Blood Loss

Posted: 4 May 2012 in Rules

“You don’t need to know about the miracles of 21st century medicine. You need to know what to do when you’re bleeding to death in an alley somewhere.” – Cyberpunk 2020.

This is the kind of thing I get up to when I’ve got time on my hands. It probably won’t get used much in play, because it moves away from the Fast, Furious, Fun aspect of Savage Worlds which I love so much; but having thought it through will help with my descriptions of combat.

Long ago, I briefly experimented with the Amber Diceless Roleplaying Game. That was worthwhile, but as a result I decided diceless games are not for me, and moved on. The things that stuck with me afterwards, which I used in 2300AD for a while, were the wound descriptions – in a game with no hit points or saving throws, one conveys to players how badly damaged they are by describing their symptoms.

In an idle moment, I wondered whether something similar would be useful, or at least possible, for Savage Worlds. It turns out that it’s definitely possible, although the jury is still out on useful. Specifically, I can match wound levels to the symptoms of hypovolemic shock, which is the default assumption for EMTs treating trauma victims. Nothing like gaming for broadening your horizons.

Shaken. Acquiring this status from physical damage corresponds to losing up to a litre of blood, perhaps 10-15% of your blood volume, a little more than the average blood donation. I’ve done that, so I speak from experience when I say that looks like a lot if it gets spread over your clothes, and it is common, but not inevitable, to feel a bit light-headed, weak and wobbly, which may partly explain the game effects. Your heart rate may increase a little, or it may not. However, all you need in the way of treatment is a nice cup of tea and a sit-down. (As well as being the all-purpose cure for everything in British culture, the tea helps restore your circulation volume.)

One Wound. You’ve lost up to 30% of your blood volume, call it 1 to 1.5 litres. Typically you’re now agitated (-1 to skill rolls), breathing faster to offset the loss of oxygenation, and your skin is cold and clammy as your body reserves blood for the important core organs – skin and muscle begin to die after 4-6 hours without blood, and most internal organs can manage 45-90 minutes, but the brain and lungs are toast after 4-6 minutes, so this shift makes sense.

Two Wounds. Loss of 1.5 to 2 litres, 30-40% of your blood volume. That’s nearly half a gallon in old money. You’re breathing hard and fast now; your heart rate is up, but it can’t compensate for the loss of blood, so your blood pressure is falling. The body protects your brain’s blood flow as a priority, but it can’t cope by this stage, so you’re confused (-2 to skill rolls), and may get tunnel vision or greyed-out vision. In the real world, blood transfusions are called for.

Three Wounds. You’ve lost more than 40% of your blood, more than 2 litres for most people. This is life-threatening. Your blood pressure has crashed, your heart rate is over 140 beats per minute as it tries (and fails) to compensate, your respiration has collapsed, you’re lethargic and while you may still be thinking straight it’s only in short bursts (-3 to skill rolls). Your skin is pale and cold, and you’re quite likely to black out.

Incapacitated. Now we’re into irreversible shock. You get all of the above, but more so; you have a sense of impending doom, and rightly so. (Nothing induces this in players more than making them roll on the injury table.) In the real world, even if you survive the initial trauma, you could die from it any time in the next few days.

People in great physical shape (high Vigour, Brawny Edge, I’m lookin’ at you) may compensate for blood loss more effectively, which I guess is why they are harder to wound in the first place. Note, though, that bigger people have more blood to lose, but bigger veins and arteries to lose it through, so the rate of loss is pretty much constant, hence why they don’t have more Wounds.

Healing Rolls. The priority is to stop further blood loss by applying pressure, tourniquets, etc. If the setting technology level and party equipment allows it, anyone with actual Wounds gets oxygen and/or an IV drip, and possibly a PASG (the medical version of a pilot’s g-suit). Regardless, the patient is laid down, kept warm and protected from weather, and gets plenty of fluids to restore circulation volume.

Thankfully, I’ve led a sheltered life, and I have no formal medical training; so I’ll listen respectfully to corrections from anyone who has “seen the elephant”.

  1. Andy, I really like what you done here. I’ve often thought about how to explain the wound levels but never really came to any conclusions. In my mind I wasn’t quite close to your ideas but man it make sense now that I seem them written out like this. Thanks for sharing!

  2. thetailrace says:

    Gosh I remember Amber, a good series of books too. But as you hinted not everybody’s cup of tea, and quite difficult in practice.

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