Medicine and the DBNO state


One shot headshots, while realistic, have been a highly divisive subject, with some saying that no weapon should be able to get one shot kill because it makes it too easy to ambush players, others saying weapons with one shot kills just need to be balanced by other features, and yet another group saying that all weapons should be capable of getting one shot headshots because that would raise the skill ceiling. I would like to propose a compromise: headshots (and perhaps shots that hit near center of the upper chest) should not do enough damage to kill instantly, but should always cause a severe bleeding status condition that if left unattended, would cause the player to bleed out very quickly. Perhaps headshots with certain weapons could instantly do enough damage to put an unarmored player into a DBNO state.

Down But Not Out State

Various posts have mentioned DBNO or unconsciousness states, but none of these suggestions (that I can recall at the moment anywaus) have been satisfactory for a multiplayer survival game, generally this is because they would make an unconsciousness status that traps the player in a state worse than death, or they would copy-paste the DBNO state from Fortnite and give a massive advantage to players with teammates (and putting solo players in massively disadvantaged position relative to other players.) For these reasons, I’ve tried to come up with DBNO mechanics that would still allow player input, would allow the player to recover without aid from squadmates, and would

  1. Being in the DBNO state should not automatically cause health to drain (although it wouldn’t necessarily stop health from draining either.)
  2. The inventory of a downed player should be accessible without having to finish them off.
  3. A player in the DBNO state should be able to switch between two stances: one for crawling around on their hands and knees and one for laying on their back and using one handed weapons (like in L4D) or other items (like painkillers)
  4. Consumables should be able to raise or lower the amount of health at which the player will enter into or recover from the DBNO state.
  5. In survival, any player should be able to use healing items on anyother player, regardless of group affiliation or whether the player is downed or not.

Medical Items

  • Medkits: as has been stated oft before, medkits should not function as a singular consumable item, but as nested storage.
  • Tourniquet: A medical item that temporarily stops bleeding. A makeshift tourniquet can be crafted from common ropes or clothing.
  • Bandage: A medical item that slows bleeding and reduces the risk of infection on a wound. Is made from sanitized cloth.
  • Drugs should be able to impact passive health regeneration, stamina regeneration, the amount of health the player can lose without entering the DBNO state, (maybe this should be referred to with a shorter phrase like “pain tolerance,”) temperature, immunity, movement speed, scope sway, and various other stats and statuses.

Health and Statuses

Similar to in The Long Dark or Escape from Tarkov, it should be possible to have status effects (like bleeding or risk of infection) that are specific to certain body parts, and can be treated topically.
The game should have a quantified health stat, because there’s no other health system to speak of that works for videogames. A meter of the exact quantity of the player’s health isn’t strictly necessary as part of the HUD that is visible at all times, but the game must visually convey an adequate amount of information about the player’s health when relevant. Separate health bars for specific body parts like in Escape From Tarkov, (but this time they aren’t included in The Long Dark) add a great deal of complexity, for little reason aside from realism. They might work well with specific suggestions like aputating limbs, or having greater differentiation between left-handedness, right-handedness, ambidexterity, shooting from support side, but those are not at all essential features.


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