 a minute, or a quarter of the rate if that is more.
🩺 Stethoscope
Needs a stethoscope. Reveals lung sounds and heart sounds.
Hold the left mouse button on a spot to listen. There are five: right and left upper, right and left lower, and the heart.
Compare both sides. One side being quiet means nothing until you hear the other. A lung finding needs both sides of the same level, upper or lower.
| You hear | Means |
|---|---|
| Quiet on one side | Collapsed lung, or blood at the base of the lung |
| Silent on one side | Tension pneumothorax |
| Gurgling | Water in the airway |
| Stridor | The airway is swelling or injured |
| Crackles | Fluid in the lungs, pneumonia |
| Wheeze | Asthma, anaphylaxis |
| Muffled heart | Blood around the heart, tamponade |
What you hear makes the injury suspected on the chart, which is enough to treat it. See Trauma & Life Threats.
📡 Ultrasound (FAST)
Needs the ultrasound (Equipment Locker, rank 1+). 6 seconds without the minigame.
Hold the probe on a window and tilt it with A / D until the picture is sharp. Keep it there to save the view. Press ENTER when done.
| Window | Shows |
|---|---|
| Right lung / Left lung | Sliding is normal. Not sliding is a collapsed lung |
| Heart | Fluid round heart is a tamponade |
| Liver / Spleen / Pelvis | Free blood is internal bleeding in the belly |
The result is Positive or Negative. Unlike the stethoscope, the ultrasound confirms what it shows, collapsed lung, tamponade, and internal bleeding in the chest or belly, right there at the roadside.
📟 With a monitor
A patient monitor reads the numbers, heart rate, blood pressure, oxygen, breathing, temperature. Sounds, the airway, pupils, sugar and the pulse by hand still need you.
🟢 Easy mode
Not every department wants minigames.
| Per department | /emsadmin → Staff → Jobs → Easy mode on that job. See Jobs |
| Whole server | Config.UI.minigames = false |
Either way, every check becomes a progress bar and simply reveals everything.
🔊 Sounds
Breath, heart and pulse sounds are generated. To use your own recordings, add them to Config.UI.sounds:
| Name | |
|---|---|
breath_<kind> | clear, diminished, absent, crackles, wheezing, gurgling, stridor |
heart_<kind> | normal, rapid, slow, muffled, none |
pulse | The beat under the fingers |
⚙️ Settings
shared/config/tests.lua → Config.Diagnostics
| Setting | Default | |
|---|---|---|
exams.pulseTolerance | 20 | How far (% of the rate) a counted pulse may be off |
exams.breathTolerance | 6 | How far (breaths a minute) a counted breathing rate may be off |
tools.<id>.exam | - | Which tools are played by hand: pulse, breathing, auscultation, ultrasound |
Trauma & Life Threats
Four injuries kill on a clock: a collapsed lung, blood around the heart, a blocked airway and a broken pelvis. They come on top of the normal injuries, and each one has its own fix.
Treatments
The complete reference for fixing every injury. Treatments are applied to a body part through the patient panel.