Bloody Mess is there, but it just makes critical hits nastier, no narrative requirements. That said, I'll be very disappointed in any GM who runs this and DOESN'T narrate the explosive gore.
The Fallout fandom can be ridiculously toxic at times (I haven't seen that here on ENW yet, the criticisms that I read seem rational to me). Those who hate Bethesda are very vocal about it and I advise avoiding r/fallout if you want help with lore and sticking to either r/fo4 or r/falloutlore...