Injury

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Humanoids, animals, and mechanoids sustain injuries from sources including melee weapons, weapons fire, explosions, ceiling collapses, and fire. Colonists, visitors, and prisoners can be operated upon and may suffer an injury from a surgical mistake. Each kind of injury has a value of pain, a description for its scar, and flavor text for being mended by medicine. A colonist in shock from extreme pain or incapacitated due to loss of movement becomes 'downed'. Doctors will automatically rescue downed colonists.



Health Difficulties

Main article: Health Difficulties

These are the general types of injuries that can be inflicted on a colonist. A bladed weapon would cut you, while a firearm would inflict gunshots, etc.

Name Pain[1] Old Pain[2] Old Label Combines?[3] Bleeding Become Old Chance Naturally Heals Destroyed[4] Destroyed Out[5] Treated Well Treated Inner Treated Well Inner Treated Solid Treated Well Solid Treated
Burn 1.5 0.5 Burn scar Yes 0.0 1% Yes Burned off Burned out Bandaged Poorly bandaged Sutured Poorly sutured Set Poorly set
Crush 1.0 0.5 Scar Yes 0.4 1% Yes Crushed Crushed Bandaged Poorly bandaged Sutured Poorly sutured Set Poorly set
Crack 0.8 0.5 Scar  ?[6] 0.0 0% Yes Shattered Shattered Healed Poorly healed Healed Poorly Healed Set Poorly set
Cut 1.0 0.5 Cut scar Yes 1.0 1% Yes Cut off Cut out Bandaged Poorly bandaged Sutured Poorly sutured Set Poorly set
Scratch 1.0 0.5 Scratch scar No 0.1 1% Yes Torn off Torn out Bandaged Poorly bandaged Sutured Poorly sutured Set Poorly set
Bite 1.0 0.5 Bite scar No 0.1 1% Yes Bitten off Bitten out Bandaged Poorly bandaged Sutured Poorly sutured Set Poorly set
Stab 1.0 0.5 Stab scar No 0.8 1% Yes Cut off Cut out Bandaged Poorly bandaged Sutured Poorly sutured Set Poorly set
Gunshot 1.0 0.5 Old gunshot No 0.92 1% Yes Shot off Shot out Bandaged Poorly bandaged Sutured Poorly sutured Set Poorly set
Shredded 1.0 0.5 Scar Yes 1.0 1% Yes Torn off Torn out Bandaged Poorly bandaged Sutured Poorly sutured Set Poorly set
Bruise 1.0 0.5 Old bruise No 0.0 0% Yes Destroyed Destroyed Bandaged Poorly bandaged Sutured Poorly sutured Set Poorly set
Missing Body Part[7] - - - - - - - - - - - - - - -
Misc[8] 1.0 0.0 Scar No 1.0 1% Yes Destroyed Destroyed Bandaged Poorly bandaged Sutured Poorly sutured Set Poorly set
  1. Pain per point of damage. See pain for how it works.
  2. Pain per point of damage. See pain for how it works.
  3. Whether or not this injury stacks to become something like 'Burn ×2'
  4. Prefix for external injuries that result in body part loss (e.g. Shot off left arm).
  5. Prefix for internal injuries that result in body part loss (e.g. Torn out kidney).
  6. Not defined in the files whether or not it combines.
  7. Only applies to missing limbs. No values provided besides a name. Cannot be treated except for limb/organ transplants.
  8. Default/debug damage type. Doesn't occur in the normal game.


Feelin' the Pain

Main Article: Pain

Most biological creatures in Rimworld feel pain caused by injuries. Extreme pain causes colonists, raiders, and animals alike to go into shock. Pain causes unhappy thoughts. Once pain passes 10%, it'll start to have an effect on consciousness.

Most pain is temporary, but scars and certain diseases can cause long-term or permanent pain. A Painstopper implant will get rid of all a colonist's pain and negate any pain-related mood penalties. Note that colonists with the Masochist trait get a mood bonus from pain instead of a penalty, so it's usually better to leave them alone.

Formula

Pain follows a somewhat painful formula:

Pain = Number of Injuries ÷ [80.0 × Max Pain Level Multiplier[1] × Health Scale[2] + Extra Pain ÷ (80.0 × Max Pain Level Multiplier)]

  1. This is 1.0 for humans.
  2. This is also 1.0 for humans


Extra pain is determined by individual injuries:

Extra Pain = Injury Damage × Injury Pain Value


  • 50 crush damage would do 50 damage × 1.0 crush pain = 50 extra pain
  • 50 burn damage would do 50 damage × 1.5 burn pain = 75 extra pain


Non-Local Injuries

Starvation

When a pawn's food meter reaches 0% they will begin to suffer from malnutrition, shown on the Health tab. When a colonist is starving they will prioritize eating over other activities, including firefighting and doctoring.

  • Malnutrition starts at 0%; upon reaching 100%, the pawn will die.
  • Malnutrition (minor): consciousness -5%
  • Malnutrition (moderate): consciousness -15%
  • Malnutrition (severe): consciousness -25%
  • Malnutrition (extreme): consciousness max 10%

Blood Loss

Blood loss occurs when a pawn has untreated bleeding wounds. Bleeding wounds are identified on the Health tab by a blood icon and a tooltip shows the bleeding rate. Total blood loss is listed under Whole Body and its tooltip shows the total blood loss. Overall bleeding rate is shown at the bottom.

  • Blood loss starts at 0%; upon reaching 100%, the pawn will die.
  • Blood loss (minor): consciousness -10%
  • Blood loss (moderate): consciousness -20%
  • Blood loss (severe): consciousness -40%
  • Blood loss (extreme): consciousness max 10%

Shock

Caused by extreme pain, it incapacitates the affected target. There are no other causes of shock besides pain currently.

Pawns go into shock if their amount of pain is greater than or equal 0.800000011920929 (about 80%).

Heatstroke

Heat stroke occurs when a pawn has prolonged exposure to temperatures well above their maximum comfortable temperature.

  • Heatstroke (initial): consciousness -5%
  • Heatstroke (minor): consciousness -10%, moving -10%, pain 15%
  • Heatstroke (serious): consciousness -20%, moving -30%, pain 30%
  • Heatstroke (extreme): consciousness max 10%
  • Heatstroke (100% severity): death

Hypothermia

Hypothermia occurs when a pawn has prolonged exposure to temperatures well below their minimum comfortable temperature.

  • Hypothermia (shivering): consciousness -5%, manipulation -8%
  • Hypothermia (minor): consciousness -10%, manipulation -20%, moving -10%
  • Hypothermia (serious): consciousness -20%, manipulation -50%, moving -30%, pain 15%
  • Hypothermia (extreme): consciousness max 10%, pain 30%
  • Hypothermia (100% severity): death


Scarring

Scars are permanent markers of injuries. They permanently lower the maximum health of the scarred body part, making it easier to damage the affected body part in the future. They also cause a character a small amount of pain, even if the relevant body part is fully healed. Pain from scars results in a permanent mood penalty for non-masochistic characters. For a colonist with the Masochist trait, scar pain will provide a continual mood bonus instead of penalty.

Scars can be caused by poor quality treatment or simply not treating wounds, though injuries have an inherently low chance to scar, as seen above. Sometimes colonists are generated with minor scars and old gunshots already in place.

It is possible to remove the pain from scars by replacing the scarred body part. This is obviously only possible for limbs and eyes as there's no way to remove the torso, neck or head.

Another way to work around scar pain is to implement a Painstopper, preventing all ongoing pain. The downside to this however, is that should the pawn with an installed Painstopper take serious damage - they won't go down until they either lose a leg (or have it heavily injured), or die. Therefore you should be extra watchful of their health as to decide whether to withdraw them from a controllable scenario (i.e. combat), as to prevent them from losing their life.


Heart Attack

Heart Attacks can randomly occur on any pawn at any time, but they become more frequent as they pass half of their life expectancy (e.g. 40 years in Humans).

The average interval between heart attacks is curved as follows (in days)...

0-50% of LE: 99,999,999 - 99,999,999
50-60% of LE: 99,999,999 - 2,500
60-100% of LE: 2,500 - 300

Examples of intervals and chances:
55% of Life Expectancy (e.g. 44 in humans): 50,001,249.5 days (approx. 0.00000002% per day)
80% of Life Expectancy (e.g. 64 in humans): 1,400 days (approx. 0.000714% per day)

Old Age

Strictly speaking, these aren't truly injuries but the result of old age taking its toll on a colonist's body. Chronic diseases are significantly more likely to occur past a pawn's life expectancy. All occurring ages are based on humans, and will obviously be different with animals dependent on life expectancy. Humans stop getting birthdays past the age of 99.

Alzheimer's (From Age 36)

  • Consciousness
    • -5%/-10% (Minor)
    • -15%/-20% (Major)
  • Thoughts will be removed occasionally
  • Occasional Confused Wandering, like with Dementia

Artery Blockage (From Age 21)

  • Blood Pumping
    • -5%/-10% (Minor)
    • -15%/-35% (Major)
    • -60%/Max 0% (Extreme)
  • More Frequent Heart Attacks (every ... days)
    • 600/500 (Minor)
    • 300/200 (Major)
    • 120/Death (Extreme)

Asthma (From Age 2)

  • Breathing
    • -5% (Minor)
    • -15%/-25% (Major)

Bad back (From Age 41)

  • Movement: -30%
  • Manipulation: -10%

Carcinoma (From Age 25)

  • Pain (Note: 30% chance not to cause pain)
    • 10%/20% (Minor)
    • 35%/50% (Major)
    • 60%/70% (Extreme)
  • Part Efficiency Loss
    • 10%/25% (Minor)
    • 50%/80% (Major)
    • 90%/Destroyed (Extreme)

Note that Carcinomas always start at 0.3 severity, meaning 20% pain and 25% efficiency loss. The only way a Carcinoma is at its least severe is if it's been in remission for long enough.
This is when below 0.15 severity.

Cataracts (From Age 49)

  • Sight: -35%

Dementia (From Age 69)

  • Consciousness: -15%
  • Talking: -40%
  • Hearing: -40%
  • Occasional 'Confused Wandering' Mental Breaks

Frail (From Age 51)

  • Movement: -30%
  • Manipulation: -30%

Hearing Loss (From Age 49)

  • Hearing: -35%

Generally these 'injuries' can be replaced by natural or bionic implants.


Trauma Savant

A pawn may become a trauma savant upon taking and surviving an injury to the Brain. Certain capabilities will rise and some will fall. Trauma Savant currently only removes all ability to socialise and opinions of others, but increases Manipulation by 50% - this is great for doctors and general workers, but it'll make affected wardens a write-off in that aspect.

There is a 12% chance of any pawn becoming a trauma savant upon receiving brain damage.