Healing Items — left4dead

"First to aid, last to die."

"Hope you don't mind, I'm gonna... take this First Aid kit here."

Healing items are those used to restore lost health, be it a temporary health boost or a permanent restoration. They can be found in ambulances, safe rooms, or randomly throughout levels, but are most often found inside of first aid stations. First aid stations may contain up to four bottles of pain pills, but they may contain first aid kits instead, depending on how well the Survivors are doing, the difficulty level, and the gameplay mode. First aid stations found in safe rooms and at finales always contain first aid kits.

Primary healing slot

First Aid Kit

"Can everyone stop a sec? I'm gonna heal!"

―Zoey

"Now don't waste this by getting pounced on or something."

―Nick

Early HUD icon.

The First Aid Kit, colloquially known as a med kit or health pack, is used to heal damage the Survivors take during a campaign. When carried by Survivors, it is held on like a backpack with no visible straps holding it.

First Aid Kits are vital to survival, as they can be healed from near-death to relatively good health. When used on Survivor in their Final Incapacitation state, they will both be healed normally and have their Incapacitations reset.

First Aid Kits can always be found inside of safe rooms, and during the finale of a campaign. First aid cabinets can also possess health kits, but only if it is in the safe room or finale. Hard Rain's Burger Tank and the safe room leading to the Sugar Mill will always contain two Health Kits, even if they were opened despite the campaign and Survivors stating otherwise. There are a few lone exceptions.

Difficulty affects the Director's mood for first aid kits. If it detects a Survivor with low health, the Director will generate Health Kits sporadically until that Survivor's health is restored. If the whole team is low on health with limited healing, the Director will spawn more first aid kits. A maximum of 3 first aid kits can be spawned in a first aid cabinet while the whole team is hurt. On Expert, health kits become exceedingly rare if not outright impossible to find during a level, outside of The Parish's The Park and The Cemetery levels.

In Versus mode, if the players heal each other, the Director will spawn more health kits within the map. Keep in mind if you are the first team to play as the Survivors, whatever health kits you caused the Director to spawn will also be available to the other team when it's their turn. This could be a hazard as the Infected team could use it to their advantage for when they become the Survivors and learn the locations of the spawned health kits when dead or as a ghost in spawn mode.

In Left 4 Dead 2, the player has the choice to pick up a Defibrillator or Ammo Upgrades instead, which can be used to revive dead teammates or ignite/explode the Infected with special ammunition.

In The Passing, First Aid Kits can sometimes be recovered from a defeated Fallen Survivor.

Usage

It takes five seconds to use the First Aid Kit to heal yourself or another Survivor, during which you cannot defend yourself in any way. However, in Left 4 Dead 2, if you are under the effects of Adrenaline while healing yourself or another Survivor, it will only take three seconds. Unlike most other items recovering a set amount of health, First Aid Kits will only restore 80% of the user's missing health. For example, if a Survivor has 30 health, using a First Aid Kit will add 56 (80% of 70) to the Survivor's health, bringing the Survivor to 86% health. This healing is not based on any temporary health a Survivor might have after taking pain pills, and will remove any extra health gained by them. After incapacitation, Survivors will always have only 1 permanent health (the rest will be temporary), and thus will always receive 80 health points from a First Aid Kit. Note that First Aid Kits can never bring a Survivor back to 100% health, and given their rarity, they should be used sparingly.

Defibrillator

"What the fu- aww hell I'm back here again!"

―Coach

"Come on! Work, damn it!"

―Nick

The Defibrillator (also referred by Survivors as "chest paddles") is a medical resource featured only in Left 4 Dead 2. It is a one-time use only device that will revive a dead Survivor.

For game balancing purposes, Survivors cannot carry a Defibrillator and First Aid Kit at the same time.

Official Description

Bring teammates back from the dead. Like the First Aid Kit, a Defibrillator Unit is a one-time use item.
Defibs can resuscitate fallen teammates, and take three seconds to use.^[1]

Usage

To use the Defibrillator, a player must first select it from inventory. This action will reveal where the closest teammate's corpse is lying via emitting a faint red glow. The user must approach the corpse and hold either of the attack buttons. A charging meter, which takes three seconds to complete, will appear followed by a short burst of electricity whereupon the dead Survivor's body will do a sudden jump and will be resurrected.

A resurrected Survivor comes back with 50 health (which is permanent health that does not decline like the temporary health obtained after being incapacitated). This player will have no items save for their secondary weapon, and must pick up their dropped equipment from the ground. A team message will come up on the left side of the screen identifying who brought whom back to life.

Tactically, it is recommended most Survivors carry First Aid Kits and to designate just one Survivor as the team's "Defibrillator medic". The Defibrillator is especially useful when playing on Expert and Realism Modes since the risks of a player dying prematurely are extreme. In Versus, Survival and Realism Mode, rescue closets are disabled. With Defibrillators being the only way to resurrect a fallen teammate in these modes, it can prove invaluable, but note that using Defibrillators for Versus will cause a penalty.

Defibrillators don't tend to spawn often, usually one per level apart from a few exceptions. If a Survivor is on the verge of death, the Director will tend to spawn one nearby. If the group is near a first aid cabinet, one Defibrillator may be included in the cabinet.

A Defibrillator can be used on any Survivor corpse - even if they have already been saved from a rescue closet. It should be noted that in earlier versions of the game if the defibrillator was used on a player's own corpse, the player's "consciousness" would enter the body of the newly-revived teammate. Moreover, defibrillation was impossible if somebody was standing over the target corpse. These variables have been changed subsequently. Now when a Survivor is revived, the Survivor in a rescue closet will disappear and if a Survivor is rescued via rescue closet, the corpse does. This serves to maintain the number of Survivor graphic images at a maximum of four at anytime.

Depending on the situation, there may be times when it is a good strategy to intentionally kill a teammate, then revive them with the defibrillator. For example, killing a near-death teammate who is operating in their Final Incapacitation state, and then using the defibrillator on them will reset their incapacitation count, and restore them to 50 or 100 permanent health. This tactic can be crucial on the higher difficulty settings where health packs and pills/adrenaline are at a premium. However, it's better to ask for permission from teammate before doing this, sometimes it will be mistaken as trolling or teamkilling.

If someone dies from hanging (holding onto a ledge), they cannot be revived using the Defibrillator since they fall and become a ragdoll. However, if they are killed by another Survivor whilst hanging via friendly fire (rather than losing their grip and falling to their death) their body may fall into an accessible area that allows them to be defibrillated and revived. An example of one such opportunity exists in respect to the stairs to the first floor in the finale of Dead Center, allowing players to skip an entire level.

Secondary/Temporary healing slot

Pain Pills

"Pills here!"

―The Survivors

"Ah, a little pick me up."

―Francis/Nick

Pain Pills, unlike the First Aid Kit, will only give the user 50 temporary points of health when taken. When carried by Survivors, it is held on the Survivor's right hip, probably on the belt.

Pain Pills can be given to teammates by pressing the melee button (right mouse button on PC by default, or left trigger on Xbox 360).

Since the health from Pain Pills is only temporary, it will slowly decrease over time, but are also capable of removing speed penalties if your total health is greater than 40. As temporary health decreases by one every 3 seconds, the effects of Pain Pills will last for 150 seconds (2.5 minutes), though practically this is much shorter due to the potential damage one might absorb on the way.

Keep in mind that if you have both permanent and temporary health, any damage taken will always reduce permanent first unless it is at 1, by which point temporary health drops instead.

Adrenaline Shot

"Grabbin' a shot!"

―The Survivors

Adrenaline Shots (labeled as ADRENA-SHOT) are included in Left 4 Dead 2, occupying the temporary healing slot.

Official Description

An adrenaline shot gives you a fifteen-second health and energy boost that lets you run faster, use items in half the time, and run through zombies without getting slowed down by their attacks.^[2]

Usage

Upon injection, the user gains 25 temporary health. For 15 seconds, they move faster, do not experience melee fatigue, are immune to the Horde's slowing attacks and their speed isn't affected by water.

It also increases the speed of using First Aid Kits, reviving Survivors, completing objectives (e.g. pouring gas cans into the generator in Scavenge), reloading and switching weapons or items (however, it does not speed up the activation of generators during Crash Course and the Sacrifice).

As temporary side effects, the user also experiences tunnel vision and monophonic sound, hindering their ability to determine the direction from where a sound came. This can become annoying during a split-screen campaign if one player uses Adrenaline too much, as the monophonic penalty is bugged and affects both players.

This item could become valuable at the end of a finale, where Survivors must reach a rescue vehicle while being impeded by the Horde.

Like Pain pills, the Adrenaline Shot can be passed to a teammate by using the melee button.^[3]

The Adrenaline Shot is a very precious item during a Scavenge game, as it can increase your speed and the speed of the gas pouring by roughly 50%. Generally, two shots will be spawned during a Scavenge game.

Achievements

Left 4 Dead

	DEAD GIVEAWAY	(10G)
	Heal a fellow Survivor when your own health is below 10.

	PHARM-ASSIST	(20G)
	Give pain pills to 10 Survivors.

	FIELD MEDIC	(20G)
	Heal 25 Survivors with a First-aid kit.

	UNBREAKABLE	(30G)
	Finish a campaign without ever using a first aid kit on yourself.

Left 4 Dead 2

	THE QUICK AND THE DEAD	(30G)
	Revive 10 incapacitated Survivors while under the speed-boosting effects of adrenaline.

	HEARTWARMER	(20G)
	In a Versus round, leave the safe room to defibrillate a dead teammate.

	SHOCK JOCK	(30G)
	Revive 10 dead Survivors with the defibrillator.

Behind the Scenes

Early screenshots show that at one time the first Aid Kit was a box made with rigid materials, complete with a handle. The final icon still reuses this legacy design.

Early videos showed it was possible to share med kits like pills instead of healing them.

The placeholder for the adrenaline shot was just a yellow tinted version of pain pills. The texture can still be found in Left 4 Dead 2 files.

Likewise, the defibrillator's world model placeholder was a re-skinned first Aid Kit model with a lightning bolt icon. Its textures can still be found in Left 4 Dead 2 files.

Notes

Survivor Bots cannot pick up or use Defibrillators. The only way they can hold it is if a human player was controlling a Survivor in an online game, and picks one up, but then quits or goes idle, leaving the bot to take over the Survivor holding the Defibrillator. They will not use it and will immediately swap it for a first aid kit if one is available lying around.
On very rare occasions when a Survivor died, it required 2 or more defibrillators to revive the Survivor. This was patched on February 20, 2011.
Defibrillator behavior in Versus was changed slightly as of the June 18th 2010 update: The Director now spawns Defibrillators based on map length, and are limited to only one spawn per map unless there are multiple guaranteed spawn points on a map, e.g. The Atrium. Reviving a dead Survivor also results in a penalty of 25 points.
Note that if a player dies, but then is revived without a defibrillator (E.G. The cheat "respawn_all", rescue closets, or starting a new chapter), and then the defibrillator was used on their body, they will despawn and teleport to there the revived body is and will only have 50 permanent health. Interestingly, a player can revive themselves directly, and after revival they will appear as being revived.

First Aid Kits cannot be used if the player's health is at least 99, due the console variable first_aid_heal_percent. The default value of that variable is 0.8, meaning that 80% of all health currently lost will be replenished. Because health cannot have decimal values, the game rounds down the amount of lost health and applies it as the health gained from using first aid kits.
- Similarly, Pain Pills cannot be used when the player's health is at least 99, again due to a console variable - specifically, pain_pills_health_threshold - its default value of 99 means that total health must be lower than that value for pills to be usable. Adrenaline shots are exempt, however, as they can be used regardless of how much health a Survivor has. This is because even at full health, Adrenaline shots apply the speed boost and each other shot taken resets the timer of the effects of the Adrenaline shot.
Although by default the Pain Pills lose a health point each 3 seconds. Some Valve's official server (such as North Europe servers) may have them set to never decrease. As evidenced by command pain_pills_decay_rate being occasionally set to 0.001 instead of default 0.27. In such cases Pain Pills can be treated as First Aid Kits except it does not reset player's down counts. A.I. Teammates in such cases does not heal themselves unless the health goes below 40 or is in the safe room (except on Expert difficulty).
Bill cannot be brought back to life in The Passing with the Defibrillator. This is due to the Defibrillator being a gameplay mechanic, which goes against its main purpose but also because Bill's body is merely a decoration.
A poster in The Terminal advertises these specific pain pills, saying "Yes, we've got…pills here!"
- This references one of Survivors' quotes upon finding pills: "Pills here!"
Even whilst holding Pain pills, Defibrillators, Adrenaline, or a First Aid Kit, Survivors can still use their flashlight.
In-game, Survivors swallow the entire bottle of pain pills at once. However, if someone were to do this in real life, they would likely die from overdose soon after or choke on the pills, considering the Survivors don't ingest them with water. Additionally, Ibuprofen usually takes around 20-30 minutes to actually start relieving pain, with a recommended dose of no more than six tablets per day, where in the Left 4 Dead franchise, the pills take effect immediately.
- It is possible that only a few pills remain in the bottle, because of their usefulness for both pain relief and euthanasia.
- Furthermore, the Survivors take the pills without removing the caps.
In the original levels of Left 4 Dead, used syringes can be found lying around which may seem to be Adrenaline; they are only for decoration and cannot be used.
It is possible for a merciful Director to change Pain pills into a First Aid Kit, even if a Survivor has already seen the pills.
Pain pills are attached to the Survivors' belts with no visible strap holding them. Likewise, the First Aid Kit and Defibrillator stay on their backs with apparently no straps keeping them on.
After using a First Aid Kit, small bands of gauze will appear on the right arm and left thigh of the target, but disappear a couple of seconds later.
The First Aid Kit, like the new Pistol in Left 4 Dead 2, has no walking animation, and is still on the screen when moving.
The Defibrillator has no cords from the pads to the pack on a Survivor's back, this would make the Defibrillator unusable in real life.
Survivor Bots will never take the Defibrillator, similar to their treatment of throwable weapons such as molotovs and pipe bombs.
Using a Defibrillator on a Survivor who has become a ragdoll (falling after hanging onto a ledge) may sometimes cause a glitch where the Defibrillator will be used, the animation will play, and it will count towards the achievement, but the Survivor will not be revived.
Louis, Bill, and Francis each seem to have the same healing animation, while Zoey's is unique. While the three men simply strap the gauze around and appear to rip off the excess from their wrist, Zoey straps it around and seems to bite it.
Much like the weapons, the healing items for the first game are based on real-world items. The First Aid Kit is modeled after two types of first aid pouches by Ortovox. Both pouches were designed for use by hikers and skiers and are meant to be fit into hikers' backpacks (which accounts for the lack of shoulder straps on the in-game medkit). The Pain pills also have a label that is based on the generic brand Ibuprofen from the Target shopping stores prior to April 2010 (after which Target updated their label), with subtle alterations (such as the Target symbol being removed, where it states "Compared to Advil" and the tablet count is replaced with "PAIN KILLERS"). The First Aid Kit itself also has differences from the real-world examples they are based on, such as the inverting of the first aid symbol (on the real-world pouches there is only a white cross. In the in-game version, it is a red cross inside of a white box. Also, where the patch that states the company's name in the real world items, the "First Aid" patch is located in the in-game item).
According to the text on the Adrenaline Shot, it is called "Adrena-shot", contains 0.3 milligrams of adrenaline and may be used to treat allergic reactions and Anaphylaxis, both of which are two real life uses for adrenaline.
- Additionally, "allergic" on the shot is missing one of the two "l"s
On the Xbox 360, there is an unlockable First Aid Kit avatar reward for finishing all five original campaigns in Left 4 Dead 2. The avatar simply holds it for a moment, puts it down, then moves it a couple of times before it vanishes.
It's also noted that the Medic's achievement (Infernal Medicine) in Team Fortress 2 uses the same HUD icon as the Left 4 Dead Pain pills with a fire effect around it.
Using a Defibrillator on a dead Survivor in an elevator that has been activated will revive the teammate, but the Survivor will be revived in the same exact spot causing him/her to not be in the elevator by the time he/she is revived. In Dead Center's first elevator, this allows the revived teammate to jump into the neighboring elevator and either continue on his own provided that his teammates do not open the elevator doors, or wait in front of the closed elevator.
If you have a First Aid Kit and are about to complete a chapter (safe room door closes when all Survivors are inside), you can use the medkit and health will replenish immediately instead of waiting 5 seconds (3 seconds under the effects of an Adrenaline Shot).
Adrenaline does not increase crouch walking speed.
In reality, portable defibrillators cannot revive somebody from death; they are merely designed to physically restart the fibrillating (i.e. contracting out of sync) heart muscle, which may revive a person from the near-death condition (unless the patient's brain is dead, which takes about 5 minutes after the heart stopped beating properly). It specifically cannot save people from dying of wounds, so the in-game defibrillator is just a symbolic 'revival item', not any sort of realistic representation of a defibrillator.
When playing the original campaigns in Left 4 Dead 2, the original Survivors cannot vocally identify the Adrenaline Shot. This happens to the bile bomb, new weapons released in Left 4 Dead 2, and Explosive/Incendiary Ammunition as well.
- The original Survivors will use the "Look" command to vocalize their discovery of an Adrenaline Shot. Humorously, Zoey may say "Well, this looks dangerous," after she picks up a shot referring to it possibly being deadly. This line is normally spoken when she picks up a pipe bomb.
For unknown reasons, the Defibrillator does not spawn commonly in the campaigns with the original Survivors, No Mercy and The Sacrifice. You can still find a Defibrillator located in first aid cabinets if your entire team is hurting (which means only one possible spawn in The Sacrifice, and two in No Mercy), but they do not randomly spawn like First Aid Kits do. Although it's assumed that the reason for this is simply because there were no new spawn points programmed for Defibrillators, it also possible that they simply weren't as common at the time of the Left 4 Dead campaigns, since they take place earlier than the Left 4 Dead 2 campaigns, and Defibrillators were not widespread at that time, with the lack of spawns complying with the timeline of the two games.
- However, it is notably unusual that Defibrillators can't be found regularly during the later levels of the No Mercy campaign, due to the fact that the levels are set in a Hospital.
When viewed from a first-person perspective, it is unclear whether the Survivors inject the Adrenaline into their arms or body, as the inject animation moves downward to the screen, which could be a part of the Survivor's torso, hence, the arm does not appear upon the animation. However, when viewed from third-person, the Survivor is seen injecting the Adrenaline into their hip.
A car alarm chirps when a player or survivor bot uses adrenaline shot and pain pills near an alarmed car.
On rare occasions, a Pain Pills bottle can get duplicated and obtained by two (or probably more) characters at once if it's grabbed at the exact same time. This is most commonly seen with bots (it's unconfirmed if real players can achieve this), as their movements sometimes can become perfectly synchronized.
The Adrenaline Shot in-game is based on real-life emergency "EpiPen" auto-injectors, which are filled with synthesized epinephrine (adrenaline). The adrenaline acts as a vasoconstrictor, slowing the body's allergic response and delaying the victim from going into anaphylactic shock.^[4] Since as much as 15% of the United States population is considered 'at-risk' for anaphylaxis,^[5] it is not beyond the realm of plausibility for the adrenaline shots to be found as often as they are, particularly if they were included as part of CEDA's Emergency Relief Supplies.
On Left 4 Dead's launch, there was a bug that made Pills fall through the floor when handing them to other Survivors in No Mercy's elevator.^[6]