Quick, atmospheric and fun, really like it.
If I may comment on the items though, in my opinion, being able to use multiple of them is overpowered and leads to less tension than it could have been, since:
-It's always a good idea to use cigs when lacking HP, there's no downside
-It's always a good idea to use a magnifying glass (very broken item btw in a game whose main principle is not knowing what's in the chamber) and decide from there whether shooting oneself with a blank or making a devastating combo with a saw and/or a handcuff
--Not being able to combo would trade knowing what the next shot is (already powerful) with being able to do anything else
-The beer becomes less attractive and is only really useful if I don't have a magnifying glass or a handcuff to control the flow
-I end up keeping the saw mostly for when I can get an assured shot with a mag glass
Food for thoughts. The same with a 1 item restriction per shot would introduce way more thinking and tough decisions