Endurance Coalition

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{{Ambox|type=speedy|image=[[File:Red EMS Symbol.png|50px|link=]]|text='''No information on this page should be construed as medical advice'''. <br/>Use of medications in the real world require consultation with a licensed medical professional. Terminology and real world labels are used for immersion ''only''.<br/> Information is ''very likely'' not accurate to real world medical practice.}}{{Ambox|type=speedy|text=This is not a valid certification or qualification.}}[[File:Ace adv medical cheatsheet card.png|thumb|557x557px|A cheat sheet relating to ACE medical designed for medic use.]]
This page is designed for a soldier playing on an Endurance Coalition controlled environment to assess whether their condition can be self-managed during a firefight or whether they need a medic. For information useful to medics specifically, see [[Medical guide/For medics|the medic sub-page]].
The basic training provided by the Endurance Coalition goes over the '''[https://steamcommunity.com/workshop/filedetails/?id=463939057 ACE]''' medical concepts strictly necessary for the average riflemen to play with the unit comfortably. This page will review certain concepts in more depth for deeper understanding.


The addon used to simulate medical conditions in a more realistic manner than vanilla Arma is strictly from '''[https://steamcommunity.com/workshop/filedetails/?id=463939057 ACE3]'''. At this time, Endurance does not use the even more advanced '''[https://steamcommunity.com/workshop/filedetails/?id=2020940806 KAT]''' variant.
<!--== Can you stay in the fight? ==
{{Note|The bleeding indicator on the top right of the medical menu is only visible when assessing oneself.|type=}}


== Core principle ==
If you are:
The primary way you, as a soldier, can be an asset to your medic and your squad's health is to '''eliminate the enemy causing harm'''. The medic's first(-ish) priority is to tend to you and your teammates. Your first priority is fighting. The main goal for you is to assess whether your current condition is sufficient to keep fighting, or whether you will imminently die/go unconscious without a medic's assistance.  
# Not actively bleeding; and
# Your blood loss indicator is yellow or grey; and
# You otherwise "feel" fine.


== Self-assessment ==
You can keep fighting.
When you've been harmed (usually this is by being shot), and there is a lull in the fight or enough people are putting shots down range, quickly open the medical menu using {{Key press|H}} and double check your name is at the top. If it isn't, click the circular icon to switch to yourself.  


Once you are sure you are looking at your ''own'' condition, the list of priorities are:
{{Note|Morphine must be injected into a limb that does not have a tourniquet.|type=reminder}}


# Are you currently bleeding? If so, how badly?
If you are in the middle of a firefight and your character's pain is so severe that you cannot properly engage the enemy, use a morphine autoinjector. If you do not have one, '''call a medic'''. 
# Have you lost blood? If so, how much?
# Are you in pain? If so, is it hurting your combat effectiveness?


If you see any limb is not grey, and you see the bleeding indicator, quickly review all non-grey limbs. Any limb with a wound that is '''''not''''' an '''Abrasion''', '''Contusion''', or '''Bruise''' is likely causing bleeding. If such a limb ''only'' has those 3, it can be ignored for the time being. If possible, apply a tourniquet to the bleeding limb. If not possible (not enough tourniquets and/or it's the chest/head), apply sufficient bandages to get bleeding to stop. If you see a ''lot'' of a wound that isn't the aforementioned 3, and it isn't a limb you can tourniquet, you can safely call for a medic.
If bleeding, tourniquet all limbs with wounds (if possible). Any limbs that cannot be tourniqueted that have wounds should be bandaged. Use '''Field Dressing''' or '''Basic Bandages''' for large wounds (Medium+) and use '''QuickClot''' for everything else. ACE applies bandages in order from the largest wound on the limb to the smallest, hence the suggested order of application.  


If you are:  
If bleeding stops, look at the above checklist again and, if you meet all criteria, return to the fight.  


# No longer bleeding; and
However, if: 
# Your blood loss indicator is yellow; and
# You otherwise feel fine.


Keep fighting. If you cannot get bleeding to stop (either at all or the number of wounds indicates it will take a long time), your blood loss indicator is orange or red, or your condition is causing you to otherwise be combat ineffective, call for a medic. Generally, if you are performing due diligence and doing your best, it is better for a medic to look at you and bitch at you (lovingly... usually) for wasting their time than it is for you to go down because you misjudged your wounds.
# You see a ''lot'' of wounds in your '''chest''' or '''head''' (indicated by the limb being orange or red); or
# You lack sufficient medical supplies to stop bleeding; or
# Your blood loss indicator is orange or red; or
# Something else is otherwise making you combat ineffective.


The only other thing to mention here is pain. You likely have morphine on your person. Morphine will eliminate pain, but it messes with your blood pressure and heart rate for a ''very'' long time. If you are not careful, you can overdose, or application in combination with your condition can cause a heart attack. Only use morphine without a medic's consultation if the level of pain you are experiencing is effecting your ability to adequately engage the enemy and you need to engage the enemy '''right now'''. If you simply notice you have pain during downtime, ask a medic to give application a thumb's up.
Call a medic.
 
=== Post-firefight ===
After the firefight has ended, you should bandage ''all wounds'' with the end goal of removing your tourniquets, and then '''alert a medic'''. Tourniquets induce pain after 5 minutes of use. The medic will speed up your bandaging and stitch your wounds so they cannot re-open. You should not assume that because you bandaged yourself, and your indicators are only yellow and grey, that you do not need a medic to review your condition.  
 
The medic may instruct you to remove your tourniquets near the end of your treatment. They don't do this for you because a tourniquet goes into the inventory of the person who removes it.
 
=== Fractures ===
Sometimes, a limb will '''fracture'''. This is indicated by a red diagram of your bone appearing in the relevant limb. Despite how scary it looks, it isn't fatal, nor does it within of itself incur bleeding. Arm fractures mess with your ability to aim and shoot. Leg fractures reduce your speed to a snail's pace. Use a '''Splint''' on the relevant limb to address fractures. '''If you have a fracture of any kind and have no splints, this is a valid reason to call a medic'''.
-->
== Medications ==
There are 4 medications.
 
# Morphine
# Epinephrine
# Adenosine
# Atropine
 
Morphine reduces blood pressure (BP), reduces heart rate (HR), and suppresses pain. Morphine does not ''eliminate'' pain, and pain will return depending on the wound itself and the state of said wound once the morphine wears off (i.e is it bandaged, is it stitched, etc). Morphine generally wears off after 30 ''real world'' minutes. Due to morphine's affect on BP and HR, it is generally advised that {{Emdash}} unless in a firefight and it's required to engage the enemy {{Emdash}} morphine not be injected without a medic's go ahead. The morphine may cause problems with future injuries or treatments.
 
Epinephrine has a single effect, which is it increases HR. It stays in the player character for 2 ''real world'' minutes and reaches maximum effectiveness after roughly 30 ''real world'' seconds, raising the beats per minute (BPM) by upwards of 50. It is rarely used for this purpose, however, and tends to be used for it's special effect {{Emdash}} it dramatically increases the chance an unconscious player will awaken once stabilized. Because of how high it can raise BPM, however, it should be applied with caution if the unconscious individual's HR is already high.
 
Adenosine and atropine are rarely used by the Endurance Coalition, but in ACE they are regulatory medications in that they ''only'' lower HR. A HR meeting or exceed 200 BPM may result in ACE invoking cardiac arrest, and so a medic with adenosine could use it to stabilize the individual instead of using morphine which would ''also'' mess with the patient's BP.


== CPR ==
== CPR ==
A medic may occasionally ask you to assist in performing CPR. This is because a medic performing CPR is not any more or less effective than a soldier. It is more efficient for a medic to bandage, since they can do so quickly with '''Elastic Bandages''' and then immediately stitch the wound. CPR is performed by clicking the chest, clicking Advanced Medical treatment, and clicking CPR. Continue doing CPR until instructed to stop (you'll have to keep using the menu to do it over and over).  
{{Note|Checking a patient's pulse while CPR is ongoing will result in a false positive.|type=reminder}}
A medic may sometimes ask someone else to perform CPR. This is because the effectiveness of CPR is the same regardless of who does it, however, medics are faster at bandaging and can stitch wounds {{Emdash}} thus efficiency demands they bandage while a laymen perform CPR. If asked, perform CPR twice in a row, then check heart rate. If there is no heart rate, or it's weak, repeat the cycle until it reads as strong unless told otherwise by the medic. Once it's strong, you may return to the fight unless the medic requests further assistance. 
 
== Fluids ==
ACE medical has 3 fluid variants {{Emdash}} plasma, blood, and saline. They all perform the same function, being to raise blood pressure and address blood loss. The variation chosen is preferential to the mission / scenario creator.
 
== Blood loss ==
A healthy and normal blood level is 6 liters. Severity is based on how many liters of blood have been lost.
 
* 6 liters is baseline.
* 5 liters is "''Lost some blood''"
* 4 liters is "''Lost a lot of blood''"
* 3.6 liters is "''Lost a large amount of blood''"
* 3 liters is "''Lost a fatal amount of blood''"
 
Medics usually have fluids on them in variants of 250, 500, and 1000 milliliters. 1000 milliliters is 1 liter. An individual with a ''stable'' (not necessarily ''healthy'') blood level is an individual with 5 liters or more. The greater the loss of blood, the more fluids which are required to correct it.
 
The reason 3 liters is fatal is because, to stabilize, the medic would need to dispense 2000-3000 milliliters of blood into the patient {{Emdash}} this would ''catastrophically'' effect their carried supply of fluids. So much blood loss also has implications on heart rate and blood pressure, which may result in cardiac arrest, and thus a level of attention from the medic that likely cannot be spared in a war zone.
 
== Bandages ==
[[File:Bandage effectiveness reopen.PNG|thumb|548x548px|A more detailed chart than is on the cheat sheet comparing wound types against the bandages.]]
Bandages in ACE have 3 important mechanics at play. The first is their efficiency at bandaging a particular wound (e.g how many of X bandage type is needed for a Y wound type of Z size), the chance the bandage has to re-open at all, and if it ''does'' re-open, the delay between the re-opening being triggered and blood loss resuming.
 
* '''Field Dressing''' is the average joe of the bandage types. Not awesome, but not horrible.
* '''Packaging Bandages''' are more likely to re-open, ''but'' the delay before blood loss resumes ''is'' higher than a '''Field Dressing'''.
* '''Elastic Bandages''' will close any wound of any size on first application, ''but'' it's chance to re-open is ''super high'' and the delay before blood loss resumes is ''super low''.
* '''QuikClots''' take almost double or more to be consumed to cover a Y wound of Z size than the other 3 types, but it's chance to re-open is ''super low'' and the delay before blood loss resumes is ''super high''.
 
Elastics are favored by medics because the 2 major downsides {{Emdash}} the high re-open chance and low blood loss delay {{Emdash}} are ''entirely negated'' by the fact medics will stitch the wounds they close, which makes them unable to ''ever'' re-open. So, the fact they work quickly and will always fully resolve any Y wound type of Z size works tremendously to their benefit.


If you notice the medic is busy and you have been doing it for awhile, you can check the individual's pulse. If there is '''none''' or it's '''weak''', keep going. If it's '''strong''', notify the medic, cease CPR, and return to the fight.
QuikClots are favored for smaller wounds since they are more likely to fully resolve it. This is also why basic training advises using Field Dressings and Packaging Bandages on wounds of Medium+ size before falling back on them for Smalls, since ACE applies bandages in order of largest wound to smallest wound. This helps reduce wastage of bandages which may save your life or someone else's life.


== Footnotes ==
== Wounds ==
{{Reflist}}
ACE has 8 wound types.
[[Category:Arma III]]
{| class="wikitable"
!Wound
!Pain Level
!Bleed Rate
!Description
|-
|''Abrasion''
|Light
|Slow
|Skin rubbed on rough surface.
|-
|''Avulsion''
|'''High'''
|'''Fast'''
|Entire or partial external structure removed.
|-
|''Contusion (Bruise)''
|Light
|None
|Internal structure traumatized without breaking skin
|-
|''Crush''
|Light
|Slow
|Self-explanatory.
|-
|''Cut''
|Light
|<u>Proportional to wound size</u>
|Slice wound with even edges.
|-
|''Laceration''
|Light
|<u>Slow/Medium (wound size a factor)</u>
|Separating wound with ragged edges.
|-
|''Velocity''
|'''High'''
|<u>Medium (wound size a factor)</u>
|Object enters body at high speed (e.g bullet).
|-
|''Puncture''
|Light
|Slow
|Sharp object enters body (e.g knife).
|}


== References ==
== References ==
* DiscountNinja. “''The Definitive Arma 3 ACE Medical Guide''” Golden Legion. Accessed April 12, 2025. https://golden-legion.com.
* DiscountNinja. “''The Definitive Arma 3 ACE Medical Guide''” Golden Legion. Accessed April 12, 2025. https://golden-legion.com/the-definitive-arma-3-ace-medical-guide.
* NOID and FindingNima. “''ACE3 Adv Medical + Cheat Sheet''” Steam Community. Accessed April 12, 2025. https://steamcommunity.com/sharedfiles/filedetails/?id=930706887.
* NOID and FindingNima. “''ACE3 Adv Medical + Cheat Sheet''” Steam Community. Accessed April 12, 2025. https://steamcommunity.com/sharedfiles/filedetails/?id=930706887.
* Lynx. “''ACE3 Advanced Medical''” Steam Community. Accessed April 12, 2025. https://steamcommunity.com/sharedfiles/filedetails/?id=2172390846.
* Lynx. “''ACE3 Advanced Medical''” Steam Community. Accessed April 12, 2025. https://steamcommunity.com/sharedfiles/filedetails/?id=2172390846.
 
* Fleff. "13th CORPS FIELD MANUAL - BASIC TRAINING (0.1)" Endurance Coalition. Accessed April 12, 2025. [[:File:Fleff_EDC_ArmaIII_Basic_Training.pdf]]
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