You have two choices from dropping out of the duct: take the second one which puts you next to a medkit. You'll want it handy for when--yeah, when that flamethrower guy that just startled you appears. Pump him full of lead, picking up the medkit when your health gets low. When he's dead, go around and pick up his weapon: the napalm cannon. [REFLEX INJECTOR #2: Continue forward from where you pick up the napalm cannon to enter a bathroom next to a Squee-Z Juice vending machine. A reflex injector is on the floor.] Proceed through the room and head down the hallway. [INTEL #21, "I.M. transcript #3": Located in the hallway next to a debris barricade.]

Keep making your way through the rooms and hallway, dealing with enemies as you encounter them. Pay particular attention to avoiding the fire as you navigate the burning building. If you're using the napalm cannon, be careful not to catch yourself on fire by getting too close to enemies your flame.

After moving through several rooms, you should come to a set of stairs. Walk down to the next floor and you'll hear a couple of enemies talking to each other. Follow the sound of their voice and chuck a grenade in their direction when you can see them. [INTEL #22, "I.M. transcript #2": The Housekeeping office across the hallway from the elevators holds another intel.] Proceed to the surgery recovery room at the end of the hall.

Get ready to fight several soldiers patrolling the next set of rooms. Go through the recovery room and back area, then through the door to encounter the first set of foes. Kill the first one limping in front of you, throw an incendiary grenade into the room in front of you, then move left down the hallway. Kill the enemy in the room ahead, then turn to the hallway and deal with two guys next to the column. Walk toward the column, entering the room on the other side to collect a medkit. A couple more enemies will appear in the hall. Follow the path of blood and bodies to continue. [INTEL #23, "Op guidelines": In the room where you see two soldiers opening fire on one of Alma's creatures.]

Take a jaunt down the blood-stained stairs. A couple of frag grenades can be picked up from the Admitting Office. Continue through the hospital, passing through a set of double doors to find two soldiers shooting at a creature. Throw a grenade at them to dispatch them all. Walk down the hall, being careful not to get shot in the back by the guy hiding in the first room on the right. Move up, deal with another guy around the corner, and take the elevator.

Collect the medkit on the floor of the surgery prep room when you exit the elevator, then enter the viewing gallery. Equip the armor vest and drop into the surgery room. You're about to get mauled by a bunch of deranged patients. As soon as you're back up, immediately get out of the surgery room and find a corner. While this may sound like a bad idea, it actually will force the creatures to come at you from the front and gives you a clear shot at them. There's about half a dozen of them, so sit tight until you're certain you've killed them all. Another will come out of an adjacent room, so beware of that too.

Move out through sliding glass door and continue through the hallway to meet up with Jankowski. Crawl through the vent in the room and drop down to the floor below to finish the level.

V. Withdrawal

"Sgt. Jankowski died in front of you, torn up by some kind of surgical machine. Meanwhile, Armacham black ops teams are about to destroy the facility. You need to get out before the whole place comes crashing down. Snake Fist insists you are being hunted by someone named Alma who will eventually absorb you."

You've dropped into the radiology lab where there are two sets of examination and x-ray rooms. You need to open the doors to the second room, 202, to proceed. Use the computer in the adjacent examination room to unlock the doors. [INTEL #24, "Info: SGT Fox": Located in Room 201.] Head on through and have a chat with Fox. Afterward, make your way through the rest of radiology. [INTEL #25, "Info: SGT Morales": Found on a copier in Reception Rm. 205]

After passing through reception, you should hear a man frantically talking. That's your sign that a fight is coming up. Turn the corner and you'll find a batch of enemies preparing to evacuate the hospital. Shoot the yellow explosives to kill a couple of them, the clean up the rest using the corner for cover. Continue through the rest of the ward, entering a more high-tech area. As you snake through the tight corridors, be on your toes. A creature will jump out at you after coming down a set of stairs in front of the frosted windows you just walked by, so pull back as soon as it does and open fire. [INTEL #26, "Harbinger failures": After killing the creature, you can pick up intel next to a dead nurse on the ground ahead.]

Go up the stairs and through the door. [REFLEX INJECTOR #3: Before going down the corridor, pick up the injector on the terminal by taking a right down the stairs.] Run down the corridor to the elevator taken by the mysterious figure. Hit the button on the left to call the elevator. Act fast because the hallway starts collapsing and you need to get out of there. When the elevator arrives, run in and push the buttons to head up.

The moment you get out of the elevator, you're accosted by a handful of soldiers. Use the elevator for cover, throwing grenades and shooting at them until the coast is clear. Collect the armor vest, go upstairs to grab the medkit and grenades, then climb down the ladder.

Follow the corridor until you reach a metal walkway. Your new objective is to escape the outer shell before it goes boom. As you walk across the grating, pipes will jet white-hot flames. Time your progress to avoid them, as they will instantly kill you. When you reach the end of the grating and a flame jet blocks your way, hop off onto the concrete and look to your left. Inch forward and then hop back onto the walkway at the left. Keep going until you're off the walkway and in a concrete corridor. Continue until you reach a small squad of enemies that you can chuck a grenade and be rid of. [INTEL #27, "Schedule change": Sitting on a sawhorse in the area.]

Move up to another metal catwalk. The path on the right leads to a shock grenade, whereas the left takes you to a series of ladders. Climb down them, making sure to grab the armor vest and ammunition on the middle platform. Wait for the enemies to leave the room before taking the final ladder to the ground. Activate slow-mo to go through the door. Once through, take cover on the wall opposite the door. Eliminate the first enemy on the catwalk, then the second that takes cover behind the palate truck. Next, run behind the palate truck to access the manual door override to open the chain link fence door. Run back to the wall where you originally took cover. From there, activate slow-mo and turn around the corner to kill the remaining enemies.

Run up and over the debris as you continue through the tunnel. When you drop done on the other side, swap in the assault rifle. You want it for good range in the fight just ahead. A napalm cannon-equipped enemy pops out from the back of the transport. Don't use the assault rifle, use the shotgun or submachine gun instead. Switch to the assault rifle after you've killed the napalm cannon guy. Zoom in and dispatch the enemies that appear on the catwalk in the distance. Be wary of moving up until you're certain the coast is clear.

More enemies await at the bottom of the ladders at the opposite end of the room. Inch forward along the left side of the room, zooming in to get a shot of them with the assault rifle. An armor vest is nearby, so take it if necessary. After killing the first few, more will come down from the catwalk. Dispatch them and climb up to face a few more enemies. Kill them, grab the medkit at the end of the catwalk, then climb down the ladder.

After traipsing through the tunnel, you'll meet up with a bunch of soldiers. You're in a bad position on the catwalk because they have a clear line of sight and can shoot through the metal grating. Hop down, activate slow-mo, and take them out. Grenades are helpful, but you're likely to run out at which point just aim well and shoot. Remember to use medkits when your level dips low. Continue, killing any resistance down the tunnel.

When you reach the next area, a pipe bursts. You need to find a way to stop the fiery leak in order to continue forward. [INTEL #28, "Info: P. Fettel": On a metal shelf in the storage area adjacent to the pipe tunnel. It's next to grenades and an armor vest.] The valve connected to the leak is at the other end of the tunnel. Defeat all enemies, of course, before trying to turn the valve. Once the turned, expect a bunch of enemies to filter in from the other side. Kill them all and head up the ladder where the leak was. Proceed through the door, up the stairs, and through the collapsing room to end the level.

VI. Replica

"Sgt. Fox was killed by the same horrific force you encounter in the TAC Lab. You've discovered that the hospital is actually a clandestine underground facility. Armacham seems to have accelerated its schedule for demolishing the place. Snake Fist has warned you that Alma's presence may have activated 'Replica Soldiers,' but he didn't elaborate on what that meant."

Unfortunately, you're still stuck in the outer shell and need to move fast to find an escape. Climb out of the water using the ladder and exit the control room. Move through the facility, passing a locked sliding glass door. [INTEL #29, "Replica upgrades": Find this intel in a room near the locked glass door next to a bloody corpse. There's also a medkit in this room.] Keep going until you reach an second sliding glass door, which you can enter. The hallucinations make the going disorienting, but there's nothing to really worry about since there aren't any enemies that attack in this area.

Continue through the control room, crouching through the broken glass windows. Down the stairs ahead are some health injectors and proximity mines. Grab them and head down the curving hallway to the right. Scramble over the debris and walk down to Station 2, as marked on the wall. Access the computer terminal in the control room to open the chamber doors. The sliding glass door to the cells is now locked, so you need to backtrack to the curved walkway and hop down. There's a crawler hiding in the last cell, so expect it to jump out as you walk by.

Walk through the unlocked sliding glass door, turning right into the next room when you reach the broken pipe. Two crawlers want to rip out your throat as you walk by the creepy test subject. Kill them quickly, as their attacks quickly whittle away health. [REFLEX INJECTOR #4: Follow the stairs around to a back room where you can turn a valve to stop the leaking pipe. Run back to find a newly accessible room that contains a reflex injector.] Continue up the yellow stairs, making your way through an observation room above the test subject. Pick up the medkit here. [INTEL #30, "Testing reminder": On the terminal is a piece of intel.]

Exit the observation deck to a corridor with a huge pipe. A crawler breaks through a slate of windows, quickly pump it full of lead an proceed. Another one comes out from the corner down the hallway. Get to the end of the room and another couple crawlers appear. The shotgun works well in making pulp out of them. Don't forget to equip the armor vest sitting on a crate near where the last two crawler appear. You may need it for the crawler that jumps at you when you head down the stairs.

There's some ammunition for the shotgun and submachine gun, as well as an armor vest. Don't pick it up if you have partial shielding left. Crawlers in the room ahead may eat into that, so save it for that confrontation. There are three of them. Another bursts through a vent in the floor as you walk past the rigged columns. Walk backwards and shoot one of the explosive barrels to kill it; just make sure you're far enough back before you do. At the end of the area you'll see some health injectors. Don't run for them! Take the three injectors on the concrete behind them, instead.

Drop down between the columns, kill the crawler that appears, then climb up the ladder. Go through the door and kill the trio of crawlers that run out. [INTEL #31, "Combat testing": Located on the counter nearest the door in this room.] Pass through the next laboratory to reach the elevator. Call it and take it up.

Exit the elevator and grab ammunition, health injectors, and an armor vest through the chain link fencing on the right. Head into the big room and prepare for a fight against a new enemy: Replica soldiers. Run around grabbing ammunition during the talk in anticipation of the battle. Note the location of the health injectors so when your health gets low, you can just sprint over and grab them. There's also a medkit on the destroyed car, as well as an armor vest you can use when your shielding gets low.

When you've defeated all the Replica soldiers, find the opening with steam emanating from it. Drop down through it to end up at the Replica staging area. Fight a handful of them as you work your way to a ladder. Head up and fight more Replica soldiers in the adjacent staging area. When you trigger the checkpoint, you know you're about to encounter about half a dozen Replicas in the small room ahead. Go to the left side of the room as you enter, walking behind the big object there. Use it for cover, then hit slow-mo, emerging from cover to take out Replicas. After they're all dead, lift the obstruction from the front of the door and proceed. Of course, collect the medkit on the ground.

The next room is a bit tough. You'll hear the sound of gunfire, which signals the Armacham guards are fighting the Replicas. Head into the room and start engaging the surviving Replica soldiers. These guys are tough and the space is small. Use cover and slow-mo to take them out one-by-one. Grenades don't work terribly well here because they bounce around and there's so much cover that the Replicas take cover to avoid them. There's an armor vest and a medkit up the ladder, if you need it. [INTEL #32, "Threat report": Next to the armor vest in the area above the ladder.] Additionally, the Replicas will drop health injectors if you get low. When the first batch is cleared, make your way to the stairs at the other end of the room, being careful of the Replica that appears as you approach.

A crawler darts by as you enter the pipe corridor, the sounds of gunfire overhead. You join the battle by climbing the stairs at the end of the tunnel, after killing the crawler naturally. There's only one Replica in the area immediately proceeding the stairs; more wait in the next room. One jumps from the right down to the ground, while a couple more stream in from the far side of the room. Use slow-mo to get them all at once. Walk into the room, zooming in on the far left corner. At least half a dozen Replicas will come in from there. Press them by using slow-mo as it recharges, killing as many as you can. There are explosive barrels you can shoot too. When you've dispatched them all, head to that corner to continue through the pipe vent.

When you reach the end of the pipe, you're in another warehouse area. Climb down the ladder and start making your way to the elevator. [INTEL #33, "Lift problems": Sitting on a desk next to an armor vest in the office at the base of the ladder.] The elevator, unfortunately, doesn't work. You have to release pressure from valves located throughout the room to get it functional again. Every time you twist a valve, though, Replicas appear. Don't try turning a valve until you clear the handful of Replica soldiers first.

After turning the second pressure valve, you face a powered armor unit. The thing is pretty powerful, so make sure to utilize cover and slow-mo. Chuck grenades to stun it and open fire using the assault rifle or get relatively close to it and use the shotgun. Get out of the way when it opens fire, as it will take huge chunks from your health. You know it's getting close to exploding when electricity starts flying from the body. When it's down, turn the last pressure valve and take the elevator topside.

VII. Ruin

"You have escaped the underground facility and established contact with Lt. Stokes and Sgt. Griffin. Your orders are to rendezvus with your team at a rally point near the stadium. Sgt. Keegan and Sgt. Morales are on their way there in the APC."

When the lift stops, turn around and walk up the stairs to the platform behind you. Take the ladder there up and walk across the metal catwalk. Watch the plane go down, then head through the office. [INTEL #34, "Replica activity": On a desk to you right as you walk through the office after seeing the airplane crash.] Jump up on the counter in front of the window and smash it. A couple of grenades and a medkit are available down the hall to the left, but you can continue to down the stairs to the right if you don't need them. Pass the lockers and exit to witness the devastation outside. Follow the streets until you come to a building with a red door. Go in. It was unpleasant weather outside anyway.

Leap over the railing and take a left down the hall after the lights go out. Don't worry about that shadow; the poor guy is already dead. Shoot the padlock on the chain link fence door and open it. Make you way to the back exit (another red door) and go back outside. Maybe the weather's improved.

Nope, it's actually gotten a little worse. A lot worse actually, now that you have to deal with some bizarre enemy with psychic-powered tendrils. As the guy runs around the area, he raises dead soldiers like puppets. Shoot them down as he raises them, then unload on him. It takes a few rounds of shooting him, then (re)killing the soldiers before he finally goes down. [INTEL #35, "Civilian threat": Sitting on a desk in the building in the area where you fight the mysterious psychic tendrils enemy.]

Go inside the ruin of the building here after defeating the tendril guy. Lift the filing cabinet out of the way and collect the items on the floor. Continue through the door. Looks like Alma sent some friends to play with you, but they don't play very nice. Shoot the ghosts as you make your way through the office building. The pistol works well against them, plus it preserves submachine gun and assault rifle ammunition. After emerging from the air duct, you need to drop down from the second floor of the building out of the blown out wall to the top of a delivery truck. From there, jump down to the alley and walk to the street to find that plane you saw earlier.

Unfortunately, it's belly up on the asphalt. Much like the enemies up ahead will be. After first letting him kill two guys for you, a napalm cannon soldier can be taken down by shooting the canisters on its back or just pumping him full of bullets. More enemies come out of hiding from the bus blocking the end of the street. Hang back where you dropped down from the debris barricade and kill them from a distance. Collect ammunition, any needed health injectors and the medkit and armor vest in the burning room to the left. Stocked up, go toward the building on the right side of the street next to the crashed plane. Inside will be a few more soldiers on the first floor. Take them out from outside before heading in. You're more likely to be overwhelmed if you go in and get surrounded. Go up the stairs when those guys are dead to kill two more. Also, be wary of the rocket launcher in the building across the street. Take him out before using the plane as a bridge to their building. [REFLEX INJECTOR #5: Located on the second floor of the building adjacent to the downed airplane.] [INTEL #36, "Powered Armor": Sitting right next to the Reflex Injector.]

Make your way through the crumbling building to reach a doorway blocked by an electrified puddle of water. The solution is simple: aim for the power box on the power line to the left and shoot it. That clears your way to pick up the missile launcher in the next room. You want it to destroy an Elite Powered Armor. Drop through the floor and watch as the enemies take down the first Elite. Don't waste any of your rockets shooting at the first one; let these guys do the work for you. When he explodes, switch to your assault rifle and kill the rocket launch on the other side of the street, nesting in the second floor of the building there. Then eliminate the second enemy near your position.

Step into the street once it's clear to trigger the arrival of the second Elite. This is what you saved your rockets for. Unload them quickly and immediately take cover at the ammunition box near where you entered the area. From that vantage point, unload rounds of assault rifle ammo into the thing until it explodes. It takes the full five rockets and a couple clips. Alternately, you can make a dash across the street and grab more rockets from the second floor, but it's a riskier tactic.

With both Elites out of the way, you can figure out how to continue. The street to the next building is blocked by another puddle of electrified water, although this one is pretty big. Like before, you need to shoot out the power boxes on the poles to stop the electricity from flowing through the lines and into the water. Some enemies will annoy you, so get rid of them before tinkering with the electricity. When you're done, hop across the water and into the building at the end of the street to end the mission.