指南：重伤治疗

## 指南概述

本指南旨在提供各种重伤的详细信息及治疗方法，为医护人员提供参照。

重伤是一种特殊的伤害类型，当患者的特定肢体遭受了太多伤害时产生。

## 类型概览

* 钝器伤：根据受影响的肢体不同，从而减少患者的交互与移动速度
	+ 关节错位（Joint Dislocation）：对特定肢体使用正骨器
	+ 细微骨折（Hairline Fracture）： 需要手术，在手术中使用骨胶或医用胶带后等待愈合，用纱布包扎稳定伤口防止恶化
	+ 开放性骨折（Compound Fracture）： 与轻微骨折相同，但手术需要时间更长且步骤更多，用纱布包扎可以暂时回复肢体功能

* 撕裂伤：会使患者持续流血，严重程度越高失血速度越快
	+ 皮肤擦伤（Rough Abrasion）：一般情况下无需处理
	+ 开放性撕裂伤（Open Laceration）：用纱布包扎受伤肢体止血，缝线和烧灼器也可以直接减少出血量，紧急医用注射笔（Emergency Medipen）内含凝血物质可以帮助身上的伤口闭合
	+ 开放性大出血（Weeping Avulsion）：尽快减少出血量，对患者使用紧急医用注射笔和纱布，并缝合/烧灼伤口直至其严重性下降

* 穿刺伤：出血量低于撕裂伤，但不会自愈，受伤部位如果再次受到击打会导致流失更多血液
	+ 微小刺伤（Minor Breakage）：使用纱布，缝线或烧灼器就可以闭合伤口
	+ 开放性刺伤（Open Puncture）: 用纱布包扎受伤肢体止血，缝线和烧灼器也可以直接减少出血量，紧急医用注射笔（Emergency Medipen）内含凝血物质可以帮助身上的伤口闭合
	+ Ruptured Cavity：穿刺修复手术可以快速高效地治疗伤口，使用烧灼器会造成一些烧伤

* 严重烧伤：使肢体所受伤害更多，三级烧伤和灾难性烧伤会导致感染
	+ 二级烧伤（Second Degree）：对肢体使用再生贴和软膏并等待其自愈
	+ 三级烧伤（Three Degree）：对受伤部位实施清创手术，或者再生贴/软膏与太空西林/紫外线笔灯（UV Penlight）
	+ 灾难性烧伤（Catastrophic Burns）：步骤同三级烧伤，但更严重

上述的说明足够让你在遇到类似情况时做出快速反应，如果你能明白上述内容，你已经可以应对大部分情况了。如果你仍然不确定的话，使用健康分析仪会给你治疗的相关建议。

## 深入了解

本部分为想更深入了解重伤，或寻找更好治疗患者方法的医生设计。上文在有扫描仪的情况下已经足够医生对患者进行治疗了。下文会阐述如何能更好的治疗患者并提高治疗效率。

重伤有两种要素：类型，严重程度. 类型有四种（钝器伤，撕裂，穿刺，严重烧伤）, 三种严重程度（中等，严重，极度严重）。严重程度越高，所需治疗约复杂。

* 钝器伤会导致关节错位和骨折，通常由钝器导致的外伤产生，这些伤害通常比其他类型更难处理，且根据不同的受伤部位有不同的症状
	+ 手臂：降低交互速度，增加点击冷却时间
	+ 双腿：减缓移动速度
	+ 躯干：击打受伤部位会导致咳血，躯干只会骨折。
	+ 头部：产生直到骨折治愈后才会被移除的临时脑损伤，头部只会骨折。

* 撕裂伤通常由锋利的物品如刀，剑导致。失血速度随严重程度增加。
	+ 标准的肾上腺素医疗注射笔和紧急医疗注射笔都含有凝血物质，短时间内可以帮助对身上所有的流血伤口闭合。对身上多处流血的患者效果良好，在没有纱布和缝线等医疗品时非常有用。
	+ 锋利武器还会损坏连身衣，使其失去保护能力，在面对这类武器的时候建议携带护甲保护自己

* 穿刺伤通常因长枪，子弹等穿透皮肤，导致内出血。受到穿刺伤的肢体受到伤害时会使血液从伤口中喷洒出来，提高失血量
	+ 穿刺修复手术可以高效地治疗穿刺伤，且此手术只需要手术刀，止血钳和烧灼器（或可以烧灼伤口的物品）即可完成。

* 严重烧伤相较于其他重伤更难处理，只有在组织损伤和感染都被清除，伤口才会愈合。
	+ 组织损伤：治疗组织损伤，只需要对受伤部位使用软膏和再生贴即可，用纱布包扎可以加速愈合，并提高软膏作用时长。
	+ 感染：严重和极度严重都会导致伤口感染。极度严重感染速度更快。你可以用检视来查看感染的严重程度。太空西林，紫外线笔灯，和清创手术都能有效的治疗伤口感染。

## 你知道吗

* 连身衣对各种重伤都提供微量抗性，在某个时机，说不定你的连身衣会让你免于遭受重伤
* 对某个部位进行多次攻击会使连身衣对特定部位提供的抗性失效，使用布可以修复连身衣
* 有意思的是，对大部分重伤用纱布包扎通常不是减少伤口恶化速度就是加速伤口愈合，如果你犹豫不决的话，就先用纱布包扎吧
* 撕裂伤很容易产生，尤其是对无防护的人来说。但钝器伤就相对不容易，虽然钝器伤无视护甲效果。穿刺伤会导致，容易由远程武器如投掷长矛，枪弹产生。严重烧伤对无服装保护的人伤害很高，但最难产生
* 如果你很懒的话，你可以直接把患者放进冷冻仓来让他们的重伤恢复
* Changling 可以通过 fleshmend 直接治疗所有重伤和疤痕
* 服用鲤鱼毒素可以移除身上所有的疤痕

## 详细信息

### **钝器伤**

#### **中等：关节错位**

* 负面效果：降低交互速度（胳膊），移动速度（腿），不能被施加在躯干和头部
* 治疗方法：对受伤部位使用正骨器
* 其他方法：对患者2级抓握，并与受伤部位交互，可以强行扭动关节并有一定概率治愈。战斗模式下进行此操作会导致患者骨折。气闸和消防门的压迫也有 1 /3 的概率治愈，但会使你受到外伤，不会导致重伤

#### **严重：细微骨折**

* 负面效果：降低交互速度（胳膊），移动速度（腿）， 随机临时中度脑损伤 （头），受伤导致咳血（躯干），被截肢的肢体也会遭受骨折。
* 治疗方法：需要手术，手术刀和正骨器就可以治愈
* 其他方法：对受伤部位使用骨胶，并用医用胶带固定。用这种方法对自己治疗有几率在使用骨胶时失败，并导致昏迷。开放性骨折对自己治疗失败几率更高。喝醉，注射吗啡等会降低失败概率。使用医用胶带会缓慢治疗受伤部位，并在自愈过程中身体随机受到外伤和体力伤害。对自己治疗恢复时间更长，开放性骨折恢复时间也更长。
* 紧急处理：你可以用夹板（medical splint）固定骨折部位，可以减少负面效果惩罚，但你仍然需要进行上述步骤来治愈。

#### **极度严重：开放性骨折**

* 负面效果：失去肢体机能（胳膊或双腿），临时严重脑损伤（头部），受击导致咳血（躯干），被截肢的肢体也会遭受骨折。
* 治疗方法：手术需要5步，前三步为标准的做切口/止血钳/牵开器，第4步将骨头归位，此步骤虽然可以用医用胶带和普通胶带完成，但还是建议使用正骨器。第5步修复骨折部位，可以用骨胶/医用胶带修复
* 其他方法：如细微骨折一样可以使用骨胶和医用胶带治疗，但恢复时间更长，失败惩罚更重
* 紧急处理：你仍然可以像细微骨折一样用夹板固定受伤部位使受伤部位重新恢复肢体机能，但负面惩罚与细微骨折相同

### **撕裂伤**

* 不同于钝器伤造成的重伤，撕裂伤所有程度的重伤治疗方法都相同，只是紧急程度不同而已，且不止撕裂伤会导致流血，其他伤口也会导致流血
* 伤口流血会提高撕裂伤的严重性，以下因素会影响重伤的流血速率：
	+ 凝血率：中等和严重等级的撕裂伤会逐渐闭合，极度严重的撕裂伤不会闭合，相反，它会持续恶化，增加出血率
	+ 伤口包扎：包扎伤口会提升凝血速率并提供恢复速率加成
	+ 凝血物质：
	+ 缝合/烧灼：每次使用时，缝合和烧灼会立即减少出血，可以重复使用，直到治疗结束。缝线可以减少出血，同时治愈外伤，如果你没有可用的缝线，你可以用类似点燃的香烟，焊枪一类的东西烧灼伤口。这会有点痛，但不会消耗药物。
	+ 更多的伤害：进一步的劈砍/枪击不仅可以提升伤口的严重程度，还可以直接增加血液流量，增加伤害的百分比。
* **记住：一针及时节省九针！**你的血液流失会有效的表示你的伤口的严重程度，以及每一刻流失多少血液，所以尽快将其缝合是很重要的。立即应用绷带、肾上腺素笔，甚至一到两根缝线/缝合器，都会在伤口愈合时使流血总量降低许多

#### **中度：皮肤磨损**

* 该重伤本身不会造成很大威胁，且一段时间后就会自愈。如果出血量不大，你可以考虑让他们自己闭合，但重伤部位遭受攻击会提高重伤等级

#### **重度：开放性撕裂伤**

* 相比上一级需要多加注意。应立即用绷带包扎，或用缝线与烧灼器闭合伤口。如果条件不允许，可以对伤口压迫止血，且应当对伤口多加注意，防止重伤升级

#### Critical: Weeping Avulsion

* While moderate and severe slashes usually aren't immediate matters of life and death, critical slashes are by far the most dangerous wound you can suffer. Not only have you likely suffered large amounts of damage to your limb, you're also losing blood at a dizzying rate that is actively getting worse rather than better. Either wrap up what you're doing within the next minute, or run and hide for a bit to treat yourself before too long passes. Your top priority, whether you're treating someone with a critical slashes or are the patient yourself, should be to do everything you can to lower your bleeding, starting with applying bandages and sticking yourself with a medipen, followed by sutures or cauterization. Otherwise, you'll be flirting with passing out before too long.
* Also note that critical slashes count as mangling flesh, which means that if you have this, you're pretty close to getting this bodypart severed entirely. Just another reason to get it fixed ASAP!

### Pierce Wounds

General notes:

* Like slashing wounds, these mostly cause bleeding. Unlike slashing wounds, these require manual treatment in order to stop bleeding, though they're not nearly as pressing. Also, lowering the bleeding rate will not demote it to a lower tier wound.
	+ Bandaging: Wrapping the pierce with bandages significantly amps up your clotting rate while active, providing a potent buff to recovery speed.
	+ Coagulants: Epipens and emergency medipens contain a coagulant reagent that treats all bleeding wounds, excellent for when you need to immediately slow down bleeding or are dealing with a patient with multiple cuts.
	+ Suturing/Cauterization: Sutures and cauterization immediately reduce bleeding with each application, which you can repeat until treated. Sutures are great because they reduce bleeding and heal brute damage at the same time, but if you don't have any available, you can cauterize the cut with anything that can light a cigarette. It'll hurt a bit, but you won't use up any consumables.
* **Remember: A stitch in time saves nine!** Your blood\_flow is both a tracker for how serious your wound is, as well as how much blood you lose *every tick*, so sinking it as soon as possible is important. Immediately applying a bandage, jabbing a medipen, or even managing one or two sutures/cauterizations can make a big difference in the total amount of blood lost by the time the wound is healed.

#### Moderate: Minor Breakage

* Notes: Causes a little bit of bleeding, but not to the point that you should interrupt what you're doing to fix it by itself. Simply suture, cauterize, or gauze at your convenience.

#### Severe: Open Puncture

* Notes: Still not super serious, but remember that every blow to this limb can cause you to lose extra blood from the hole in it. For reference, the base bloodflow here is a bit higher than a moderate slash. If you have a surgical drapes, a hemostat/scalpel, and a cautery, the Repair Puncture surgery is very quick (simply incise, hemo/scalpel, cautery/anything hot, repeat 2 & 3 until treated, close surgery) and effective at treating piercing wounds.

#### Critical: Ruptured Cavity

* Notes: Almost every hit to this bodypart will cause you to lose additional blood, and you're bleeding at the rate of a severe slash. Not pretty! While not as immediately life threatening as a critical slash, this is still a very big issue and should be treated rapidly. At this point, the Repair Puncture surgery is likely your best option.
* Also note that critical pierces count as mangling flesh, which means that if you have this, you're pretty close to getting this bodypart severed entirely. Just another reason to get it fixed ASAP!

### Burn Wounds

General notes:

* While you can technically get burn wounds from any burning type weapon, in reality the mixture of a general lack of high damage burning melee weapons and the high thresholds required to deal burn wounds means that the vast majority of these will come from lasers. In addition, since undirected/general damage don't qualify for wounds, you cannot suffer serious burns from being set on fire or being exposed to space. Lava can though, so I've heard...
* Unlike cutting wounds, serious burns have very high threshold penalties (the highest of all three types in fact). This means a limb suffering from bad burns is almost trivial to cause bone wounds in, and the penalty for a moderate burn is actually higher than the threshold for a moderate cut, meaning any sharp attack that does enough damage to roll wounds (5 force) will automatically cause an abrasion, if not worse, without strong armor. Combined with the fact that burns increase all incoming damage on that limb, lasers make for an excellent way to soften up lightly armored/unarmored targets for melee fighting.
* Burn wounds will slowly heal their flesh as long as the limb has < 10 burn damage, the burn has no infection, and the patient is fed.

Burns from exposure:

When your body temperature is over the 400.5 K (126.8 C, 260.3 F) threshold you have a chance to gain a burn wound, the longer you are exposed the more likely you will gain a burn wound on a random limb. All burn wounds from exposure to high temperatures slowly progress to even more severe burns if the temperature is high enough.

Temperature thresholds for increasing wounds

* 400.5 K (126 C, 260 F) Moderate: Second Degree Burns
* 800.5 K (526 C, 980 F) Severe: Third Degree Burns
* 3200.5 K (2926 C, 5300 F) Critical: Catastrophic Burns

#### Moderate: Second Degree Burns

* Negative effects: Fairly easier to deal wounds to this limb, take 10% damage on incoming attacks on this limb.
* Full Treatment: Slap on some ointment or regenerative mesh and wait a bit.

#### Severe: Third Degree Burns

* Negative effects: Significantly easier to deal serious wounds to this limb, 20% extra damage on incoming attacks on this limb, slow infection.
* Full Treatment: Two step surgery with hemostat/scalpel and bandages will resolve all infection and some flesh damage. Otherwise, infection can also be treated by spaceacillin, sterilizine, or paramedic UV penlights. Ointment and regenerative mesh can heal the rest of flesh damage.
* Improvised Treatment: Miner's Salve is fairly effective at both healing flesh damage and sanitizing any infection.

#### Critical: Catastrophic Burns

* Negative effects: The limb is incredibly easy to cripple with serious wounds, takes 30% extra damage on incoming attacks, and becomes a hotbed of infection.
* Full Treatment: Two step surgery with hemostat/scalpel and bandages will resolve all infection and some flesh damage. Otherwise, infection can also be treated by spaceacillin, sterilizine, or paramedic UV penlights. Ointment and regenerative mesh can heal the rest of flesh damage.
* Improvised Treatment: Miner's Salve is fairly effective at both healing flesh damage and sanitizing any infection.

## Appendix 2: Wounding Table

*\*Base Attack Force: Assuming a weapon/attack has 0 wound bonuses (cutting weapons may need more vs armor, less vs flesh), how much force it will take to have a decent chance at dealing this wound assuming either no existing wounds, or only the lower tier version of this wound type.*

* Note that some wounds, critical bone wounds especially, may require multiple types of active wounds to be feasible.
* Burning wounds are simply listed as Atk Force "Lasers!" since lasers are the main source of them by far anyway. Continually lasering the same limb with no armor will probably deal critical burns within a half dozen shots, maybe plus a few.