User:Diarik/Triage Explained

This is a paper written by Diarik Erasto as a summation of his experience in triage.

What is a Triage? Why do we have them?

Wikipedia defines a triage as, "a system used by medical or emergency personnel to ration limited medical resources when the number of injured needing care exceeds the resources available to perform care so as to treat the greatest number of patients possible."

Too often, Elanthians mistake a triage simply as "the place to drag the dead". This could not be further from the truth.

In Elanthia, a triage is a process by which the wounded and dead are admitted for recovery in order to support a defensive effort against an invasion. A triage location is the room in which this occurs, and is manned by a triage team consisting of specialized adventurers.

A triage's first priority is to keep every fighter able and ready to fight. Its second priority is to establish a defensive base to which fighters can fall back if hard-pressed. Everything is tertiary to these two goals.

The Process of New Life

Death

First, determine the nature of your death. A vitality death is easier to handle than a traumatic death (where some body part has been severely damaged, such as a missing neck.) If you have more than one bleeder or missing part, this it's safe to assume it is a traumatic death. This information is useful to those who help you, if you are one of many.

Second, decide, based on how much time you have before automatic departure, the regional situation, and your position, how feasible it is to anticipate help. If an invasion is underway and you died in an out-of-the-way place, receiving aid in the near future may not be likely. You may decide to depart immediately or wait or call for a friend.

The Cleric's Role

The cleric's role in the process of new life is first to protect a corpse's memories, and then to enact Resurrection.

Disclaimer: Please note that any cleric has the right to refuse service to any corpse.

The Empath's Role

The empath's role is, quite obviously, to heal you. The empath can only do this with sufficient mana to heal themselves simultaneously, and if their body has the sufficient resilience to take the damage you've sustained in the first place. Overhealing is not uncommon when working on a corpse, and an empath should remember that their life is more useful.

Disclaimer: Please note that any empath has the right to refuse service to any corpse.

Raise/Depart

If a cleric is unable to raise you, or an empath unable to heal you sufficiently, departure is a safe option. Be aware of nearby departure points and plan accordingly.

New Life

At the point of new life, your vitality, attunement, fatigue, and spirit are typically quite low. Take some time and let these recharge before you go back out into the field. Spend your time considering the usefulness of favors while you're waiting.

Ready to Fight

You may consider yourself ready to fight when:

• Your vitality is full. (Your body feels at full strength.)
• You have no significant wounds.
• Your spirit is either half full, or a Vigil is active on your person. (Your spirit feels rather shaky.)

Lifecycle of a Triage

A triage has three purposes. First, it is the place where the dead are brought to be dealt with. Second, it is the place where wounded go to be healed. Third and most rare, it is the last resort fallback point.

First Sighting

Usually, sightings of invaders are gwethed. As such, those who typically participate in triage should give serious consideration to keeping an ear on the gweth traffic in case of a call. Sightings give a general indication of what region will be under attack, and thus draws a scrimmage line behind which one should locate the triage.

Triage Location Named. Begin Convergence

Most populated areas have triage locations of tradition, and thus this isn't a problem. However, some places are better than others, and situations change over long periods of time, requiring eventual re-evaluation of past decisions. It is typical, for instance, for a city like Crossing to maintain two triages–one in the Empath's Guild, and one in the Cleric's Guild–even though this practice makes triage efforts difficult. Neither location is good for an efficient triage.

Convergence refers to the movement of triage participants–typically clerics and empaths, though other guilds have their own roles and interests–from wherever they may be to the triage location. Note: There should never be more than one triage location.

Having multiple rooms is usually detrimental to a triage. There are several reasons; the primary one is that any beneficial spells or effects in place in a single room do not extend to another. Thus, secondary triage supports must have their efforts doubled. A paladin needs to create two Banners; Raise Power must be cast twice; two paladins must do Glyph of Mana; and so on.

There are good reasons to intentionally use two or three rooms, as well. An assembly line mentality, for instance, or to try to compensate the hectic atmosphere of a triage. Also, as unlikely as it is, there remains the possibility for a divided front battle, where "behind the lines" is in two places, and thus two triages might have to be set up. Defending Dirge and Crossing from an attack originating from Arthe Dale, for instance, or an attack on Theren and Langenfirth originating from the area near El'bain's Stop.

Protecting Triage

Creating a no-fight zone

There are two simple ways to do this: either cast and maintain a Banner of Truce, or have a Bard sing Albreda's Balm constantly. The effect is to place all persons in the room under a Calm status, nullifying the possibility of violence.

Sealing off the entrances

Combatants should keep an eye out on all possible routes of entry and attempt to keep these lanes as clear as possible. The reason for this is because we need to be able to bring deaders in via dragging, and the draggers should be kept as safe as possible for this.

Safeguarding the line of departure

The "line of departure" is the fastest known route between the place where one departs and the triage where one's grave is. This line should be as short as possible, and if it spans more than one room, be in a protected position. The best example of this is probably the Theren chapel.

Moving Triage - Falling Back

The best method for moving triage is by moongate. It is fast, efficient, and elegant. However, for dozens of reasons, this is not always possible. In order to minimize the chaos that will ultimately result from a change in triage, there are a number of things that should be done.

First, assign 3-4 non-empaths to broadcasting via gweth the new location. Ignore this if the enemy is also on the gwethnet. Broadcast for a good five to ten minutes, at approximately one minute intervals, to make it very clear as to the change in plans.

Empaths and half the complement of triage protectors should be the first to move. Empaths, in finding a new location, should verify that it is sound as a triage location. This should be affirmed by the protectors, at which point the deaders should be dragged across while the empaths get back to work. The final stage comes when the remainder of the protectors fall back to the new triage location, completing the process.

How does a Triage work?

Empath Readiness

The empaths are the backbone of a triage. Unless an appointed triage leader disagrees, the empaths' requests must necessarily come first during a triage. Why?

1. Empaths heal the living wounded.
2. Empaths heal the wounded dead.

Without empaths, you have no triage. Clerics are secondary; you only need them for triage when dealing with deaders.

Who is more important than who?

1. Empaths.
   Empaths are always the most important. When they're returned to life, they add to the strength of triage phenomenally, even a novice. The obvious reason is because the more empaths there are, the more distributed wounds are.
2. Living fighters.
   It's less work to push a living adventurer to Ready to Fight than it is a dead one. Making it possible to send them back out into the fray and add to the opposition against the invasion is preferable.
3. Living moongaters and triage clerics.
   This is a nerve check. Both of these types of triage personnel are heavily dependent on strong nerves to carry out their roles. Typically, further wounds are irrelevant during the heat of triage, and should be ignored. Rejuvers and Raisers are useful for obvious reasons, and Gaters are remarkably useful for changing the topology of a battle.
4. Dead people.
   Corpses should be handled in the same order as above, empaths, then fighters, then gaters and clerics. Note that some clerics should be considered fighters first if they are intent on contributing to the fight, rather than triage.
5. Everyone else.
   People seem to have a knack for figuring triage empaths can heal their wounds when they're busy with a heavy stream of pertinent wounded. If there isn't anyone else, then there is obviously little reason not to touch them up. Unless you don't want to. In which case, don't.

Quarantining Disease

Anyone who notices a contagious disease should immediately inform as many people as possible. This means to shout it out and gweth it; disease is notoriously deadly when left unnoticed for a significant amount of time. An empath should declare a secondary triage to hold quarantine and direct all diseased individuals there. A quarantined triage should have a strong line of departure, but it should not worry about defenses, since they typically become irrelevant. The Infirmary of the Empath Guild is an excellent quarantined triage, as it has been used as such in the past before.

Blessing Weapons

If there are undead invading, a reasonably capable Cleric should make herself available to provide Blesses to weapons. Such a cleric should obviously possess the spell Bless; it is recommended that this cleric further possess multiple cambrinth (of at least 20 mana capacity) and have the spell Persistence of Mana. A bless of 58 streams yields 163 strikes, which appears to be the maximum possible. A bless of 58 streams also yields 2 anlaen when placed on a person, and distributes 100 strikes to each weapon in your group.

Note: Weapon blessings are NOT part of triage. The purpose of triage is to process the wounded and the dead. Weapon blessings are a support staff role. Occasionally, you will find that a triage cleric is willing to help, but their mana usage is generally tied up. The best way is for a cleric to set himself apart from both combat and triage to offer his services.

The Art of Patience

Triage is typically hectic. The order outlined above is one I strongly recommend and, further, folllow because it is logical to me. People generally differ in opinion, and this topic is no exception. Demanding service rarely helps your cause; to remind the triage personnel of your presence is one thing, but to nag them is another. Blessing weapons is not part of triage, and should not be lumped in.

The Role of Indirect Guild Abilities

Some guilds have abilities that they often believe would help out during triage. Some truly are helpful, some are only helpful in certain cases, and others are actually a complete hindrance. For instance, a Banner of Truth is a choice that will always help, whereas a Fire Rain is a fairly bad idea. This section lays out the more uncertain options and explains what I consider to be what.

Paladin's Glyph of Mana

Never hesitate to use this ability when a body and a cleric are present. It only does good.

Cleric's Meraud's Blessing

This ability should be conserved in favor of utilizing devotion for the power perception bonus. The mana gain is insufficient incentive; its primary usage should be to protect triage.

Zephyr and Barbarians

Zephyr is more important than keeping a Barbarian's Inner Fire up. You should announce it if you're casting, and barbarians should step out for the brief moment you cast, or accept the hit gracefully. It is better to have a good Zephyr in the area. In general, triage-friendly spells always supercede the need to be courteous to Barbarians. They should be notified, but this is triage, not a forward base.

Bardic Enchantes

Hodierna's Lilt

This may always be sung or played. A bard should feel free to play regardless.

Albreda's Balm

This may always be sung or played. A bard should feel free to play regardless. However, it should be noted that a Paladin's Banner of Truce spell negates the usefulness of this enchante, and the bard should consider this when selecting their enchante.

If Balm is in effect, a Banner cannot be cast. Please keep aware of any paladins and stop playing if they declare they are casting a Banner of Truce.

Sanctuary

This is generally a bad idea, because it blocks Moon Mage Locates and familiar arrival, both of which may be critical.

Nexus and Naga's Blessing

This may always be sung or played. A bard should feel free to play regardless.

Empath's Raise Power and Guardian Spirits

Always have someone cast Zephyr before casting this spell. Everyone, further, should join the empath casting to maximize the mana gain from it. A gusty Zephyr will regain your full fatigue in three to five pulses, negating the detriments. Patience serves you well.

Guardian Spirits may make it difficult to cast area spells, such as Banner of Truce. As a result, it is recommended that the empath dismiss them before such spells are cast.

Compost

Generally, never cast this spell. If a box happens to be on the ground, you'll deliver serious pain to many of the patients, some of which may be in a near-death status as it is. To minimize the risk of aggravating this, it is wiser to never consider Compost as a permissible spell.

The sole exception for this rule is in a well-coordinated triage, where the Ranger and others in triage have an understanding. This exception should generally be considered irrelevant.

Ethereal Fissure

Strictly speaking, no one cares. The spell does not adversely affect anyone, and only aids the amount of mana for Elemental mana users. Never feel obliged to ask before casting.

Locating Triage - Where To Toss the Body

The Necessity of Mana

Mana is critical to the survival of a triage. Bards depend on Elemental mana, Empaths on Life, Clerics and Paladins on Holy. You cripple their ability to contribute without mana. Because Empaths are of primary importance to triage, the chosen location must necessarily have strong Life mana; if an empath says there isn't enough, that's justification for moving. Secondarily, the location should have strong Holy mana, but if this is not possible, then there should be strong Holy mana nearby.

Strategic Locations - The Bottleneck

Invasions move room by room; the creatures spawn at a certain point and move forward from there. Thus, you can safeguard a triage simply by defending a room leading into the triage. This is the nature of the bottleneck.

A bottleneck requires that there be a minimal set of exits into and out of triage; this makes it possible to Seal off the Entrances. For instance, in Crossing, you can hypothetically hold triage inside the Northeast Gate. Why? Because the gate creates a bottleneck: if you can hold the invaders there, they cannot enter the city through it. (I'll leave it to the reader to reason why this location is nevertheless a poor triage. Consider it an exercise.)

Strategic Locations - The Corner

The idea of "fighting with your back to the wall" is remarkably sound. It means that you don't have to worry about an enemy behind you, because the enemy cannot manuever into that position. Thus, places like store shops are surprisingly useful as triage locations, because it's a One-Way Bottleneck. In order to get to triage, you must first get in through the bottleneck.

Strategic Locations - The Escape Route

The problem with a Corner is that there isn't an escape route. A good triage plan includes possibilities of falling back. When the defenders are overwhelmed, or if the invaders do a trick like Yhaman's moongate appropriation, you must have a route of escape to ascertain that triage remains safe. All primary triage locations should include an escape route; all last resort triages will be in a corner.

How to Evaluate a Triage

There are two topics to note here. One is that a given triage location may be better than another. The other is that experiencing a triage helps evaluate how one can improve it.

Triage Location

While my scoring system is not designed to favor one location over another, I am nevertheless most familiar with Crossing, Langenfirth, Therenborough, and Shard and base my evaluation of triage locations on this knowledge. It may be less applicable on the islands or in Forfedhar, but the same principles should apply.

A score of zero means that the location is acceptable as a triage location, but not preferred. A negative score means that the location should not be used at all.

Mana levels

Mana levels should be determined by unboosted magic users. (Clerics: this means your PP bonus should not be factored in.) At a minimum level of mana, a location is awarded zero points. For each level of mana perceptible above the minimum, aware one point. For each level below, penalize by one point. Minimum levels are:

• Life mana perceived by 150 +/- 30 PP - pulsating.
• Holy mana perceived by 200 +/- 30 PP - pulsating.

Departure Proximity

Generally speaking, you should always know where you will depart to if you do. The closer a triage is to the departure point, the better, in order to minimize the distance a recent deader has to run back to his grave or ward.

• Award one point if the room is the departure point or one room away.
• Penalize one point for every room past the sixth.

Departure Angle

With sufficient experience, regular invasion participants will note that the fighting is done in a number of general areas. Placing the departure point on the other side of any of these areas is asking a deader to run through the thick of battle to get to his grave. This is stupid.

• Penalize three points for bad angle. Because I think it's really dumb.

Mechanical Inconveniences

In some locations, there are problems with actions, such as spellcasting, hiding, or teleport wards. These may get in the way of triage operations.

• Penalize one point if any exist.
• Penalize one point if indoors without a window. (Test by attempting to focus a moonbeam.)
• Penalize a thousand bloody points if spellcasting is disabled.

Bottleneck

As described above, a Bottleneck minimizes the number of exits into a triage location in order to make it more easily defended. The fewer the exits, thus, the better.

• Award one point for 0 to 2 exits.
• No points for 3 exits.
• Penalize one point for 4-7 exits.
• Penalize two points for 8 or more exits.

Triage Competence

The goal of this section is to provide a system by which a triage can be evaluated and its capabilities assessed. Such a review will give people the ability to determine what competencies are lacking and suggest ideas for filling these gaps.

I haven't figured out any reasonable metrics by which to rate triages. Until then, just ignore this section.

Leadership Presence

Even the least effective triages can operate passably with good leadership. The leader should be agreed to by all participants. The quality of leadership is indicated by an understanding of what is necessary during the course of the triage, awareness of how things are going both inside and outside the triage (e.g., the duration left on the Banner, who needs healing and who doesn't, etc.), and knowledge of conventional strategy, like how and where to move triage in case of an emergency.

Number and Type of Participants

The number of triage participants should be proportional to the number of fighters active in the invasion.

• For every 10-15 fighters, there should be one empath. The more capable the empath, the larger a load he may take, but 10-15 is usually a fairly safe bet.
• For every 30-50 fighters, there should be one cleric. Competent clerics are naturally capable of handling a much larger load than empaths, and are thus less necessary in large numbers. The cleric should utilize Room Rejuvenation, minimize Resurrections to those that are easy to do, and maintain her own spells.
• Each triage should include 1-2 paladins for maintaining a Banner of Truce, warding the dead, glyphing mana, and restoring fatigue.
• Each triage should hope for 1 moon mage who is capable with Moongate. His purpose is to minimize the amount of dragging that the fighters are doing by shortening this process. He should not need to leave triage. A moon mage is also an excellent way to add an Escape Route to a Corner, as normal restrictions do not apply.
• Each triage should hope for 1-5 bards singing Lilt, Balm, Naga, and Nexus.