Grimshore Ambulance Standard Operating Procedures

Grimshore Ambulance preserves life, delivers patient-centred care and supports safe, immersive medical roleplay.

• Treat every patient with dignity, impartiality and confidentiality regardless of alleged offending, faction or personal relationship.
• Clinical decisions belong to the appropriately qualified treating clinician. Police retain security and custody authority but do not direct clinical treatment.
• Use the patient’s displayed injury state and examination findings as the in-world clinical foundation; roleplay may add context but must not contradict the supported patient state.
• Prioritise life threats, realistic communication and continuity of care over speed-running a revive interaction.

Members work within their training, current qualification and the direction of the senior suitable clinician.

• Student Paramedics require direct supervision; Paramedics provide ordinary response care; advanced and intensive-care ranks manage higher-acuity assessment within approved capability.
• Station Officers coordinate crews and immediate operations; Regional Manager and executive ranks govern standards, staffing and major incidents.
• Do not perform or claim a procedure beyond qualification merely because an item or interaction is available. Request higher clinical support where needed.
• A senior rank may coordinate the scene while a more clinically qualified member leads patient care.

Ambulance responses begin with a clear dispatch acknowledgement and a proportionate, safe approach.

• Acknowledge the call, identify unit and response status, and review the available location, patient count and hazard information.
• Use warning devices and emergency driving only when the response priority justifies it. Intersections, pedestrians and traffic remain the driver’s responsibility.
• Provide arrival, situation and transport updates. Request additional Ambulance, Police or Fire resources early.
• Dispatch or distress information is a response lead, not permission to ignore hazards or enter an unsecured violent scene.

No treatment is effective if the crew becomes another casualty.

• Approach with an escape route, identify traffic, weapons, fire, electricity, hazardous materials, unstable vehicles and aggressive persons.
• Stage until Police secures violence or Fire controls rescue/fire hazards. Police lead criminal security, Fire leads fire/rescue zones and Ambulance leads clinical care.
• Use a shared command point at major incidents. Communicate patient numbers, access requirements, triage priorities and transport needs.
• Do not enter a declared hot zone without authorisation, training and suitable protective equipment.

Assessment comes before treatment unless an immediate life threat requires simultaneous action.

• Establish responsiveness and conduct an airway, breathing, circulation and catastrophic-bleeding assessment.
• Use the available patient examination to identify supported limb injuries, bleeding, broken bones, gunshot or other injury states.
• Ask about mechanism, symptoms, allergies, medications and relevant history where the patient can respond.
• Record findings and distinguish what was observed, what the patient reported and what the system displayed.

Choose treatment that matches the patient’s actual injury state and the member’s scope.

• Control supported bleeding and treat configured injury types with the appropriate medical item or interaction.
• Medical bags, bandages, splints, sutures, trauma supplies and other configured equipment remain accountable clinical stock.
• Do not repeatedly apply items to brute-force health or bypass the intended treatment workflow.
• Explain interventions in roleplay, monitor response and reassess after treatment. A revive is not a substitute for assessment, stabilisation and continuing care.

Grimshore uses staged responsive, critical and deceased states that should guide the scene.

• Treat last stand as time-critical deterioration. Encourage bystanders to provide safe information and basic aid without crowding the patient.
• An unconscious or dead-state player cannot provide reliable tactical information obtained while incapacitated.
• Revive only when clinically and operationally appropriate through the authorised system. Establish a plausible post-revival condition and continue treatment.
• If the system requires respawn, the patient follows Grimshore’s New Life Rule and item-loss settings; clinicians must not promise a particular inventory outcome.

Patient movement must be planned, communicated and appropriate to injury and scene access.

• Use the configured stretcher for patients who cannot reasonably walk or where movement could worsen injury.
• Coordinate lifting, nominate a leader, secure access to the ambulance and avoid dragging patients through unsafe obstacles.
• Select the receiving facility according to availability, severity and operational direction.
• During transport, continue monitoring and advise Police of custody or escort issues without disclosing unnecessary clinical information.

Facilities are clinical workplaces and protected roleplay environments.

• Use designated treatment areas, beds, lockers, supplies, garages and check-in functions as configured.
• Maintain order and patient privacy. Visitors and Police access may be limited where care or safety requires it.
• Do not use facility management or supply interfaces for personal gain, unauthorised stocking or economy abuse.
• Complete handover before clearing and return equipment/vehicles to serviceable condition.

A defensible patient-care record explains what happened, what was found, what was done and what changed.

• Record dispatch details, scene hazards, patient identity where known, assessment, system-supported injuries, treatment, response and destination.
• Use factual, respectful language. Do not include unrelated criminal allegations or speculate beyond clinical observations.
• Police may receive information necessary for immediate safety, custody or a lawful investigation; broader clinical detail remains confidential.
• Correct errors transparently and never delete or alter a medical record to assist a patient, colleague or investigation.

Multiple casualties require structure, restraint and shared situational awareness.

• The first suitable Ambulance member establishes provisional medical command, gives an initial casualty estimate and requests resources.
• Create safe casualty collection and treatment areas with Police and Fire. Use triage priorities consistently and reassess as conditions change.
• Do not allow the most vocal patient to displace a more urgent silent casualty.
• Record command transfer, transport allocation, receiving facilities and unresolved patients.

Clinical authenticity depends on supervised practice, honest records and continual improvement.

• Complete recruit/student induction, supervised cases and competency sign-off before independent practice.
• Use scenario training for trauma, medical deterioration, violent scenes, vehicle rescue and mass-casualty coordination.
• Report equipment loss, unsafe care, record misuse and serious policy breaches through command.
• Remedial training addresses skill gaps; deliberate abuse, fabrication or confidentiality breaches may require professional-standards review.