Guide to Wounds

Chief Medical Officer Kingston says: "Are you going to be alright? Well, let's deal with all those broken bones, and then I'll get back to you on that..."

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!

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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

• Sharp 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

• 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 all factors, otherwise apply ointment/regenerative mesh to heal skin and remove infection, and get someone to aggro grab + use a sharp object on your limb to remove dead flesh.
  • 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.

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Types of wounds

Wounds are classified by two things: Type, and severity. There are three types (brute-sharp, brute-other, and burning), 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.

• BRUTE-SHARP wounds are cuts and slashes that cause you to bleed and are caused by sharp weapons and attacks. The treatment for all sharp wounds is the same: apply a bandage, sutures, and maybe cauterize it with a burning tool or a laser weapon if you're desperate, the difference is that more severe cuts bleed much faster, and while moderate and severe cuts will slowly clot themselves, critical cuts will instead slowly open up and get worse, so dealing with it quickly is important! The emergency medical pens available in emergency medkits found in O2 lockers have small amounts of coagulant, which greatly helps clotting.
• BRUTE-OTHER wounds are broken and dislocated bones, and are dealt by brute attacks that aren't sharp. These have higher thresholds than sharp or burning wounds, and will likely be less common, but can still be a nuisance when suffered.
  • Moderate bone wounds, or dislocated joints, can be treated with the application of a bonesetter from surgery, or by simply aggressively grabbing the patient, and interacting with them helpfully while targeting the limb to set it back in place. This may take a few tries! You can also snap their arm this way by interacting with them on disarm or harm intent if you're a sadist. They can't tell the difference until it's too late!
  • Severe and critical bone wounds are broken bones. They incur sizeable slowdowns to interactions with that arm, or force you to walk with a limp if it's a leg, and critical wounds will disable that limb entirely. These penalties can be lessened, and in the case of critical fractures the limb can be reenabled, by splinting the limb with medical gauze or sticky tape. The better the splint (gauze being the best, standard sticky tape being the worst), the more the penalties are lessened. To be fully healed, you must perform surgery.
• BURN wounds are nasty burns that are dealt with lasers and fire weapons like the welding tool. These wounds are dangerous in the long run, as while they don't harm you much directly immediately, they increase further damage on that limb, make further wounds much easier to deal to the limb, and at severe and critical levels can breed infection. In addition, there are a few things you need to treat when it comes to severe and critical burns, making them a bit more tricky to heal. The following are the three factors that go into healing a burn wound:
  • 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.
  • Dead flesh: This represents flesh that's outright dead and needs to be removed entirely. You can remove it safely and quickly through debriding surgery, but in a pinch, you can simply aggressively grab the patient and apply a sharp object to the limb on help intent to carve the dead flesh off directly. This may take a little bit and will incur some brute damage, so be prepared to deal with that.
  • Infection: Severe and critical burns will breed infection, with critical wounds becoming infected more quickly. This is really important to keep track of, and you can helpfully do so by simply examining yourself and seeing how dire the purple text describing your wound is. If there's none, great! No infection yet. The infection works by an "infection" level counter, which increments naturally as time goes on, and decrements if a separate "sanitization" counter is above 0. Basically, sanitization freezes the progress of infection and reverts it, so it's best to get on it early. You can increase sanitization by: applying ointment or regenerative mesh, having spaceacillin or sterilizine in your bloodstream, using the special paramedic penlights that paramedics spawn with on them to blast them with UV light! Bandages will also extend the usefulness of sanitization, making them great to slap on early. Infection is the only factor that gets worse after the wound is created, so once the other two are taken care of, this is all you'll have to worry about
  • Once all three of these are at 0, the burns go away! Hooray!

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Bone Wounds

Moderate: Joint Dislocation

• Negative effects: Slightly slower interactions with that limb (arms), slight limp with that limb (legs)
• 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)
• 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: Your limb is outright disabled, and cannot be reenabled by healing the brute damage on the limb.
• 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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Sharp Wounds

General notes:

• Unlike dislocations and fractures which have different properties at different severities, cutting 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 is initially set when the cut wound is gained, with worse cuts having higher blood_flow values. Every tick, you lose that much blood, and your blood flow is modified based on a few factors (hopefully lowered), noted below. When your cut's flow goes below a certain threshold, it is demoted to the level below, but while it is possible to increase the 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, though moderate cuts clot at a faster rate than severe cuts. A moderate cut can heal by itself in as little as 20 ticks if left alone, while a severe cut will take around 15 ticks to demote to moderate, then another 20-ish ticks to clear up. Critical cuts, however, will slowly open up and get worse if left on their own. This means applying a bandage or otherwise getting the bleed threshold down to severe is imperative, putting critical cuts at the top of the triage importance list.
  • Bandaging: Wrapping the cut with bandages significantly amps up your clotting rate while active, providing a potent buff to recovery speed.
  • Coagulants: Epinephrine medipens and emergency medkit medipens both contain a proprietary coagulant substance that provides a substantial buff to clotting speed, and unlike other treatment options, coagulants affect all of your active cuts at once! If someone is suffering from multiple bad cuts all over their body, quickly jabbing them with a medipen can very well be the difference between life and death.
  • Suturing/Cauterization: Whereas bandages and coagulants are applied once and passively lower bleeding, sutures and cauterization provides a more immediate solution, rapidly reducing bleeding with each application. 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 a surgical cautery, or almost anything that can light a cigarette. You'll suffer some burn damage along the way, but it's still a very effective way to staunch bleeding and doesn't use up any consumables to boot! If you're REALLY desperate, you can also apply a lasgun directly to the cut to cauterize it that way, though point blanking yourself with a lasgun is obviously very painful.
  • More Cuts: Not only does having the cut wound make your limb more susceptible to further wounds, any additional sharp attacks on that limb that don't increase the severity will still increase the bleeding rate by 5% of the damage. That means a scalpel cut of 10 damage adds another .5 bleeding, equivalent to the damage undone by one suture. Be careful!

• 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.
• Sharp weapons are generally much less effective at dealing cuts when the target has any armor at all, including the small wound protection afforded by standard jumpsuits, but are much more effective against bare skin. To compensate, sharp weapons (along with burning weapons) have the ability to "shred" clothing by dealing damage to individual limbs with repeated attacks. The key takeaway is that sharp weapons become much more dangerous once they've landed 2-3 hits on the same limb assuming the target has no dedicated armor, and repeated attacks in the same spot are much more dangerous than spreading the damage around evenly. Since only jumpsuits are shreddable in this way right now, sharp weapons are much MUCH less effective against armored opponents, and if your enemy is wearing an armor vest, you should attack their exposed limbs instead to maximize bloodloss.
• Cut wounds have by far the lowest thresholds and penalties of the three wound types, meaning that limbs already suffering from damaged bones or severe burns are almost trivially easy to score cuts on, but cuts are not very effective at softening up limbs for other wound types. If your enemy is already suffering from broken bones or severe burns, it's much easier to add on cuts and bleeding by focusing on those limbs with a sharp weapon.

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 cuts 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 cuts usually aren't immediate matters of life and death, critical cuts 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. If you don't think you can win whatever fight you're in within the next 45-60 seconds, now is probably the time to disengage and hide for a bit, or at least jab yourself with a medipen before too long passes. Your top priority, whether you're treating someone with a critical cut 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.

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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...
• Similar to cutting weapons, burning weapons suffer from large wounding penalties when faced with armor, but have the ability to shred clothes. Just like with sharp weapons, a jumpsuit may protect you from severe burns from one or two stray lasers, but being shot in your bare skin is very dangerous and can easily cause wounds.
• 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:
• 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)
• 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: Your limb is outright disabled, and cannot be reenabled by healing the brute damage on the limb.
• 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.

Other fun facts that I need to work into a real guide:

• 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, slap a bandaid on it and hope for the best.
• If you're really lazy, you can just throw them in cryo for a long while and they'll eventually regenerate wounds.