Guide to Wounds

Chief Medical Officer Kingston says: "How on Earth did you manage to break every single bone in your body?"

Wounds are specific injuries that can happen to people if they accumulate large spikes of damage on a specific limb, or in other words, when they get hurt really bad all at once. Most things regarding them are still WIP and up in the air, but here's a rough guide on how to deal with them and what's important about them.

First, some helpful infographics! (Now somewhat outdated)

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These will give you general insight into how wounds work and how to treat them, but we'll include a bit more information below.

Wounds 101: Oh Shit Wat Do

So you/someone around you is grievously hurt, and you need advice now! Here's each type of wound, what they do, and how to treat each one.

• Bone Wounds: Cause interaction/movement slowdowns depending on the limb
  • Joint Dislocation: Use a bonesetter or get someone to aggo-grab you and click on you with help intent
  • Hairline Fracture: Get surgery, or apply bone gel followed by surgical tape to the limb and wait. Gauze can splint the wound to lower penalties.
  • Compound Fracture: Same as hairline fracture, but both the surgery and gel/tape method take longer. Gauze splints will re-enable the limb until it can be healed

• Slash Wounds: Make you bleed, worse cuts bleed faster
  • Rough Abrasion: You can probably ignore it
  • Open Laceration: Apply gauze to the limb to greatly staunch bleeding, sutures and cauteries (or anything that can light a cigarette) reduce bleeding directly, emergency medipens help clot all active cuts if you have several
  • Weeping Avulsion: Lower your bleeding ASAP! Apply emergency medipen and gauze, then apply sutures/cauterization as necessary until down to at least an Open Laceration, if not an Abrasion

• Pierce Wounds: Bleeds slower than slashes but doesn't clot, chance to lose some blood when hit again in this limb
  • Minor Breakage: Not super important, sutures, gauze, or cautery will fix it
  • Open Puncture: Apply gauze to the limb to greatly staunch bleeding, sutures and cauteries (or anything that can light a cigarette) reduce bleeding directly, emergency medipens help clot all active cuts if you have several
  • Ruptured Cavity: Important to deal with, Repair Puncture surgery is quick and effective, as is just using a cautery, even if you take some burn damage from it.

• Burn Wounds: Attacks deal more damage to this limb, Third Degree and Catastrophic Burns become infected
  • Second Degree: Just apply some ointment or regenerative mesh and wait a bit
  • Third Degree: Debriding surgery takes care of both infections and flesh healing effectively, otherwise use more ointment/mesh along with some spaceacillin or a paramedic UV penlight
  • Catastrophic Burns: Same as Third Degree, but with more urgency

The above steps give you enough info to handle the very basics of CQC first-aid, allowing you to at least look like you know what you're doing when someone gets hurt. If you get a good handle on the above information, congratulations! You have a good enough grip on wounds to deal with most situations that may arise, and be able to render aid to people who get hurt if you need to, or seek out aid for yourself. If you're ever in doubt, find a wound scanner or a health analyzer set to wound mode, and you'll get a big readout of what you need to do to fix them up.

Wounds 305: The Thick of It

Paramedic Jones says: "It's bad enough this asshole chose to bleed out and make me piece him back together, but he could've at least limped somewhere public before passing out..."

Welcome to Wounds 305! This is for players who want to learn more about the specifics of wounds, whether you're a medic looking for the best ways to stabilize and treat them, or a nefarious individual looking for the best ways to deal them. The above information in Wounds 101, combined with use of a wounds scanner in game, provides enough information to generally treat injuries and understand their most important parts. The following information is supplemental, and goes into extra detail to help you understand the finer points of treating them, and how to be more efficient in doing so.

Wounds are classified by two things: Type, and severity. There are four types (blunt, slashing, piercing, and burn), and three main severities (moderate, severe, and critical). The higher severity a wound is, the more damage it takes to suffer, and the more debilitating it is until treated.

• BLUNT wounds are broken and dislocated bones, and are dealt by brute attacks that aren't sharp. These have higher thresholds than cuts or burns and lack the ability to shred jumpsuits, making them harder to deal than the other types. However, they are a bit harder to treat, and are less affected by armor. These have different effects based on where they're dealt.
  • Arms: Slower interaction speed and longer click cooldowns with that arm.
  • Legs: Walking with that leg gives you a limp.
  • Chest: Further hits to the chest will make you cough up blood. The chest can only suffer Severe and Critical bone wounds.
  • Head: You will suffer temporary brain traumas as long as the wound exists. The head can only suffer Severe and Critical bone wounds.

• SLASHING wounds are cuts and slashes that cause you to bleed and are caused by most sharp weapons like swords and knives. The treatment for all sharp wounds is the same: apply a bandage, medipen, sutures, and maybe cauterize it with a burning tool. The difference in severities is that worse cuts bleed faster, and while a moderate cut isn't very dangerous, a critical cut is immediately life threatening if left alone.
  • Standard epinephrine medipens and emergency medkit medipens contain coagulant, a special chemical that greatly increases clotting on all open cuts for a short duration. This makes it excellent for stabilizing patients with multiple cuts, or as a way to immediately reduce bleeding after a serious cut is suffered, without fussing with gauze or sutures.
  • Sharp weapons are usually much worse at dealing cuts against armored opponents, even if it's just a jumpsuit. Sharp weapons can shred jumpsuit protection with a few slashes though, so be sure to bring other armor if going up against sharp objects.

• PIERCING wounds are when an attack pierces your skin, causing internal bleeding, and are caused by most bullets. These are treated the same as slash wounds mostly, except they must be treated in some way to go away due to lack of clotting. In addition, being hit on a limb with a piercing wound will cause more blood to spray from the limb, increasing bloodloss.
  • Piercing wounds can be treated by the repair puncture surgery, which can be performed using only a scalpel and a cautery (or welder/lighter/whatever). This is an efficient way to treat piercing wounds without expending resources.

• BURN wounds are a bit more fiddly to treat than the other wound types, as there are two factors to recovery: flesh damage, and infection. Once both are taken care of, the burn will be healed.
  • Flesh damage: This represents the flesh that needs to be healed, and is the only factor relevant for moderate burns. To heal flesh damage, simply apply ointment or regenerative mesh to the affected limb, and wait! Having a bandage applied to the limb will make flesh regeneration much more efficient, and let a little bit of ointment go a long way.
  • Infection: Severe and critical burns will breed infection, with critical wounds becoming infected more quickly. You can see how infected your burn is by inspecting yourself and seeing if there's any purple text on the wound examine text. Sterilizine, spaceacilling, paramedic UV penlights, and debriding surgery are all effective ways of reducing infection.

Other Fun Facts

• Jumpsuits offer very slight protection against wounds! If nothing else, your trusty grey jumpsuit may very well be the difference between a stray laser shot leaving you mostly unharmed other than the normal burn damage, and suffering debilitating second or third degree burns.
• Burning and slashing weapons generally are much more effective against completely bare flesh. To help with this, they can also shred basic clothing and jumpsuits, with multiple attacks on a specific limb disabling the clothing's protection on that limb. The clothing can be repaired with cloth to reenable it.
• When in doubt, applying gauze to most wounds will either lessen the negative effects of it, or actively speed recovery.
• Slashing wounds have very low thresholds and are easy to apply, especially against unarmored foes, but contribute little to further wound penalties. Bone wounds are fairly hard to apply, with higher thresholds, but aren't as affected by armor as cutting or burning wounds and make further wounds a decent bit easier to deal. Piercing wounds only deal a bit of bleeding and make other wounds only slightly easier, but can be applied from distance with guns, making them more of a nice add-on than a primary focus. Burning wounds are very unlikely to be dealt to covered skin, even if it's only a jumpsuit, but gain very large bonuses against bare flesh. They also apply the highest threshold penalties, making it almost trivial to deal serious slash, pierce, and bone injuries to burnt limbs.
• If you're really lazy, you can just throw them in cryo for a long while and they'll eventually regenerate wounds.
• Changelings can instantly heal all their wounds and scars through use of fleshmend and regenerate limbs.
• Regular folk can remove all their scars by ingesting carpotoxin.
• Neckgrab table slams are brutal, neckgrab table slams by a hulk are even more brutal.

Appendix 1: Full Wound Listing

Blunt Wounds

Moderate: Joint Dislocation

• Negative effects: Slightly slower interactions with that limb (arms), slight limp with that limb (legs). Cannot be dealt to the chest or head.
• Full Treatment: Use a bonesetter on the affected limb.
• Improvised Treatment: Get a friend to put you in an aggressive grab, target the dislocated limb, then interact with you on HELP intent. They'll start straining your limb and hopefully pop it back into place. Doing this on DISARM or HARM intents will instead try to snap the arm and cause a fracture, but you won't be able to tell which is which until they succeed!
• Improvised Treatment #2: Being crushed by an airlock or a firelock has a 33% chance to pop dislocated limbs back in place. Don't worry, crushing can't wound you, so all you have to lose is time and some brute damage!

Severe: Hairline Fracture

• Negative effects: Fairly slower interactions with that limb (arms), sizable limp with that limb (legs), random mild brain traumas (head), chance to cough up blood when hit in chest (chest). Counts as mangled bone for purposes of dismemberment.
• Full Treatment: Three step surgery, requiring a scalpel, a bonesetter/bone gel/sticky tape (one of these), and a cautery. This will instantly repair the bone upon completion.
• Improvised Treatment: Apply bone gel directly to limb, then apply surgical sticky tape to the limb and wait. It's much better to have a friend apply these, as self-applying the bone gel can fail and cause you to pass out briefly (consuming one use of bone gel). The chance to fail and pass out is much higher with compound fractures than hairline fractures, though being drunk, on morphine, or in a combat high from a wound will lower your chance to fail. Lastly, applying the sticky tape will start to regenerate the limb, during which you will randomly take brute/stamina damage around your body. This regeneration period is longer if you apply the surgical tape to yourself, and is also longer for compound fractures than for hairline fractures. After a few minutes, the wound will be gone.
• Triage Stabilization: You can secure the bone with a "splint" by using medical gauze on it. This will lessen your interaction/limp slowdowns, though you'll still need to get the bone treated.

Critical: Compound Fracture

• Negative effects: If suffered on an arm or leg, the limb is disabled until treated or splinted. If suffered in the head, random severe brain traumas until fixed. If suffered in the chest, significant chance to cough up blood when hit in chest. Counts as mangled bone for purposes of dismemberment.
• Full Treatment: Six step surgery, starting with the standard incise/clamp/retract, and ending with the standard cauterize to close. Step 4 is to reset the bone, and is best done with bonesetters, though surgical sticky tape or standard sticky tape can do in a pinch. Then step five is to repair the fracture, which is done with either bone gel or surgical sticky tape, with normal sticky tape working as an alternative. Truly, duct surgical sticky tape is a miracle fixer that no self-respecting paramedic should be without.
• Improvised Treatment: Apply bone gel and surgical sticky tape to the affected limb, same as with hairline fractures. Having a friend help you is even more important than with hairline fractures, as your penalties for successful gel application and tape recovery time are more punishing than for hairlines.
• Triage Stabilization: You can still secure the bone with gauze, same as hairlines. In addition, a splint will reenable the limb, though you still have severe penalties.

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Slash Wounds

General notes:

• Unlike dislocations and fractures which have different properties at different severities, slashing wounds all function the same and use the same treatments, just with different levels of severity and urgency. As such, their mechanics are described below, and each severity will have a short note for how to approach them.
• Cuts are based off a blood_flow counter that increases with wound severity. Every tick, you lose that much blood, and your blood flow is modified based on a few factors noted below. When your slash's flow goes below a certain threshold, it is demoted to the next lowest severity, but while it is possible to increase blood flow, you cannot raise the severity directly by doing so. The factors for modifying your bleeding rate are:
  • Clot rate: Moderate and severe cuts will slowly clot naturally on their own (severe more slowly than moderate), while critical cuts slowly open up more over time. Just another reason that reducing the severity of cuts as soon as possible is important!
  • Bandaging: Wrapping the cut with bandages significantly amps up your clotting rate while active, providing a potent buff to recovery speed.
  • Coagulants: Epipens and emergency medipens contain a coagulant reagent that treats all bleeding wounds, excellent for when you need to immediately slow down bleeding or are dealing with a patient with multiple cuts.
  • Suturing/Cauterization: Sutures and cauterization immediately reduce bleeding with each application, which you can repeat until treated. Sutures are great because they reduce bleeding and heal brute damage at the same time, but if you don't have any available, you can cauterize the cut with anything that can light a cigarette. It'll hurt a bit, but you won't use up any consumables.
  • More Slashes: Not only can further slash attacks upgrade the wound severity, they'll also directly increase the blood flow by a percentage of the damage dealt.
• Remember: A stitch in time saves nine! Your blood_flow is both a tracker for how serious your wound is, as well as how much blood you lose every tick, so sinking it as soon as possible is important. Immediately applying a bandage, jabbing a medipen, or even managing one or two sutures/cauterizations can make a big difference in the total amount of blood lost by the time the wound is healed.

Moderate: Rough Abrasion

• Notes: Not very threatening on their own, and will seal themselves up shortly if not made worse. While you won't lose much blood by leaving them to clot on their own, they're very vulnerable to further attacks which can cause more severe slashes and other wounds.

Severe: Open Laceration

• Notes: Worth worrying about, at the very least you should get it bandaged or apply a few sutures or cauterizations before you lose too much blood. As noted above, reducing blood flow is better done sooner rather than later, and if you're not busy dealing with an actively hostile environment or treating patients in worse conditions, you should be prioritizing reducing the cut to moderate severity before losing too much blood.

Critical: Weeping Avulsion

• Notes: While moderate and severe slashes usually aren't immediate matters of life and death, critical slashes are by far the most dangerous wound you can suffer. Not only have you likely suffered large amounts of damage to your limb, you're also losing blood at a dizzying rate that is actively getting worse rather than better. Either wrap up what you're doing within the next minute, or run and hide for a bit to treat yourself before too long passes. Your top priority, whether you're treating someone with a critical slashes or are the patient yourself, should be to do everything you can to lower your bleeding, starting with applying bandages and sticking yourself with a medipen, followed by sutures or cauterization. Otherwise, you'll be flirting with passing out before too long.
• Also note that critical slashes count as mangling flesh, which means that if you have this, you're pretty close to getting this bodypart severed entirely. Just another reason to get it fixed ASAP!

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Pierce Wounds

General notes:

• Like slashing wounds, these mostly cause bleeding. Unlike slashing wounds, these require manual treatment in order to stop bleeding, though they're not nearly as pressing. Also, lowering the bleeding rate will not demote it to a lower tier wound.
  • Bandaging: Wrapping the pierce with bandages significantly amps up your clotting rate while active, providing a potent buff to recovery speed.
  • Coagulants: Epipens and emergency medipens contain a coagulant reagent that treats all bleeding wounds, excellent for when you need to immediately slow down bleeding or are dealing with a patient with multiple cuts.
  • Suturing/Cauterization: Sutures and cauterization immediately reduce bleeding with each application, which you can repeat until treated. Sutures are great because they reduce bleeding and heal brute damage at the same time, but if you don't have any available, you can cauterize the cut with anything that can light a cigarette. It'll hurt a bit, but you won't use up any consumables.
• Remember: A stitch in time saves nine! Your blood_flow is both a tracker for how serious your wound is, as well as how much blood you lose every tick, so sinking it as soon as possible is important. Immediately applying a bandage, jabbing a medipen, or even managing one or two sutures/cauterizations can make a big difference in the total amount of blood lost by the time the wound is healed.

Moderate: Minor Breakage

• Notes: Causes a little bit of bleeding, but not to the point that you should interrupt what you're doing to fix it by itself. Simply suture, cauterize, or gauze at your convenience.

Severe: Open Puncture

• Notes: Still not super serious, but remember that every blow to this limb can cause you to lose extra blood from the hole in it. For reference, the base bloodflow here is a bit higher than a moderate slash. If you have a surgical drapes, a hemostat/scalpel, and a cautery, the Repair Puncture surgery is very quick (simply incise, hemo/scalpel, cautery/anything hot, repeat 2 & 3 until treated, close surgery) and effective at treating piercing wounds.

Critical: Ruptured Cavity

• Notes: Almost every hit to this bodypart will cause you to lose additional blood, and you're bleeding at the rate of a severe slash. Not pretty! While not as immediately life threatening as a critical slash, this is still a very big issue and should be treated rapidly. At this point, the Repair Puncture surgery is likely your best option.
• Also note that critical pierces count as mangling flesh, which means that if you have this, you're pretty close to getting this bodypart severed entirely. Just another reason to get it fixed ASAP!

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Burn Wounds

General notes:

• While you can technically get burn wounds from any burning type weapon, in reality the mixture of a general lack of high damage burning melee weapons and the high thresholds required to deal burn wounds means that the vast majority of these will come from lasers. In addition, since undirected/general damage don't qualify for wounds, you cannot suffer serious burns from being set on fire or being exposed to space. Lava can though, so I've heard...
• Unlike cutting wounds, serious burns have very high threshold penalties (the highest of all three types in fact). This means a limb suffering from bad burns is almost trivial to cause bone wounds in, and the penalty for a moderate burn is actually higher than the threshold for a moderate cut, meaning any sharp attack that does enough damage to roll wounds (5 force) will automatically cause an abrasion, if not worse, without strong armor. Combined with the fact that burns increase all incoming damage on that limb, lasers make for an excellent way to soften up lightly armored/unarmored targets for melee fighting.

Moderate: Second Degree Burns

• Negative effects: Fairly easier to deal wounds to this limb, take 10% damage on incoming attacks on this limb.
• Full Treatment: Slap on some ointment or regenerative mesh and wait a bit.

Severe: Third Degree Burns

• Negative effects: Significantly easier to deal serious wounds to this limb, 20% extra damage on incoming attacks on this limb, slow infection.
• Full Treatment: Two step surgery with hemostat/scalpel and bandages will resolve all infection and some flesh damage. Otherwise, infection can also be treated by spaceacillin, sterilizine, or paramedic UV penlights. Ointment and regenerative mesh can heal the rest of flesh damage.
• Improvised Treatment: Miner's Salve is fairly effective at both healing flesh damage and sanitizing any infection.

Critical: Catastrophic Burns

• Negative effects: The limb is incredibly easy to cripple with serious wounds, takes 30% extra damage on incoming attacks, and becomes a hotbed of infection.
• Full Treatment: Two step surgery with hemostat/scalpel and bandages will resolve all infection and some flesh damage. Otherwise, infection can also be treated by spaceacillin, sterilizine, or paramedic UV penlights. Ointment and regenerative mesh can heal the rest of flesh damage.
• Improvised Treatment: Miner's Salve is fairly effective at both healing flesh damage and sanitizing any infection.

Appendix 2: Wounding Table

Wounding table

Wound Name	Threshold Minimum	Threshold Penalty	Base Atk Force*
BLUNT
Joint Dislocation	35	(+15)	~15 force
Hairline Fracture	50	(+30)	~15 force
Compound Fracture	115	(+50)	~25 force
SLASH
Rough Abrasion	20	(+10)	~10 force
Open Laceration	50	(+25)	~15 force
Weeping Avulsion	80	(+40)	~18 force
PIERCE
Minor Breakage	30	(+10)	~20 force (.38, medium-close range buckshot, autorifle)
Open Puncture	50	(+25)	~25 force (.38 close range, buckshot close range, L6 SAW)
Ruptured Cavity	100	(+40)	~30 force (repeated .38 close, buckshot close range, most repeated large guns)
BURNS
Second Degree Burns	40	(+30)	Lasers!
Third Degree Burns	80	(+40)	Lasers!!
Catastrophic Burns	140	(+80)	Lasers!!!

*Base Attack Force: Assuming a weapon/attack has 0 wound bonuses (cutting weapons may need more vs armor, less vs flesh), how much force it will take to have a decent chance at dealing this wound assuming either no existing wounds, or only the lower tier version of this wound type.

• Note that some wounds, critical bone wounds especially, may require multiple types of active wounds to be feasible.
• Burning wounds are simply listed as Atk Force "Lasers!" since lasers are the main source of them by far anyway. Continually lasering the same limb with no armor will probably deal critical burns within a half dozen shots, maybe plus a few.