Medical and the Bloom

There are no hospitals and no ambulances. Press F2 to open triage. The monitor at the top shows your heart rate, oxygen, blood pressure, breathing and core temperature, and they move with your real state: blood loss drops your pressure, exertion and fear raise your heart, smoke and dust in your lungs drop your oxygen, a fever lifts your temperature. Below it your body is an X-ray: every wound, broken bone, burn and infection, where it is. Each treatment tells you what it will do before you use it.

Bleeding

Blood loss is what usually kills. Every open wound bleeds until you stop it.

• Every wound has a stage bar: bleeding, then stabilized once it's covered or stitched, then recovering, then healed. A deep wound needs more than one dressing before it's covered: a severe one takes three.
• While a wound is stabilized, sprinting, jumping and climbing can tear it open again. Take it easy until it's recovering.
• A rag stops some bleeding. A sterile dressing stops most of it and keeps it clean.
• A tourniquet stops all bleeding in a limb, but it hurts and the limb suffers if you leave it on. Take it off once the wound is dressed.
• Every wound shows its contamination. It heads toward whatever touches it: bare skin as dirty as you are, the clothes over it (dirty clothes, or clothes you've soiled, make it filthy), or the dressing. A boiled rag is clean, an ordinary rag half clean, torn clothes filthy. At the infection line the wound turns infected.
• Disinfect with rubbing alcohol, iodine, antiseptic wipes or strong spirits like moonshine (vodka and whiskey are too weak to do much). It keeps the wound clean only until it evaporates, so change a soiled dressing: take the old one off, clean the wound and put a fresh one on.
• Your immune system fights an infection. A clean, dressed wound on a fed and rested body usually beats it; a dirty one, or several infected wounds at once, can win, and then the infection spreads into your blood and turns into sepsis, which brings fever, then delirium, then death. Antibiotics knock it back and help your body for half an hour; garlic and vitamins give a small push. A strong constitution helps and hunger, exhaustion and radiation weaken it. See Dirty water, hygiene and sickness.
• Sutures close a clean wound so it stops reopening. A surgical kit digs out a lodged bullet or shrapnel.
• Your body makes blood back slowly while you're fed, watered and not bleeding. A saline drip or a transfusion is faster. Check the blood type first.
• An aloe leaf works as a poultice on light bleeding and fights infection. Two aloe leaves and a gauze pad make a burn dressing.

Burns

Fire, molotovs, explosions, burning vehicles and hot surfaces burn you. A burn covers part of a limb or your body, and a big one leaks fluid: past about a fifth of your body you go into burn shock (thirsty, cold, heart racing). Burn gel cools it and takes the edge off the pain, and a cooled burn seals about twice as fast; it still needs a clean dressing over it. Three aloe leaves and boiled water make an aloe burn gel. Left open, a burn gets infected.

Radiation

The waste barrels at the Ark's dock are leaking. Radiation has no smell and no color: you only hear it on a Geiger counter switched on from your pockets. The dose builds up the longer you stay and the closer you get. A sealed gas mask with a working filter keeps out the dust you would breathe in, but nothing stops the gamma. Potassium iodide taken before you go in halves what you breathe in.

• A real dose makes you sick: nausea and vomiting, then weakness, bleeding gums and bruises that weep, fever, and your hair coming out. A big enough dose bleeds you from the inside, and the worst doses kill.
• Get out and stay out: your body repairs some of it over time. Dust settles on your skin and clothes and keeps dosing you, so wash yourself with soap and water, and wash your clothes with soap too.

Fractures and pain

Falls, crashes and heavy blows can break bones. A broken leg makes you limp and a broken arm spoils your aim. Splint it so it can heal. A bone that heals badly leaves you with a lasting limp until it's reset. Painkillers dull the pain for a few minutes, and morphine kills almost all of it but slows your heart, so don't stack it.

Drips and oxygen

A med station can be fitted with an IV drip stand and an oxygen concentrator, and Haven's clinic has both. Hook up a saline drip with a Saline Bag and an IV Line: it runs for about six minutes and doubles how fast you make blood, even on an empty stomach. Stay by the stand, because walking off pulls the line out and wastes the bag. Breathe oxygen from a powered concentrator to clear carbon monoxide out of your blood after a smoky room. See Fires and cooking.

The Bloom

The Bloom is the infection that made the dead. It's a number that rises and falls, and it will kill you if you ignore it.

• It comes in from the world: bad food and infected meat, the Red Fog, the polluted water of the Rot, a swell's spores, and contaminated loot carried out of a Blackzone.
• Early on, a bite or a scratch from the infected is a wound. It bleeds and gets dirty, so treat it like any other wound. Triage always shows where you stand.
• It falls on its own while the load is low and you're fed and watered, faster sitting at a camp and fastest asleep. Past a certain point it starts spreading by itself.
• Antivirals push it back hard. An auto-injector does less than a full dose from someone with medical training. Herbal tea and an immune booster help a little.
• As it rises you run a fever, get hungrier and thirstier, and start to sway on your feet. Near the top it starts to take your health.

Knocked out

A heavy blow to the head, a boss's blow, too much blood lost while you push on, or choking smoke and gas can knock you out cold for a while. Others can shake you awake, carry you, or bring you round at once with adrenaline. Coming round, your head pounds.

Going down

When your health runs out you usually go down rather than die. A red distress flare goes up by itself, your squad gets an SOS marker, and survivors nearby are told. You have a few minutes before you bleed out, and every blow from the infected while you're down costs you time.

• You only come round once you're stable: every big bleed stopped (a packed wound that only seeps is fine), at least 101 fl oz of blood in you, and a heartbeat. Triage on a downed survivor says in plain words what is still missing.
• Stop your own bleeding if you can. Once you're stable, hold E to struggle back up after about a minute.
• Anyone can help you: a squadmate, or a stranger who earns honor for it. Adrenaline brings a stable survivor round at once. Given before they're stable, their eyes flicker open, they slip back under, and the dose is wasted. Saline or a transfusion gets the blood back up; a field surgery kit dresses the worst wounds and runs in some fluid, but it never brings anyone round.
• Lose too much blood, bleed almost to the end of the clock, or lie in thick smoke or gas, and your heart stops. The monitor goes flat. Someone has to look at you and choose Start CPR, cycles of compressions and breaths, until a pulse comes back. A defibrillator (AED) is far more likely to do it, and adrenaline in you helps both. The clock keeps running the whole time.
• Hold X to give in if nobody is coming.

Dying drops everything you carry except your secure pouch. Killed by the infected or the world, it all becomes a grave that only you and your squad can loot for twenty minutes. Your level and skills are never lost.

Bodies

Once someone is past saving, their body is left where they fell in a body bag, with everything they carried inside. It stays for fifteen to thirty minutes and then it's gone, along with whatever nobody took. An emptied bag is taken away within a couple of minutes.

• Walk up to a body bag and choose Search the body to open it.
• You'll know the name on it only if they were in your squad or an allied squad. Anyone else is an unknown survivor.
• A grave left by the infected or the world still belongs to its owner and their squad for a while, and that claim always ends a few minutes before the bag goes.

A round your vest stops leaves a bruise, not a bullet wound, and a bare steel plate can throw fragments that cut. See Body armor and plates.