User:Sirdog/Advanced medical concepts: Difference between revisions

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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'''. Use of medications in the real world require consultation with a licensed medical professional. Terminology and real world labels are used for immersion ''only''. 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.]]

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 basic training provided by the Endurance Coaltion goes over '''[https://steamcommunity.com/workshop/filedetails/?id=463939057 ACE]'''medical briefly so that players understand what it is and how to navigate it. This page will go into more depth. In particular, this page will:

<!--== Can you stay in the fight? ==

~~# Give a basic rule of thumb on how to assess if a riflemen can stay in the fight.~~

~~# Go over the difference between the various medications.~~

~~# Go over CPR.~~

~~# Go over the difference between the various fluids.~~

~~# How to ascertain based on the blood loss indicator how much fluid to give.~~

== 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=}}

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You can keep fighting.

~~If you ''are'' bleeding and you see any~~ limb ~~is yellow, orange, or red, apply a tourniquet to all relevant limbs. If~~ not ~~possible (i.e you don't~~ have ~~enough tourniquets or the bleeding is from a chest or head wound), tourniquet what you can, then apply bandages on limbs ''without~~ a tourniquet'' to get bleeding to stop. Use '''Field Dressing''' or '''Basic Bandages''' for large wounds (Medium+) and use '''QuickClot''' for everything else. ACE will apply bandages to wounds in order from largest to smallest. In other words, if you have a mix of wounds from Large to Small, use the first 2 bandage types, then, when only small ones are left, switch to '''QuickClot'''.

{{Note|Morphine must be injected into a limb that does not have a tourniquet.|type=reminder}}

If you ~~get~~ bleeding to ~~stop~~, look at the checklist ~~above~~ again and, if you meet all criteria, return to the fight.

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'''.

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

However, if:

# You see a ''lot'' of wounds in your chest or head (indicated by the limb being orange or red); or

# 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.

~~'''~~Call a medic.~~'''~~

Call a medic.

After the firefight has ended, you should bandage ''all wounds'' with the end goal of removing your tourniquets, and '''~~then call for~~ a medic'''. Tourniquets ~~will~~ 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.

=== 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.

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=== 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.

~~=== Pain ===~~

# Morphine

{{~~Note|Morphine must~~ be injected ~~into~~ a ~~limb that does not have a tourniquet~~.~~|type=reminder}}~~

# 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.

~~In most cases all soldiers get morphine autoinjectors as part~~ of ~~their basic kit~~. ~~Morphine will eliminate pain~~, ~~but it messes with your heart rate and blood pressure~~, and it ~~stays in your system for a long time~~. ~~This may complicate your treatment or health in future engagements. If you are not careful~~ with ~~morphine, you can give yourself a heart attack~~.

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.

~~Only~~ use morphine ~~without a medic~~'s ~~permission if you are actively engaging an enemy and pain is making you combat ineffective~~.

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 ==

{{Note|Checking a patient's pulse while CPR is ongoing will result in a false positive.|type=reminder}}

A medic may ask ~~you~~ to perform CPR. This is because ~~a medic performing~~ CPR is ~~not any more or less effective than a soldier. Medics ''~~are~~'' better than a soldier~~ at bandaging and ~~closing~~ wounds~~, so the goal is for~~ a ~~soldier to~~ CPR ~~while the medic bandages~~. CPR is ~~performed~~ by ~~opening~~ the medical ~~menu using~~ {{~~Key press|H~~}} ~~while looking at the patient~~, ~~clicking the patient's chest~~, ~~clicking~~ the ~~square icon with the zig-zag lines~~, and ~~then clicking CPR~~.

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.

~~Do so twice~~ in a ~~row~~, ~~then check~~ heart rate. ~~If there~~ is ~~none~~, 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~~.

== Blood loss ==

~~[[Category:Arma III]]~~

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.

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.

== Wounds ==

ACE has 8 wound types.

{| 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

|Proportional to wound size

|Slice wound with even edges.

|-

|''Laceration''

|Light

|Slow/Medium (wound size a factor)

|Separating wound with ragged edges.

|-

|''Velocity''

|'''High'''

|Medium (wound size a factor)

|Object enters body at high speed (e.g bullet).

|-

|''Puncture''

|Light

|Slow

|Sharp object enters body (e.g knife).

|}

== References ==

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* 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]]

~~__NOTOC__~~

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-{{Construction}}
+{{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.]]
+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 basic training provided by the Endurance Coaltion goes over '''[https://steamcommunity.com/workshop/filedetails/?id=463939057 ACE]'''medical briefly so that players understand what it is and how to navigate it. This page will go into more depth. In particular, this page will:
+<!--== Can you stay in the fight? ==
-# Give a basic rule of thumb on how to assess if a riflemen can stay in the fight.
-# Go over the difference between the various medications.
-# Go over CPR.
-# Go over the difference between the various fluids.
-# How to ascertain based on the blood loss indicator how much fluid to give.
-== 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=}}
@@ Line 19: / Line 12: @@
 You can keep fighting.
-If you ''are'' bleeding and you see any limb is yellow, orange, or red, apply a tourniquet to all relevant limbs. If not possible (i.e you don't have enough tourniquets or the bleeding is from a chest or head wound), tourniquet what you can, then apply bandages on limbs ''without a tourniquet'' to get bleeding to stop. Use '''Field Dressing''' or '''Basic Bandages''' for large wounds (Medium+) and use '''QuickClot''' for everything else. ACE will apply bandages to wounds in order from largest to smallest. In other words, if you have a mix of wounds from Large to Small, use the first 2 bandage types, then, when only small ones are left, switch to '''QuickClot'''.
+{{Note|Morphine must be injected into a limb that does not have a tourniquet.|type=reminder}}
-If you get bleeding to stop, look at the checklist above again and, if you meet all criteria, return to the fight.
+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'''.
+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 bleeding stops, look at the above checklist again and, if you meet all criteria, return to the fight.
 However, if:
-# You see a ''lot'' of wounds in your chest or head (indicated by the limb being orange or red); or
+# 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.
-'''Call a medic.'''
+Call a medic.
-After the firefight has ended, you should bandage ''all wounds'' with the end goal of removing your tourniquets, and '''then call for a medic'''. Tourniquets will 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.
+=== 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.
@@ Line 38: / Line 36: @@
 === 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.
-=== Pain ===
+# Morphine
-{{Note|Morphine must be injected into a limb that does not have a tourniquet.|type=reminder}}
+# 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.
-In most cases all soldiers get morphine autoinjectors as part of their basic kit. Morphine will eliminate pain, but it messes with your heart rate and blood pressure, and it stays in your system for a long time. This may complicate your treatment or health in future engagements. If you are not careful with morphine, you can give yourself a heart attack.
+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.
-Only use morphine without a medic's permission if you are actively engaging an enemy and pain is making you combat ineffective.
+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 ==
 {{Note|Checking a patient's pulse while CPR is ongoing will result in a false positive.|type=reminder}}
-A medic may ask you to perform CPR. This is because a medic performing CPR is not any more or less effective than a soldier. Medics ''are'' better than a soldier at bandaging and closing wounds, so the goal is for a soldier to CPR while the medic bandages. CPR is performed by opening the medical menu using {{Key press|H}} while looking at the patient, clicking the patient's chest, clicking the square icon with the zig-zag lines, and then clicking CPR.
+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.
-Do so twice in a row, then check heart rate. If there is none, 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.
+== Blood loss ==
-[[Category:Arma III]]
+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.
+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.
+== Wounds ==
+ACE has 8 wound types.
+{| 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 ==
@@ Line 58: / Line 138: @@
 * 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]]
-__NOTOC__