Save Your Colonists: RimWorld Bleeding Crisis Solutions That Actually Work
Quick-Start: RimWorld Medical Lifesavers
TL;DR – Don't let your colonists die when help is a click away
In RimWorld, even a simple cut can turn deadly without proper care. Here's a Quick-Start checklist to avoid common rookie mistakes and keep your pawns alive.
- Stabilize Immediately: After a battle or accident, pause the game and check each injured colonist's Health tab. Prioritize those "Bleeding out in X hours". If someone is far from your base and severely bleeding, set up a quick medical spot in the field and tend them there.
- Use Your Best Doctor & Medicine Wisely: Assign your highest-skilled doctor to treat life-threatening injuries and diseases. Use herbal medicine or better for anything serious. Save the precious Glitterworld medicine for surgeries or extreme infections.
- Keep It Clean: Infections kill! Make a habit of cleaning hospital room floors of blood and dirt before and after tending patients. Even early game, put down wooden floors or sterile tiles in your infirmary.
- Bed Rest and Sleep: Mark a bed as Medical and make wounded pawns rest until healed. Resting increases immunity gain which is critical for diseases like plague.
- Amputate to Save a Life: If a pawn has a limb with an extreme infection that you can't control, amputate the limb. It's better to lose an arm than lose the whole colonist.
- Monitor Diseases: When a colonist gets sick, click their Health tab and compare Immunity % vs. Disease %. Keep them in bed and tended. If disease is winning, boost care with better medicine or consider a Healer mech serum.
- Don't Neglect Self-Tend: If your only doctor is hurt, enable Self-tend on them (in their Health tab). They treat themselves at 70% efficiency, which is often enough to stabilize.
- Schedule Regular Doctor Training: Train your doctors during downtime with harmless surgeries or by tending slight wounds. Post-Biotech, extract hemogen from prisoners for safe XP gain.
- Prepare for the Worst: Keep a stock of medicine (herbal grows slow – plant it early!). Buy Glitterworld meds and mech serums when available from traders. Build hospital beds when you can.
Efficient Hospital Layout
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║ 🏥 HOSPITAL ROOM 🏥 ║
║ ║
║ 🛏️ 🛏️ [📺] 🛏️ 🛏️ ║
║ Bed1 Bed2 VITALS Bed3 Bed4 ║
║ MONITOR ║
║ ║
║ 🛏️ 🛏️ [💊] 🛏️ 🛏️ ║
║ Bed5 Bed6 MEDICINE Bed7 Bed8 ║
║ CABINET ║
║ ║
║ [🔬] [⚡] ║
║ RESEARCH POWER ║
║ BENCH ║
║ ║
╚═══════════════════════════════════════╝
Connection Lines: ┌─ All beds connected to vitals monitor
└─ Sterile tiles throughout
Early-Game Triage: "Doctor! We need help now!"
In the early game, you often start with mediocre doctors and very limited supplies. Injuries are inevitable – even a raider's shiv or a mad squirrel can leave your colonists bleeding on the floor.
Assessing Injuries
The moment combat ends, check your colonists' health tabs. RimWorld shows bleeding rate and time to death for each pawn. Focus on any pawn with "Death in X hours". If X is very low (under 4 hours), you have a critical situation.
If the pawn is far from your base, do field triage:
- Designate a sleeping spot right there on the ground and mark it as Medical
- Draft a doctor to go there
- If no medicine is in inventory, harvest nearby healroot immediately
- Tend the pawn on the spot instead of carrying them all the way back
Triage Order
Always tend to the most life-threatening issues first:
- Rescue/tend colonists before tending prisoners or animals
- Tend those with the shortest "death in X hours" timer first
- If two colonists are both bleeding heavily, tend the one with fewer injuries first
- Use fast medicine on heavy bleeders
Even without medicine, just performing a tending job will drastically reduce bleeding (down to 0% for that wound if successful).
Medicines and When to (Not) Use Them
In early game, medicine is scarce:
- Herbal medicine (0.4 potency): Sufficient for most early injuries and even infections on normal difficulty
- Regular medicine (0.7 potency): Save for emergency surgery or extreme disease
- No medicine: Still stops bleeding but greatly increases infection chance
Pro-tip: Toggle a pawn's permitted medicine in their Health tab to save precious meds. For bruises, you can set "No medicine" since they'll heal on their own.
Even with good care, an injury can get infected. If you receive an infection notice, immediately set the colonist to Bed Rest priority 1 and use your best available medicine. Early game infections are one of the scariest threats.
Basic Base Hospital: From Shack to Infirmary
Once you've weathered the first few fights and maybe recruited a couple extra hands, it's time to think about a more permanent medical setup in your base.
Setting Up a Hospital Room
You'll want a separate room that's only for medical use:
- Even a 4x4 room can serve as a mini-hospital
- Place a few beds and mark them as Medical
- Aim to have at least one bed per 5 colonists, or minimum 2 beds
- If you have extra quality beds, use those for hospital as higher bed quality improves patient rest rate
Cleanliness Above All
Turn that room into the cleanest space in your colony:
- Keep a stockpile of cleaning tasks queued
- Clean blood immediately
- Construct sterile tile flooring when you can (+0.6 cleanliness)
- If sterile tile is too expensive, any flooring (wood, concrete) is better than dirt
- Prevent unrelated traffic through the hospital
Storage in Hospital
Keep some medicine in the hospital room:
- Create a small stockpile with critical priority for medicine
- Be careful in case of fire or raiders – medicine is flammable and valuable
- Consider keeping only a portion in hospital and the rest in safer storage
Lighting and Comfort
- Add lights (doctors get surgery work speed penalty in dark)
- Place stools or chairs by hospital beds for doctors
- When a doctor tends someone, if there's a chair, they will sit, increasing comfort
Ventilation and Temperature
- Keep the hospital in a temperature-controlled area
- In hot biomes, use a passive cooler or cooler unit
- Fevers (like with malaria or plague) push pawn body temps up – a cool room helps
Hospital Bed and Vitals Monitor (Research Goals)
In early-mid game, a big milestone is to research Hospital Beds:
- A hospital bed increases medical tend quality and surgery success chances
- Once you have hospital beds, replace your infirmary beds with them
- Each hospital bed allows one Vitals Monitor attachment
- A vitals monitor gives +5% surgery success and +2% immunity gain factor
- One monitor can serve multiple beds if placed strategically
Mid-Game: Optimization, Training, and Preventative Care
Now that your colony is stable and you have a functional hospital, mid-game is about refining your medical approach. Threats get harsher, but your tech and wealth allow better tools.
Advanced Furniture & Layout
The ideal layout might be:
- A row of hospital beds, each with space at the head or side for a vitals monitor
- If you can't build many monitors yet, place one centrally to affect multiple beds
- Consider installing end tables and dressers for comfort buffs
- Optional: Add a sun lamp if you have any Grow Beds for healroot inside the hospital
Biosculpter Pods (Ideology)
If you have Ideology, consider biosculpter pods in mid-game:
- These pods allow a healing cycle every 30 or 60 days
- Research Bioregeneration to unlock the powerful healing cycle (requires Multi-analyzer)
- The bioregeneration cycle can regrow missing fingers, cure bad back, cure chronic diseases
- It takes 8 days for that cycle, but it's amazing for fixing permanent injuries
- Each pod can be biotuned to a specific pawn which speeds up their cycles
Doctor Skill and Training
By mid-game, you want at least one doctor with skill ~10+ if possible. When selecting colonists for medical roles, consider checking our traits guide to identify pawns with medical-related traits like Careful or Fast Learner. Training methods:
💉 Surgery on prisoners
Repeatedly install and remove a peg leg or denture on prisoners. Each surgery gives XP. Be careful though – each surgery has a failure chance. For more details on managing prisoners effectively, see our prisoner recruitment guide.
🐄 Use animals
Tending animals yields XP too (though less than humans). Some players purposefully injure an animal slightly just to create a small wound to tend.
🧬 Biotech hemogen extraction
A risk-free operation you can do over and over. It "cannot fail" and the game queues up repeated extractions automatically if you set it. The prisoner gets mild blood loss that will recover.
Mid-Game Diseases
You will likely face malaria, plague, or flu by mid-game. With a decent hospital, these are manageable:
- Always treat as soon as immunity-tending cooldown allows
- If multiple pawns are sick, consider assigning one doctor per sick pawn
- Penoxycyline: One pill every 5 days will completely prevent malaria, plague, and other diseases
- Monitor immunity % vs. disease % - if immunity reaches 100% first, they survive
Late-Game Medicine: Bionics, Archotech and Beyond
By the late game, you might have bionic super-soldiers and glitterworld tech at your disposal. The focus shifts to enhancing and future-proofing your colony's health rather than just survival.
Full Bionic Upgrades
Consider giving your best colonists bionic limbs and organs:
- Bionics not only replace lost function, they improve it (125% efficiency)
- A soldier with two bionic legs and a bionic eye is significantly more effective
- Transhumanist colonists will be thrilled
- With EPOE mod: advanced bionics (135%), AI chips, exoskeleton suits, etc.
Archotech Artifacts
In unmodded RimWorld, true archotech items are rare:
- Archotech eyes or arms give 150% efficiency – basically the peak
- Healer Mech Serum instantly heals the worst health condition on a pawn
- Resurrector Mech Serum brings a dead pawn back to life (with potential complications)
Luciferium and Long-Term Drugs
Luciferium is a red pill that many RimWorld veterans both love and fear:
- It permanently improves a pawn's healing (gradually healing old wounds and scars over time)
- Boosts many stats slightly and improves blood filtration (+70%)
- Once someone takes luciferium, they must continue a dose every ~6.7 days for life, or they will die
- Consider giving it to someone with multiple permanent injuries or to save someone from a severe plague
- Keep a dedicated luciferium stockpile and monitor it
Gene Tailoring (Biotech)
If you have Biotech, late game you can create custom xenogerms:
- Strong Immunity/Super Immunity gene: Makes diseases much easier to survive
- Fast/Ultra-fast wound healing: Recover from injuries twice or four times as fast
- Deathless gene: Tied to Sanguophage, essentially makes pawns immortal if tended
- Antitoxic lungs/Tox immunity gene: Great for dealing with pollution or enemy tox weapons
By late game, maintain a stockpile of key supplies: hundreds of herbal medicine, dozens of normal medicine, Glitterworld medicine for surgeries, neutroamine, components/advanced components, spare body parts, and emergency drugs like Go-Juice or Penoxycyline.
Ideology and Biotech DLC Considerations
Ideology
The biggest change is the moral framework around medicine:
- Beliefs Affect Care: "Transhumanist" pawns want bionics, "Flesh-purist" pawns hate them
- Organ Use Precepts: Harvesting organs could be abhorrent or acceptable
- Special Role: Medic: If your Ideology has a Medical Specialist, they operate/tend better
- Preach Health: Moral Guide can boost healing speed +25% for a few days
- Biosculpter Pods: Heal injuries and age reversal for transhumanist ideologies
Biotech
New challenges & tools:
- Pregnancy & Childbirth: Keep mom well-fed and rested to prevent miscarriages
- Children's Health: Children heal fast and can go into growth vats
- Sanguophages (Vampires): Can self-regenerate non-lethal injuries during deathrest
- Coagulate ability: Free emergency tending on others
- Mechanitor Effects: Paramedic mechs can rescue and tend colonists autonomously
- Genes: Customize colonists with immunity or healing genes
Must-Have Mods for Medical Mastery
Widely adopted mods that improve the medical experience:
Expanded Prosthetics & Organ Engineering (EPOE)
Craftable prosthetics from basic to archotech. Great for players who want to fully bionic-up their colonists. Be mindful it can upset game balance.
Rah's Bionics and Surgery Expansion (RBSE)
An alternative to EPOE focused on balance. Includes surgeries for curing diseases and scars, plus a "Hardcore" mode for greater challenge.
Pharmacist
Fine-grained control over medicine usage. Set bruises to get no medicine, minor cuts herbal, major injuries normal med, surgeries glitterworld only.
Smart Medicine
Allows pawns to carry medicine in their inventory and use medicine more intelligently. Reduces micromanagement, especially on caravans or in combat.
Medical Tab
Presents a full overview of your colony's health in one interface. You can see at a glance who's injured, bleeding, has which disease, etc.
MedPod
Adds ultimate medical beds that heal colonists completely without consuming medicine. Expensive to build but perfect for late-game hospitals.
Frequently Asked Questions
How can I prevent infections early on?
My doctor keeps botching surgeries. What can I do?
Is it worth making hospital beds and vitals monitors?
How do I train my Medical skill without risking my colonists?
My colonist lost an eye/arm/etc. What's the best replacement?
What's the deal with biosculpter pods and how do I use them?
Should I harvest organs from prisoners? What are the consequences?
How do I handle diseases like plague or malaria?
Transhumanist vs Flesh purist – how do I manage my colonists' preferences?
What are some rookie mistakes to avoid in RimWorld medicine?
Conclusion: A Story in Every Scar
Medicine in RimWorld is more than just numbers and treatments – it's storytelling through scars, bionics, and dramatic hospital episodes. Think back to your colonies: perhaps you remember Dr. White, who started with skill 3 but through constant practice became a legendary surgeon that saved dozens of lives. Or the time a plague hit during a raid – you had three colonists down with disease, two injured from battle, medicine running low, and somehow you juggled tending everyone just in time.
In the end, a successful RimWorld colony isn't one where nobody ever gets hurt – that's impossible – it's one where you adapt and overcome. Every colonist that pulls through a critical injury is a victory. Each time you install a prosthetic limb, you're turning a catastrophe into a stepping stone.
As a gamer-to-gamer: Don't be disheartened by early setbacks. It's gut-wrenching to lose a beloved pawn to an infection or a surgery gone bad. But every failure teaches a lesson – maybe you build that sterile room next time, or train an extra doctor. Eventually, you'll have that elite hospital humming along, and you'll look back on your first makeshift sick bay in the dining room and laugh.
Action Step Recap
- Establish Emergency Protocols: Decide early who is the main doctor and set up a plan for triage after battles.
- Designate a Hospital Area: Get a room for medical use only. Put a couple of beds and keep it clean. For optimal hospital placement within your base layout, check our colony design guide.
- Grow and Stock Medicine: Plant healroot early, buy medicine from traders, and don't squander it. New to RimWorld? Our starting scenarios guide can help you choose the right difficulty and setup for learning medical management.
- Research Key Medical Tech: Beeline important medical techs like Hospital Bed and Drug Production.
- Train a Backup Doctor: Don't rely on a single surgeon. Train at least one other pawn to a moderate medical skill.
- Implement Preventative Care: Use Penoxycyline in disease-prone biomes and set sensible drug policies.
- Upgrade Your Hospital Mid-Game: Build hospital beds and vitals monitors. Add comforts like TVs if possible.
- Improve Colonist Resilience: Replace lingering injuries with bionics or healing. Fix chronic issues as you get the means.
- Leverage DLC Features: Use Preach Health, biosculpters, and gene mods to bolster your colony's health.
- Prepare for Endgame Scenarios: Maintain a stash of emergency items for the final challenges.
Further Resources
- RimWorld Wiki – Health & Medicine: Detailed breakdowns of mechanics like Immunity, Tend Quality, Surgery Success Chance, etc.
- Official RimWorld Manual/Patch Notes: Ludeon's blogs often explain design rationale and patch changes.
- RimWorld Reddit and Forums: Countless discussion threads where players share hospital designs, mod setups, or medical stories.
- Steam Workshop (Mods): Visit mod pages for details and discussions about medical mods.
- YouTube – RimWorld Medical Guides: Video guides on topics like setting up the perfect hospital or handling specific medical challenges.
RimWorld Medical Patch History
Alpha & Beta Era (pre-1.0): Medicine was simpler - only one type existed until Beta 18
Version 1.0 (Oct 2018): Official release. Introduced medical potions differentiation
Royalty DLC (Feb 2020): Added Healer Mech Serum and Resurrector Mech Serum
Update 1.1 & 1.2 (2020): Various balance changes - Glitterworld medicine buffed
Ideology DLC (July 2021): Added Ideoligion Precepts like organ use and drug use
Update 1.3.3101 (Aug 2021): Biosculpter healing cycle split into Medic and Bioregeneration
Biotech DLC (Oct 2022): Added genes affecting health, pregnancy, Sanguophages
Update 1.4.3555 (Nov 2022): Hemogen extraction no longer requires medicine