Tending to the Severe Lacerations affliction

[Thaumajig]

In the aftermath of a cougar attack, I think it's interesting how the player needs to spend a significant portion of their carried medicine to treat the injuries sustained, and replacing those medical supplies becomes an immediate priority as Severe Lacerations randomly applies further afflictions until it heals completely. These afflictions mean that long actions (e.g. sleeping) are very risky since they could accidentally kill your character if you get unlucky with the timing, encouraging players to sleep hour-by-hour for the full duration of Severe Lacerations to treat any new bleeding afflictions as soon as they occur.

What if we could pre-emptively tend to the affliction, essentially changing the wound's dressing to manage the risk of bleeding and infection at the expense of consuming additional medical supplies? Less frequent wound dressing changes saves supplies, but with higher risk of the additional random afflictions. This would encourage spending saved medical supplies to recover from Severe Lacerations with bed rest rather than hour-by-hour waiting, and when these supplies are exhausted, the player would need to decide between foraging for supplies in the cougar-infested region (very risky), increasingly sparing use of medical supplies (also risky), or moving into a new region.

[Mroz4k]

It is an interesting idea, but how would it work mechanically? Maybe like with infection risk, there would be "blood loss risk" that would increase during laceration affliction, but could be lowered by changing wound dressing?

[Veskaida]

Could be an interesting change, but it might be difficult to implement (sounds like an entirely new medical/bandage system and UI), and it might be difficult to teach the player in real-time how to do this, while they're also bleeding/Afflicted.

I like the severity of "Severe Lacerations", it's very demanding but 3 days isn't 'that' long. Not quite the long-term malady like Broken Ribs, Intestinal Parasites or Scurvy, but IMO it's right up there in potency. Yes this is probably one of the biggest issues with the Affliction: that it is largely a waiting game (and I'd imagine could also be quite frustrating if you're at extremely low condition and can't realistically heal/sleep for long periods of time for 3 days).

[Lexilogo]

I've played other survival games where Wounds are essentially like equipment slots, you equip a bandage to it or etc and that'll cause its durability to degrade, allowing this kind of risk-reward "do I change my dirty bandages regularly, or do I save on material at the expense of the quality of my healing" decisionmaking, and it can be really nice. But for TLD it wouldn't make sense to introduce such a new system for just one wound and would probably take a lot of work.

There's probably a simpler way to implement the same idea though, and I agree the ability to preemptively spend bandages to safely sleep would be nice. I think Mroz4k's idea of it being a visibly building Blood Loss Risk instead of RNG could work. (which would also allow for certain things to clearly affect it for players, like the risk building way faster when sprinting or doing other physically exerting activities) Though, there'd have to be a good balance struck between it still feeling like you've barely holding onto life without being absurdly annoying.

[bascolais]

maybe something easy to implement, playable, and still in line with high  injuries:

• during 12 nights, antiseptic & bandages are mandatory for every sleep
• during 30 days, more fatigue & less recovery due to body healing.

[Pencil]

I would like an option like this. It could be that every extra bandage you apply will give you X hours of no blood loss and every extra antiseptic treatment will give you X hours of no infection. It wouldn't have to change RNG if that makes anything any easier. 

There is also the point to be made that this affliction is meant to hinder your ability to regenerate health. So while I would like the ability to prevent more afflictions, it might be designed so that you have to sleep 1-2 hours at a time. 

Edited July 3, 2024 by Pencil

[Mroz4k]

Problem with that design would be that it is very easily manageable. You are basically throwing extra bandages at the problem until its over. The main challenge in this affliction comes from its unpredictability - if you sleep for too long, you will most likely bleed out because even single blood loss drains condition greatly.

I see no problem in spending more bandages to lessen some risks of it, but preventing them altogether for set amount of time is too much. 

I think best way would be if it was via blood loss risk but in a sense parasite risk works - aka based on current risk in set intervals, blood loss could occur, with bandages being able to lower that risk. But even that might make the laceration affliction easier to handle. There would still have to be some chance of blood loss developing outside that risk to maintain the RNG nature.

[UTC-10]

How about using fishing tackle to sew up and close the worse (or all)  lacerations?  The point of stitching up the laceration(s) is to forestall injury that causes the wound to start bleeding again.  It would provide yet another use for fishing tackle other than sewing and fishing.  

Obviously there would be "what about infection"?

For disinfection of the tackle, boil it in a recycled can (might be proportional to the difficulty: one per can for Interloper, two for Stalker, three for Voyager, and four for Pilgrim (if applicable) for a required period of time, say the time for non-potable water to become potable so cooking skill may apply.  Then the sterilized fishing tackle can get used to sew the laceration(s) together.  This also sacrifices the fishing tackle as it would not be usable for any other purpose after being used to sew up a laceration (one fishing tackle can  handle all lacerations from one Cougar encounter or it might take multiple fishing tackle, leave that to the implementation to work out).  This is also a "use now" kind of expectation as keeping sterilized things sterile in these conditions seems highly unlikely.  Of course, the character does not have to sterilize the fishing tackle prior to use which leads to:

Infection risk, whether singular or multiple depends on implementation, that can be prophylactically treated with antiseptic (not old man's beard wound dressing) or when the infection affliction occurs with antibiotics or reishi tea.  The risk is low (how low may vary with difficulty) when using sterilized tools and comparatively high when using unsterilized tools.  

Once the lacerations get stitched, there is a period of time (i.e. 3 days or more depending on difficulty) where the stitches could be undone because of physical trauma - i.e. like a fall or something like spraining a joint or even another struggle against a wolf or bear or moose - which would cause the stitching to have to be redone or risk a chance of bleeding for the remaining time.  Once the period of time has passed, the threat/danger of the laceration also passes.  

Times and risk % can be fixed or vary with game difficulty.  

To also not forget that maybe painkillers might be needed either to make the stitching almost certain to succeed or to avoid a chance of the stitching to fail due to pain.  

Thought later to add that stitching up the laceration(s) does not have to be done (it is an option) either because squeamish or lack of pain killers (and the chance of failure due to pain) or lack of fishing tackle or a can or a fire.  If not stitched up, the severe laceration effects including possible inopportune incidents of bleeding would apply.  

 

Edited July 6, 2024 by UTC-10
Added about painkillers and options

[Veskaida]

On 7/3/2024 at 11:02 AM, Lexilogo said:

I've played other survival games where Wounds are essentially like equipment slots

I agree, if there was one system in TLD that I'd love to see redesigned to be more intuitive: it's the current medical system.

It's a bit annoying and unfun for example, to Drink a "Rose Hip Tea" to try and treat Pain, but if you do not select the correct Affliction it yields the error "That treatment did nothing". As if you need to apply or diagnose your affliction, for a tea you drink to have any effect; or that drinking a painkilling tea helps the pain from one sprain, but not from another sprain you have, or the Broken Ribs you have.

[bascolais]

On 7/5/2024 at 9:49 PM, UTC-10 said:

How about using fishing tackle to sew up and close the worse (or all)  lacerations?  The point of stitching up the laceration(s) is to forestall injury that causes the wound to start bleeding again.  It would provide yet another use for fishing tackle other than sewing and fishing.  

Obviously there would be "what about infection"?

For disinfection of the tackle, boil it in a recycled can (might be proportional to the difficulty: one per can for Interloper, two for Stalker, three for Voyager, and four for Pilgrim (if applicable) for a required period of time, say the time for non-potable water to become potable so cooking skill may apply.  Then the sterilized fishing tackle can get used to sew the laceration(s) together.  This also sacrifices the fishing tackle as it would not be usable for any other purpose after being used to sew up a laceration (one fishing tackle can  handle all lacerations from one Cougar encounter or it might take multiple fishing tackle, leave that to the implementation to work out).  This is also a "use now" kind of expectation as keeping sterilized things sterile in these conditions seems highly unlikely.  Of course, the character does not have to sterilize the fishing tackle prior to use which leads to:

Infection risk, whether singular or multiple depends on implementation, that can be prophylactically treated with antiseptic (not old man's beard wound dressing) or when the infection affliction occurs with antibiotics or reishi tea.  The risk is low (how low may vary with difficulty) when using sterilized tools and comparatively high when using unsterilized tools.  

Once the lacerations get stitched, there is a period of time (i.e. 3 days or more depending on difficulty) where the stitches could be undone because of physical trauma - i.e. like a fall or something like spraining a joint or even another struggle against a wolf or bear or moose - which would cause the stitching to have to be redone or risk a chance of bleeding for the remaining time.  Once the period of time has passed, the threat/danger of the laceration also passes.  

Times and risk % can be fixed or vary with game difficulty.  

To also not forget that maybe painkillers might be needed either to make the stitching almost certain to succeed or to avoid a chance of the stitching to fail due to pain.  

Thought later to add that stitching up the laceration(s) does not have to be done (it is an option) either because squeamish or lack of pain killers (and the chance of failure due to pain) or lack of fishing tackle or a can or a fire.  If not stitched up, the severe laceration effects including possible inopportune incidents of bleeding would apply.  

 

ya, I think this is a very good idea. stitching up as a mandatory actiivity to lessen the risk. the laceration could be deep, all you wrote goes with the "severe" laceration concept from my point of view.

something more difficult to handle regarding the other threats.

[deathbydanish]

Just a thought but maybe we are overthinking this?

I just underwent minor surgery (nothing near as bad as a cougar attack) but even with less severe nature of the surgical incision, I am having to as OP described go through gauze/bandages to help with the blood that does go through the stitches. In fact I popped a stitch and was able to bleed through the gauze/bandage relatively quickly (it bleed through to my clothes fairly fast). Now I wasn't in any danger since the incisions were not deep and the blood loss was relatively minor, but if we are trying to figure out how to do this in game, I would just keep it simple. The minutiae of learning how to deal with a bleeding surgical incision is probably going to go beyond what is in scope for this game. Suffice it to say I am going through a lot of gauze right now for just this small incision, I can only imagine how much more work it is for something much worse.

[Veskaida]

14 hours ago, deathbydanish said:

I just underwent minor surgery (nothing near as bad as a cougar attack) but even with less severe nature of the surgical incision...

I'm sorry to hear that and I hope you recover well soon. Yes, superficial wounds tend to bleed a lot, but usually not at high volume. "Severe Lacerations" in TLD is probably meant to simulate a large/deep/complex and possibly arterial wound which has not been stitched and is prone to re-opening. TLD seems to simulate the survivor's knowledge/learning with the "Skills" system, a 'Medical Skill' could be an interesting idea, but given how late into TLD's development lifespan it is I'm not optimistic for such a change to be implemented, though I'd love to see that if it was.

IMO TLD's medical system is functional as-is and reasonably well developed, though I'd also argue it could use a slight redesign or additional checks to make it harder to waste/more intuitive for new players to use some medical effects (e.g. drinking Rose Tea and selecting 'Pain' cures the pain, but drinking Rose Tea and selecting 'Sprained Ankle' does not).

Stopping blood loss can be challenging in the field particularly:

• Self-treating injuries (all situations in Survival TLD)
• Arterial wounds (with high pressure blood flowing out)
• Large/deep wounds
• Wounds on difficult to reach bodyparts (e.g. places with high mobility/movement,
• wounds with smooth edges (e.g. cut from a sharp metal blade, not really something simulated in TLD)

IRL (and some other video games) blood loss from some of these wounds is sometimes treated by requiring:

• Pressure applied to the wound
• Suspending limbs (above the heart) and/or immobilization
• Tourniquet
• Hemostatic powder

[deathbydanish]

@Veskaida I bought some quikclot just in case, I think its more for convenience at this point, the incision is still bleeding, but its not as bad as before, I'm also using hydrocolloid dressings now that can absorb a certain amount of exudate before needing to be changed.

After thinking more on this if in the game we had to deal with much worse bleeding than I am doing now, I'm gonna guess our player character would have to find lots of material that could be used as gauze and since there might not be any formal medical supplies (I'm thinking medical tape or transparent dressings like Tegaderm) I think scrounging the homes for something like saran wrap to keep it wrapped up on a limb for example might be the only choice.

[vancopower]

I just died in sleep from severe lacerations. Im so 100% for this idea. Here is how I see it. Remove old bandages option should be implemented. You instantly get the 2 blood loss and infection which you can treat again and reset the 12 hour timer.   Which I just found about a minute ago  Died in ash canyon killed a wolf but the cougar got me good. 

[Veskaida]

Oof! I'm sorry to hear that! Severe Lacerations is no joke: I've lost characters to it, and watched/read others as well! Best of luck on your next run, here's hoping you blast that kitty into kingdom come. 🐈

[Stranzua]

The ability to stitch your wounds would be cool. However, it would have to come with some risk. For example, maybe running, falling, or getting attacked by wildlife could ruin the stitches and reopen the wound starting the process all over again.