A doctor's suggestions for DayZ's medical system

[bacter 46]

I wondered how a neat and authentic medical system for DayZ could look like without

• making it too hard to implement by building on what's already in game. I think the additional mechanics could be implemented relatively easy and yet would add a lot of depth to this lovingly punishing game.
• making it overly complicated / too technical, it still should be 'fun'.

Note: this is not realistic, I tried to translate real life medical conditions into a game environment. For example a lot of antibiotics can be used for a variety of underlying diseases but having to use a specific one for your condition in-game makes it more challenging.

Medical items

- Bandages

Bandages (and wounds, see below) should be visually represented on the player model when clothes are taken off (to avoid clipping, also it would be cool if you had to undress after a fight to check and treat your injuries). After application, bandages gradually diminish in 'quality' (pristine, worn) and need to be replaced when 'ruined'. 'Ruined' bandages and rags are likely to cause wound infections (see below). Crafting options: Bandage + gaze = pressure bandage, bandage + antiseptic = antiseptic wound dressing.

- I.v. Catheters

After an intravenous catheter is inserted, bandaging it with gaze should make it possible to keep it in place for later use (like in hospitals). It could be represented on the player model's forearm as a circular bandage-texture without causing clipping. It would be useful for rapid fluid / blood replacement in combat situations. Keeping it in for too long gives a chance of wound infection, sepsis.

- Antibiotics, drug intake

I've settled on widely used antibiotics to cure the infectious diseases mentioned below. Like magazines a packet of antibiotics (and painkillers) contains a certain amount of pills or tablets. You have to take them regularly (every in-game-hour for example) for a certain amount of time in order to cure an undesired effect. If you find a watch in-game it could display your character's relative time and be used to time drug intake.

Negative status effects

- Arterial bleeding

Sharp items or gunshot wounds should have a chance of causing arterial bleeding, which is represented by

A) A characteristic pulsating squirt. They nailed it in the game Overgrowth https://youtu.be/0lp3HD3RQOY?t=28 (pretty close to those I’ve seen in RL).

B) Clothes that get more and more soaked in blood.

New particle effects and the new renderer should allow visual representation for both A and B. Causing rapid loss of blood and hypovolemia. Treated with a pressure bandage and i.v. fluid replacement or blood transfusion (more effective).

- Blunt trauma

is visualized by hematoma and excoriations. Head trauma has a chance of passing out, chance of tinnitus, chance of temporary visual and motor impairment. Extremity trauma is already in (limping, decreased aim, shaking). Treated with painkillers and regular bandages for excoriations.

- Fractures

treated with splints and painkillers. Visually represented by severe hematoma (axial deviation would be cool but I guess it would be hard to implement)

- Respiratory infection

caused by exposure to cold, wetness, airborne transmission when being around infected individuals for too long. Coughing gives away your position. Reduced stamina. Treated with Clarithromycine.

- Gastrointestinal Infection

caused by ingestion of spoiled food. Causes vomiting and hypovolemia. Symptom control with intravenous fluid replacement (Saline) and charcoal tabs. Treated with Doxycycline.

- Wound infection, sepsis

chance of infection every time a wound is not treated with an antiseptic and bandaged. Untreated wound infections may lead to sepsis: shivering, reduced stamina and eventually unconciouseness and death. Visually represented by purulent discoloration of wounds and bandages and a spreading rubor around the injury. Wound infections and sepsis can be treated with Amoxicillin/clavulanic acid.

- Phonotrauma

Tinnitus when a gun is fired in your direct vicinity, temporary.

Please feel free to share your thoughts!

Edit: typos, formatting

Edited May 31, 2016 by bacter

[Funkdoc 46]

some good suggestions on medical treatment in dayz.

do you know the ACE3 (still in development) medical system for Arma3? they made some really cool improvements like a fully reacting heart rate and blood pressure system, several types of infusions like saline, blood, and plasma, injectors like morphine, epinephrine, atropin..., several wound treatments and bandaging possibilities, tourniquet, CPR, and so on...

this would be really nice to have this in game.

what to do if u get wounded from animal predators and can escape with gaping wounds....

a medical system is needed for a realistic survival game

 

[Funkdoc 46]

argh

 

Edited May 31, 2016 by Funkdoc

[Funkdoc 46]

shit whats up, sorry double post

 

Edited May 31, 2016 by Funkdoc

[chambersenator 106]

Seconding Funkdoc's recommendation to check out the ACE medical system (both the old A2 and new A3 versions). The ACE med sys can give you a reasonable idea of what is generally possible with the ArmA engine. Even though SA has a number of 'under the hood' differences, you'll be able to see more of the overall logic of both the constraints of the engine and the clever workarounds they were able to create. I wouldn't want to simply see an ACE med system clone become part of 'vanilla' SA, as I think the system might go a bit too far for the general player base (though I wouldn't mind it being part of a mod for SA when that time comes). However, I think there's a reasonable balance between that and the current system that would be really nice to see.

I like your ideas, and have a few thoughts on them
 

Quote

 

- Bandages

Bandages (and wounds, see below) should be visually represented on the player model when clothes are taken off (to avoid clipping, also it would be cool if you had to undress after a fight to check and treat your injuries). After application, bandages gradually diminish in 'quality' (pristine, worn) and need to be replaced when 'ruined'. 'Ruined' bandages and rags are likely to cause wound infections (see below). Crafting options: Bandage + gaze = pressure bandage, bandage + antiseptic = antiseptic wound dressing.

 

Separating the different kinds of wounds (slashes, punctures, bullet wounds with either significant or minimal internal damage, 'gut shots' that would bleed slower but nearly guarantee sepsis, compound fractures, etc) that require different kinds of attention would require a ton of work by the devs, but could be worth it if designed so that it can be added in increments over time with minimal re-designs of the system at each stage. Something that complex may have to wait for a mid-version expansion, if they decide to to that.

That said, I think there could be a significant amount done with the current system just by clearly separating the levels of blood loss from wounds into two categories - heavy and light - and make the player aware of which one they have. Heavy bleeding would require a pressure bandage, made either by your suggestion of gauze+rags, but also by using either 2 bandages or two rags. Using only one bandage should slow the bleeding rate somewhat, but would 'consume' the bandage at a faster rate, and even faster if the player is running in such a state. The bandaging animation for heavy bleeding should take at least 2x as long to vaguely simulate the additional time required to apply pressure to the wound. If necessary, the animation could be cancelled at any point by the player, but rather than a binary 'bandaged/unbandaged' state, it would at least count the time you were bandaging/applying pressure so that you could reduce bleeding in 25% increments, depending on when you cancelled it (this would be similar to how the planned 'partial eating/drinking' calculation for actions cancelled in mid-animation would be handled).

Additionally, at heli crashes and some military sites, there should be a relatively rare, 6-slot 'military medkit' that spawns, that in addition to the standard medkit items, includes some form of pressure bandage with a coagulating agent and either a morphine injector or some form of topical antibiotic that reduces the chance for infection/sepsis (anything from old sulfa-based powders or sealed alcohol gauze/swabs). An improvised (but of course, less effective) method should be available as well, in the form of high-proof alcohol or even honey, to be used when changing bandages of serious wounds. 

Of course, the key here is to balance the realism with practical gameplay. A serious torso or leg injury with heavy bleeding should require only two actions - one right after the injury, and later on, one bandage change (requiring at least 2 bandages again) with some form of antibiotic agent added, if available. Constant running while so injured should significantly slow the healing process, consume the bandages faster, and if ignored for long enough, the wounds open and bleeding begins again.

The player should get messages throughout this process, such as "my wounds are bleeding heavily, my wounds are bleeding less, my wounds have stopped bleeding, my wound has re-opened, my bandages are drenched in blood, my wounds seem slightly/somewhat/very infected, I'm feeling light-headed, etc.

I also hope that SA will include different kinds of walking/jogging/stumbling/running animations that would work with this sort of medical system. IIRC, there has been some mention of this in the past. I hope at least we can have something that replaces the 'morphine and splints makes all the boo-boos go away and we can instantly start running on leg we just broke a minute before' situation we have now. Even just forcing a stumbling/limping run for 30 minutes after 'fixing' a broken leg would be great to see.

 

 

 

[nl 986]

Some good ideas but as it is now in the game many times the right meds are hard to find. If I get sick from drinking something or have an infected wound from a zombie I will usually die within 20-30 minutes in which time I will have to find meds and usually don't succeed.

Sure, it would force you to first find a broad array of meds (takes up pretty much room in inventory) before you expose yourself to risk. But with predatory animals coming you may not have that luxury.

[Funkdoc 46]

 i wouldnt see it so tight...

if u get infected a timer of 2h should just be fine, wihthin this time u should be able to check some medical buildings and military installations for first aid or other medicine.

like senator wrote, a 6 slot medi kit should contain some different items of bundled medications. but u will also be able to treat your/anothers wounds instancly with basic things like rags, alc, or even crafted items u can find in the wilderness.

allways the best way is to avoid such medical emergencies.

in some cases one will die... and thats good so

i find that 2 or 3 hard zombie hits should infect a player, which will also die in 2h ..maybe the dead body could turn into a zombie after a time.

this makes holding zombies off ur body at any time a hard quest but more realistic.

 

 

Edited June 1, 2016 by Funkdoc

[bacter 46]

22 hours ago, Funkdoc said:

do you know the ACE3 (still in development) medical system for Arma3? they made some really cool improvements like a fully reacting heart rate and blood pressure system, several types of infusions like saline, blood, and plasma, injectors like morphine, epinephrine, atropin..., several wound treatments and bandaging possibilities, tourniquet, CPR, and so on...

Sounds good, I'll look into it!

22 hours ago, Funkdoc said:

what to do if u get wounded from animal predators and can escape with gaping wounds....

Good point! Like in RL, a bite wound should be considered as infected and treated with antibiotics.

17 hours ago, chambersenator said:

That said, I think there could be a significant amount done with the current system just by clearly separating the levels of blood loss from wounds into two categories - heavy and light - and make the player aware of which one they have.

That's what I meant. Arterial bleeding could be the 'heavily bleeding' state, excorations/blunt trauma could be 'lightly bleeding' (not realistic but makes a lot of sense gameplay-wise).

Also I didn't mean a wound should be visible at the exact spot of suffered trauma (which would be hard to implement I guess).

Obviously, the game already differentiates between head, torso or extremity trauma, so e. g. a blunt hit on an arm results in a change of texture (minor hematoma) regardless of the exact impact. A fracture would result in a 'severe hematoma' texture ect.

Likewise, for arterial bleeding, only representation for some major arteries would be needed: Carotid artery for hits of the head/neck, brachial and radial arteries for arms (knife fights!) and femoral artery for lower extremities. These four predefined spots on the player model would be enough to make a cool simulation of arterial injury.

17 hours ago, chambersenator said:

Constant running while so injured should significantly slow the healing process, consume the bandages faster, and if ignored for long enough, the wounds open and bleeding begins again.

Even just forcing a stumbling/limping run for 30 minutes after 'fixing' a broken leg would be great to see.

I really like your ideas!

Edited June 1, 2016 by bacter

[Parazight 1599]

On ‎5‎/‎31‎/‎2016 at 0:45 PM, bacter said:

I've settled on widely used antibiotics to cure the infectious diseases mentioned below. Like magazines a packet of antibiotics (and painkillers) contains a certain amount of pills or tablets. You have to take them regularly (every in-game-hour for example) for a certain amount of time in order to cure an undesired effect. If you find a watch in-game it could display your character's relative time and be used to time drug intake.

Some great brainstorming here. 

How would your proposed system negotiate accelerated time modifiers?

[chambersenator 106]

4 hours ago, Parazight said:

How would your proposed system negotiate accelerated time modifiers?

I can answer that, I believe.

To the best of my understanding, this kind of issue has already been resolved. You might remember about 6-8 months ago, there was a huge issue regarding accelerated time and the thirst/hunger system, where people were suddenly dying of thirst and hunger about 10 minutes after spawning. IIRC, it turned out the timer for the consumption of food/water somehow got directly linked to the 'ticks' of time on the server. So accelerated time = accelerated digestion. It didn't take long for the issue to be fixed and the timers separated, so one could assume that the timer for this proposed idea would be separate from the server's accelerated time as well.

 

[Parazight 1599]

25 minutes ago, chambersenator said:

I can answer that, I believe.

To the best of my understanding, this kind of issue has already been resolved. You might remember about 6-8 months ago, there was a huge issue regarding accelerated time and the thirst/hunger system, where people were suddenly dying of thirst and hunger about 10 minutes after spawning. IIRC, it turned out the timer for the consumption of food/water somehow got directly linked to the 'ticks' of time on the server. So accelerated time = accelerated digestion. It didn't take long for the issue to be fixed and the timers separated, so one could assume that the timer for this proposed idea would be separate from the server's accelerated time as well.

 

Ahh yes. That was during an experimental build. .57 or.58,iirc. I remember experiencing that. It was more like 3 mins.  I suppose it could be separate from daytime. Forget about the whole watch timer idea mentioned above though, I suppose. 

[Funkdoc 46]

15 hours ago, chambersenator said:

 It didn't take long for the issue to be fixed and the timers separated, so one could assume that the timer for this proposed idea would be separate from the server's accelerated time as well.

 

i think nothing needs to be separated. only the "power consumption coefficiency"  factor (a value describing consumption per time unit) needs to be recalculated including energy loss through physical exercise. this factor integrates over time (maybe every second) the energy level (32bit floatingpoint value) to zero.

i mean thats how i would make it :)

Edited June 2, 2016 by Funkdoc

[Troll_Hunter 54]

Question to the doctor here.

In the light of learned (from books and/or experience) game skills, could you make a 2 level system of injuries and treatments that reflects the medical skill of a normal survivor and that of a medically skilled survivor? I'm thinking about how skilled players could be valuable to groups and hostage takers that may have some serious / special medical issues that require a skilled person to solve. Maybe resetting a leg to get rid of limping? Or maybe taking out a bullet to stop the constant infections?

I love the idea of visible trauma, having actually bruises, cuts, holes on the body, with blood squirting out if it's artery bleeding. I also think our characters need to scream their painful injuries "fuck my leg is broken!" followed by sounds of enduring extreme pain, audible feedback, for near friend and foe. Good player feedback is essential for a feeling of fairness of a game.

 I.v. Catheters, I think this is not something that works well for this type of game, because In real life I think I.V.'s do not allow people to run with backpacks while using guns. Some treatments are not realistic when on the run.

However I would like to see treatments that are realistic on the battle field. Such as tourniquets. Pro version (hospital/army/police), and the improvised (rope,wire)

In my view the medical system is about connecting character modifiers (abilities) to wounds and illnesses to treatments, using tools and skills. The wounds and illnesses should have very good clear feedback and logic. The tools should be divided in 'pro' and 'improvised', as the treatment skill level. The player's treatment skill may determine how fast and how much a wound (player ability) is restored. For instance: an unskilled player is only able to restore a leg to 90% recovery, making the player limp a step every 10 steps. A medically skilled player can bring it to a 100%. This will make having a medically skilled player a valuable asset to your team. Bandits with injuries may stop shooting on sight and choose holding up people in search of specialists to have their medical (and other) issues/needs taken care of. Player skills make living people more valuable. - think of the role playing opportunities -

Deteriorating objects: I think dayz has a lot of tuning to do, because the current levels are often far from realistic, and I don't like farm ville ;) I think the bandages, pills, alcohol, should not deteriorate, only destroyed when shot. It's unrealistic given a survivor may live only for a few days, and bandages, pills are well packaged to last for months. Game-play wise I think players already have enough maintenance to do with keeping their arms in good shape, their vehicles in good condition, their bases up to snuff and their batteries charged. Let alone getting food and water. - getting more of topic by the line - I think the game should centre around 'your story', and for me that revolves around personal encounters and interactions with new and striking individuals, that have skill and other items to give, share, steal or trade. I would like to see drama, plot and depth, and those can only be reached with connection and immersion. The game should feel realistic, deep, logical and fair.

Edited June 6, 2016 by Troll_Hunter

[bacter 46]

18 hours ago, Troll_Hunter said:

Question to the doctor here.

In the light of learned (from books and/or experience) game skills, could you make a 2 level system of injuries and treatments that reflects the medical skill of a normal survivor and that of a medically skilled survivor? I'm thinking about how skilled players could be valuable to groups and hostage takers that may have some serious / special medical issues that require a skilled person to solve. Maybe resetting a leg to get rid of limping? Or maybe taking out a bullet to stop the constant infections?

I think it would work, IRL what would seperate laymen from medically trained people would be better wound treatment (irrigation, suturing), correct use (indication) and administration (intravenous) of drugs and professional CPR. 

But I'm not sure if I want such a seperation in game (the notorious soft-skill-debate...) - If they implement it they would have to make sure progress (e. g. medical skill) can't be made by grinding (injuring a friend, bandaging him, injuring him again...) - I don't know how skill progression without grind could look like. As you said, advancing when finding and reading books (or medical journals!) like in Fallout could be a solution.

On the other hand I really like the possibilities you mentioned - sparing valuable players and 'keeping' them!

18 hours ago, Troll_Hunter said:

Deteriorating objects:

I meant bandages should deteriorate only after application to simulate progressive contamination. There should be need to change them every once in a while.

Edited June 7, 2016 by bacter

[Troll_Hunter 54]

"But I'm not sure if I want such a separation in game (the notorious soft-skill-debate...) - If they implement it they would have to make sure progress (e. g. medical skill) can't be made by grinding (injuring a friend, bandaging him, injuring him again...) - I don't know how skill progression without grind could look like. As you said, advancing when finding and reading books (or medical journals!) like in Fallout could be a solution."

May I offer an idea:

1) find a medical book,

2) perform at least 3 advanced skills (on others) to learn the book and gain the skill.

I'm in doubt about making the book deteriorate fast, limiting the time window of learning the skill. And or to make the book big and heavy in order to make it a burden (hard choice) to carry it around. A big medical book can be like 4-6 loaded magazines big and heavy, and nearly fill up a school girl's backpack. Also the book could be made a rare find. Or a 1 time consumable, so only 1 person can get the skill.

I'm relaxed about people hurting friends with advanced injuries, because one can make the advanced skills to be applied only on near fatal injuries. For instance performing CPR to bring a person back from a near fatal state. If the risk of your book equipped friend not succeeding to bring you back is say 50%(because he's learning..), would you let your self be shot so your friend may gain 1/3 of the 'advanced medic' skill? - In short I think there can be a balance. I love the prospect of seeing people with an occasional limp, or recurring infections, searching for a medic in DayZ. Also seeing a medic in a group dragging people to safety, performing CPR (reviving people from shock), applying a tourniquet (saving people from artery bleeding), applying broken leg (re)setting (to remove the occasional limping that is a 10% speed reduction), removing bullets to keep the group mobile and effective would be a valuable contribution and a very rewarding role, especially since this game is permanent death!

[Roshi (DayZ) 397]

As another real world doc who sees the potential of this side of dayz, I'm happy to see this discussion re-dredged. I put up a couple of threads earlier in the stand alone development (treating yourself and treating others). I'll try to find the links again and repost here. They even had pictures :) 

I'd rework some of the ideas I posted then having done some more intensive care/resuscitation work since. I think you could definitely have a basic and more advanced system without resorting to full simulation (although from my perspective that would be pretty badass). 

Anyway the only suggestion I'd like to contribute here is an IO (intraosseous) set which basically is an alternative to an iv Luer that doesn't require much skill to use. It's essentially a battery powered drill with a needle that you bore into a bone (usually shin but could be elbow or sternum) that gives you quick, reliable iv access. Would be cool kit for a squad medic. Takes a while to get good with IVs, and it's trickier in patients who are hypovolaemic (due to dehydration or haemorrhage say). IO - bang,  access.

Oh that and a portable ultrasound :)

Edited August 10, 2016 by Roshi (DayZ)

[Roshi (DayZ) 397]

Ps I take the view that the medical system should be pretty unforgiving. If you know what to do,  then it might work. If you don't,  you don't fix the patient. If you are doing chest compressions on a penetrating chest wound and they have a tension pneumothorax,  they won't get better. You need to whack in a big needle to relieve the trapped air (and then a chest drain which makes this unlikely to be implemented in game). Dayz to me should reward realworld knowledge in all areas,  rather than having a character that learns skills. Open to a degree of soft skills to accommodate motor performance learning (even suggested the concept in the forums a couple of years back), but not read a book and then perform type stuff (unless the book is a reference the player actually has to read). 

That's just my opinion though and I recognise the devs have to please the bulk of their players (by giving them what they want,  not what they ask for).

[General Zod 1118]

On 01/06/2016 at 11:01 AM, Funkdoc said:

 

i find that 2 or 3 hard zombie hits should infect a player, which will also die in 2h ..maybe the dead body could turn into a zombie after a time.

this makes holding zombies off ur body at any time a hard quest but more realistic.

Those aren't actual zombies, they are rabid humans and the survivors and those with immunity. 

[Whyherro123 2283]

-ahem-

Much of this has been suggested before. The Devs haven't implemented any of it. The medical system has barely been touched since it's implementation.

Do "vitamins" actually do anything?

Does the "Injection bottle of sodium bicarbonate" do anything? As an aside, what the fuck are we going to be using Sodium Bicarbonate for, heartburn? I don't think acidosis is going to be that big of a problem

Does using a syringe on yourself or another player do anything?

AS far as I know, the answer to all of the above is pretty much "no".

Yet we get more guns and vehicles....

[sneakydude 480]

On 6/1/2016 at 10:00 PM, chambersenator said:

I can answer that, I believe.

To the best of my understanding, this kind of issue has already been resolved. You might remember about 6-8 months ago, there was a huge issue regarding accelerated time and the thirst/hunger system, where people were suddenly dying of thirst and hunger about 10 minutes after spawning. IIRC, it turned out the timer for the consumption of food/water somehow got directly linked to the 'ticks' of time on the server. So accelerated time = accelerated digestion. It didn't take long for the issue to be fixed and the timers separated, so one could assume that the timer for this proposed idea would be separate from the server's accelerated time as well.

 

don't we still die like that? oh wait that's hyper-thermal my face is melting bug...

clothing heat and the accelerated hunger - water is crazy... they need to fix that, it is so unrealistic.

[sneakydude 480]

6 hours ago, Whyherro123 said:

-ahem-

Much of this has been suggested before. The Devs haven't implemented any of it. The medical system has barely been touched since it's implementation.

Do "vitamins" actually do anything?

Does the "Injection bottle of sodium bicarbonate" do anything? As an aside, what the fuck are we going to be using Sodium Bicarbonate for, heartburn? I don't think acidosis is going to be that big of a problem

Does using a syringe on yourself or another player do anything?

AS far as I know, the answer to all of the above is pretty much "no".

Yet we get more guns and vehicles....

No we get more raincoats, hats, footwear, changes of buildings around cities and more bugs. I have only seen a few weapons actually spawning, the rest are being worked on.

 

i forgot heatpacks, batteries, pens, clothing, shovels, hoes, hardhats, seeds, and more seeds and did i say hoes?

 

oh and tons of tires.

Edited August 11, 2016 by sneakydude

[Arthur Dubrovka 376]

This would be awesome! Maybe a Dev or a Mod will share their thoughts or plans about those suggestions?

What's possible what's not?

Edited August 15, 2016 by imunone

[sneakydude 480]

I honestly believe that we should be able to administer medical things and not be forced to give others.

I decided to add it here, because the devs might take the medical ideas seriously, on all counts.

1. Saline bags should be able to administer to yourself

2. The re introduction of cpr, revive system for fallen comrades. We used to have a red revive kit.

3. Blood bag, given to  yourself (Apologizes i have never done it before)

Since the system is hardcore deaths it is very difficult to save yourself in a horrible situation. I believe very strongly that if you win a battle, and come out alive you should have the option to give yourself medical attention.

Even if you come from knocked out, return alive, or simply very greyed out. Giving yourself administered kits to help save  your life is the best reward a winner in pvp, or pve should get.

Not sure how others feel but i feel it is a missed idea, or not wanted after its creation.

 

[FlimFlamm 509]

OP contains some really great suggestions! Beans!

 

[Salty seadog 125]

Great post OP. If I could add my .02 cents to your idea, id also like to see one or two other changes ontop of your idea.

--- When fully hydrated/energised: I wish they octupled the time it takes to recover blood in this state, so a saline or BB is sometimes a smart idea, and worth seeking out. Alternatively, if you want to recover blood from food, make it so eating a piece of "fresh food" (ie. grown vegetables, freshly caught meats/fish) speeds up the recovery time (to approx half what it is now) for 15 minutes per piece of food. So its worth keeping better foods with you, and helps to promote some survival aspects and other game mechanics.

--- The ability to self administer iv catheters and a blood/saline bag (if only taking much longer than having a friend do it, maybe even a full two or three minutes so it isnt abused mid firefight). Im in no way medically qualified, and ive been able to put a catheder in a vein, tape it, and attatch a saline after waking up from a loose wedding night (friends an EMT, free salines for everyone!) still drunk and beyond hungover, so im sure if everones life depended on it, they could do the same! Or give it the ol college try...  save a few dingle berries who'd inject straight oxygen bubbles into their tube or something, or pump a full bag into muscle tissue...  ( I dunno, maybe there is an extremely tiny chance of getting a septic wound from self administering OR a small chance or accidentally ruining your catheder, and if your very low on blood and dizzy, maybe that chance could increase?)

--- Unrealistic one here, but it would be cool if the defibs had a chance to bring someone back from death! I know they dont work like that irl and only stop dangerous arrhythmias, v-fib etc.. but I think itd be cool to have it in just for gameplays sake. Maybe using a defib takes a full minute or two animation, is ruined after one full attempt at resuscitation weather sucessful or not, and only has a ~60-70% chance to revive that person. I dunno, could understand if people wanted to go with realism on this one, but seen as its in the game, and has no use since you can just carry an epipen, I think it could add in a cool mechanic. Maybe making a medic role a viable playstyle in a group of survivors.