Medical system for DayZ Part 1 – Self-treatment of wounds:

[Roshi (DayZ) 397]

A key idea is that wounds/bandages/splints etc. show up in the inventory screen on the survivor as shown below:

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When you first sustain a wound, the clothing could look bloodied and damaged (and might later need to be repaired or replaced):

 

 

 

You could apply compression to slow blood loss, but you would then need to make a decision as to how to address the wound. Your options could include:

- irrigating (with sterile saline ideally or with boiled or sterilized water or, if you want to risk it, unsterilized water) which would affect the chance of a wound developing an infection;

- bandaging (which would work alone for more minor cuts) or

- suturing for deeper wounds (with a sterile suture kit, a suture needle and alcohol/disinfectant, or a needle and thread – again with left-to-right increasing risk of infection).

- prophylactic antibiotics.

 

You could move the cursor over the wound to get more contextual information to decide what to do – e.g. “This wound looks shallow”, “This wound is bleeding profusely” or “There is debris in this wound”.

 

This approach would allow you to see the state of healing wounds by running the mouse over the wounded area. For example, placing the mouse over the bandage on the left arm might give a message “This bandage looks clean”, indicating that the wound is healing and doesn’t require further attention (yet). However, the wound on the right thigh looks different and moving the cursor over the wound gives you:

 

 

(NOTE that the bandage has some visual evidence of pus and bloody ooze).

 

This would suggest that further attention is required – antibiotics, debridement (cleaning up with a scalpel and tweezers), irrigating the wound. And the same wound may require re-bandaging. If a bandage looks clean for a period of time, the player could remove the bandage (via context menu with cursor over the bandage) and examine the wound with again the mouse cursor – a healed wound could display a message such as “This wound looks healed”, after which it disappears.

 

It would be great to be able to perform these minor interventions in the inventory screen by dragging the item you want to use over the wound to give you a context menu (e.g. dragging a bag of saline or a water bottle over the wound and being given the option “Wash out wound”).

 

A similar mechanic could apply to sprained ankles and broken bones, and using sports tape (or duct tape) or splints, respectively.

 

A decent pain mechanic would also be good – where you have to manage your pain levels while performing procedures on yourself (e.g. a hit of morphine before reducing and splinting a fracture or morphine or local anaesthetic before suturing a wound). This could be accomplished by visual effects – e.g. a pulsing red overlay on the screen – and a reduced chance of success with the procedure. Passing out would also be a possibility.

 

As an aside, I think players should be able to use blood bags or saline bags on themselves. IV line placement should be performed first in any situation (treating self or others) and then the bags attached to the line (rather than the current system of attach the IV line to the bag and then use the combined IV/bag on the player).

 

Each intervention could have a chance of success (basically a dice role) – I think you should get better with practice and that this should be reflected as an increasing chance of success. 

 

For part 2: Emergency care for other players:

http://forums.dayzgame.com/index.php?/topic/161874-medical-system-for-dayz-part-2-emergency-care-for-other-players/

Edited January 4, 2014 by Roshi

[nighhawk 41]

Summarize please, its 3 in the morning I can't read all that :P

[Roshi (DayZ) 397]

Main point to remember is that wounds are shown in the inventory screen, and can be treated in the inventory screen by dragging items over to the wound, etc. And get some sleep you fool!

[DreadX 1]

Summarize please, its 3 in the morning I can't read all that :P

 

LOL ... i read half of the OP's post and skipped to yours. I laughed because it's 2:24 here and I couldn't finish it either. We're the internet generation. More than140 characters and we lose all focus!!!

[Hakiki 10]

I like some of the ideas here and it's definitely a concept which would be cool to see some more interaction around.  

 

However, as soon as you are out of immediate combat danger one of the first things one would do is to put a bandage UNDER the clothes, not on top of them.

Additionally, I don't believe most people would be able to do anything useful at all after taking a hit of morphine, let alone fancy stuff like self-administered medical procedures.

[Roshi (DayZ) 397]

LOL ... i read half of the OP's post and skipped to yours. I laughed because it's 2:24 here and I couldn't finish it either. We're the internet generation. More than140 characters and we lose all focus!!!

That's why I included pretty pictures...

[Roshi (DayZ) 397]

I like some of the ideas here and it's definitely a concept which would be cool to see some more interaction around.  

 

However, as soon as you are out of immediate combat danger one of the first things one would do is to put a bandage UNDER the clothes, not on top of them.

Additionally, I don't believe most people would be able to do anything useful at all after taking a hit of morphine, let alone fancy stuff like self-administered medical procedures.

Yeah the details aren't the main concern for me at the moment - I just think the whole using the inventory screen to manage wounds thing is worth investigating. As for the morphine thing agreed, although it depends on dose and route of administration a bit. However, it doesn't knock you out (unless higher doses) - it spaces you out. I envisage this being for more minor injuries. I have a bunch of ideas for treating others but it looks like I'll have to cut it down a notch for readability.

PS I'm doing my medical training at the moment so I've been in emergency situations and I'm trying to keep it as authentic as possible without going too nuts.

[serenityrick 218]

I like some of the ideas here and it's definitely a concept which would be cool to see some more interaction around.  

 

However, as soon as you are out of immediate combat danger one of the first things one would do is to put a bandage UNDER the clothes, not on top of them.

Additionally, I don't believe most people would be able to do anything useful at all after taking a hit of morphine, let alone fancy stuff like self-administered medical procedures.

 

The whole bandage over clothes point is a good one.

 

A good solution would be that you actually have to take off pieces of clothing in order to treat wounds which would be pretty good actually:

 

Twisted ankle: Remove boots

Leg injury: Remove pants

Torso/Arm injury: Remove shirt/jacket/combat vest

Head injury: Remove helmet/mask/hat

 

Would make for some intense situations. Your friend was just mauled by a bunch of zombies and he's fading fast and you're yelling "Take your jacket off! Hurry!" because you see he's bleeding from multiple locations on his chest and arms. Or if he passes out, you have to rip off his shirt in order to start treating him.

 

Great thread OP. I approve. I especially love being able to examine wounds first. You can do many things with this system. For example your friend is shot and you examine his wound and it says something like "you can see something inside the wound" So rather than automatically bandaging it up, you could sterilize some pliers first and attempt to remove the bullet. By not removing the bullet, perhaps he has a permanent stamina reduction or gets sick more easily.

[Roshi (DayZ) 397]

The second thread I'll put up focuses on managing other people's injuries - in emergency (time dependent) and non-emergency situations. It's a longer post than this one was so need to edit.

Agreed about clothing removal - if the patient is conscious and able then removing clothing would work well. The external bamdage would be for in an emergency to reduce bleeding if you are alone. In an emergency where you are treating an unconscious person who is bleeding profusely, for example, then you cut the clothes off... Have some pics that'll post in part deux

Edited January 4, 2014 by Roshi

[serenityrick 218]

More ideas:

 

If someone in your group is shot multiple times and passes out this is how it should shake out:

 

You and a friend run up to your injured team member and you see the following menu options:

 

Gear

Examine arm wound

Examine leg wound

 

So you tell your friend "alright, I'll take the arm, you take the leg". You select the arm and you get the following information in the bottom left corner: "It's bleeding. There is no exit wound."

Your friend selects the leg and sees "It's bleeding. There is an exit wound"

 

First you remove his shirt and sterilize your pliers (and hands?) and attempt to remove the bullet. Meanwhile your friend removes the pants and tends to the leg and simply applies alcohol tincture to clean the wound and bandages it. By removing the bullet, a little more blood is lost but the long term effect will be worth it. Once removed, you can simply bandage the wound and begin to nurse your shot up friend back to health.

 

Would that not be awesome? And it seems completely doable within the current system. I think the only thing you'd have to add is the ability to see a visual of the wounds if you're treating someone else (similar to your idea of being able to see them on your inventory screen).

Would be awesome to have two people be able to treat an injured player at once if there is more than one injury

 

 

The second thread I'll put up focuses on managing other people's injuries - in emergency (time dependent) and non-emergency situations. It's a longer post than this one was so need to edit.

 

 

 

My bad man! Didn't mean to hijack it then, haha

Edited January 4, 2014 by serenityrick

[Roshi (DayZ) 397]

"My bad man! Didn't mean to hijack it then, haha"

Haha all good - just good to see people on the same page.

Edited January 4, 2014 by Roshi

[floj 393]

Love it - 1 quick word to add: superglue.

[Roshi (DayZ) 397]

Oh shit yeah - superglue is a great idea!

[Heiduk 265]

I'm all for a complex medical system where real-world knowledge is transferable. I must say though, despite Rocket's talk I lost a lot of faith in that actually happening when they added a defibrillator (that runs off a 9V battery!). I guess I should at least be happy the defibrillator doesn't resurrect the dead.

 

As long as the best way to control bloodloss is sprinting between buildings until you find a shirt to tear in to rags I'm afraid the medical system will remain a joke.

[Roshi (DayZ) 397]

In Rocket's defense he has said that he thinks the medical system is currently about 10% complete.

[Heiduk 265]

In Rocket's defense he has said that he thinks the medical system is currently about 10% complete.

 

Isn't that what he says about everything?  ;)

 

My issue isn't that the system is incomplete it is that what they have added is just plain wrong, e.g AEDs for reviving people and dumping alcohol on a wound to clean it. These things may make perfect sense according to video game logic but don't have much basis in actual medical practice.

 

An AED is not a treatment for any of the things that kill people in DayZ, and although our mothers may think otherwise, dumping random chemicals, e.g. disinfectant spray, iodine, hydrogen peroxide, alcohol, etc. into an open wound is generally a bad idea. One that tends to damage viable tissue and may increase the risk of infection.

 

I would much rather have a medical system that is 10% implemented but whose rules are grounded in real world anatomy and physiology rather than a complete system whose rules are only documented in the DayZ wiki. 

[Roshi (DayZ) 397]

Isn't that what he says about everything?  ;)

 

My issue isn't that the system is incomplete it is that what they have added is just plain wrong, e.g AEDs for reviving people and dumping alcohol on a wound to clean it. These things may make perfect sense according to video game logic but don't have much basis in actual medical practice.

 

An AED is not a treatment for any of the things that kill people in DayZ, and although our mothers may think otherwise, dumping random chemicals, e.g. disinfectant spray, iodine, hydrogen peroxide, alcohol, etc. into an open wound is generally a bad idea. One that tends to damage viable tissue and may increase the risk of infection.

 

I would much rather have a medical system that is 10% implemented but whose rules are grounded in real world anatomy and physiology rather than a complete system whose rules are only documented in the DayZ wiki.

Regarding my suggestion in this post you'll see that I suggest you use sterile saline to irrigate wounds (not alcohol tincture as currently implemented). As for AEDs I've commented on them earlier elsewhere - as you say they only work on some rhythms (generally VF and VT). As they're in game they got a mention in my part 2 thread, but for what they should be used for in dayz - well that remains to be seen. I totally agree with you regarding the need for authenticity and I appreciate good critical feedback. I can only assume that you are criticizing the currently implemented system, but anything else that you notice in my suggestions that are off - well point em out...

[Heiduk 265]

Roshi, don't get me wrong, I like your ideas and would love to see something similar implemented. I'm just not convinced the developers have much real interest in a complex medical system beyond a more elaborate version of the toy system we have now that does little more than keep us traipsing across Chernarus in search of widget X or magic potion Y.

[Roshi (DayZ) 397]

I re-read your first post and I see what you were talking about.

[Ineedscoffee 464]

I just to be able to John Rambo my survival knife to cauterize a bullet wound, and yell Hurrrrrgggghhhh in the process......

[yessaul robinovich 42]

dean has mentioned several times that he wishes for more of the gameplay systems to involve complex mechanics grounded in real-world knowledge and principles that can be utilised by someone familiar with the subject. I think he is rather sincere when he says that. I also think that, this being an alpha test, what we get in the final game is what we argue for and assist in devising. I would just ask any moderator with sufficient access to point dean towards this man's threads because the stuff outlined herein seems like the groundwork for healing people in dayz at least as involved and nuanced as ..killing people in dayz.

 

instead of just "traipsing across Chernarus in search of widget X or magic potion Y."

 

One question i have for roshi though - under your medical system, how would you abstract treating injuries that heal over considerable lengths of time or require complex surgery?

Ie: serious fractures/shattered bones. shattered kneecup? no problem, here's some morphine.

 

also, how come all survivors have hemophilia?

Edited January 13, 2014 by yessaul robinovich

[Roshi (DayZ) 397]

Yeah - tricky that. As for things requiring surgery - say a severed major artery or intestinal injury I'm tempted to say these could well be fatal but in different time scales - and your character should be a dead man walking. Simulating surgery in any meaningful way would be probably too big an ask (and not that plausible unless you have access to a surgical team, expert knowledge and good kit - although it's entirely possible).

Fractures are trickier in a way because of the healing times are in the order of weeks. You'd have to speed that up of course. I think splints will be what get used, but from the perspective of recover I'd love to see recuperation on logging out (and thirst/hunger developing also to keep it real) but limited to 8-10 hours. If you're logged out for 4 hours your character gets 4 hours rest (equivalent to a fair bit of healing) but if you are logged out for a week it gets maxed out at 8-10 hours say. And you'd be hungry and thirsty on log in.

I'd also like to see different phases of fracture healing from limping in a splint to not being able to run, sprint, etc. But also some persistent problems with some injuries even after healing that bother you occasionally - "youre old leg injury aches" associated with inability to sprint. This could sorted with some pain relief, but could be a recurring thing. This would be due to not giving a broken leg or arm adequate rest while healing (because you just can't have 6 weeks non- or partial-weightbearing in the zombie apocalypse :)

Edited January 13, 2014 by Roshi

[djporternz 644]

I don't see any advantage in this system over what we already have in-game. The only difference is that you are seeming to want the game to hand-hold you and tell you exactly what you need to be doing. Why not have the game automatically treat you as well if you have the required materials?

 

Sorry, I can't support this idea.

[n.mettala@gmail.com 5]

This nice concept!

[elLoCo 154]

This nice concept!

Use transslator, make short sentences ^^