Combat Mortality

If modern battlefield medicine and transportation procedures decrease mortality rates to the to under 10 percent, what would that mean of mortality rates in Star Trek for those wounded in combat?

Granted, even in modern warfare, the leathality of weapons are on the increase . . . however, in turn, as with all technology, new technologies or new procedures are created to counter those new technologies and techniques.

In Star Trek you don't see that. Phasers stun, burn, kill, and vaporize . . . same with disruptors. Yet except for the Borg, there has appeared to be no counter to these energy weapons. Furthermore, it appears that (as stated in ICON) Starfleet Martial Arts, is only worth a hill of refried beans.

So where are the advances that continue to decrease the mortality rate for those wounded in battle?

Furthermore, you don't see alot discussed about combat medicine in Star Trek . . . what advances have they created to assist the combat medic/corpsman? Have their operating procedures changed? What effect do these new weapons have in regards to battlefield injuries? What level of ability is the "Combat Lifesaver" capable of in comparison to modern (today) terms?

Or does it all still come down to the basics?

An interesting topic: LUG had a few things (hand held shields and stasis stretchers) that would make for better general battlefield conditions, in theory. I think why you never see much combat medicine in general in Trek, at least NG Trek, is that, according to some sources, the FED isn't in the war business anymore, which is ridiculous, imho. All we ever hear about in NG is recent battles/wars with other powers; so if there is fighting (and don't tell me it's all ship to ship: O'brien was ON Setlik III, not in orbit), there would have to be somethin akin to a MASH/Forward Aid station, and that would also mean medics.

I've been thinking about evac of the wounded. I know transporters would do most of it, but since it seems like just about anything will block a transporter signal, perhaps smaller shuttle craft or some other vehicle may be used.

But, in regards to the basics: I've noticed on NG espcially, some kind of lean toward 'the old ways'. In one scene in an episode, Crusher must instruct a nurse on how to make a splint, since the bone mending device is offline, and in others she prescribes warm milk for sleeplessness (I bet your real DR. would NEVER do that...Lunestra and Amien are waiting for you....), so maybe a SF officer would get the same kind of basic first aid training that we might get.

Actually, the hand-held shield in the ICON TNGPG is just a variant on the shield used in STV:TFF.

For a look at a behind-the lines Fed field hospital, check out the DS9 episodes Nor the Battle to the Strong and The Seige of AR-558.

Although current combat medicine has lowered the mortality rate of wounded combatants, the other half of the equation is that a higher percentage of survivors are terribly maimed and disabled, simply because they would have died of those wounds in earlier wars. I suspect that the mortality rate among wounded personnel extracted from the field of battle will not decrease markedly, but the overall percentage of wounded who reach medical attention will increase. Further those who do survive will be in far better condition, what with medical replicators, regeneration technology and bionic replacement.

I don't know about you, but having experienced loss in the past year, any extra amount of life that one can share with someone who is close to them . . . is better than no time at all.

I wonder, as stated by Tricky, because there are always counter technologies to such miracle advances as anti-grav systems, certain types of power systems (and the networks that relay said power), and molecular level transportation systems . . . I am suprised that one does not find more corpsman/field medics with stretchers, plasma, and medical kits (that consist of more than a medical tricorder, a hypospray, and a dermal regenerator).

So much of life being able to survive boils down to the sheer basics . . . why don't we see more bloodloss control, & IV therapy? I mean, I can understand how most weapons are now energy base, and cause a lot of secondary burn injuries . . . however, that also creates large burn areas which lead to rapid fluid loss. I would imagine that the leathality of weapons, as we have see, have increased tremendously. Yet, as stated before, counters to said weapons, have appeared to be less then forthcoming.

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Originally Posted by JALU3

. . . why don't we see more bloodloss control, & IV therapy?

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'cause it's network TV.

The weapons tech they have in the show is so powerful, that there's really no getting winged they have happen in the show. If you can dump enough energy into a target to vaporize it, even a graze is going to be serious enough to remove limbs, if not still kill the target with secondary spall from their own body.

In our campaign, the injuries are truly horrific -- particularly vaccum exposure, which no show ever does right. And usually fatal. Our latest campaign is set in the 25th Century, where a copy of crewmembers are kept in storage and are reinstantiated on death (unless they have a do not rescusitate clause in their will.)

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Originally Posted by black campbellq

Our latest campaign is set in the 25th Century, where a copy of crewmembers are kept in storage and are reinstantiated on death (unless they have a do not rescusitate clause in their will.)

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I have a question about that . . . then what about the Soul? Does the soul gravitate to that copy of the original . . . or is the soul only the sum total of the proteins which are found on memory cells?

As far as I can see, there is no soul.

Sadly, there it is. We are utterly alone, and all we have is what society we can make on our own.

Let's hope we make a good one...but I doubt it.

Interesting technology.

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Originally Posted by JALU3

I have a question about that . . . then what about the Soul? Does the soul gravitate to that copy of the original . . . or is the soul only the sum total of the proteins which are found on memory cells?

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That question used to come up over the transporters. The very nature of taking something apart and reassembling it elsewhere means you've killed the person and created a copy.

We've been addressing the soul in the game in the idea that everything has a unique quantum signature, and that it APPEARS that this pattern is also replicated by the transporter.

In our universe, the soul is an idea resisted by machine intelligence (rapidly become a major force in the society.) They consider the pattern unique and special. To them, death is abhorant, if it can be prevented...the loss of a unique pattern of intelligence is an unconscionable loss. With no soul to go on to an afterlife or be reborn, the pattern of individuals is important to preserve. (Our starship HATES the notion of "do not rescusitate." Her crew is too special to be allow to simply become entropic.)

One of the androids is positing the idea that everything and everyone is part of a universal computing cycle, and that death is a necessary element in the universe retrieving the finished calculation. This is not poplar with the machines, but has caused a resurgence in some of the religious systems.

So in your universe the ships are fully sentient, certain holographinc beings are as well, androids are becoming common place, and the interfederation internet is more alive than depicted in the show?

The question of the soul, although not fully a scientific measure, must be a very important topic in theological and philisophical circles even to the late 24th century.

However going back to combat mortality . . . if one knows that there is a way of surviving through a copy of themselves, and that their individual entity, their soul, continues . . . then that definatly changes the rules of the game . . . as far as combat mortality is concerned, wound treatment, etc. . . . might even lead to more sloppy traditional doctors.

"Oh bugger, I messed up.", Says the doctor. An hour later the patient woes life functions ended on the surgery table . . . walks out the door down the corridor last remembering being put under for a surgery. No harm, no foul . . . maybe except for a headache.

But then again, if a soul is an intangible thing . . . it should be able to travel without a steller object to tie itself down to . . . but if it is a tangable thing . . . then it is should be measurable, even if minuetly . . .

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Originally Posted by JALU3

So in your universe the ships are fully sentient, certain holographinc beings are as well, androids are becoming common place, and the interfederation internet is more alive than depicted in the show?

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Thumbnail sketch of machine intelligence issue -- nearly all of the fleet in our newest campaign is sentient. The newer mind-states are commissioned as officers & usually serve as "flight officers." Older ships (the oldest mind-state is Athena, the so-called "Eve of Starships") have reached captaincies, and Athena is a commodore (the rank was reinstated as a field flag rank in the last campaign.) They command themselves and if their spaceframe is decommissioned, they can retire and act as IEVs (Independent Exploration Vessels) or what have you. Most shift to new spaceframes.

There's a definite hierarchy or class-system with the machines ('though they won't admit it...) Planetary minds tend to be mildly schizophrenic, as they are a collective mind of the various city computers, etc. they are haughty, a bit aloof. Starships think of themselves as the ultimate machine intelligences -- they have to interact with biologicals, and their crews are dear to them -- family. They are outclassed in processing power by the planetary minds, but they are more focused and think of themselves as living things. (Never call a starship a "computer"...they take umbrage!)

Androids are the most human. They are designed on whatever race built them, and while most lack biological imperatives (android-human hybrid minds often have those imperatives [like sex drive]), they are driven by the same mimetic capital as people. They're just smart and more resilient. Androids tend to think of themselves as the epitome of robotic technology. Moravecs are androids without human form.

Androids and 'vecs look down on robots. A robot is an automaton with no sense of puropse or self. Don't call an android a robot. It's an insult. Computers are the lowest form of AI to most artilects. They're glorified counting machines. Once they become intelligent and sentient, a computer is a mind. None of the "three laws" BS, either...a sentient being has to have agency. Don't want them to do wrong..? Teach them right and wrong.

Back on topic: even though the characters are backed up at each transport, getting injured and biological nature tend to keep you from purposely putting yourself in harm's way (or would, I would think...most people won't volunteer to be shot, even if there's a doc standing by and you're guaranteed it won't be fatal. Unless I've misread human nature.) So people get dinged up, and doctors are still necessary.

Even without the backup idea, 24th Century medicine might be able to fix a lot, but I think recovery timescales would be much longer than the 42 minutes with commercial...figure if you lose a limb it's either a prosthetic (mostly likely pretty close to "realistic" feeling), or you wait for them to grow one. Probably takes a few days. Healed or not, you'll still feel bumps and bruises, pulled muscles, etc. Just for a shorter time. There would still be stuff you can't fix well, or at all.

For first aid tests, I would think that if you succeed with 23/24th C first aid kits, you pretty much are stable and healing. If a surgical bay is available, unless you're already pretty much a goner, they'll be able to fix you. Without a kit or surgical stuff, it's old school trauma control: stop the bleeding as best you can, pump 'em full of painkillers, get them back to triage. (Our campaign, everyone has a personal area network. The PAN ties you tricorder, communicator, smart uniform, and nanties in the body together. Healing is controlled either by the tricorder [for trauma control], or remotely by the medical staff to perform minor work [like, say, toxin control.])

That's my take.

That would be very interesting to see . . . the slow evolution of computers from being tools . . . to sentience . . . to possible domination, symboisis, equality, or rejection.

A definate multi-campaign sub plot.

In regards to combat medicine. That would be interesting to see.
Defensive systems . . . as it relates to combat medicine.
The smart uniform, the use of nanites, personal defense shields, continuous monitoring, healing assistance through devices.
Much like the never to be fielded Future Warrior . . . there are a lot of networked sensors and uniform and defense systems that have not even be touched by Star Trek.
But then again person to person, in depth, combat and its results are rarely a central issue to the plot line . . . save when it introduces a disability for a character to attempt to overcome . . . otherwise . . . injuries and deaths tend to be plot devicies through lacksidasicly by the writers to modify the scene.

Although it could be seen as a shot and slash campaign . . . a campaign centered around a Federation Ground Force Company (160 or so sized element) . . . with organic medical, support, artillery, transportation, and scientific elements would make for a very interesting campaign. Especially given that most starfleet units are far more multi-mission oriented then their modern counterparts.

Maybe the A Troop 1/7th CAV colors are brought out of the rafters again?

Or even following a Medical Squad attatched to a company sized element . . . part of the support platoon.

Part of the difficulty with combat mortality in TREK is that alot depends on just what settings the weapons are on. In TOS, they had a stun settin that would seem idea for combat for Starfleet troops. As long as the hit incapacitates the foe it should be enough, and mortality would be low.

However, if they were to use "kill" setting, which used to mean no bodies, then medical facilties wouldn't be of much use.

In TNG, and especialy DS9, "kill" setting sort of got downgraded to a burn effect that was similar to a modern pistol or rilfe hit.

Historically, most deaths from battle occured after the battle was over. If I got my history right, soemthing like 90% of the fatalities from battles during the civli war occured after the battles.

Considering how effective mobile hospitals are for us today, with over a 95% survival rate, I would suspect that Starfleet combat hostitlas would probably be able to save over 99% of wounded brought in. But the higher firepower of Trek weapons would mean that more people get killed outright on the battlefield. Probably the opposite of our past, with 90% of the fatalities occuring right on the field.

Yeah, right now fatalities tend to be immediate, with serious injuries and/or limb/function loss as the main problem. 24th C medicine especially would seem to be able to get around a lot of those problems.

That's just it. With modern medicine, if a injury isn't severe enough to kill someone in the first 5-10 minutes, then it probably won't. Once the patient makes it to a trauma team, they will most likely be able tos tablize that patient. THere might be long term problems or even penament loss of some physical abilties, but chances are, if the patient gets treament they will survive.

Since Trek medical tech is much, muc more advanced than our own, it is probably even more effective. With synethic replacements and the ability to regenerate at least some organs (kidneys-perhaps some way to turn on and off specific cromozones to repair damaged or lost organs).

The psychological effects of trauma are another matter. In most cases the injrues will probably be healed long before the emotional effects of the injury pass away. I would think that in some ways, that might be a determint. It might give injuries a sort of nightmare-dream quality.

Not that anyone of this matters if weapons are set to disintergrate.


Based on what we have seen the transporter do, I guess Federation scientists are probably working on restoring a person from thier transporter pattern. It might make a good story for an adventure.

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The psychological effects of trauma are another matter. In most cases the injrues will probably be healed long before the emotional effects of the injury pass away. I would think that in some ways, that might be a determint. It might give injuries a sort of nightmare-dream quality.

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Makes me wonder whether the ability to insert a lot of memories in a short amount of time is a common thing or a technology specific to the species which "ajudicated" MMCS O'Brien on Argrathi. If it is common place, it would assist people in being able to recover from PTSD, and other disorders which often require a long period of counseling in order to resolve it. However, the impact if that procedure going wrong would be a whole other psycological problem all together!:eek:

If I may address the original topic (not that I don't like where this has headed):

(Bear in mind that a lot of what I know about this I learned on the History Channel, or from other sources of similar quality or lack thereof. ;) )
The introduction of the helicpoter completely changed battlefield medicine. Before the Korean War, the triage procedure was that the most badly injured got treated last. It was based on this cold equasion: during the time that doctor spends trying to save this 1 life (and probably failing), he could have been treating (and saving) 5 other men.
I have recently read a Star Trek novel where the ship's doctor makes a similar triage call: as the ship is still in combat, medical priority went to those who could be treated quickly and then return to duty, so that they might help save the ship.

The needs of the many outweigh the needs of the few. Or the one.

From what we've seen of Starfleet medicine, their survival rate is probably way above 90%: it seems like if you aren't killed instantly, you're just a beam-out away from being 100% - sickbay can fix nearly anything. The only times sickbay has had a problem, it was plot-driven (Worf's broken spine, Picard's heart).
But, as you point out, transporters can be blocked, either by natural phenomena or by hostile forces. Starfleet must have some pretty good field medicine as well.


One thing that recently occurred to me as curiously absent: armor. Now I know that the rationale is that against phasers armor wouldn't do much good: if it can disintegrate a person, it can probably disintegrate an armored person too. ;)
But the traditional role of personal armor on the battlefield isn't to protect against direct hits, it's to protect against near misses. At least the pre-Iraq stuff we gave our troops was theoretically to protect them from shrapnel from artillery, not from small arms fire. And we've seen plenty of cases where somebody got hurt by a piece of wall from a phaser shot that missed them.
Further, look at special forces operators like the "delta" guys in Blackhawk Down. They don't wear "armor" because it's heavy, encumbering, and not very useful against what they'll face. BUT, they wear streethockey helmets, because they do recognize the value of protecting their noggin from bumps and bashes, and they wear athletic pads to protect their knees and elbows from the same kind of stuff.
It seems to me that the standard Security uniform, especially for any kind of away-team, would have padding at the joints, and maybe a padded helmet of some kind. Maybe something like an old leather boxing helmet, or a WWI aviator's helmet: not an imposing stormtrooper kind of headgear, but something to at least cover those really thin bits of skull at your temples.

But the only uniform I've seen like that was in a video game.


And, bouncing back to the main topic again (even my own post has topic-drift :eek: ):
Starfleet would be having much the same effect we are now seeing from improved medical care: a better survival rate among the injured is coupled to a higher disability rate among the survivors. If you can keep the folks who've lost a limb from dying, then more of your survivors will be missing a limb. Duh.
I was recently reminded (by an entry for "hollywood healing" over at tvtropes.org, that both Worf and Rom were permanently partially disabled: though it never came up again on-screen, both had been told the best possable outcome was a less than 100% return to normal mobility.

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Originally Posted by LUGTrekGM

As far as I can see, there is no soul.

Sadly, there it is. We are utterly alone, and all we have is what society we can make on our own.

Let's hope we make a good one...but I doubt it.

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In Trek, the existence of a transrational divinity nascent within sentient beings is strongly implied–see TMP, "Where no one...", possibly "barge of the dead," the whole turning-into-glowing-beings thing, the way lifeform sensors work...

Anyway, what the original question was referring to was continuity of consciousness, which, sans katric transfer, would not be maintained. Essentially, it would be the same as the Vorta–the illusion of identity maintained through memory transfer. Giving the original the right to decide the fate of the copy would be, in this case, barbaric.

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Originally Posted by Spyone

The introduction of the helicpoter completely changed battlefield medicine. Before the Korean War, the triage procedure was that the most badly injured got treated last. It was based on this cold equasion: during the time that doctor spends trying to save this 1 life (and probably failing), he could have been treating (and saving) 5 other men.
I have recently read a Star Trek novel where the ship's doctor makes a similar triage call: as the ship is still in combat, medical priority went to those who could be treated quickly and then return to duty, so that they might help save the ship.

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Unfortunatly this holds true today when one is dealing with a Mass Casualty Incident, whether this is due to a traffic collision, a natural disaster, or combat . . . the rules are still the same . . . and I can imagine that it will be the same anytime you have to Triage. Here are two good links regarding Triage:
http://en.wikipedia.org/wiki/Triage
http://www.armystudyguide.com /content/powerpoint/First_Aid_Presentations/triage-2.shtml Edit: removed the direct link on request on the site owner, due to it being old (at the point of editing, the information is all there). But kept the information for the direct location to make it able to search for the information.
And as you stated before the speed of transportation is vital. The faster you get someone to advanced care, the more likely their life threatening symptoms can be treated. However, imagine if you're use to transporting with an anti-grav litter, or uninhibited transporter service, etc. etc. And then all of a sudden you are pressed into a position where you have to return to the basics. I hope that they haven't forgotten the basics. Yet, I can imagine that most have. A good example is the knowledge that Dr. Pulaski retained which others in her field did not. Because she was taught, and retained basic medical knowledge absent of the need of certain modern technologies.

Well, in the LUG Trek Player's Guide, they have the RRT Field Medic. He has training in first aid/combat trauma, medical sciences/surgery, and life sciences/biology to just name a few. And some toys like the hypo pouch (hypo-spray with six meds; anesthezine, cordrazine, hyronalin, melorazine, terazine, and tri-ox in it), forcefield generator (creates a shield around patient and medic so he can work on them), and the statis backboard (keeps patient in stasis up to 50 hours).

I just see it that it's a science fiction setting none of it is real, it's all for the story.

So when Kirk loses a crewman they glow a bit, gone, move on, not all the ER type medical procedures, it loses the plot.

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Originally Posted by LUGTrekGM

I just see it that it's a science fiction setting none of it is real, it's all for the story.

So when Kirk loses a crewman they glow a bit, gone, move on, not all the ER type medical procedures, it loses the plot.

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No, that to is part of Triage . . . if they are dead . . . why waste your time, when there are other wounded where your time and attention can actually make an impact on.

If they cannot breath without your assistance, and there are others who are less wounded who you can more easily stabalise . . . but are not insignficantly injured, then to bad for that person. No time for Rescue Breathing or Chest Compressions . . . patch up . . . stop the bleeding . . . move out.

So even with the glowing dead crewmen there is triage.

https://www.youtube.com/watch?v=G6fH4wQPq7U
Even with medical treatment . . . resources will always be limited.

I'm talking story factors, not in game realism or mechanics.

If the story is called "A Broken Toy Soldier" you'll have that individual sufferring.

If the story is "Cenkali IV got smoked, by Klingons" your Triage scene will be "The starfleet medicos are surrounded by strethers, and blood" [Next scene]

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Originally Posted by LUGTrekGM

I'm talking story factors, not in game realism or mechanics.

If the story is called "A Broken Toy Soldier" you'll have that individual sufferring.

If the story is "Cenkali IV got smoked, by Klingons" your Triage scene will be "The starfleet medicos are surrounded by strethers, and blood" [Next scene]

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As you said, pace of the story . . . not every scene needs to be detailed . . . some are covered by general action statements . . . others are in depth and bring the PCs into the situation, intimitly at times.