Guide to Medicine: различия между версиями

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>Nanako
(rearranged suffocation section)
>Nanako
(Adjustements to toxins)
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<small><i>This shows up as a <b><font color=green>GREEN</font></b> number on the Health Analyzer and Crew Monitoring Console</i></small><br><br>
<small><i>This shows up as a <b><font color=green>GREEN</font></b> number on the Health Analyzer and Crew Monitoring Console</i></small><br><br>
Toxin damage sometimes causes vomiting. Getting a blood sample of the patient with a syringe and using a Mass Spectrometer will reveal what toxins are located in the patient's blood. [[#Radiation Sickness | Radiation]] will also cause Toxin damage.<br>
Toxin damage is the most difficult damage type to diagnose, because it has so many different causes. Dylovene is a powerful, widely available go-to antitoxin medicine, but remember that it only cures the symptoms, not the cause of the poisoning. Toxins are the most common damage type which doesn't heal over time, a poisoned patient will stay poisoned until you do something to fix it.
* Stabilize a critical patient.
When a patient comes in with toxin damage, follow these steps to diagnose and treat them correctly
* Administer Dylovene.
 
* If necessary, remove the patient from the source of the poison.
*Are they critical? If so, why.  
* Monitor the patient's vitals for any changes. Some poisons are tricky and stay in the system for a long period of time.
**If they have a lot of brute damage and broken bones, in addition to toxins, or if the scanner shows an unknown substance in their blood, it's probable they were mauled by a spider. Administer dialysis to purge the toxins from the blood, until the toxin levels stop rising
* Poison can be removed from a patient's bloodstream by putting them in a sleeper for dialysis. This will also lower their blood volume.
**If their damage is mostly toxins, it's probable they either have sepsis, or a late stage viral infection. Administer lots of spaceacillin and dylovene immediately, and put them in a full body scanner to find out which.
* Treat the root cause. Toxin damage can be caused by infection, exposure to phoron or radiation, poisoning, medication overdoses, alcohol and drug abuse, viral disease, and several other more exotic sources.
*Talk to the patient, if possible. Ask them if they ate, drank, inhaled, or injected anything, this can help you act accordingly.
* If the patient was poisoned severely or for an extended period of time, check for organ damage.
**If they were injected with something unknown, then you should analyse their blood. Take a blood sample with a syringe and inject it into a Mass Spectrometer, this will usually tell you what poisoned them.
**If they've inhaled phoron, that will poison their blood, and require dialysis before dylovene
*If an analyser shows a non medical reagent in their stomach, then they probably ate or drank something poisonous. There's no easy solution to this, keep gradually administering dylovene, and keep them in medical until it passes through. Or give them dylovene pills to take themselves periodically
*If they work in engineering or science, it's quite probable they have [[#Radiation Sickness | Radiation]]. The full body scanner will tell you this. Anti radiation medicines will treat it most effectively, but lots of dylovene will manage it too
**Since radiation dissipates naturally over time, it's quite probable an irradiated patient will no longer be irradiated by the time you examine them, and will just have leftover toxins.
*When possible, try not to administer dylovene until you've discovered and fixed the root cause. While the patient has dylovene in their system, you won't notice their toxins slowly rising
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Версия от 06:31, 6 мая 2016

General Diagnostics

Medical care is serious business. Going half way with your medical treatments can result into someone dying, or ending up worse than dead. So pay attention and follow these steps on how to fix people. This guide is long and wordy, but following its advice should help you keep the whole station from dying.


Diagnostic Tools

  • A must have tool is a health analyzer. It can show overall damages, with breakdown by organ, bleeding locations, fractures (not always with location), and some other conditions.
  • Most complete information can be gathered with an Advanced Body Scanner. It shows pretty much all information one would need to perform a surgery. If there're several conditions to fix, remember to print out a report to take with you.
  • Stethoscope. Using it you can detect problems with lungs or heart as well as suffocation damage. Tuck it on your scrubs for easy access and looking like you're a real doctor.
  • Penlight. By shining it in patient's eyes, you can tell a few things from pupils' reaction - brain damage (different response speed between eyes), sleepiness (slower response time), drugs in patient's system (pinpoint/dilated pupils) or eye damage.
  • When nothing is around, you can just use your hands. Grab patient, aim at the bodypart you want to inspect and click on patient with help intent. This will start inspection process that would tell you about wounds, fractures, and some other conditions like suffocation or high toxins levels.

Robotic Limb Malfunctions

Injuries located on robotic limbs cannot be treated by the standard equipment located in Medbay. Those patients should be sent to the Roboticist for repairs. It is still important for individuals to receive treatment for these wounds as soon as possible, as limbs may explode after receiving a certain amount of damage to them.

Robotic limbs are tougher than normal limbs, and do not count towards overall damage. However, they can only be repaired by welders (for brute damage) or wires (for burn damage), and malfunction if damaged. If one of the medical personnel has training in electronics, they may want to carry a welder and some cable to repair prosthetics; otherwise, keep the roboticist on call.

Artificial eyes and hearts can be repaired during surgery with nanopaste.

Robotic limbs are the best way to treat patients who have suffered a traumatic amputation. It is recommended to maintain good relations with robotics and perhaps, if they are not too busy, acquire a set of robotic limbs just in case you need to attach one.


Critical Patients

Anytime a patient has either very quickly dropping vitals, or a Health Analyzer shows that they are below 0 health, you should act quickly to prevent their death.

  • Remove yourself and the patient from the source of the injury, whether it be a space carp, phoron-saturated clothing, or a murderous traitor. Adding yourself to the list of casualties won't help anyone.
  • Stabilize the patient to the best of your ability before transporting, because otherwise they'll keep taking damage. Inaprovaline or CPR will help (unless the patient is a Vox, for whom inaprovaline is poisonous).
  • Bandaging bleeding wounds before transport will help prevent blood loss and the damage that comes with it.
  • Treat suffocation damage with dexalin or dexalin plus (unless the patient is a Vox - use nitrogen if they are) and, if necessary, make sure the patient's internals are functional and not out of air.
  • Always use a roller bed to transport a critical patient. Dragging them can result in further injury. In case no roller beds are avaliable, GRAB them and move.
  • A cryo tube can slow or stop a patient from dying, as well as healing some kinds of damage. If the cryo tube is cold and loaded with medication, putting a critical patient in cryo can help stabilize them when immediate treatment is not possible. This is most useful when you have multiple critical patients or if your character does not have the skill set to treat a patient.

Triage

In situations where there are multiple critical patients being reported or flooding into medbay, use the Triage System. Wearing a Medical HUD will help you spot out which individuals are in the most desperate need of treatment first.


Damage Types and Basic Treatments

In the world of Baystation Medicine, most damage will fall under four major categories: Suffocation, Toxin, Brute, and Burn. These will show up on the Health Analyzer and in low amounts are very easily treated. There are also treatment kits for each of these categories located within medical storage.

Suffocation Damage

Toxin Damage

Brute Damage

Burn Damage

Unlisted Damage

Mechanics

This section covere important detailed information about deeper mechanics of the medical system


Infection

Infection is a condition whereby bacteria infest an open or untreated wound, and start eating the body from the inside. This results in a fever, then mild toxin damage, but it gets really serious in the late stages, quickly causing limb death, organ failure, and massive toxins. A stage three infection is almost unstoppable, and spells near-inevitable death for the patient.

Infections work by a Germ Level value. A series of them actually, there is a germ level for:

  • Each patient's body, as a whole
  • Each bodypart (arms, legs, head, etc)
  • Each wound (cut, burn, bruise) and
  • Each internal organ (heart, lungs, etc).

The patient's body will accumulate a general germ level up until a value of 200, as they move around and do things. This is not directly harmful, but it will affect wounds if the patient gets hurt. The patient's germ level can be easily reset to zero by either showering, or by washing their bare hands (gloves must be removed). So hygiene is important, stop being filthy.

If a patient has open or untreated wounds, those wounds will gradually accumulate germs at a rate of about 1 point per second, up to the germ level of the patient's body, and will become infected if their germ level rises too high. A wound can be treated physically, with ointment, bandages, or an advanced trauma/burn kit. Once treated the germ level of a wound will stop rising, and it will become Sterilized after a short amount of time (averaging a minute) which completely resets the wound's germ value to zero. Even if wounds aren't properly treated, healing medicines, or natural regeneration may close them, and that will prevent their germ level from rising farther. but treating them physically is the safest option.

When a patient has infected wounds, they will spread their germ level to the muscles of the bodypart that wound is on, and this is where things get bad. Muscular infections can't usually be treated instantly, and will get worse over time naturally, in addition to recieving more germ level from infected wounds. Hence they will continue to worsen even after the wounds are treated. While the patient has >5u of spaceacillin in their system, the natural worsening of muscular infections is halted, and their germ level will gradually drop back to normal. If not addressed in time, muscular infections will spread to other nearby bodyparts, and eventually to internal organs too.

There are several stages to the severity of a muscular or organ infection. The effects of these stages stack on top of each other

  • Stage 0: from any germ level between 0-100, the bodypart is not considered 'infected', there are no ill effects, and injecting 5u of spaceacillin will clear the germ level from that bodypart instantly. At this stage the germ level will not rise naturally, and treating infected wounds in the area will halt it.
  • Stage 1: Ocurring at germ level 100, the part in question is considered lightly infected. The patient will suffer a fever, which will show an increased body temperature on Health Analysers. At this stage the germ level will start to naturally rise over time, at an accelerating rate as it rises higher. A greater than 5u dose of spaceacillin will stop the natural worsening, and will cause the infection level to drop by 6 points per second, so this is easy to treat if caught in time.
  • Stage 2: Ocurring at germ level 500, this is where things get bad. At stage 2, the infection will start to spread to other bodyparts and internal organs. Nothing can prevent this spreading except simply bringing the infection level down. Spaceacillin will now only cause the germ level to drop by 2 points per second, making it far slower to treat, and the patient will start to suffer a point of toxin damage, roughly every 30 seconds.
  • Stage 3: Ocurring at germ level 1000, This is where people die. When a bodypart or internal organ reaches stage 3, it immediately suffers death, and becomes nonfunctional. For muscles, this is crippling, but for most internal organs it's lethal. A patient without lungs or a heart cannot breathe, and a patient without a liver will suffer massive ongoing toxin damage. In addition, the patient starts to suffer an additional point of toxin damage every second.

If there is a high dose (>30u) in the patient's system, the organ or bodypart death will be prevented, and they will not suffer this additional toxin damage. But if the drugs aren't there before this stage, spaceacillin will not revive dead organs.


Preventing Infections

Prevention is better than a cure, there are a few simple ways that a patient, or the doctor treating them, can help to prevent infections ocurring.

  • Hygiene! Washing your ungloved hands, or showering, will reset your body's germ level, and prevent any wounds from becoming too infected. Note that washing your hands with gloves on, will not do this. The simplest approach is to shower after getting injured. If you've been in a fight, you're probably covered in blood anyway.
  • Treat the wounds. There are three different types of wounds that can become infected
    • Cuts
    • Bleeding Bruises
    • Burns

Of these three, burns are the most likely to become infected. Cuts and bleeds will close up and heal into uninfectable bruises, but burns will only heal into lesser burns which are still infectable.


Treating Infection

So an infected patient has just walked in. Chances are they don't know they have infections, many security personnel tend to build up infection over time, unnoticed. Sometimes until it's too late to save them. Infections will show up on the full body scanner, and you've probably found an infection while treating them for other wounds.

The prevention steps still apply. Make the patient wash, and treat their wounds Your next action will depend on the severity of the infection. The scanner will tell you in words how much germ level the part has accumulated, use this handy list to translate the words into a germ level:

  • Mild Infection: 100-300
  • Mild Infection+: 300-400
  • Mild Infection++: 400-500
  • Acute Infection: 500-700
  • Acute Infection+: 700-800
  • Acute Infection++: 800-999
  • Septic: 1000+


In any case, you want to inject them with spaceacillin. It metabolises slowly so not a lot is needed, 10u will handle most mild infections, 15u for acute infections up to 700 germ level.

IF the patient is suffering from Acute Infection++, then they're very close to sepsis. You want to get a MUCH larger dose of spaceacillin into them, 45u should be good. And then monitor them closely for signs of worsening.

If the patient is in sepsis, then things are bad. Print out their scan, Steel yourself for the high likelihood of their death, and hope that your chemist put clonexadone in the cryotanks. Inject them with 45u spaceacillin, and a fair bit of dylovene. Some peridaxon will help if you have any. Then throw them into the cryotubes and pray that they cool down enough before they die. Cryotubes will stop a lot of infection activity, but will also stop spaceacillin from working.

If you can manage to get them stable in the cryotubes, and bring their damage values down to zero, then they might survive. Bring them out of the cryotubes so that the spaceacillin can work, and gradually bring down the infection. While they're out of the tubes they're going to start accumulating damage again quickly, so dose them up with whatever you need to, to keep them alive, and don't be afraid to put them back in the tank if you can't control it.

Now is the time to look more closely at their scan and assess the damage. If it's only an arm or leg that's in sepsis, then it's dead and gone. Amputate it, and give them a prosthetic. If it's an internal organ that's dead, their odds of survival are grim. Your only option is to cut the organ out and transplant in a replacement, if you have one. The odds of that are low unless you've been harvesting organs from corpses, or you have a suitable donor in the morgue.

Diagnosing Other Conditions

Even after treating the common injuries listed Basic Treatments, the patient could still have other underlining conditions you should keep an eye out for.

Low Blood Count

Danger: [Depending on severity]
Shows up on Health Analyzer

  • Patient feeling woozy, paleness of skin.
  • Drops of blood, or blood puddles near patients.
  • Suffocation damage that returns repeatedly when treated.

Internal Bleeding

Danger:
Shows up on Health Analyzer.

Heart Trauma

Danger: [Depending on severity]

Blood Rejection

Danger: [Depending on severity]

  • Toxin damage without foreign chemicals in bloodstream.
  • Unexplained suffocation damage.
  • Patient recently recieved blood transfusion.

Collapsed Lung

Danger:

  • Patient's cough containing blood.
  • Patient gasping for air in breathable environment.

Bone Fractures

Danger:
Shows up on Health Analyzer

  • Patient screaming in pain, dropping held items, and falling over.
  • Facial Deformities (showing up as Unknown) are often coupled with skull fractures.

Dismemberment

Danger:

  • MISSING. LIMBS.
  • No, seriously, the limb is missing upon visual examination.

Embedded Objects

Danger:
Shows up on Health Analyzer.

  • Visible embedded objects sticking out of patient.
  • Reports of pain when moving.
  • Embedded object shows up when scanning the patient.

Bacterial Infection

Danger: [Progresses if left untreated]
Shows up on Health Analyzer.

  • Toxin damage without foreign chemicals in bloodstream.
  • Visible inflamed wounds.
  • Damage to internal organs without external wounds.
  • High body temperature.

Viral Infection

Danger: [Depending on severity]
Shows up on Health Analyzer (Only if virus has been analysed)

  • Coughing, sneezing, vomiting, hallucinations, twitching, urges to eat, feeling pale, are all symptoms of various diseases.
  • High and/or rising body temperature.

Appendicitis

Danger: [Depending on stage]
Shows up on Health Analyzer.

  • Toxin damage without foreign chemicals in bloodstream.
  • Patient experiences abdominal pains.
  • Uncontrollable vomiting.
  • Coughing.

Intoxication

Danger:

  • Slurring, confused movement.
  • Hallucinations. Hallucination damage.
  • Uncontrollable drooling, twitching.
  • Possible toxin damage.

Radiation Sickness

Danger: [Depending on severity]

  • Patient is feeling weak, passes out.
  • Steady increasing toxic damage that returns when treated.
  • Possible DNA mutation (shows up as "incomplete cloning").
  • Hair loss.
  • Radiation level is visible on the full-body scanner.

Genetic Defects

Danger:

  • Highly varied, and differ depending on defect. With often only one or two of the following appearing:
  • Seizures, random swearing, non-drug-induced hallucinations.

Brain Damage

Danger:
Shows up on Health Analyzer

  • Concussion, in minor cases.
  • Headaches, impaired vision.
  • Impaired motor ability, with both arms and legs.

Facial Deformation

Danger:

  • Patient's face damaged beyond recognition.
  • Patient's vocal cords distorted.
  • Patient shows up as "Unknown" despite having an ID.

Joint Dislocation

Danger:

  • Patient can't use a limb, but it's not necrotic.
  • Patient's limb is bulging/crooked oddly.

Deafness

Danger:

  • Patient is unable to hear speech.
  • Patient was recently near sites of explosions.

Impaired Vision

Danger:

  • Patient is unable to see far away objects, objects appear blurred.
  • In severe cases, patient's pupils do not react to penlight.

Itch

Danger: negligible

  • Itching.
  • Shivers in more severe cases.

Bad Stomach

Danger: negligible

  • Discomfort in stomach area.
  • Vomiting.

Headache

Danger: negligible

  • Headache.

Decapitation

Danger: ✜

  • Patient's head is detached from the body.
  • There is no head attached to the patient's body.

Tools, Machinery, and Facilities of Medbay

Even knowing exactly what's wrong with patient and how to treat it won't do you much good if you have no equipment. Here is the list of basic medical tools and machinery.

Tools

Basic tools

Tool Purpose Usage
Ointment Speeding up healing of burns. Also can be used to treat infected wounds. Target damaged body part and click on patient.
Advanced Burn Kit Speeds up the healing process of burns. Also treats infected wounds. It is more effective than Ointment. Target damaged body part and click on patient.
Файл:Bpack.png Gauze/bruise pack Speeding up healing of brute damage. Also stops wounds from bleeding. Target damaged body part and click on patient.
Advanced Trauma Kit Increases the speed of healing for brute damage and stops wounds from bleeding. It is more effective than a Bruise Pack Target damaged body part and click on patient.

Health Analyzer Must-have tool for Medical. Scan people to find out damage levels (and location for brute/burn), some conditions, blood levels and some other info like body temperature. Click on patient.
Syringe Administering medicine to people (5 units per injection). Taking blood samples.
  • Click on things/people to inject or draw.
  • If either of characters moves during it, injection fails.
  • To switch between draw/inject modes, click on syringe in hand.
AutoInjector A single-use 5 unit injector containing inaprovaline for use in emergencies. Click on patient while holding the Injector.

Chemicals

Using proper medicinces can be difference between life and death for patient.
Some chemicals come pre-made in medikits or vendomats (i.e. inaprovaline and Dylovene), but most of them have to be made in Chemistry Lab.

Файл:IVdrip.png IV drip

Used to transfer chemicals (usually blood) from the vessel loaded in it to the patient in small dosages every second. Since some medicines are metabolized slower than new are injected (e.g. Tramadol will last in blood ~10 times longer than most meds), IV medication can still cause overdose with those chemicals, so mind dosage.

  • Hooking/unhooking patient: Click and drag IV sprite on patient.
  • Loading chemicals:Click on unloaded IV with vessel in hand.
  • Unloading chemicals:Click on loaded IV with empty hand.
  • Changing modes: To change modes between giving/taking, right click on IV and use Toggle Mode option.

Roller Bed

Used to transport patient fast and safe.
Buckle/unbuckle patient as with chairs and usual beds.
Can be folded into pickupable roller bed item.

  • Buckling Patient: Drag the patient on top of the unfolded bed, click and drag from patient to bed.
  • Unbuckling: Click on the bed.
  • Folding: Click and drag roller bed sprite to your character.
  • Unfolding: Click on folded item in hand.

Stasis Bag

  • Stops metabolism(breathing, bleeding, chemicals in blood, etc.)
  • One-use only(don't open that bag until you're ready to treat them)
  • No IC skills required(one of the few devices that are ICly as simple to use as OOCly)
  • Causes brain damage to the occupant so should only be used when the patient is in critical condition.

Other medical equipment

  • Medical Doctor Closet - Contains different uniforms for different sections of Medbay, as well as different colored surgical scrubs.
  • Medical HUDs - When placed on like glasses, allow you to see a patient's vitals from a distance. More can be acquired from Research and Development.
  • Medical Belts - Can be loaded with medications for easy access.
  • Medical Kits - There are four different kits: First Aid, Oxygen Kit, Burn Kit, and Toxin Kit. More can be ordered from cargo.
  • Nurse Outfits - Can be worn by female doctors. In emergency may be worn by male ones too.
  • Various Beakers - These have multiple uses depending on type, and can be replenished by the Chemist. Browsing over the Guide to Chemistry will let you know what chemicals do what.
  • Bio-Hazard Closet - Are filled with biosuits to be worn when there is a viral outbreak.
  • Straight Jacket and Muzzle - For restraining dangerous and possibly insane patients. Usually considered a last resort.
  • Syringe Gun - Can be loaded with a single syringe that can be shot at a person from a distance.
  • Prescription Glasses - For helping those who can't see good and wanna learn do other stuff good too. Also contains prescription meson glasses and sunglasses.
  • Space Cleaner - Can be fired ahead three tiles to help clean up the inevitable mess that Medbay becomes.
  • Syringes - For use in taking blood and injecting chemicals into patients.
  • Body Bags - Used for storing dead bodies in. Can be labeled with a pen.
  • Sink - Use this to wash your dirty, dirty germ covered hands.
  • Mass Spectrometer - Used for testing toxins in a patient's blood. One does not start off in Medbay and has to be ordered from Research and Development.

Machinery

Cryogenic Chambers

Used for putting critical patients into stasis, finishing newly cloned patients, or treating patients with genetics damage. Be sure to check periodically to see if the chambers need to be restocked with chemicals.

Cryo starts out warm and has to be set up, and is useless until it's cold and loaded with medicine. Since it's the patient's body temperature that determines whether cryoxadone and clonexadone work, you won't get very fast results until the cryo tube is cold enough to quickly freeze the patient--around 50 Kelvin is good. Removing space suits speeds up the process as well.

Setting Up Cryo

Using Cryo

Sleeper

Sleepers are used to administer medication and perform dialysis.
Placing patient in: Grab them and click on the unit.
Getting patient out: Right-click on unit -> Eject Occupant.
Dialysis: Once the patient is inside, click 'Start Dialysis'. Dialysis filters out blood, having the bonus of pulling out chemicals. This treatment should be used when you believe someone to be overdosing or to be poisoned. The beaker inside the sleeper will fill with the blood and eventually you will need to empty it. To retrieve the beaker, right-click on the sleeper and click 'eject beaker'. Dialysis can cause a patient to suffer from severe blood loss if the patient is left in too long.
Use console to interact with unit.
The machines will not stabilize critical patients, though they can be used to administer inaprovaline.

Sleeper Chemicals

Advanced Body Scanner

Body scanner is used to locate broken bones, organ damage, and internal bleeding. Also can be used to find implants and foreign objects inside people.
Placing patient in: Grab them and click on the unit.
Getting patient out: Right-click on unit -> Eject Occupant.
Use console to interact with unit. Printing out a report and sending it along with the patient to surgery will help the surgeon.

Procedures

CPR

Used to heal some suffocation damage caused by being in critical condition. Inaprovaline is usually better, but if you have a patient with severe poisoning and Dylovene in their system, Inaprovaline will just react to form Tricordrazine, which isn't particularly helpful. In this case, administer Dylovene and stabilize with CPR. Clicking someone with an empty hand and help intent will perform CPR on them.
Shaking an individual means that they are not in critical. Will not work if either you not the patient is wearing a mask.

Blood Transfusion

When a patient is low on blood, they will need a blood transfusion.

Blood Compatibility

Brain Transplant

If patient is diagnosed with lack of head and the patient's torso is destroyed or missing, this will be needed to clone them.

Facilities

These are the vital machines and rooms you will need to treat your patients.

Surgery Room

The surgical area of Medbay is comprised of several smaller rooms. There's the main Operating Theatre for surgeries, an Observation room for people to observe, a rest area for patients, and a cold storage room. See: Surgery for more details on preforming surgeries.

Surgery Room Features

Chemistry

The main housing station for the chemist. They are in charge of the making and passing out of chemicals to assist members of the station. See: Guide to Chemistry for more details.

Genetics

This is where the geneticist works on manipulating the human genome, torturing monkeys, and clone a dead body or two during a shift. See: Guide to Genetics for more details.

Virology

Hopefully, a virologist will spend more time in here curing diseases rather then releasing them. See: Guide to Virology for more details.

Medical Storage

This area contains the majority of the tools you will need for curing patients.

Patient Rooms

These are best used for non-critical patients awaiting treatment, patients needing to rest after treatment, or for holding mentally unstable patients waiting evaluation.

Morgue

This is where cadavers are stored. There is an autopsy table located here, as well as several morgue trays. See: Guide to Cadavers for details on dealing with dead bodies. Шаблон:Gameplay Guides

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