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About this mod

Adds a bleeding mechanism and bandages to stop the bleeding.

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Hello wasteland wanderers, I bring you my first ever mod, an attempt to improve the damage and medical system in Fallout 4. I always felt the medical system in FO4 was a bit basic even in hardcore mode, it just didn't feel very realistic or immersive. The inspiration for this mod comes from Rust, S.T.A.L.K.E.R., and similar games.

The player and most NPC's can be wounded and receive bleed damage but the bleeding can be reduced with bandages. This will make gun fights much more strategic since you will need to avoid being shot as much as possible. The aim of the mod is to add a new level of depth to the game and make it more challenging while remaining intuitive.


This mod combines Bleeding Wounds System and Wasteland Wound Care so that bleeding wounds caused by BWS can be patched up with bandages from WWC. Bandages will now reduce the damage taken by bleeding, however certain bandages such as the Pre-war medicated bandage will also have healing effects which will work even when not bleeding.

Limbs will not auto heal, you'll need to use a Scavver Medkit, Scavver Surgery Kit, or Elastic Bandage. Stimpaks do not have any limb healing effects and they will now restore a constant amount of HP rather than a percentage amount. Stimpaks can still be improved substantially with the Medic perk and Medicine Bobblehead, as well as the Chemist perk.

Agony is highly recommended for more first aid items, custom bandage models and animations, more realistic wound mechanics, and other extended features. Raider Overhaul is also recommended for a few extra first aid items and better raiders. Wasteland Imports also adds a few more first aid items and many other cool items from previous Fallout games.

First Aid Items:

- Dirty Rag Bandage: reduces bleeding but high risk of infection
- Clean Rag Bandage: reduces bleeding moderately
- Elastic Bandage: reduces bleeding and heals limbs slightly
- Sterile Bandage: reduces bleeding considerably
- Medicated Bandage (Pre-War): reduces bleeding substantially and restores health
- M1a1 Advanced Trauma Dressing: reduces bleeding greatly and restores health
- Scavver Surgery Kit: makeshift surgery kit for healing limbs, will cause bleeding
- Scavver Medkit: makeshift first aid kit for healing limbs, wont cause bleeding
- Raider Rad-Out: removes radiation. Side effects include pain, nausea, etc
- Wasteland Wound Balm: will heal limbs slightly without side effects
- Blood Pack: will reduce bleeding but high risk of infection

First Aid Items from Agony:

- Dirty Bandage: higher quality alternative to Dirty Rag Bandage
- Clean Bandage: higher quality alternative to Clean Rag Bandage
- Surgery Kit: higher quality alternative to Scavver Surgery Kit
- First Aid Kit: higher quality alternative to Scavver Medkit
- Pain-Killer: will cure pain caused by surgery and open wounds
- Blood Pack: Agony adds even more risk to using blood packs
- Safe Blood Pack: safe way to reduce bleeding substantially

First Aid Items from Wasteland Imports:

- Doctor's Bag: similar to First Aid Kit, safe way to heal limbs
- Super Stimpak: better alternative to Stimpak, will heal legs slightly
- Ultra Stimpak: even better form of Stimpak, will heal legs slightly
- Healing Powder: will restore a small amount of health

First Aid Items from Raider Overhaul:

- Sealed Pain Killers: will lessen damage and cure pain if used with Agony
- Expired Pain Killers: less safe and less powerful pain killers


The mechanics are essentially the same as in BWS but slightly simplified. Damage taken from small caliber weapons will inflict moderate wounds which cause bleeding damage for 3 minutes. Large caliber weapons will cause serious wounds which drain your health a bit faster than moderate wounds and last for 5 minutes. The damage will stack.

Many melee weapons and creatures will also inflict a moderate or serious wound. Wearing power armor will prevent small caliber wounds and reduce serious wounds so they become moderate wounds. In the latest versions of Stop The Bleeding damage resistance will also offset some of the bleed damage instead of doing the same damage regardless of your armor.

I've also added a notification to let you know that you've been wounded and you can now check how much you're bleeding by looking in your Pip-Boy where it tells you the effects of diseases, chems, hunger, etc. You will also be able to see the effects of bandages in the same place. Try to apply bandages until they cancel the effects of the bleeding.

If the healing effect of the bandages is greater than the bleeding effect then you will gain health but the bandages will be removed once you have stopped bleeding and they can only be applied when you are bleeding. Stimpaks should still be your main way of recovering health and bandages should be rationed appropriately.

The bleeding system will also affect all creatures and NPC's except for "essential" people such as your companion so they don't randomly go down and because if they're bleeding heavily they can go down again right after being revived. Synths will also "bleed" since they have hydraulic fluid systems, but simpler robots and turrets will not.

Agony Mechanics:

If using the Agony patch bleeding mechanics are totally overhauled and more tightly integrated with the wound system in Agony. Bandages are no longer simple healing items because getting shot/stabbed/etc will cause two effects: an open wound and mild or heavy bleeding depending on the weapon, and the open wound can only be healed with a bandage.

After applying a bandage it will become a dressed wound and will partially offset some of the effects caused by the bleeding such as the loss in movement speed. The drop in movement speed and HP damage will stack each time you are wounded but each time you turn an open wound into a dressed wound the restoration effects will also stack.

All bandages and their effects will still be removed after bleeding stops like in the normal version but any open/dressed wounds should remain. Open wounds will heal own their own without bandages if you wait a while. Dressed wounds will also disappear after a while, at which point you should be fully healed.

Open wounds will also cause the pain effect from Agony unless the adrenaline effect is active, and can be treated with pain killers if you do not have any bandages to heal the open wound. Surgery will also cause pain as it does with Agony but the duration of the effects are significantly reduced to last only a few minutes.

Unarmed and blunt weapons:

There are some other minor features in Stop The Bleeding which have been carried over from the Crippled limbs overhaul module of Bleeding Wounds System; enemies will drop their weapon if their right arm becomes crippled and there's a chance for punches and blunt melee weapons to stun, knock down, or disarm enemies.


* This is my first mod so I cannot promise there will not be any bugs so start a new game or backup your save files.

* A script runs whenever someone is wounded to apply the bleeding effect but there should be no performance impact.

* I've only tested this mod in survival mode but I don't really see any reason it wouldn't work in other modes.


This mod will generally be incompatible with anything BWS and WWC are incompatible with. Mods which change vanilla weapons may remove the bleed enchantment from guns. Mods which alter the loot lists may also prevent you from finding bandages, creating a merged patch with FO4Edit should resolve the problem for you. New weapons added by mods will not do bleed damage unless patched.

Compatible mods:

- Armor and Weapon Keywords (AWKCR)
- Weapons of Fate (Ballistics Overhaul)
- Vanilla Weapons HD
- Extended weapon mods

Patches for these mods are available:

- Realistic Guns and Bullets Overhaul
- Wasteland Imports (Mojave Imports)
- Raider Overhaul
- Agony

Example load order:

Unofficial Fallout 4 Patch.esp
Weapons of Fate.esp
Realistic Guns and Bullets Overhaul.esp
ValdacilsItemSorting - WastelandImports TAGS.esp
MK_Agony_VIS Patch.esp


In the process of making this mod I inadvertently discovered the exact cause of the infamous VATS freezing bug which occurs only in survival mode. My mod was causing the bug to occur very often and I was able to track down what was causing it and resolve the issue. In my effort to make the effects of bleeding show up in the Pip-Boy I discovered that essentially only "Potions" (aka ingestible items like chems, food, etc) will show their effects in the Pip-Boy. This is how effects like hunger, thirst, and diseases work, there is a potion for each condition and the EquipItem() function is used in the survival mode manager script to force the player to consume the potion so the effects will show up in the Pip-Boy.

Effects caused by "spells" and weapon "enchantments" don't seem to show up in the Pip-Boy regardless of how one tries to make it work. So I created a potion for the moderate and serious wound effects and I used the EquipItem() function the same way. I continued using a spell for NPC's because it just seemed cleaner and safer. Then I started to get the VATS freezing bug and I immediately suspected it had something to do with consuming potions while in VATS. I did some Google searching and only found one other person who had correctly realized that getting hungry while in VATS was the cause of the crash, everyone else was making wild guesses based on what was happening when their game crashed.

After some testing it was clear that VATS would freeze any time I got shot but if I used a spell on the player instead of a potion it would work fine. So at this point I needed a way to check whether or not the game was currently in VATS mode so I could delay the bleeding effect until VATS had exited. First I tried GetVATSMode but it seems like that's a remnant from FO3 and/or NV and doesn't work at all in FO4. Next I tried the IsVATSPlaybackActive() function which the CK wiki suggests does work with FO4 but it seems like "playback" means the part of VATS after you fire, so it wont return true in all stages of VATS. Then I thought maybe I check if the slow motion effect was active... nope that didn't work either.

Eventually I discovered that the problem could be solved using the IsMovementControlsEnabled() function because movement is always disabled while in VATS mode. Of course the function will apply to other situations where movement is disabled but if you're shot while you cannot move it's probably best you cannot bleed. So with that function I could ensure the call to EquipItem() only happens after VATS mode has ended. You will still receive wounds while in VATS but the effects wont activate until after you exit VATS, at which point the potion will be used and your health will begin to drop. It may be possible to completely fix the VATS freezing issue but I don't yet feel confident modifying the survival manager script. VATS fix now available!


- Creation Kit
- FO4Edit
- Wrye Bash