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ASMRB House Rules

Version 1.5
January 9, 2000

19.0 Morbidity, Mortality and Critical Wounds

19.1 Losing Body Below Ø Body

Generally, the stat Body represents blood volume, resistance to shock, and just pure remaining bulk. The principal mechanical dangers which threaten life immediately after wounding are asphyxia and hemorrhage. Thus, the classic "Paramedic roll to stop Bleeding" is more generally:

  1. controlling major bleeding with tourniquets, manipulation of pressure points, pressure dressings, hemostats, etc.; note that internal hemorrhage can only be controlled by surgery (or magic!).
  2. ensuring an adequate airway (especially in comatose characters); performing CPR if needed.
  3. restoration of lost blood volume (in 'modern' campaigns) with whole blood, serum albumin, plasma (gamma globulin), saline, Ringer's lactate, etc.

Only #1 could conceivably be performed in the space of a phase or turn; the remainder could take 30 seconds to 10 minutes. Since indefinite stabilization is unlikely to result from rapid application of a pressure dressing alone, a new game mechanic is proposed, and the following definitions:

'Bleeding to Death'

This game mechanic (lose 1 BOD per post-segment 12) more generally represents any rapid or sudden worsening of the character's condition when death is near. Initially (within seconds after wounding) it usually will be massive blood loss; at later times this game mechanic represents major shock effects (up to coma, asphyxia, or circulatory collapse) requiring artificial respiration, CPR, or other 'heroic measures.'

'Modified Paramedic Roll'

The 'minus half the amount of Body below Ø' roll needed to control 'Bleeding to Death'.

Characters below Ø Body whose 'bleeding' is controlled by a successful modified Paramedic roll must be attended to again, within 5 or 10 minutes, or they will resume dying by losing a Body point immediately, and another every 12 seconds. The second Paramedic roll, to stabilize the character, does not take minuses for Body below Ø. If a character begins 'bleeding' again due to a lack of successful treatment, another modified Paramedic roll must be made, and then a further straight Paramedic roll must be made to stabilize the character. This process can continue until either the character runs out of Body points, or a stabilization roll has been made.

The stabilization roll takes nominally 1 minute (so up to 5 minutes can be taken, for a +1 to the Paramedic roll). The assumed equipment needed for the 'bleeding control' roll is a tourniquet, pressure dressing, or other method of stopping major bleeding; of course, the nature of the injury (physical trauma, thermal trauma, chemical trauma, or a radiation injury) may call for more, less, or different equipment. For the stabilization roll, a medic kit is the assumed equipment; attempting to stabilize a character with no equipment at all will cause a -2 modifier to the roll. Note that Class 2 Hemorrhage is considered to be 1.0 to 1.5 liters blood lost (out of 11 liters in an average man); it is at this level that shock begins to set in, with rapid breathing and pulse rate above 100. Class 3 Hemorrhage is about 2 liters lost; at this level the skin is cold, and cyanosis is visible. A "unit" of blood is about 1/2 liter.

Example: Cherry (Body 10) takes a 12 point bullet wound in the chest. He begins to lose Body at 1 per post-segment 12; fortunately, on the next turn, Mr. X, who only has an 8- familiarity with Paramedic, makes a -1 Paramedic roll anyway and controls Cherry's bleeding, probably with a big, basic bandage or field dressing. Five or six minutes later, it is time to prepare Cherry for transport to the ripperdoc; Mr. X fails his Paramedic roll and Cherry loses another Body point, and will lose one more each turn until a modified Paramedic roll is made. He has probably stopped breathing, and has lost a lot of blood; Mr. X obviously is beyond his medical depth.

Fortunately, the Pod is nearby with a 14- Paramedic roll (due to his cyber-enhanced brain) and a medic kit, and immediately makes a -2 modified Paramedic roll to stabilize Cherry again. After a few minutes of CPR or a high-tech equivalent, he easily makes his 14- Paramedic roll for stabilization. Cherry can now survive more or less indefinitely.

Characters who were in the 'Bleeding to Death' phase can expect one to four days (at least) of medical excitement, involving shock, and cardiovascular, hormonal, electrolytic, or other pathologic responses. Then there are infections, and nasty side effects of anesthesia, traction, or drugs - fun, fun, fun!

19.2 Critical Wounds

An extended treatment of vital tissue destruction is hereby proposed. The following mechanics apply primarily to human beings; presumably, creatures made of sterner stuff would modify some of the numbers involved. Characters damaged by Killing attacks in important locations must make Mortality rolls or die more or less immediately (regardless of their actual remaining Body):

Head wounds (locations 3-5) or Vitals wounds (location 13):

roll* = 21 - ( damage done** + Total Stun Mod*** ) + 1/5 of BOD characteristic

* A roll of 6- always succeeds.
** Limited to a maximum equal to the Damage Class of the attack.
*** Total Stun Mod is the attacking mod plus the location mod.

The severity of a 'failed' roll indicates trauma to one or more important organs or vessels of the affected area. A character failing the Mortality roll might still survive if surgical (not first aid) treatment is applied within seconds, or at most a minute or two - so, try and get shot in the emergency room if possible. There is normally nothing that can be done with a medic kit and Paramedic skill in the field for a person who fails a Mortality roll.

Example: Billy Joe Gotez (Body 21, Con 20, Stun 43) is shot in the chest and head by an AK-47, each hit for 7 BOD with a +1 Stun Mod. From the chest hit, he takes 28 Stun and is Stunned, but is not impaired, being an astoundingly tough guy. From the head hit, he is Stunned, impaired, and unconscious, and has to make a 13- Mortality roll (≈ 80% chance of surviving). Even if he makes the Mortality roll, he will have lost 21 Body, and be in serious need of a Paramedic roll.

19.3 Impairing and Disabling Wounds

A more detailed treatment of these effects is being considered.

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Document last modified Friday, June 01, 2001