Wanted: Medical expertise

[matthijs]

I'm (re)designing the combat system for my historical role-playing game, "Draug", set in Norway 1801. The new system will have a strong emphasis on realistic effects of wounds, such as infections, internal haemorrhages, shock, panic etc.

I'm looking for someone to answer my questions. A lot of info is available on the internet, but there are some areas that are hard to find research on. Specifically: what are the risks of infection from a stab or bullet wound; how does pain from wounds affect a combatant; what rate of blood loss is reasonable for different types of wound; what percentage of wounds will have little or no effect on combatants.

If anyone can help me with this, or give me links to sites/references to literature, it'll be greatly appreciated.

[peejay]

Hope the following helps if you need more info reply or drop me a line.

Risk of infection is related to a number of things including;
Purity of causal agent (for example it was not unheard of for swordsmen to smear their blades in faecal matter), What the target is wearing (fibres that may become lodged in wounds), environment (hot & humid environs promote bacterial growth) and treatment (ethyl alcohol acting as a anti-bacterial agent in primitive surgery).

Pain from wounds;
Examine typical symptoms of a shock reaction which can be found in most medical texts or first aid guides. For example a shock reaction effects cognitions, body temperature etc.

Rate of blood loss from wounds;
Look at any anatomical drawing of the human body that shows blood viens & arteries. Areas where there are either large ones (i.e. jugular, carotid) or many small ones (i.e. the scalp) will bleed more profusely than others. Blood Pressure (B.P.)also effects rate of blood loss - the higher the B.P. the greater the blood loss, note that as you lose blood your B.P. drops (less volume in the body) thereby slowing the rate of blood loss (but not enough to save you if a major artery has been cut!).

Percentage of wounds that would have little or no effect;
All wounds will have an effect even if only as an initial distraction before the bodies natural painkillers kick in. 'Flesh wounds' would fall into this category although they can be a source of later infection. Wounds that would have little or no effect in a combat situation would for example be cuts that do not penetrate deeper than the first couple of layers of the dermis.

Cheers,
Peejay

[Doc_Peck]

I'm not sure what exactly you need, but if this is not enough kick me an email.

I dont know if your game has hit locations or not, but just about any part of the body has the potenital to kill you if injuried properly.  I'm not a historical nut, but if you game is set in the early 19th century I am guessing most injuries will be from low tech firearms.

Most deaths from combat will occurr in the first 6 minutes.  This deaths are the severed heads, bullet to the heart etc.  They could happen on an operating table and little can be done with them. About 25% of injuries on the battlefield fall within this category (this has been reduced to 20% in the past few years thanks to Helmets, Flak vests, and eye protection, most of the death/injuries in the GWOT at to the legs, and arms.)

The first hour the big concern is bleeding out.  If you can apply enough direct pressure (or CLW spells :) ) they should be ok.  Without medical attention you will lose 10% more to hemorraging. 

The second hour airway problems become your big killer (dropping another 10%) .  Think of blockages that make people sound like a duck when they breath. 

If you have not bleed out or choked by hour 3 collapased lungs (tension pnuemothorax) become your next problem.  It can take hours to build up enough air/fluid in the lung cavity to 'squeeze' the lung so it doesn't collect enough air to live.  It will kill about 10%. 

The next big killer (hour 4) is closed head injuries and hypo/hyperthermia.  Closed head wounds bleed, and there is nowhere to let off the pressure causing the injured to start acting like he is intoxicated.  Your body also starts to lose it's ability to regulate heat, which helps your injuries spiral out of control.

From here to hour 72 infections start to cause havoc.  killing another 10%.  Pretty much if you make it this far you should survive.  Total fatality is about 50% after 72 hours.

Now with modern medicine, all of these problems are treatable except for the first 25% drop. The above numbers assume ZERO medical attention (guy gets injured and lays in a field alone for 3 days).  I dont know what level of medicine your game will have but you might want to keep that in mind.  If you have some kind of hit location system you will have to consider that as well.

I hope this helps.
If you want/need anything email me.
docpeck(at)toadmail(dot)com