Witness the Rusanov’s descent into madness first-hand, as you struggle to keep everyone alive with the limited resources you have at your disposal.
Recent Reviews:
Very Positive (10) - 90% of the 10 user reviews in the last 30 days are positive.
All Reviews:
Mixed (77) - 68% of the 77 user reviews for this game are positive.
Release Date:
Jan 27, 2023

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Early Access Game

Get instant access and start playing; get involved with this game as it develops.

Note: This Early Access game is not complete and may or may not change further. If you are not excited to play this game in its current state, then you should wait to see if the game progresses further in development. Learn more

What the developers have to say:

Why Early Access?

“Negative Atmosphere: Emergency Room is a free standalone prologue to Negative Atmosphere. With this Early Access launch, the tutorial and first operation of the prologue are immediately available to players. Further operations will release in the coming months, progressing the timeline in-game towards the events of Negative Atmosphere and bringing with them new gameplay mechanics, features & enhancements.

We feel it is vital to get feedback on the core systems early in the development process, as the systems built and tested in this game will be re-used within Negative Atmosphere.”

Approximately how long will this game be in Early Access?

“Negative Atmosphere: Emergency Room will remain in early access until all planned operations are implemented. Our current estimation is 9 to 12 months, but this depends on how quickly we can implement our planned features and content.

However, this is only an approximate date. External factors may influence the duration of the early access period.”

How is the full version planned to differ from the Early Access version?

“The full version of Negative Atmosphere: Emergency Room will include all planned operations & narrative events with QOL improvements, tweaks to gameplay balance and updates based on the feedback from our Early Access adopters.

During the Early Access period, we intend to release a number of major updates that will each bring a new playable operation & mechanics to the game. We will of course release smaller non-content updates which tweak the balancing of existing operations & implement bug fixes/feedback.

We anticipate that Negative Atmosphere: Emergency Room will evolve substantially over the course of the Early Access period and we are dedicated to ensuring the final product is a compelling and polished experience.”

What is the current state of the Early Access version?

“The Early Access build allows the player to experience the core gameplay of the game. Two operations are playable. The Tutorial & The Autopsy. Both are fully voice-acted with subtitles & reach our final visual fidelity standard.

The game supports gamepad & mouse + KB with full Steam achievement integration. Updates to the game will bring balancing changes and add or modify existing mechanics.

We feel the Early Access build whilst limited in scope allows you to experience our final vision of Negative Atmosphere: Emergency Room.”

Will the game be priced differently during and after Early Access?

“Negative Atmosphere: Emergency Room is currently free.
As we add new operations and content, the price of the game may increase.”

How are you planning on involving the Community in your development process?

“We intend to gather feedback from our community on each operation release and to make tweaks, improvements & changes accordingly.

We have a dedicated Discord & social channels where we will collate & ask for feedback from our early access community. Our Steam Community forums will be closely watched.”
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About This Game

Negative Atmosphere: Emergency Room is a first person, cinematic medical horror experience dedicated to precision, tension and trauma. As the Chief Medical Officer on the TRH Rusanov, Samuel Edwards must triage, examine and operate on his crew-mates, as disaster builds and shady figures set the events in motion that will eventually lead to Negative Atmosphere.


Witness the Rusanov’s descent into madness first-hand, as you struggle to keep everyone alive with the limited resources you have at your disposal.

As Chief Medical Officer of the Rusanov and an experienced surgeon, Edwards has a confident, in-depth understanding of everything from drugs to scalpels. During the course of Negative Atmosphere: Emergency Room, all the patients coming into the OR will be your responsibility and although Edwards will be there to support you, you will have to learn quickly in order to get your crew-mates through the rougher parts. Your wit and observation skills are key to their survival.

Edwards has sworn a Hippocratic oath. This means that morality is not just about what you want as a player, as every decision will have an effect on Edwards. You have every freedom to set your own priorities during medical procedures, but the outcome might be different to what you were hoping for. Your patients live or die by your decisions and Edwards and his team will suffer the consequences of those losses.

With extensive accessibility options all - except the most faint of heart- will be able to experience the horrors Negative Atmosphere: Emergency Room has to offer, be the blood green, purple or otherwise discoloured. In addition the episodes will be free for the foreseeable future, removing any barrier to entry and making it possible for everyone to delve into the universe of Negative Atmosphere.

  • Control Rebinding
  • Dyslexia Font
  • Configurable Subtitles
  • Toggle / Hold options

There is no bringing back the dead. There is no do-over in life. If you lose a patient, you have to move on and live with what has happened. The crew will have to cope with losing one of their own and you will have to adjust for future operations, so take care. You only get one chance per playthrough to make things right.

Mature Content Description

The developers describe the content like this:

Negative Atmosphere: Emergency Room contains scenes that are not appropriate for all ages, nor viewing at work.

Content warnings include, but are not limited to: frequent violence, gore, nudity, profanity, substance abuse, medical procedures, mental health disorders and psychological manipulation.

System Requirements

    • OS: Windows 10, 64 bit
    • Processor: Ryzen 3 3100 / Intel Core i3-10100 (4 Core/8 Thread CPU)
    • Memory: 8 GB RAM
    • Graphics: NVIDIA GTX 1660 / AMD RX 5500 XT 6GB
    • Storage: 3 GB available space
    • Sound Card: DirectX Compatible Sound Card
    • Additional Notes: 1080p (1920x1080) at 60 FPS.
    • OS: Windows 10, 64 bit
    • Processor: Ryzen 5 5500 / Intel Core i5-11400F (6 Core/12 Thread CPU)
    • Memory: 8 GB RAM
    • Graphics: NVIDIA RTX 2070 / AMD RX 5700 XT 8GB
    • Storage: 3 GB available space
    • Sound Card: DirectX Compatible Sound Card
    • Additional Notes: 1440p (2560x1440) at 60 FPS.

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