Recovery from Serious Injuries

[Chthon]

I have noticed that sometimes a Xenonaut "corpse" will receive a +5 hp when you hit it with a medipack. I also have noticed a minor correlation between this person recovering at the end of the mission with 1 hp, or not when you use medipacks on them. This seems to go up if I finish the mission quickly, and keep someone next to them to continue applying medipacks until the end.

Is this just my imagination, or is there a mechanic here of helping with severe trauma? If not, is it just pure luck?

[llunak]

No, it's just a minor bug (that's been fixed in X:CE 0.24) . Medipacks shouldn't work on soldiers that have 0 HP. In official release this makes a difference because soldiers keep bleeding even after dropping to 0 HP, so they can get below the has-a-chance-to-recover limit.

[Chthon]

No, it's just a minor bug (that's been fixed in X:CE 0.24) . Medipacks shouldn't work on soldiers that have 0 HP. In official release this makes a difference because soldiers keep bleeding even after dropping to 0 HP, so they can get below the has-a-chance-to-recover limit.

So, what you are saying is it does make a difference, but this is due to a bug? That doesn't make much sense, because if you stop the bleeding, and get them to stable condition, even at 0 hp they should survive at least until the hospital.

Of course there are other issues, punctured lungs, pressure pneumothorax, etcetera, but stuff like this should be just abstracted out to "he's dead jim" nothing left to do.

Is there anyway we can turn this from an undocumented feature to an actual thing you can do in the game, with a message that says "stabilized?" Sort of like -1 to -10 hp in D&D 3rd edition? Once stabilized, they can be left and will survive the rest of the mission, unless hit by an explosive.

[Max_Caine]

There is a mechanic for soliders who have died, i.e. have reach zero or negative hp. They can make a "saving throw" at the end of the mission. The saving throw is modified by how below zero their hp was at time of "death", with -20hp being the cap. A solider who dies of bleeding, and has say, -4hp at the end of the mission stands a good chance of recovering, compared to a solider who copped a heavy plasma shot and is on -17hp.

[Dranak]

So, what you are saying is it does make a difference, but this is due to a bug? That doesn't make much sense, because if you stop the bleeding, and get them to stable condition, even at 0 hp they should survive at least until the hospital.

In the world of trauma, dead is dead. Generally speaking you don't do CPR on them, evac them, or even do any bandaging, and I would have never performed any sort of recussitative measures on a corpse on a battlefield. But this is a video game where you go from okay to dead with no middle ground, so the mechanic mostly works.

[Chthon]

In the world of trauma, dead is dead. Generally speaking you don't do CPR on them, evac them, or even do any bandaging, and I would have never performed any sort of recussitative measures on a corpse on a battlefield. But this is a video game where you go from okay to dead with no middle ground, so the mechanic mostly works.

Yes, there is that line you do not cross, but if their heart is beating, and they are still breathing, or it has just stopped doing one or the other, and combat is over, then you still perform trauma on them in hopes they stay that way.

Every soldier in the US Army is taught CPR with their trauma. They aren't expected to do this during a firefight, but after one is over, they are allowed to try if the victim hasn't been dead for long. Other trauma items can and will be applied to an unconscious target if he is not obviously dead, and can help save the life of a dying man. Once again however, nothing trauma related in real life short of a tourniquet is ever applied during a firefight by anyone other than an actual trained medic.

In real life we also have the option of calling for a medevac for downed soldiers/civilians during a mission. Such a thing never happens in games, and is what smoke grenades are most often used for signaling after the radio.

[Dranak]

I'm not trying to be overly nitpicky here, but as a former army medic/current critical care paramedic the ideas of CPR that get perpetuated by Hollywood just annoy the heck out of me.

Traumatic cardiac arrest in a prehospital setting is not a survivable event, especially in the setting of any sort of gunshot/shrapnel injury. Assuming 0 HP in game means death, that person would stay dead no matter what you do (from a realistic medical perspective). It doesn't matter what you do to a corpse to stop fluids leaking out of it/adding more, it's still a corpse.

There's maybe a little wiggle-room if we think of the game as using DND-ish rules of unable to keep fighting at 0, but not dead-dead until -10 (-20 in this case), and really at that point it's starting to get a bit silly trying to rationalize a game system to be consistent with reality instead of just going with it.

And speaking of rationalizing game mechanics, I always rationalized this game's medkits as being like performing Buddy-Aid. Even if every member of your team was a full fledged medic, they still wouldn't really do any more than that during a fight anyway.

[Chthon]

I'm not trying to be overly nitpicky here, but as a former army medic/current critical care paramedic the ideas of CPR that get perpetuated by Hollywood just annoy the heck out of me.

Traumatic cardiac arrest in a prehospital setting is not a survivable event, especially in the setting of any sort of gunshot/shrapnel injury. Assuming 0 HP in game means death, that person would stay dead no matter what you do (from a realistic medical perspective). It doesn't matter what you do to a corpse to stop fluids leaking out of it/adding more, it's still a corpse.

There's maybe a little wiggle-room if we think of the game as using DND-ish rules of unable to keep fighting at 0, but not dead-dead until -10 (-20 in this case), and really at that point it's starting to get a bit silly trying to rationalize a game system to be consistent with reality instead of just going with it.

And speaking of rationalizing game mechanics, I always rationalized this game's medkits as being like performing Buddy-Aid. Even if every member of your team was a full fledged medic, they still wouldn't really do any more than that during a fight anyway.

If we assume 0 hp means death, than many soldiers should lose consciousness long before 0 hp. This is what I am getting at. 0 hp does not mean death in game terms. 0 hp means you still have a chance of survival but are unconscious. This is the sort of soldier I was trained to look for to try to save, where as -20 hp means actual death. Stabilizing a dying unconscious soldier is something you do on the battlefield, but once they reach -20 then they are dead.

I find it to be a bug that even -0 hp soldiers are shown as corpses if they can magically end up in your hospital at 1 hp after the mission.

[Jack]

Let’s agree on this that we all start to grow fond on the one and other soldier and hate to loose them after many missions. I prefer to know immediately if my dropped soldiers are dead or not, instead of playing a lucky dice-game at the end of the mission, especially if I have no clue how serious they got wounded.

It’s particularly annoying if they drop to their unknown corpse-status just because of 1 missing HP due bleeding and few APs lacking to apply a medic kit.

The medic mechanics of XCOM:EU with stabilizing and later revival including its moral-debuff worked perfectly.

[Chthon]

Let’s agree on this that we all start to grow fond on the one and other soldier and hate to loose them after many missions. I prefer to know immediately if my dropped soldiers are dead or not, instead of playing a lucky dice-game at the end of the mission, especially if I have no clue how serious they got wounded.

It’s particularly annoying if they drop to their unknown corpse-status just because of 1 missing HP due bleeding and few APs lacking to apply a medic kit.

The medic mechanics of XCOM:EU with stabilizing and later revival including its moral-debuff worked perfectly.

Yes, that's all I'm asking for, a chance to stabilize them so that they don't actually die. When they drop below 0, and they have bleeding wounds, you apply a medipack 5 hp at a time to try to stop the bleeding wound. The target does not actually gain hp. You can keep doing so, but if you're being fired upon, it's not wise. Kill the enemies first. If you are lucky, you will get a message "Stabilized" and you know he will survive till the end. If you are not successful they will bleed out and their life signs stop completely and you get a message "Dead."

To assist with this, unconscious soldiers do not have their panels disappear, though they will be empty. No indications will appear at all that they are alive or dead until you attempt first aid. If they are already dead, the panel will vanish. If they are alive but still bleeding out, they will show a red + over the panel. If they are stabilized it will show a green + over the panel.

To be clear, you have to evaluate the casualty by using a medipack before any indicators show at all, otherwise it's a black panel with their number, and has their name when you hover over. Some soldiers will fall unconscious without bleeding injuries, these are the ones that would recover regardless and result in "automatic" success when you evaluate them.

At most you will have 4 turns of bleeding out to attempt to stop the bleeding as well. Nothing can extend this time unless they stabilize. Most times you might be able to finish the firefight before it's too late. Doing so while under fire will likely result in other casualties as the target may not have had sufficient cover in the first place.

Advanced medipacks using Sebilian regeneration cells could also have increased chance to stop bleeding out, as well as have more capacity in a smaller space. They would work much the way stuff like "Quick Clot" works in modern medipacks, where you rub it in a bad wound and the bleeding just stops, then you place a dressing over it. Only difference here is instead of a powdery chemical constricting blood vessels, you have nanites repairing them and closing them.

Short version:

1: Person drops below 0 HP and goes into "unconscious" status, life-signs unknown.

2: First use of medipack per turn determines current status and attempts to stop any bleeding. If dead (below -20), no other attention can be given. If not bleeding they are stabilized and no attention is needed. If bleeding they will lose 5 HP per turn. You do not know how many more turns you have. After 4 turns of bleeding status, dead status is automatically declared even if no other healing is given.

3: Continued use of medipacks on that turn have a chance of stopping the bleeding at a cost of 5 HP from the pack. No healing is performed only an attempt to stabilize the patient.

4: Patient is either stabilized, or bleeds out depending on if you have time to treat the wounds properly. Treatment is impossible if the responder is suppressed.