Captain Anorak's Guide to Gaming
Combat Systems:
After Combat Ends
All too often, combat is treated as having only instantaneous effects. In reality a wounded person takes time to heal, and until healing complete the wounded person is not in good health.

FIRST AID AND HEALING

In a lot of RPGs, first aid is a minor healing skill. Typically it might do something like healing 1D3 Hit Points. This doesn't make sense to me.

What does first aid do in reality? It does two things:
(1) It stops the injured person from taking any more damage from an injury (stopping blood loss etc.).
(2) It holds the injured parts together so that they will heal together naturally in their proper places. So the bone of a broken arm may be bound up and splinted so that it will grow back into a normal healthy arm-bone. But this takes time - the body is simply prepared for natural healing and left to heal naturally.

In fact these points are generally true of medical procedures. Few medical procedures at any level cure illness or injury. Generally they simply prevent further damage from taking place. The body is then left to heal itself at the natural rate.

How do we simulate this in game terms? I suggest a system something like this:

When a character reaches a certain level of damage (eg. he has lost two-thirds of his Hit Points), he is then dying slowly. A character dying slowly must roll periodically on an Endurance-type stat to stay alive. First aid can stabilise a character so he is no longer dying slowly, though strenuous activity (like combat) will remove this stabilisation and the character will be dying slowly once more. Once the character's damage heals above the critical level (2/3 of Hit Points in the example above), he will be able to resume vigorous activity without becoming dying slowly.

Natural healing rates should also vary with the character's behaviour. A character taking total bed rest will heal a lot quicker than someone hacking his way through a jungle fighting ape-men every five minutes.

Infection is a possibility that should be taken into account. Without the aseptic environment of a modern hospital, any serious wound can turn into life-threatening gangrene requiring amputation.