Topic: Internal vs External Bleeding?

[markc]

 I was reading an article that brought up the herb "Yarrow" I went here to read about it: http://tlc.howstuffworks.com/family/yarrow-herbal-remedies.htm . And found it works on external and internal bleeding.
 
 1) That got me thinking shout there be a difference in bleeding types for RM?
 2) How would you detect internal bleeding?
 3) How would you treat internal bleeding? Via surgery?
MDC 

[Usdrothek]

You would need surgery to treat internal bleeds.

The symptoms would vary with the bleed location. Chest, abdomen, head, into tissue?

Pain, weakness, rapid heart beat as your blood pressure tanks, difficulty breathing, difficulty moving an effected limb.

Bleeding into your brain is going to give you a stroke, vision loss, speech loss, motor control loss.

[providence13]

Surgery and or magic, sure.
I don't want to separate internal/external bleeding. In fact "hits/round" don't always have to be blood loss, for me. It's any ongoing pain, suffering, blood loss etc, that can lead to (stun) shock.

Let us know what you come up with.

[GrumpyOldFart]

You can give someone "hits per round" just by letting them get badly overheated and then dunking them in ice water. It has no more than a tangential connection to blood loss, it's systemic failure. Blood loss counts as part of it because there is no other system unaffected by blood loss, so it's just another form of systemic failure.

[RandalThor]

Detecting internal bleeding can be tricky, but only if it is a slow bleed; anything that could be considered a threat of life in hours would likely show up as a bruise. If the bruise keeps getting bigger, then the individual is bleeding internally. Otherwise, as was mentioned: pain, weakness, lethargy, etc... pretty-much all the classic symptoms of blood loss.

Treatment could mean surgery, but if it isn't too bad of a bleed, then something that helps the blood to clot could do the trick.

[markc]

 I need to get to my books and do some thinking so it will be tomorrow until I have some more clear thoughts on this issue.


MDC

[Ynglaur]

Critical tables don't generate enough injuries which take hours to kill someone...It's very rare that PCs have the opportunity for a medical adventure.  Either they figure it out in less than 5 minutes, or the poor soul expires.

[RandalThor]

I would think with the possibility of a partial success on a first or second aid roll, taking more than 5 minutes would be more than possible. But, now that I think about it, I don't remember having to deal with an injury for a long period of time.

[markc]

What about Organ Lore (SL96 p27 rank1) to detect what is wrong with the target in total? 
 


  Now the spell says it gives you the condition of an organ, and I this case I think I would/might rule that the spell would give you the condition of the target and what you need to fix the target in total. So Organ Lore would list all of the targets wounds and penalties.
  Then once you know what the problems are the caster of the spell can "target" his other healing spells to the right location. I have been using the word target in my game as the person injured but I think I am going to use the above idea and change the meaning to you have to know just what part you need to heal/repair.
 
 What do you think?
MDC

[RandalThor]

Well, I have always ruled that a skilled Healer (or Lay Healer) with access to the appropriate spells is able to pretty-much fix any injury, provided they also have enough power to do so. The biggest problem is getting the patient to the healer in time.

I think this thread is about non-magic healing, for the most part. (I.e. how does a mundane person deal with a person who is bleeding internally?)

[mistrornge]

I would think that internal bleeds using medieval technology would be extremely difficult in a conscious patient and all but impossible in an unconscious patient.
Ecchymosis (bruising) can take up to 12 hours to develop and can have utterly random symptoms like shoulder pain.  As others have said hypotension will develop over time (starting with tachycardia, mental status changes, shunting of blood to the patient's core, etc.). True drop in blood pressure is a late sign which generally means you missed the boat and the patient is likely going to die soon especially in a healthy athletic person.
Head injuries are a whole different beast.
Agreed on the lack of criticals that kill a patient in hours.

[mistrornge]

Perhaps a cascading set of penalties? -10 for 10 minutes, then -20 (with a loss of consciousness) and so on until the patient reaches -50 where they die.

Head trauma would also be scary. In a closed injury the brain in compressed until it herniates and the patient dies. Can happen quickly or over days depending on whether it causes a venous or arterial brain injury. Nausea, vomiting, headache, mental status changes, loss of function, seizures, posturing and eventually death. Again cascading penalties would work in this case as well.

Open head injuries usually die from the trauma (shards of the skull driven into the brain) or eventually infection.  Usually quick and obvious even to a lay person. 

Lung puncture cascading penalties would work also. The lung would fill with blood or the pleural space fills with air and compresses the good lung and heart. 
Its kind of a cool idea though tracking it might be a pain.

[rdanhenry]

Much as I'd love it,  such realistic injuries present practical problems in application and would probably not be popular with a majority of players. For those who would enjoy them, perhaps someday we shall see the Blood & Guts: The Critical Companion, full of revised critical tables with an even grittier and medically gruesome inventory of damage than the regular tables.

[markc]

Much as I'd love it,  such realistic injuries present practical problems in application and would probably not be popular with a majority of players. For those who would enjoy them, perhaps someday we shall see the Blood & Guts: The Critical Companion, full of revised critical tables with an even grittier and medically gruesome inventory of damage than the regular tables.

 And with revised spell lists to help heal all of the gruesomeness.
MDC

[mistrornge]

Between blood, bone, muscle, organ, and nerve you have pretty much everything covered other than those that appear in surface law (disease and poison).

Writing a blood and guts law would be very cool. Simulation of some wounds would a strain on the old brain.

[yammahoper]

Adding the damage woud be easy.  A new icon on the crit tables with those icons defined, which would include the spells/skills needed to heal the damage.  Even a small table listing specific internal damage that a GM could choose from relevant to the location of the wound or even roll on for those GM's who don't enjoy excercising fiat.

More complexity, yes, but no need to be complex in execution.

[providence13]

GM: All these dang tiny symbols! "Ok the arrow punctures your.. gall bladder. Or is that the spleen symbol?"
Player A: "Maybe it's a kidney! I can live with just one of those, right?"
Player B: "Just wondering; if my liver can regenerate, does that require concentration?"

That book won't make our games any faster.

[mistrornge]

As far as the spells are concerned an organ is an organ (lung, brain, liver, kidney, stomach, heart, etc. - though I guess a heart injury could require both muscle and organ law and brain would require nerve and organ). That is how jaranka and I worked the critical injuries to specific organs.
Which organ is injured would only be important in determining the penalties and the spells necessary to heal them. 
A solid organ (liver, kidney, spleen, etc.) would bleed more and a hollow organ would more likely to be injured by a spell like vacuum (e.g., impact critical).
The possible law book could also encapsulate called shots (with appropriate critcals) as this is noticeably missing right now. I have been asked, "I would like to strike him in the leg." It would be nice to be able to pull out the book and simulate it.

[markc]

I will wait until I see what they have done in RMU or URM before I go crazy on stuff.


 I did have an idea way back that would give humanoid location and would work with armor by the piece and called shots to hit locations. I could easily work in some new types of crits there as well as either new spell lists or expand upon the ability of spells already in the new USL or SLU.


  On a side note how about a crit book that is actual size and a page for each critical that shows exactly where it is and on the back exactly what is needed to fix it.
MDC