Injuries

Injuries

Wounds and ailments cause "injury": a (usually) temporary loss of Hit Points. Thus, your HP score measures your ability to sustain injury; see Hit Points.

Injury often results from "penetrating damage": the damage left after Damage Resistance is subtracted from the basic damage of an attack. However, disease, overexertion, and the like can cause injury without damage.

If any injury reduces you to 0 or fewer HP, you will soon fall unconscious. You can even go to negative HP ... but if you go too far, you risk death. For the average man, the difference between full HP and negative HP is one or two sword blows or bullets. This is realistic ... and dramatic. Even in cinematic battles, heroes rarely shrug off dozens of blows. Instead, they avoid being hit. Armor helps ... but fights can be deadly, so think before you act!

General Injury: Lost Hit Points

Repeated wounding eventually causes anyone or anything to weaken and collapse, even if no single injury is very great. The chart below summarizes the effects of being at low or negative HP. All effects are cumulative.

Less than 1/3 your HP left – You are reeling from your wounds. Halve your Move and Dodge (round up).

0 HP or less – You are in immediate danger of collapse. In addition to the above effects, make a HT roll at the start of your next turn, at -1 per full multiple of HP below zero. Failure means you fall unconscious (or simply stop working, if you weren't truly alive or conscious in the first place); see Recovering from Unconsciousness. Success means you can act normally, but must roll again every turn to continue functioning. Exception: If you choose Do Nothing on your turn, and do not attempt any defense rolls, you can remain conscious without rolling. Roll only on turns during which you attempt a defense roll or choose a maneuver other than Do Nothing.

-1×HP – In addition to the above effects, make an immediate HT roll or die. (If you fail by only 1 or 2, you're dying, but not dead – see Mortal Wounds). If you succeed, you can still talk, fight, etc., as above (until you fail a HT roll and collapse). Roll again each time you suffer injury equal to a further multiple of your HP, whether as a result of one wound or many. For instance, if you have 11 HP, you must roll to avoid death at -11 HP. If you survive, you must roll again at -22 HP, -33 HP, and so on ...

-5×HP – You die immediately. You have lost a total of 6 times your HP! Nobody can survive that much injury.

-10×HP – Total bodily destruction, if this makes sense given the source of the damage – 200 points of arrow wounds leave a messy but recognizable corpse; 200 points of fire injury leaves nothing but an unrecognizable lump of charcoal. The difference can be important in settings where resurrection, reanimation, etc. are possible!

Shock

Whenever you suffer injury, reduce your DX and IQ by the number of HP you lost – to a maximum penalty of -4, regardless of your injuries – on your next turn only. This effect, called "shock," is temporary; your attributes return to normal on the turn after that.

Shock affects DX- and IQ-based skills, but not active defenses or other defensive reactions; see Temporary Attribute Penalties. Therefore, on the turn after you are badly hurt, it is often a good idea to try flight or All-Out Defense instead of an immediate counterattack!

High HP and Shock: If you have 20 or more Hit Points, your shock penalty is -1 per HP/10 of injury (drop all fractions). Thus, if you have 20-29 HP, it's -1 per 2 HP lost; if you have 30-39 HP, it's -1 per 3 HP lost, and so forth. The maximum penalty is still -4.

Major Wounds

A "major wound" is any single injury of greater than 1/2 your HP. If you are using hit locations, a lesser injury that cripples a body part also counts as a major wound – see Crippling Injury. Any major wound requires a HT roll to avoid knockdown and stunning.

Knockdown and Stunning

Whenever you suffer a major wound, and whenever you are struck in the head (skull, face, or eye) or vitals for enough injury to cause a shock penalty (see Shock), you must make an immediate HT roll to avoid knockdown and stunning.

Modifiers: -5 for a major wound to the face or vitals (or to the groin, on a humanoid male); -10 for a major wound to the skull or eye; +3 for High Pain Threshold, or -4 for Low Pain Threshold.

On a success, you suffer no penalty beyond ordinary shock.

On a failure, you're stunned; see Effects of Stun, below. You fall prone (if you weren't already), and if you were holding anything, you drop it. This effect is called "knockdown," and isn't the same as "knockback". On a failure by 5 or more, or any critical failure, you fall unconscious! See Recovering from Unconsciousness.

Those with Injury Tolerance suffer reduced effects: No Brain means that skull, face, and eye injuries don't cause knockdown or stunning unless they are major wounds – and even then, the roll is at no special penalty. No Vitals means that vitals and groin injuries don't cause knockdown or stunning unless they are major wounds, in which case the roll has no special penalties. Homogenous and Diffuse include No Brain and No Vitals.

Effects of Stun

A failed knockdown roll can cause "stun," as can certain critical hit results and some afflictions. If you are stunned, you must Do Nothing on your next turn. You may perform any active defense while stunned, but your defense rolls are at -4 and you cannot retreat.

At the end of your turn, you may roll against HT. On a success, you recover from stun and can act normally on subsequent turns. On a failure, you remain stunned; your next maneuver must also be Do Nothing, but you get another roll at the end of that turn...and so on, until you recover from stun.

Mental Stun: If you are surprised, you might be mentally stunned; see Surprise Attacks and Initiative. This sort of stunning works as described above, but you must make an IQ roll, not a HT roll, to snap out of it. You're not hurt – you're confused!

Patient Status

Hospitals often describe a patient as being in Good, Fair, Serious, or Critical condition. Here's how these familiar terms equate with injury in GURPS.

Good: Vital signs are stable and within normal limits; indicators are excellent; patient is conscious. This means he has 1/2 or more his full HP; e.g., an average human (10 HP) with 5 to 10 HP remaining.

Fair: Vital signs are stable and within normal limits; indicators are favorable; patient is conscious but in moderate to severe discomfort. He has at least 1 HP, but less than 1/2 his full HP; e.g., the same person at 1 to 4 HP.

Serious: Vital signs may be unstable or outside normal limits; indicators are questionable; patient is badly injured or acutely ill, and may be unconscious. He is at 0 HP or worse, but above -1×HP; e.g., our victim at -9 to 0 HP.

Critical: Vital signs are unstable and outside normal limits; indicators are unfavorable; patient is often unconscious, and may not survive. He is at -1×HP or worse; e.g., our patient at -10 HP or below.

Temporary Attribute Penalties

Shock, afflictions, and many other things can temporarily lower your attributes. ST reductions affect the damage you inflict with muscle-powered weapons. IQ penalties apply equally to Will and Per. However, there are no other effects on secondary characteristics; for instance, ST, DX, and HT reductions do not affect HP, Basic Speed, Basic Move, or FP.

An attribute penalty always reduces skills governed by the lowered attribute by a like amount. For example, -2 to IQ would give -2 to all IQ-based skills (and to all Per- and Will-based skills, since IQ reductions lower Per and Will).

Exception: Defensive reactions that don't require a maneuver to perform – active defenses, resistance rolls, Fright Checks, etc. – never suffer penalties for attribute reductions. For instance, -2 to DX would not affect Block, Dodge, or Parry.

Note that permanent attribute losses require recalculation of all secondary attributes and skills!

Crippling Injury

When using hit locations, sufficient injury to a limb, extremity, or eye may cripple it. This requires a single injury that exceeds a certain fraction of the target's HP. For humans and humanoids, these thresholds are:

Limb (arm, leg, wing, striker, or prehensile tail): Injury over HP/2.

Extremity (hand, foot, tail, fin, or extraneous head): Injury over HP/3.

Eye: Injury over HP/10.

It is sometimes possible to cripple a body part with less damage or no damage at all; e.g., with a specific critical hit result.

A blow to a limb or extremity can never cause more injury than the minimum required to cripple that body part. For example, if a man has 10 HP and suffers 9 points of injury to his right arm, he loses only 6 HP – the minimum required to cripple his arm. Exception: No such limit applies to the eyes!

Dismemberment: If injury to a body part before applying the above limit was at least twice what was needed to cripple it, the body part is not just crippled but destroyed. A cutting attack or explosion severs a limb or extremity; otherwise, it's irrevocably crushed, burned, etc.

Crippling Extra Limbs

If you have more than two of a particular limb (arm, leg, etc.), a crippling blow is injury over HP/(number of limbs of that kind); e.g., if you have four arms, injury over HP/4 cripples an arm.

If you have more than two of a given extremity (hand, foot, etc.), a crippling blow is injury over HP/(1.5 × number of extremities of that kind); e.g., if you have four feet, injury over HP/6 cripples a foot.

Effects of Crippling Injury

Any crippling injury is also a major wound, and requires a HT roll for knockdown and stunning; see Knockdown and Stunning. Below are some additional effects specific to particular body parts; all these effects apply to dismemberment as well. These last until the fight is over, and possibly longer – see Duration of Crippling Injuries.

Hand: You drop anything you were carrying in that hand. If you were using two or more hands to hold an object, roll vs. DX to avoid dropping it. You cannot hold anything (e.g., a weapon) in that hand. You can wear a shield on that arm and use it to block, but you cannot attack with it. Until healed, you have the One Hand disadvantage.

Arm: As for a crippled hand...but while someone with a crippled hand could at least carry something in the crook of the arm, you cannot use a crippled arm to carry anything! You do not drop a shield on that arm (unless the arm is severed), but you cannot use it to block – and since it's just hanging in front of you, reduce its usual Defense Bonus by one. Until healed, you have the One Arm disadvantage. (NOTE: Nope, shields are still not glued or strapped into you. The shield is dropped.)

Foot: You fall down! You cannot stand or walk without a crutch or something to lean on. You can still fight if you brace yourself against a wall. If you have nothing to lean on, you may assume a kneeling or sitting posture. Until healed, you have the Lame (Crippled Legs) disadvantage.

Leg: You fall down! You can still fight if you assume a sitting or lying posture. Until healed, you have the Lame (Missing Legs) disadvantage.

Eye: You are blind in that eye. Until healed, you have the One Eye disadvantage – or Blindness, if you lose all your eyes – unless you have some substitute for eyes.

Optional Rules for Injury

These rules add realism, and give heroes with medical skills or healing abilities exciting tasks to perform – but they also require extra record keeping, so they are optional.

Bleeding

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If you are injured, you may continue to lose HP to bleeding. At the end of every minute after being wounded, make a HT roll, at -1 per 5 HP lost. On a fail- ure, you bleed for a loss of 1 HP. On a critical failure, you bleed for 3 HP. On a critical success, the bleeding stops completely. On an ordinary success, you do not bleed this minute, but must continue to roll every minute. If you do not bleed for three consecutive min- utes, the bleeding stops for good. Otherwise, you or someone else will need to make a First Aid roll to stop the bleeding; see First Aid (p. 424).

The GM decides which wounds bleed. Cutting, impaling, and piercing wounds usually bleed; crushing wounds generally don’t, but there are always excep- tions. Minor burning and corrosion injury does not bleed significantly: the damage sears the flesh, cauter- izing the wound and preventing blood loss. However, if such injury causes a major wound, treat it as a bleed- ing wound, oozing blood plasma until properly treated.

Accumulated Wounds

It normally takes a single injury over HP/3 to cripple an extremity – or over HP/2 to cripple a limb. For extra realism, you can keep track of injury by hit location, in which case total injury over HP/3 or HP/2, as appropri- ate, cripples the body part. Be aware that this leads to complicated record keeping! One good way to handle this is to make tally marks by the affected body part on the character’s picture.

Excess injury is still lost under this rule. For instance, if you have 11 HP, a total of 6 HP of injury cripples your arm. Ignore further injury, except for the purpose of determining dismemberment. Repeated blows to a limb or extremity cannot kill you.

Last Wounds

It can happen that a sorely wounded hero is knocked out, or even killed, by a 1 HP blow to the foot. There are those who find this unrealistic. If you wish, use this optional rule: once you have less than 1/3 your HP left, you can totally ignore any wound to a limb or extremity unless: (a) it is a critical hit; (b) it is enough to cripple that body part; or (c) it inflicts injury equal to 1/3 your HP or more at once.

Nonhuman Body Parts

Extra Arms: If you have three or more arms, a crippled arm (hand) simply reduces the number of arms (hands) you can use. You only suffer an actual disadvantage if reduced to fewer than two arms (hands).

Extra Head: If an extraneous head is crippled, you lose the benefits of that Extra Head; see Extra Head (p. 54).

Extra Legs: If you have three or more legs, see Extra Legs (p. 54) for the effects of a crip- pled foot or leg.

Striker: You cannot use your Striker to attack. If your Striker is also a wing or a tail, see below for additional effects.

Tail: Any advantages the tail provides (e.g., Extra Arm or Striker) no longer function. As well, your balance is off: -1 DX, except for close manual tasks. If you’re a swimmer or winged flyer, the DX penalty is -2 and you are at half your usual water or air Move (which will also halve your top speed with Enhanced Move).

Wing: If you have Flight (Winged), you cannot fly – and if you were airborne, you fall. If your wing is also a Striker, you cannot use it to attack.

Duration of Crippling Injuries

If you suffer a crippling injury, make a HT roll to see how serious it is. For battlefield injuries, roll at the end of combat. Success means the crippling is temporary, failure means it’s last- ing, and critical failure means it’s permanent. Dismemberment is automatically permanent – don’t bother rolling!

Temporary Crippling: Until you are back at full HP, you suffer the disadvantages described under Effects of Crippling Injury, above. Once you are fully healed, these effects disappear.

Lasting Crippling: You suffered a broken bone, badly torn (or burned) muscle, or other lingering damage. Roll 1d. This is the number of months it will take for the injury to heal fully. (If the injury is treated by a physician, subtract 3 from the roll at medical TL7+, 2 at TL6, or 1 at TL5 – but the period of healing is never less than one month.)

Permanent Crippling: You lose the use of that body part. It is either nonfunctional or gone. Either way, you acquire a new disadvantage (One Hand, Lame, etc., as appropriate). You get no extra character points for this! It simply lowers your point value. In some settings, even this degree of injury is curable; see Repairing Permanent Crippling Injuries (p. 424).

Mortal Wounds

If you fail a HT roll to avoid death by 1 or 2, you don’t drop dead, but suf- fer a “mortal wound.” This is a wound so severe that your internal injuries might kill you even after you stop bleeding.

If you are mortally wounded, you are instantly incapacitated. You may or may not be conscious (GM’s deci- sion). If you suffer further injury and must make another HT roll to avoid death, any failure kills you.

While mortally wounded, you must make a HT roll every half-hour to avoid death. On any failure, you die. On a suc- cess, you linger for another half-hour – then roll again. On a critical success, you pull through miraculously: you are no longer mortally wounded (but you are still incapacitated).

If you’re alive but mortally wound- ed, surgery may be able to stabilize your condition – see Stabilizing a Mortal Wound (p. 424). At TL6+, “trau- ma maintenance” can keep you alive while waiting for surgery. This involves CPR, oxygen, transfusions, etc. Instead of rolling vs. HT every half-hour, roll against the higher of your HT or your caregiver’s Physician skill every hour – or every day, if you are on a heart-lung machine or similar life support. You do not need to roll at all if you’re put into magical or ultra-tech suspended animation!

If you recover from a mortal wound, make a HT roll. On a failure, you lose a point of HT permanently. On a critical failure, the GM may apply the Wounded disadvantage (p. 162) or some other effect (e.g., reduced appear- ance due to scarring).

Death

If your character is killed, you may still wish to keep track of further injury. In certain futuristic or magical worlds, the dead can be brought back to life by prompt treatment, as long as the body is mostly intact (not reduced to -10×HP).

Instant Death

Decapitation, a cut throat, etc. can kill anyone, regardless of HT and HP. If a helpless or unconscious person is attacked in an obviously lethal way, he’s dead. Don’t bother to roll for dam- age, calculate remaining HP, etc. Just assume that he drops to -5×HP.

This does not apply to a merely unaware victim. If you sneak up behind a sentry with a knife, you can’t automatically kill him. Game it out realistically. Target the vitals or neck. Since it’s a surprise attack, he won’t be hitting back: make an All-Out attack! Your attack roll will almost certainly succeed. Your victim gets no active defense at all. You will probably inflict enough injury to incapacitate or kill him. But it isn’t automatic.

Dying Actions

When a PC or important NPC is killed in any but the most sudden and thorough fashion, the GM should allow a “dying action.” If this is a final blow at the enemy, it should take no more than a turn. If it’s a deathbed speech, the GM should stretch time a little bit for dramatic purposes! This has nothing to do with realism, but it’s fun.

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• Recovery