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Old 08-04-2020, 01:46 PM   #1
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Default Contest Of Skills: Paramedic and "The Golden Hour"

[Been quiet around here again, so went file-diving; found this.]

In the medical-trauma community, there is the term "Golden Hour": From the time a person has a Major Trauma inflicted, medics have 60 minutes to get the victim to a trauma center to have any hope of saving him.

How does this apply to _Car Wars_? For the most part, it doesn't -- most events elide or ignore what happens to a character after he is reduced to 0 HP. For those running continuing campaigns, knowing whether or not a character survives a close encounter of the burst-effect kind is data one needs.

THE RULES:

1) Count the number of "overkill" damage points the victim has taken.
2) +1 for every full 5 minutes after the victim has been reduced to 0 DP. This continues to add up so long as the victim is below 0 DP.
3) The Paramedic character rolls Contest of Skills against the sum of #1 and #2.
4) For every point over the sum of #1 and #2, -1 to the sum of #1 and #2 above.
5) The Paramedic may try this roll once per minute (in-game).

Example: A call comes in to my Truck Stop's Medical Bay about a driver being injured. The on-call Medic (skill +2) jumps on his Ambu-Cycle (with Medikit -- +2), and rolls out; it takes him 10 minutes (+2 to victim's Overkill) to arrive. He finds the driver ate most of a RR round, suffering 5 points of "overkill"; the medic is rolling 2d6, +2 [Paramedic], +2 [Medikit], against [5 + 2 =] 7. The Medic rolls a 5, +2, +2, for a total of 9; this exceeds "overkill" by 2, so the victim's "overkill" is now at [7 - 2 =] 5. Not good, but it will cover the time needed to get him back to the Truck Stop's Medical Bay.

After the 10-minute ride back to the Truck Stop, the victim is placed in the Medical Bay; more than one game-minute has elapsed, so the Medic can roll again. The ride took 10 minutes, so the victim's "overkill" is back up to 7. However, the much-more-extensive facilities of the Truck Stop's Medical Bay provide a +4 bonus for the Medic. The medic rolls a 7, +4 = 11, which subtracts 4 from the victim's "overkill": [7 - 4 =] 3. Since the next roll is guaranteed to reduce "overkill" to 0 or less, it is taken as-read that the victim survives the next roll. The Medic chooses to leave the victim at 1 DP (medical coma) to recover.
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Old 08-04-2020, 01:54 PM   #2
juris
 
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Default Re: Contest Of Skills: Paramedic and "The Golden Hour"

I had a similar idea to allow characters to be stabilized by a paramedic until they were at -10 hits, at which point they were unreadable (i.e. hamburger). Imposing a -1 per 5 minutes seems about right. Paramedic skill check would have to exceed the amount the person was negative to stabilize them.

This would mean a lot more duelists surviving - assuming arenas had paramedics on staff. There's a commercial incentive to keeping duelists alive as well. Stabilizing someone would probably be worth 2 skill points as well :)
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Old 08-04-2020, 11:11 PM   #3
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Default Re: Contest Of Skills: Paramedic and "The Golden Hour"

We certainly need more ways to keep campaign characters alive. In the basic game crews are somewhat disposable, and whilst that is fine for a one off, it makes character development difficult.

We added a Trauma Pack to the equipment, it provided an bonus to the dice roll to a paramedic roll and extended the time to stabilise a "dead" crewman (the basic 20 seconds for a paramedic roll is not really useful or credible in most circumstances). I think it supplemented the hospitalisation rules that appeared in an ADQ.

It was however a single use item and cost hundreds of dollars, cheaper than Gold Cross, but not so cheap that you can afford to be casual in combat.

Trauma pack $250 2lb, 1 GE. Single use item. Full four stage kit of coagulant, preloaded painkiller and adrenaline syringes, chest seal, disposable gloves, nasal airway etc with simple instructions in belt pouch. One pack may be used per patient to give +3 to all Paramedic rolls to keep someone alive during the negative HP stabilisation phase (initial, 15, 30 and 45 min). Patient still has to roll 5+ to survive before aid is possible, Paramedic must still be there within 20 seconds of "fatal" injury. May be used in conjunction with bonus from other medical kits/packs.

Last edited by swordtart; 08-05-2020 at 12:06 AM.
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Old 08-05-2020, 02:55 PM   #4
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Default Re: Contest Of Skills: Paramedic and "The Golden Hour"

Quote:
Originally Posted by juris View Post
I had a similar idea to allow characters to be stabilized by a paramedic until they were at -10 hits, at which point they were unreadable (i.e. hamburger). Imposing a -1 per 5 minutes seems about right. Paramedic skill check would have to exceed the amount the person was negative to stabilize them.

This would mean a lot more duelists surviving - assuming arenas had paramedics on staff. There's a commercial incentive to keeping duelists alive as well. Stabilizing someone would probably be worth 2 skill points as well :)
That was the idea -- the rules as-written were Not Convincing (and esp. not to the SAR types I spent my formaative years around), so I came up with something else. Note that saving a character is the sum of "how badly was he hit", plus "how long does it take the medics to get to him". (This is why we wear armor, folks. :) )
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Old 08-06-2020, 11:07 AM   #5
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Default Re: Contest Of Skills: Paramedic and "The Golden Hour"

My understanding was the golden hour was only applicable if some first aid was applied immediately (all servicemen carry field dressings).

I appreciate that the human system starts to close itself down to protect the organism without aid - during the English Civil war one of the generals survived with not treatment as his body was looted and his fine clothes stolen, hypothermia prevented him from bleeding to death).

Are we saying that our RR case left entirely alone on the field of battle to bleed out for 10 minutes can be recovered 50% of the time? Or are we assuming he is patched up with a paramedic within the 20 seconds anyway?
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Old 08-06-2020, 02:05 PM   #6
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Default Re: Contest Of Skills: Paramedic and "The Golden Hour"

Quote:
Originally Posted by swordtart View Post
My understanding was the golden hour was only applicable if some first aid was applied immediately (all servicemen carry field dressings).
One can slow down the effects of trauma; but in order to have any kind of certainty of saving the victim, he needs to be sent to a proper trauma unit (the kind with spare blood, lots of thread and needles, that sort of thing).

Of course: Up here at the local race track a couple years ago, a driver suffered a fatal heart attack -- as in "this guy was Legally Dead for three minutes" -- and was brought back successfully, so there's all sorts of variables....

Quote:
Originally Posted by swordtart View Post
Are we saying that our RR case left entirely alone on the field of battle to bleed out for 10 minutes can be recovered 50% of the time? Or are we assuming he is patched up with a paramedic within the 20 seconds anyway?
That's what the "overkill" value is for -- "how badly beat-up is the subject?". A character not wearing any armor [3 DP] who takes a direct hit from a 2d6 weapon [12 pts.] is unlikely to survive [12 - 3 = 9 "Overkill"]; add 15 minutes to that, and there's no saving him unless one has "Superman School" Paramedic skill. If the victim takes a hit from an ATG or BC, chances are he's Chunky Salsa to start with....

In the example I used: The victim was relatively fortunate -- he was wearing armor, which mitigated the "overkill" value he ended up with. Do note that in the example, the first Paramedic roll was only enough to cover the ride back to the Medical Bay; had the value been much higher, it would have taken much more effort to knock down the number far enough to get him ready for the ride ("stabilize for transport").
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