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FIST (Fusion Isometric Strategic Tactics) is an add-on pamphlet that adds injury systems like those in Metal Gear Solid 3 & Horrible Woulds for Fallout 4's Fallout Shelter, allowing characters to keep track of and treat injuries more realistically. Characters can experience a range of ailments based on the amount or type of damage inflicted upon them. Medical supplies are necessary resources used by FIST operatives during missions but must be kept stocked with careful management in-game menus such as lockers and medical cabinets that contain healing items like bandages, antiseptic gauze, saline solution, antibiotics, etc. Characters can also gain temporary health bonuses or penalties based on the difficulty of a task at hand without worrying about their actual HP values dropping to zero after an injury has been sustained in combat situations such as carrying heavy objects and sneaking around undetected by damaging themselves with less stealthy moves like firing guns too quickly during survival missions, etc. -