Medical Simulations (MEDSIM) Rules

Updated: Jan 8

Blackline MEDSIM rules are based on a simple 'hit' and 'injured' dynamic, but add a level of detail that works to accomplish four objectives.

  1. Replicate the impacts of injuries on personnel and engagements

  2. Create randomness in the level of severity of an injury

  3. Provide opportunities to practice first aid skill sets on self and others

  4. Keep participants safe

Revision Information:

These rules were last updated on 09SEP19

Hit Rules

This section details where you can be hit and the basic, universal methods in which to respond to being hit

Hit Locations

  • Head and Neck

  • Torso

  • Arm and Hand

  • Legs and Feet

Hit Rules

  • Any BB hit to any location causes an injury in that location

  • Being hit requires the injured player to fall to the ground

  • Simultaneous injuries to multiple locations are possible (ie. can have injuries to the head and legs at the same time)

  • Each injury requires separate treatment

  • Training knife impacts are treated as critical injuries (no speaking, no moving, no shooting)

Treatment and Limitation

This section deals with what limitations are placed on a player, how they are determined, and what measures must be taken to treat them. Injury determination is modeled off the frequency and severity of injuries in real combat.


  • Cards are randomly distributed to all players

  • Cards are different from player to player

  • Cards indicate three types of injuries - minor (green), major (yellow), and critical (red)

  • Cards indicate what type of injury a player receives if shot in one of the four hit locations

  • Cards indicate if a player can provide aid to themselves

  • Cards indicate player limitations based on whether they receive medical aid or not

  • Cards may not be shuffled or exchanged until the holder is extracted to a medical facility

Blackline MEDSIM Card (v1.0)

Player Limitations

  • Any injury has two states - ‘Before Aid’ and ‘After Aid’

  • Limitations on shooting, moving, and talking are different based on the ‘Before’ or ‘After’ states

  • Use the provided MEDSIM card to determine the Before and After restrictions based on what location was hit.

  • Before Aid restrictions go into effect immediately after a hit in that location

  • After Aid restrictions go into effect after medical aid has been applied to that location

  • ‘No Shooting’ limitations mean the individual cannot shoot any weapons

  • ‘No Moving’ limitations mean the individual cannot walk or crawl

  • ‘No Talking’ limitations mean the individual cannot speak

  • Injuries persist until the individual is extracted to a medical facility

Medical Aid

  • Medical aid for arms and legs may consist of bandages or replica tourniquets

  • Medical aid for head and torso may consist of bandages only

  • Applying bandages or tourniquets to yourself is only allowed for minor (green) injuries

  • Medical aid must be applied UNDER body armour or helmets

  • Bandages and tourniquets may only be removed when an individual is extracted to a medical facility


These are factors that may adjust the impact of injuries.

Armour Rules

  • Armour only protects from hits that impact armour plates or helmets.

  • Armour does not protect from hits that impact skin

  • Armour downgrades ‘Critical’ injury types to ‘Major’ injury types in the head and/or torso locations

  • Only full weight plates or helmets count as armour

Contingencies and Fail Safes

Contingencies and fail safes are built into the rules to prevent people from being injured or exposed to unnecessary safety risks.

  • Bleed Out Times - if no aid is received, the individual must wait at least three hours before attempting to leave the event space on their own. An individual may choose to leave early based on their own personal safety but is temporarily eliminated from the event.

  • An individual with the ‘No Moving’ limitation may walk while in contact with another person if the environment is unsafe for carry (steep terrain, sharp objects, other hazards)

  • An individual with the ‘No Speaking’ limitation may speak to convey location of injury, or to convey consent or safety concerns.

  • An individual may elect to stop being shot by calling out ‘Critical’, and then adopting the No Shooting, No Moving, and No Speaking limitations

  • Eyepro must remain on at all times



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