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Medical & triageBleeding & blood lossInternal bleedingInfection & sepsisFractures, dislocations & shrapnelHeart, blood pressure & strokeBrain damage

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Mood & last standFood, water, heat & sleep

The descent

All 11 layersCharactersEndings

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Difficulty and run settings in Casualties: Unknown

Short answer

Run settings are chosen when you descend. Tough is the default. Relaxed doubles the layer timer and adds loot; Paradise triples it and gives infinite last stands; Desolate strips loot and adds traps and cold; Unchipped hides your health numbers; Endless never ends. You can also make a custom mix with the sliders.

Applies to Release 1.0 (Nov 9, 2026) Sources checked

Presets compared

Run presets (wikily.gg, 1.0)
SettingToughRelaxedParadiseDesolateUnchippedEndless
Layer time limit60 min120 min180 min60 minNever runs out60 min
Loot density1x1.15x1.5x0.4x1x0.95x per layer
Trap density1x0.8x0.35x1.5x1x+0.06 per layer
Starting suppliesDefaultFull kitFull kitNothingNothingDefault
Healing rate1x1.2x1.5x1x1x1x
Infinite last standsOffOffOnOffOffOff

Demo 7.0 reworked the run settings menu into presets plus advanced sliders; 1.0 added more settings, dividers and 2-decimal slider precision. Official Official

Tough

The default. Mistakes are punishing and time matters.

Relaxed

More time, more loot, softer injuries.

Paradise

Learning mode. Infinite last stands and few traps.

Desolate

Little loot, many traps, -15°C, every layer has a modifier.

Unchipped

No chip: no health numbers, no depth meter, no time pressure.

Endless

No ending. Loot thins and traps grow every layer.

Unchipped in detail

Without the chip you lose the health panel's numbers and most moodle severities, limb icons, radiation cues, the loaded-round indicator and skill XP. Release 1.0 shows dislocations and fractures again in Unchipped and removes the radiation line. You diagnose by symptoms: shaking hands for pain, body-wide pain for radiation, bloody vomit for internal bleeding, your heartbeat in the panel. Two extra heart moodles (tachycardia, bradycardia) and a palpitations moodle appear only in Unchipped. A manual defibrillator still reads your vitals. The Solar-struck layer modifier forces Unchipped for one layer. Community wiki

Custom settings

Beyond the presets you can set the layer time limit, loot and trap density, starting supplies, healing rate, infinite last stands and more. Release 1.0 also lets you switch measurement units and has a setting to hide menu progression trinkets. Fixes in 1.0 made the trap and loot multipliers persist through save and quit. Official

Questions

What difficulty should I play first?

Relaxed is a good first run: 120-minute layers, more loot, fewer traps and faster healing. Paradise is for learning systems without losing the run.

Do run settings disable achievements?

The settings themselves are not documented as blocking achievements. What does disable them since 1.0 is using certain console commands outside the tutorial sandbox. Some achievements need specific conditions, such as finishing in under 3 hours.

What is Unchipped mode?

A challenge mode without the health chip: no vital numbers, no exact moodle severities, no limb icons, no skill XP display and no radiation line. You read symptoms instead. It is needed for the Escape ending.

What is Endless mode?

Added in 1.0. Layers keep coming: on layer 10 the Blue Heart sends you back to layer 2, and loot thins while traps grow each layer. Endless runs only end in death.

Sources