Starfleet Medical

These optional rules supplement the existing Injury, Medical Aid, and Recovery rules from the Star Trek RPG. They also reference the optional rules for die rolls and skills described on the Starfleet General Orders page.

Injury, Healing, and Death


MAX OP ENDmeasure of health, initially equal to END
CURR OP ENDcurrent level of health, never higher than MAX OP END.
all penalties and effects due to END loss are based on CURR OP END.

Effects of END Damage

Stun (non-lethal) Damagedamage from stun weapons, fatigue, sedatives, and non-lethal attacks, is subtracted from CURR OP END.
Wound (lethal) Damagemost other forms of damage are subtracted from MAX OP END and CURR OP END (current levels of both are reduced).

Cumulative Effects of END loss

When CURR OP END or MAX OP END drop below ...
75% ENDcharacter suffers a -10 penalty to all actions
50% ENDcharacter suffers an additional –10 penalty to all actions
25% ENDcharacter suffers an additional –10 penalty to all actions
INACT SAVE LEVELcharacter must make a successful END roll based on their MAX OP END whenever they try to perform any physical action. If the roll fails, the character suffers an additional 5 points of CURR OP END DAMAGE. In extreme cases, if the action could make the wounds worse, then the damage is taken from CURR OP END and MAX OP END.
UNC THRESHOLDwhen a character's END level drops below this, they must make a successful MAX OP END roll to remain conscious. Even if they succeed, they must make another roll anytime they try to perform a physical action, as above.
0when a character's END level drops below zero they automatically fall unconscious.
–25% ENDif it is the character's CURR OP END that has been reduced to this level then the character begins losing 1 point of MAX OP END per round until it reaches the same level as CURR OP END or until the character is stabilized (see below)
if it is a character's MAX OP END that has reached this level, either through injury or by CURR OP END damage, then the character is dead, but can still be resuscitated. Additionally, MAX OP END continues to drop at a rate of 1 point per round until it has dropped below -END or the character is stabilized.
–ENDwhen a character's CURR OP END has dropped below –END the character is in a coma. Their MAX OP END immediately goes to zero (unless it is already at zero or lower) and drops another point every round until the character is stabilized.
when a character's MAX OP END drops to below –END the character is irretrievably dead. Even if the body is resuscitated, there will be no brain activity.


Recovery from END loss
MAX OP END1 point per hour (per 3 hours if character is active)
CURR OP END1 point per minute (per 3 minutes if character is active)
Bleedingbleeding will slow naturally, decreasing by 1 every minute (6 rounds)
Recovery from Unconsciousness
END Level >= 0, < UNC THRESHOLDrecover when END level > UNC THRESHOLD
END Level < 0can make MAX OP END to recover when END > 0, but less than UNC THRESHOLD

Recovery From Specific Injury Types

d100 roll*BurnBoneTissueHeadOrganMuscle/Tendon

*roll is modified by END, based on the following table:


Recovery Time Multipliers

Hospital Facilitiesx0.5
Full Sickbay Facilitiesx0.25
END 01-40x1.25
END 41-70x1
END 71-90x0.25
END 91-100x0.5
END 101+x0.25

Stabilizing Patients

If a character is losing MAX OP END due to extreme END loss (as opposed to blood loss) or the character is dying because of a critical result (ie "skull fracture, character dies in 12 rounds"), the END loss, or death, can be stopped by stabilizing the character. To do so, another character (usually the Medical Officer) must make a successful skill roll on the appropriate General Medicine skill. If successful then the patient is no longer losing END (or is no longer in danger of dying), at least for the time being. In order to remove the patient from further risk, he should be taken to a medical facility. The following modifiers to the stabilization roll apply:

END level below zero–1 per point below zero
Character does not possess proper General Medicine skill–25, or 1/2 other Gen. Medicine
Level of Critical
Using Sick Bay facilities+20
No Medical Scanner diagnosis first–30
Combat situation–30

Reviving Patients

A patient who has died, either by having their MAX OP END drop below –1/4 END or due to a critical result, and whose MAX OP END is not lower than –END, can be revived. The character attempting to revive the patient must make a successful Very Hard (–20) roll on the appropriate General Medicine skill. If successful, then the patient is revived, but if their MAX OP END is still below –1/4 END three rounds after being revived they will die again. Subsequent attempts at reviving a patient, whether due to an initially failed roll or due to excessive MAX OP END damage, are made at a cumulative –5. No other forms of healing may be performed on a patient until they have been successfully revived. All modifiers for stabilizing a patient also apply here, as will an additional –1 per round since the patient died.

Specific Damage from Critical Attacks

Some critical results specify broken bones, damaged organs, tissue burns etc. in their descriptions. To repair this specific damage, the character performing the surgery must make a successful roll on the appropriate General Medicine averaged with Surgery. If the roll is successful then the damage will heal normally (see Healing Rates above). In cases where a vital organ has been damaged the patient may have to remain on some kind of life support until the damage is healed. Modifiers to the Surgery roll are based on the level of the critical: A(0), B(–5), C(–10), D(–20), E(–30). If the surgery is attempted without proper equipment additional modifiers are applied. Suggested are: Sick Bay (+20), Medical Facility (+10), Field Surgery Equipment (+0), Near Complete (–20), Partial (–30), Sorely Under-Equipped (–50).

Medical Equipment

Biocomputer (Extremely Hard [-30]) - minimum skill of 20 in Computer Operation and 10 in any General Medicine to use. A portable unit used to analyze samples of tissue and other substances and to process biological data. Does not possess innate scanning ability but can receive data from a tricorder. It can also be tied into a ship's computer through a communicator link.

Bone Setting Laser (Very Hard [-20]) - The -20 only applies to the field version of this device, which can heal 6 sprains, 3 breaks, or 1 shatter before its charge is depleted. Using the Sick Bay version requires a Hard(-10) skill roll and has no limit on number of uses.

Cardiostimulator (Medium [+0]) - used to restart a stopped heart. Considered necessary equipment for reviving a deceased patient.

Cryosurgical Frame (Hard [-10]) - used to slow a patient's metabolism during surgery. While in use bleeding, MAX and CURR OP END loss, and other time related damage is slowed by a factor of 3.

Diagnostic Table and Panel - continuously scans vital signs and other essential information. Sick Bays not equipped with Diagnostic Beds are treated as only Medical Facilities (+10 instead of +20 bonus).

Heartbeat Reader (Light [+10]) - if a tricorder or other diagnostic scanner is not available the heartbeat reader can be used. It will give a more accurate indication of a patient's pulse than a tricorder, but can perform no other function.

Hypospray (Light [+10]) - high pressure pneumatic device that injects substances through the skin painlessly, without a needle. Common drugs given in smaller doses are contained in micro-injector vials holding several doses; less common drugs are attached in larger vials before injection.

Laser Scalpels (Very Hard [-20]) - variable focal length beams used to cut tissue during surgery.

Medical Scanner (Medium [+0]) - portable version of a diagnostic bed. A five-second scan will give heart rate, blood pressure, respiration, and body temperature of a patient. It is usually used in tandem with a medical tricorder as the scanner itself does not possess a display screen. A trained physician, though, can perform a diagnostic without any display by interpreting the sounds produced by the scanner (an Extremely Hard [-30] roll on General Medicine and Small Equipment Systems Operation.)

Medical Field Kit - a small belt pouch with fold over top. It is always carried by medical officers on duty. It contains a medical scanner, hypospray, spray dressing (10 doses), and a small drug supply. The drugs usually include 6 doses each of light and medium sedatives, light and medium stimulants, Coradrenaline, Sterilite, and Tri-Ox Compound.

Medical Tricorder (Medium [+0]) - a medical tricorder will give more detailed information on chemical composition and life form readings than the science tricorder, but does not possess the science tricorder's range and versatility.

MediPouch (Field Surgical Kit) - carried by medical officers in emergency situations. It contains a medical scanner, heartbeat reader, 6 laser scalpels (of varying intensity), a Type I and Type II protoplaser, bone-setting laser, spray dressing (40 doses), hypospray, emergency surgical scissors, and a drug supply. The drugs usually include 6 doses of heavy stimulants and heavy sedatives, Coradrenaline, and a neural paralyzer, as well as 12 doses of light and medium stimulants and sedatives, Tri-Ox Compound, and Sterilite. At the medical officer's discretion, there might also be 6 doses of Cordrazine included.

Physiostimulator (Medium [+0]) - used to elevate metabolic functions in an impaired individual.

Psychotricorder (Very Hard [-20]) - minimum skill rating of 40 in the appropriate Psychology skill and 50 in Computer Operation required to operate. This complex scanning device can scan the mind to obtain a detailed account of the subject's experiences during the previous 24 to 48 hours. The results of a psychotricorder scan are always correct. The operator and the subject must have no distractions during the scan, and even then getting a good scan can be difficult. Once a scan has begun, however, the subject's true experiences will be revealed. Federation law requires that the subject agree to the scan. A psychotricorder scan can be resisted by someone with an extremely strong will. Certain Vulcan mind techniques have been known to be effective, as they are against Klingon mind sifters.

Protoplaser - Type I (Medium [+0]) - heals wounds without stitches or sutures. Will heal any wound of 5 points or less, or stop bleeding from a wound up to 5 hits/round in intensity. A type I will have no effect on worse wounds.

Protoplaser - Type II (Hard [-10]) - similar to a Type I but will heal wounds up to 10 points in intensity and stop bleeding of 10 points per round or less. A wound is damage and/or critical effects from any single attack.

Spray Dressing (Light [+10]) - the al purpose band-aid of the 23rd century. It will stop superficial bleeding (2 points per round or less) and contains an antiseptic and anesthetic agent. When a wound heals, the dressing is absorbed.

Surgical Equipment

The following equipment is standard in all Starfleet Sickbays. The GM may call for individual rolls with each piece of equipment during surgery or may only require a generic Surgery roll for the procedure.


This is a list of pharmaceuticals that have appeared in Star Trek, along with applicable rules to facilitate including the drugs in a game.

Adrenaline - acts as a light stimulant and light painkiller. Will reduce stun penalties by half. When it wears off, additional damage to CURR OP END is evaluated as if it were a medium stimulant. Can be used as a cardiostimulant for resuscitating patients or for radiation treatment if hyronalin is not available.

Benjisidrine - an antiarhythmic and cardiostimulant for use with Vulcan patients.

Coradrenaline - used for treatment of exposure and frost bite. It will neutralize 2d10 points of damage from cold-based sources, and cut further damage from cold in half for the next three hours.

Cordrazine - Extremely powerful stimulant. It will restore 3d10 + 5 points to CURR OP END and MAX OP END. The effect will last for 3 x (END stat) minutes, after which a MAX OP END save must be made at -30 or patient will suffer an additional 1d10 points from MAX OP END as well as losing the points gained by the drug. Large doses will cause acute paranoia and possibly death. Cordrazine is only used in emergency situations.

Cortropine - a stimulant that aids wakefulness and enhances sensory input, as well as assisting in focusing on specific tasks. It will restore 1d10 + 5 points of CURR OP END damage from fatigue and grant +15 to all perception, research/construction, and repair attempts. The effect lasts 2 x (END stat) minutes. Large doses are followed by a period of depression and overdose can cause death.

Formazine - standard Federation stimulant. A light stimulant, it will heal 1d10 points of CURR OP END damage. Lasts for (END stat) minutes, after which gained points are lost and a MAX OP END save must be made to avoid losing another 1-5 points of CURR OP END. Extended use will cause irritability.

Hemosclerex - a hypercoagulant. It is administered to a body location where there is bleeding. it will then lower the bleeding rate by 1 every round for up to ten rounds, at which point, if there is still bleeding, a second dose must be administered.

Hyronalin - standard radiation treatment. It will halt damage from radiation sickness and heal 3d10 points of radiation damage. The effects of radiation criticals are reduced 2 levels in severity. Extensive use can cause death.

Immunosuppressant - suppresses the immune system to prevent tissue rejection after a transplant operation.

Lexorin - used to counteract mental disorientation, whether from a head injury, mental disorder or psionic effect.

Masiform D - general poison antidote. It will grant the patient a second resistance roll against the poison at +100.

Melanex - a light stimulant, it reduces CURR OP END by 2d10 + 10 for 2 hours.

Neural Paralyzer - Medication that can greatly reduce the metabolic functions of an individual, placing them in a death-like coma. The condition is indistinguishable from death except by an Extremely Hard (-30) diagnostic using a Sickbay level medical scanner. The drug takes effect 1d10 minutes after injection. If the patient is not brought out of the coma within (END / 3) minutes then the patients metabolic functions will stop completely and he will die.

Propoxyphene Hydrochloride - A standard pain killer. It will reduce a pain & shock modifiers from damage by one level, and reduce penalties from critical results by up to 10. An overdose can cause the user to fall into a coma, however.

Retnax V - used to treat nearsightedness.

Ryetalyn - a cure for Rigellian fever. It occurs naturally and cannot be synthesized.

Sterilite - a powerful antibiotic used to prevent infection during surgery or wound treatment. It is especially useful for field surgery.

Stokaline - a medium sedative.

Strobolin - cure for choriocytosis, a disease fatal to Vulcans.

Theragen - Klingon nerve gas, when diluted and mixed with alcohol it prevents the debilitating effects of interphase.

Tri-Ox Compound - used to treat oxygen starvation. Useful during first aid treatment of decompression victims. Injections are given every three hours on planets where the thin atmosphere or low oxygen content would cause fatigue.

Vertrazine - used to combat vertigo.

Generic Drugs

Generic Sedative - sedative lower CURR OP END. They are classified as light, medium, and heavy. Light sedatives lower CURR OP END by 2d10 + 10 points and last for 2 hours, medium by 2d10 + 25 for 4 hours, and heavy by 2d10 + 40 for 6 hours.

Generic Stimulant - stimulants temporarily restore CURR OP END damage. They are also classified as light, medium, and heavy. A light stimulant will restore 1d10 points of CURR OP END for (END stat) minutes, after which the restored points are lost and a MAX OP END roll must be made to avoid losing 1-5 points from MAX OP END. A medium stimulant will restore 2d10 points for 2 x (END) minutes after which a MAX OP END save must be made at -10 to avoid taking 1-7 points of MAX OP END damage. A heavy stimulant restores 3d10 points for 3 x (END) minutes and the save is made at -25 to avoid taking 1-10 points of damage.

Poisons - There are three basic types of poisons. Simple poisons will cause anywhere from 1d10 to 10d10 or more points of damage to END (not MAX OP or CURR OP), and the damage is taken all at one time. Complex poisons do less damage (1d10 -5 to 5d10) but the damage is taken 1d10 times at 1d10 round or minute (or greater) intervals. Specific poisons operate as either simple or complex ones but affect STR, DEX, INT, or a combination of the three instead of END. Treat the effect of excessive damage to these attributes (damage that drops them below zero) to be the same as if the damage were to END. This is to show how a muscle relaxant poison (one affecting STR and/or DEX) could kill by stopping the heart and lung muscles. If the poison is not fatal, the lost attribute point swill heal at 1/2 the healing rate for MAX OP END. No matter what the poison, victims are allowed a resistance roll. This is a MAX OP END roll with a penalty dependant on the potency of the poison. If successful, the victim only takes 1/2 damage from the poison.

Antidotes and Antitoxins - Antidotes and antitoxins may halt and/or cure damage done to a character by poisons. In some cases a specific antidote may only work part of the time. An antidote for a simple poison will restore part or all of the damage done by that poison, whether an ordinary or specific one. Antidotes for complex poisons usually halt any further damage and may also restore part of the damage already done. Assuming the character survives, damage done to END will heal normally.