Medical system overhail

[Roshi (DayZ) 396]

*PS - I'll update as time goes on*

Hi all – please excuse the long post but I’ve been mulling this over for a while. I’d like to suggest few changes in the medical system to make it a bit more authentic and a bigger part of the game. I’d love to see a game with a bigger emphasis on medical treatment – almost as a mini-game requiring skill - although I’m not sure this is the game to do it, but it would fit really nicely. The closest I’ve seen are the animations in Far Cry 2 & 3, but I would love to see something involving some player skill rather than a simple button push. It would be a great way to see some grass-roots sub-specialisation with people choosing to hone their field medicine skills (and their load-out). Here are a few suggestions (not all new, but all in one place):

- Animations for a variety of medical actions (a la Far Cry series) – I would love this but I appreciate that it is a very difficult and time consuming undertaking.

- A medical decision-making tree – essentially, if you are treating yourself or another player you have decisions to make that may the effect outcome of the intervention. Based on real field medicine. Perhaps find manuals as a reference. For example, you have been shot and are trying to treat your own wound – do you apply pressure, prize out the bullet or give yourself an epi-shot to stay conscious. String together a few of these decisions – based on the nature and severity of the problem - and you have a mini-game. Why not make DayZ educational as well as fun.

- Can have more than one player working on a downed team mate.

- Airway management – for an unconscious team member – basically keeping a patent airway – if you possess a med kit then maybe inserting an artificial airway (first part of your ABCs).

- Suturing – needle and thread added as an item – close up larger wounds (e.g. gun shots) to stop bleeding when bandages/pressure just aren’t enough. Hell I’d love to see minor surgery in the game.

- Remove blood packs and replace with normal saline: blood products would not last very long at all in the absence of refrigeration/freezing. Saline is a viable alternative used to manage shock due e.g. blood loss. Given the emphasis the dev team places on authenticity, it should not restore full health immediately but should rather stabilise you after blood loss. Possible conjunction with epi-pens (epinephrine/adrenaline is a positive inotrope used to increase cardiac output in shock – with care).

- No instant heals – stabilise first then slow regeneration of health based on nutritional state and on-going care. Increase food requirement during healing – as per real life. Healing obviously accelerated greatly compared to ‘real life’ – no one wants to wait 6 weeks for good fusion of a fracture.

- Pain relief works for a given time, but requires a top up. Important early post injury but not later. Use of morphine as well as tablet based pain killers for pain. Could have involuntary crying out if in pain (e.g. broken leg) and trying to walk.

- Acute gastro-intestinal illness – dehydration is usually the killer here due to vomiting and diarrhoea. Normal water tends to go straight through up – e.g. in cholera. Add rehydration salts as an item – can add to water bottle to improve rehydration – work via gastrointestinal ion channels that pull water out of the gut to maintain osmolarity. Much increased requirement for hydration with these infections. Bad water sources (and hygiene) important vectors – proximity, i.e. team play, should be important for disease spread in most cases (except pneumonia) – this should be a balancing factor between team and lone-wolf play.

- Use of antibiotics prophylactically or as treatment for infected wounds. As well as pneumonia (which is often bacterial in cause rather than viral).

- Malnutrition – monitor a players food intake (to a degree) over a longer term than present – if they are not getting a good energy supply with a good variety of foods then decreased endurance, increased susceptibility to infection, etc. Bear in mind that the energy requirements for survivors are going to be much higher than the average sedentary person – the amount of miles racked up running across Chernarus makes the survivors endurance athletes.

- Scurvy – if you want to take it a step further – vitamin C deficiency (due to a lack of fresh veg) leads to teeth falling out (a nice animation of this could show you that you have scurvy) and even wounds reopening. Could add vitamins? But this would be all that they are good for. This is very much a peripheral suggestion…

- Splinting for fractures – has been discussed in-depth previously.

- Ankle sprains – I’ve suggested before in the DayZ forums. Modified chance with speed of movement, footwear and visibility (including use of flashlights, headlamps, flares etc.) Another use of bandages (or strapping tape in a medical kit).

- Hypothermia – fixed much better by a hot drink and a thermal blanket than a thermal blanket or heat pack alone.

- Hyperthermia - heat fatigue or with heat stroke (extreme exercise under load in the heat) - saline drip, immersion in water, get out of the sun etc.

- Alcohol - to sanitize wounds - for injuries or when cannulating a vessel - if you fail to do this then infection more likely. Also as a poor-man's anaesthetic for minor surgery.

- Anaesthetics - Could also be a place hear for ether/chloroform - could double as anaesthetic or for mugging other players as has been suggested. Alcohol as above.

- Being able to carry unconscious (and dead) survivors - to get to a safe location for proper medical attention (or looting) - either firemans lift or stretcher.

As an aside, I think that it should be challenging to continue to survive long term and not just because of other tooled-up players. There could be subtle benefits (maybe gradually increasing running distance before fatigue, maybe even slightly less gun wobble with repeated use) and increasing problems (e.g. malnutrition if you don’t balance your food intake, being leaner makes you more susceptible to cold temperatures, etc) by being a longer-term survivor. Subtle and not skill-tree based would be my vote. I’d love to see an ‘experienced survivor’ model where a longer lived survivor becomes gaunt and grows a beard (for men obviously).

I would really like it if the survivalism aspect was emphasised in the game (even though it’s pretty damn good now) so that you really feel you are against the environment, rather than just other players. Hunting should be harder in terms of animal numbers and behaviour, but should provide rich rewards. Snares would also be a great addition particularly for catching smaller animals – plenty of info on these, for example, in the SAS survival handbook.

Anyway that’s probably enough for opening discussion for now. I think it adds emergent goals without being too ‘gamey’.

Edited December 10, 2012 by Roshi

[Creep- 569]

*Overhall.

[Roshi (DayZ) 396]

*Overhaul :) But good point...

Edited December 6, 2012 by Roshi

[Tarkastio 38]

I agree, I've always wanted to see how an actual medical system in a tactical shooter would turn out.

I can just imagine it now.

Your best friend is yelling at you as you suture his bleeding wound while your other buddy is trying to hold the door while the other group is trying to kill you for your beans.

[Happymrsnowman 52]

I think it'd be a great idea. Anyone here familiar with Americas Army medical system? Where it tells you a symptom of a patient and you have a few choices to go from based on your medkit?

For instance:

Symptom: Trouble breathing

1. Field tracheoctomy

2. Apply a cold compress

3. Cut his pants off

4. Apply pressure to throat

Symptom: bleeding

1. Apply pressure/sterilize

2. Heatpack

3. Cut his pants off

4. Apply a sling

Symptom: Shaking, clammy skin

1. Heatpack

2. Bandage wrists

3. Cut his pants off.

4. field tracheoctomy

Symptom: Trouble moving a limb

1. Sling/splint

2. Suture

3. Cut his pants off

4. Antibiotics

[DiazWaffleCrabstro 39]

A medical system would be nice, would also add more benefits to playing in a group rather than lone wolfing it.

[Very Ape 748]

Cut his pants off.

You have my beans, this is a great suggestion. Perhaps this would make being a medic equal to being a pilot-- you need skill, experience.

[Roshi (DayZ) 396]

Thanks for the feedback, although there is a slightly worrying undercurrent of pants removal...

[Roshi (DayZ) 396]

I think it'd be a great idea. Anyone here familiar with Americas Army medical system? Where it tells you a symptom of a patient and you have a few choices to go from based on your medkit?

For instance:

Symptom: Trouble breathing

1. Field tracheoctomy

2. Apply a cold compress

3. Cut his pants off

4. Apply pressure to throat

Symptom: bleeding

1. Apply pressure/sterilize

2. Heatpack

3. Cut his pants off

4. Apply a sling

Symptom: Shaking, clammy skin

1. Heatpack

2. Bandage wrists

3. Cut his pants off.

4. field tracheoctomy

Symptom: Trouble moving a limb

1. Sling/splint

2. Suture

3. Cut his pants off

4. Antibiotics

I wouldn't quite go as far as things that are obviously a bad idea for a given situation - more like things that you would think might work if you aren't medically trained that might not work very well. That is, if you are a Regular Joe with no previous experience of treating serious wounds you might think it's a good idea to fuss over getting debris out instead of applying pressure or (in a very severe situation) maintaining an airway. But something like this would be cool.

I reckon if you could have some kind of animations or a graphic of the wound (not for the faint of heart) that would be awesome - e.g. see pulsating fountains of blood then probably a damaged artery - bleed out quicker - stuff like that. So you make decisions based on the evidence in front of you - not just a generic approach to 'gunshot wound in thigh'. Anyways - doesn't have to be this complex but a step in that direction would make my day :)

[Roshi (DayZ) 396]

Your best friend is yelling at you as you suture his bleeding wound while your other buddy is trying to hold the door while the other group is trying to kill you for your beans.

If survivors cried out involuntarily when badly wounded that would be awesome - if you are part of a team you need to quiet them down as they are attracting zeds (or more worryingly bandits) - dose them up with a shot of morphine to send them to la la land or, well, there's one in the chamber... :)

Edited December 6, 2012 by Roshi

[DiazWaffleCrabstro 39]

Thanks for the feedback, although there is a slightly worrying undercurrent of pants removal...

I haz your pants now, YOINKS!

[Roshi (DayZ) 396]

I'd also add management of hypothermia and hyperthermia (as per my post in http://dayzmod.com/forum/index.php?/topic/110154-heat-stroke/)

[Happymrsnowman 52]

If survivors cried out involuntarily when badly wounded that would be awesome - if you are part of a team you need to quiet them down as they are attracting zeds (or more worryingly bandits) - dose them up with a shot of morphine to send them to la la land or, well, there's one in the chamber... :)

Not a bad idea! Although to be honest when you're hurt currently, its already a massive detriment, inability to stand up, passing out, bleeding, vision hearing loss, etc. Having your guy crying is just insult to injury.

How bout this: You can walk with a broken leg on a splint, but your guy has to groan. Kind of like coughing when sick, he groans intermittently attracting zombies?

Thing is, a problem that comes up is, when fully healthy a player has all the reason in the world to play sloppy, running around making noise, etc, but when they're hurt, and badly, the penalties are SO crippling (especially if you have a broken leg) that survival becomes nigh impossible. If you get ****ed up in the middle of a city, you basically have to log off, and beg for medical assistance on the forums. Your chances of getting out are so slim, and would be slimmer still if your guy was screaming.

[Roshi (DayZ) 396]

Good point. Pain relief might do the trick though.