Standard EMS revival scripts treat death as a binary state — dead player, medic presses button, player stands up. Pickle’s Surgery System introduces a procedural layer between those two points: doctors perform actual surgical procedures using typed tools, with real consequences if the operation fails. It’s built for EMS departments that want medical RP to require skill and attention rather than proximity and a keybind.

How the Surgery System Works

The system uses Pickle Mods’ signature hand-targeting interaction model. Surgeons physically grab and interact with props using their character’s hands rather than through a menu selection. Five surgery types ship with the resource — heart, kidney, lung, arm, and leg procedures — each editable and expandable through the accessible config. Surgeons choose the correct tool for each step: the scalpel cuts tendons, the saw handles bone, and the syringe treats bleeding wounds. Wrong tool, wrong sequence, or mistimed action fails the procedure.

Failure has real weight: a failed surgery kills the patient. The surgeon can attempt again or walk away, and the dead player can seek another doctor. That consequence structure makes the skill floor meaningful — newer EMS players practice in training mode before operating on real patients, and experienced surgeons build a reputation for reliable outcomes.

Key Features

• 5 surgery types: heart, kidney, lung, arm, and leg — all editable and expandable
• Three surgical tools with distinct functions: scalpel, saw, and syringe
• Hand-targeting interaction system — physical prop manipulation, not menu-driven
• Real player surgeries — revive or recover deceased patients
• Training Mode — practice without consequences before operating on live players
• Configurable rewards: items, cash, or XP on surgery completion
• Job restriction support — limit surgery access to specific roles
• Failure mechanics — failed surgeries carry real patient consequences
• Approximately 3,000 lines of code — fully developed, not a demo build
• ox_lib required; optional Pickle XP System integration

Framework Compatibility

Pickle’s Surgery System works with ESX 1.1+ and QBCore. The code architecture includes a framework bridge that can be extended for custom setups by developers familiar with Lua. ox_lib is a mandatory dependency. The optional Pickle XP System integration adds progression mechanics for surgeons, but any standalone XP system compatible with the existing bridge can be substituted. The script runs in escrow — it’s not open source — but Pickle’s track record for ongoing updates and support is well-established across their catalogue.

Where This Fits on Your Server

If your EMS team is experienced and wants RP content that matches their investment, surgery adds depth that basic revive scripts can’t provide. The training mode is particularly well-considered: it gives new EMS recruits a structured way to learn the procedures before they’re responsible for real patient outcomes, which is exactly how a serious hospital RP setup should work. Pair it with a solid police MDT and an EMS dispatch system and the emergency services layer of your server starts to feel like an actual professional operation.