Project Zomboid Medical Guide: First Aid and Where to Loot

Short answer: bandages first, then a suture needle, tweezers and disinfectant. Antibiotics come after those. The reason is simple — wounds in Project Zomboid do not heal at all until they are treated, so carrying something to close them matters more than carrying anything else. And two things worth unlearning: First Aid does not make scratches or lacerations heal faster, and it does not change your chance of zombification. This guide covers what the skill actually does, what to use for each wound type, and which named medical buildings are worth the trip.

Verified on 31 August 2026 against Build 42.20.4, the stable release from 26 August 2026. Build 42 went stable as 42.20.0 on 29 July 2026. Values come from the official wiki (its pages target versions between 42.10 and 42.20.2); the 42.20.2, 42.20.3 and 42.20.4 hotfix notes contain no medical changes, which was checked against the official patch notes.

What to prioritise

Start with what First Aid does not do

Get this wrong and you will misjudge both what to loot and how to play. The official wiki is explicit on two points:

• It does not speed up healing of scratches or lacerations. The wiki states this directly, prefaced with "contrary to popular belief"
• It does not reduce or change the chance of zombification from a zombie scratch or bite. Levelling to 10 has no effect on that number

The same trap applies to antibiotics: they act on wound infection, which is a different system from zombification via the Knox Infection. Confusing the two is the most common and most fatal mistake, so read this alongside the Knox Infection guide.

What it actually improves

First Aid is a survivalist skill. What scales is the speed and duration of treatment, and everything to do with fractures.

On top of that you perform medical actions faster, splints become more effective, and you can evaluate the severity of wounds and infections. Fracture healing going from 50% at Lv0 to 550% at Lv10 is an elevenfold swing — that is where essentially all of the skill's value sits.

Treatment by wound type

Treatment is done by right-clicking the affected part in the health window. Identifying the wound type first is the whole game.

Scratches and lacerations

Bandage it, quickly. An untreated wound does not heal at all, so even a filthy bandage beats bare skin. And there is one rule worth internalising here.

Dirty bandages do not affect healing rate. What does affect it is time spent with no bandage on. So there is no need to fastidiously swap dirty bandages — the wiki explicitly does not recommend changing them. Leaving one on heals you faster than cycling through fresh ones.

Deep wounds with a foreign object

1. Remove the object (glass, bullet) first. Tweezers or forceps are recommended and required for a bullet. Bare hands work but cause extra pain
2. Stitch with a needle and thread, or a suture needle
3. Then bandage. Bandaging halves the recovery time

Fractures

Apply a splint where possible, then bandage. Head and torso fractures cannot be splinted. Fractures take a very long time to heal, but a comfrey poultice cuts fracture recovery time by 50%.

Burns

If you catch fire, put it out immediately with any water source or a fire extinguisher — otherwise death is close to certain. Treat the burn like a laceration afterwards, but expect it to take considerably longer to heal than other injuries.

Bites

Bandage to stop the bleeding, but understand what you are doing: unless bites are disabled in sandbox options, a bite kills 100% of the time. Treatment buys time, it does not cure.

Zombie wounds need watching afterwards

A scratch or laceration from a zombie can still turn you even when it looks handled. The figures the wiki gives are 7% for a scratch and 25% for a laceration, with an incubation period of 24 hours on default settings.

These are sandbox-dependent, so a server or custom difficulty with altered settings will not match them. Check your own settings, then watch for symptoms for at least the incubation period.

Open wounds can also become infected, but note that this too does not change the healing rate. Its effect is limited to doubling the pain gain of an untreated infected wound.

Bandage types are not equal

That is an eightfold gap between a clean bandage and a dirty one — but since healing responds to whether a wound is covered at all, never hesitate to use a dirty bandage when it is what you have.

In Build 42, foraging replaces the pharmacy run

Build 42's herbs and poultices give you a medical supply chain that does not require raiding a town. For a long run this is the more sustainable route.

All of them have dried versions that store well. Whether you happen to have comfrey when you break a leg decides how long you are out of action, so dry and stockpile it whenever you find it near base.

Which medical buildings to hit

Medical buildings hold bandages and suture needles alongside over-the-counter drugs such as painkillers, sleeping tablets and beta blockers. Laying out the named medical buildings by town makes the risk-to-reward picture obvious.

The pharmacy chain Pharmahug has 11 locations, the most of any named medical building, concentrated in Louisville and The Grand Ohio.

How to actually run it

• Early (Muldraugh or Rosewood start): one facility per town, so clear Cortman Medical or Rosewood Medical in a single trip. Neither holds enough to justify a second run
• Mid: West Point splits the pharmacy, clinic and dentist across separate buildings, so get a vehicle first and chain them
• Late: Louisville's two hospitals and many Pharmahugs dwarf everything else, but urban zombie density scales with it. Not a place to enter for medical supplies alone

Zombie placement and how much loot actually spawns in any given building depend on sandbox settings and your individual save, so this guide does not put numbers on them. For route-level detail see the Muldraugh looting routes and the early-game looting guide.

Levelling First Aid

Experience comes from performing medical actions on yourself or other players. No injury means no experience, so treating every wound properly beats trying to grind it.

• Occupations: Doctor (+6), Nurse (+3), Park Ranger (+1)
• Traits: First Aider (+1), Former Scout (+1). Fast Learner sets XP rate to 130%, Slow Learner to 70%
• Skill books: First Aid I through V, covering levels 1-2, 3-4, 5-6, 7-8 and 9-10
• VHS: tapes such as Rosewood Medical First Aid also grant XP, but entertainment gains are capped at the first 3 levels plus any overflow

Doctor's +6 stands out, but since fractures are most of what First Aid affects, those six levels rarely justify picking the occupation. Filling the first three levels with books and VHS tapes and letting real injuries do the rest is the practical path.

Summary

• Wounds do not heal until treated — bandages are the top priority
• First Aid does not speed up cuts and does not change zombification odds. It is mostly a fracture skill
• Antibiotics treat wound infection; they cannot stop Knox Infection zombification
• Do not swap dirty bandages. Time spent uncovered is what costs you
• Deep wounds: remove object, stitch, bandage — bandaging halves recovery
• Zombie wounds carry 7% (scratch) and 25% (laceration) on default settings; watch for 24 hours
• Build 42 foraging (comfrey especially) is the sustainable alternative
• Louisville has the most supplies and the most danger. Early on, clear your town's single clinic

Sources: version and patch contents from Steam's official news feed; skill effects and treatment flow from the official wiki's First Aid page; item values from the Medical page; the building list from the Medical clinic page.