Guide to Wounds

Chief Medical Officer Fails-With-Numbers says: "How on Earth did you manage to break every sssingle 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. It is key to look for and heal wounds in addition to general damage in order to make a patient healthy.

Wounds 101: What was that sound!?

So, you or 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 or movement slowdowns depending on the limb.
  • Joint Dislocation: Recommended application of bonesetter to affected limb, though manual relocation by applying an aggressive grab to the patient and helpfully interacting with afflicted limb may suffice.
  • Hairline Fracture: Recommended light surgical application of bone gel, though a sling of medical gauze will prevent worsening situation.
  • Compound Fracture: Same as hairline fracture, but both the surgery and gel/tape method take longer. Gauze splints will make the limb usable until it can be healed.

• Slash Wounds: Make you bleed, worse cuts bleed faster.
  • Rough Abrasion: Apply clean bandages or first-aid grade sutures, followed by food and rest.
  • Open Laceration: Apply gauze to the limb to greatly staunch bleeding, sutures and cauterizes (or anything that can light a cigarette) reduce bleeding directly, emergency medipens help clot all active cuts if you have several.
  • Weeping Avulsion: Reduce the bleeding ASAP! Apply an emergency medipen and gauze, then apply sutures and cauterization as necessary until down to an Open Laceration or an Abrasion.

• Pierce Wounds: Bleeds slower than slashes but doesn't clot, there is a chance to lose some blood when hit again in the same limb.
  • Minor Breakage: Treat the affected site with bandaging or exposure to extreme cold. In dire cases, brief exposure to a vacuum may suffice (Space is like an ice pack).
  • Open Puncture: Apply gauze then repair punctures in skin by suture or cautery, extreme cold may also work.
  • Ruptured Cavity: Important to deal with, Patch Wounds/Treat Burns 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: Recommended application of topical ointment or regenerative mesh to affected region then wait for a bit.
  • Third Degree: Recommended immediate disinfection and excision with scalpel of any infected skin, otherwise use more ointment/mesh along with some spaceacillin or a paramedic UV penlight.
  • Catastrophic Burns: Immediate surgical debriding of any infected skin, followed by potent tissue regeneration formula and bandaging.

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. The table below lists the damage thresholds and penalties for each type of wound.

Damage table

Wound Name	Threshold Minimum	Threshold Penalty
BLUNT
Joint Dislocation	35	(+15)
Hairline Fracture	50	(+30)
Compound Fracture	115	(+50)
SLASH
Rough Abrasion	20	(+10)
Open Laceration	50	(+25)
Weeping Avulsion	80	(+40)
PIERCE
Minor Breakage	30	(+10)
Open Puncture	50	(+25)
Ruptured Cavity	100	(+40)
BURNS
Second Degree Burns	40	(+30)
Third Degree Burns	80	(+40)
Catastrophic Burns	140	(+80)

Wounds and you: The four weaknesses

Paramedic Kiereti says: ""It'ssssss bad enough thissssss asssssshole chosssssse to bleed out and make me piece him back together, but he could've at leasssssst limped ssssssomewhere public before passssssing out...""

This section is a more in depth look at each wound type and severity including special effects and treatment options. The information in Wounds 101, combined with use of a scanner in wounds mode, 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 more severe wound is, the more damage is required to sustain it, 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: You limp when walking.
  • 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 make you 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 Medi pens and emergency med kit Medi pens 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 sustained when an attack pierces your skin, which result in internal bleeding, and are caused by most bullets. These are mostly the same as slashing wounds however they require more special treatment as they do not clot. In addition, being hit on a limb with a piercing wound will cause more blood to spray from the limb, increasing blood loss.
  • Piercing wounds can be treated by the repair puncture surgery, which can be performed using only a scalpel and a cautery (or a welder, lighter, etc). This is an efficient way to treat piercing wounds without expending resources.

• Burn Wounds are a bit fiddlier 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, spaceacillin, paramedic UV penlights, and debriding surgery are all effective ways of reducing infection.

Tips

• Jumpsuits offer very slight protection against wounds! If nothing else, your trusty jumpsuit may very well be the difference between a stray laser shot leaving you mostly unharmed, except for 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. Clothing can be repaired with cloth to restore it.
• When in doubt, applying gauze to most wounds will either lessen the negative effects of it, or speed up recovery.
• Slashing wounds have very low thresholds and are easy to inflict, 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 inflict. Piercing wounds only deal a bit of bleeding and make other wounds slightly easier to inflict. However, they can be applied from distance with guns which makes 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.
• Changelings can instantly heal all their wounds and scars through use of fleshmend and regenerate limbs. On the other hand, regular folk can remove all their scars by ingesting carpotoxin.

The Details: An in depth look at wounds

This section is an even more supplementary piece than the last, and is only necessary if you want a deep understanding of wounds including improvised treatments.

Blunt Wounds

Moderate: Joint Dislocation

• Negative effects: Slightly slower interactions with the specified arm and a slight limp if sustained to a leg. 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 with Left Click help with combat mode off. They'll start straining your limb and hopefully pop it back into place. Doing this with combat mode on will instead try to snap the limb 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 the specified arm, a sizable limp if sustained to a leg, random mild brain traumas if sustained to the head, a chance to cough up blood when hit in chest. Counts as mangled bone for purposes of dismemberment.
• Full Treatment: Two step surgery, requiring a scalpel and a bonesetter, bone gel, or sticky tape. 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 makeshift 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 on the head, you receive random severe brain traumas until the wound is fixed. If suffered on the chest, a significant chance to cough up blood when hit in chest. Counts as mangled bone for purposes of dismemberment. Brute and flinch damage done during surgery can dismember the limb, for example the saw step from organ manipulation, or moving mid surgery step.
• Full Treatment: Five step surgery, starting with the standard incise, clamp, retract. 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, though 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. Their mechanics are described below.
• 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. As your blood flow decreases so does your wound 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 cuts will clot slower than moderate), while critical cuts slowly open up more over time. It is imperative to reduce the severity of cuts as soon as possible.
  • 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 reducing it as soon as possible is important. Immediately applying a bandage, jabbing a medipen, or even managing to apply a suture or cautery 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, but 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.

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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 reduce the wound severity.
  • 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 reducing it as soon as possible is important. Immediately applying a bandage, jabbing a medipen, or even managing to apply a suture or cautery 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 blood flow here is a bit higher than a moderate slash. If you have a surgical drape, a hemostat/scalpel, and a cautery, the Patch wound 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 body part will cause you to lose additional blood, and you're bleeding at the rate of a severe slash. 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 Patch wound 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 body part severed entirely.

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Burn Wounds

General notes:

• While you can technically get burn wounds from any burning type of 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.
• 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 trivially easy to apply bone wounds to, 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.
• Burn wounds will slowly heal their flesh as long as the limb has < 10 burn damage, the burn has no infection, and the patient is fed.

Burns from exposure:

When your body temperature is over the 400.5 K (126.8 C, 260.3 F) threshold you have a chance to gain a burn wound, the longer you are exposed the more likely you will gain a burn wound on a random limb. All burn wounds from exposure to high temperatures slowly progress to even more severe burns if the temperature is high enough.

Temperature thresholds for increasing wounds

• 400.5 K (126 C, 260 F) Moderate: Second Degree Burns
• 800.5 K (526 C, 980 F) Severe: Third Degree Burns
• 3200.5 K (2926 C, 5300 F) Critical: Catastrophic Burns

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.

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