ACE 3 Medical Tutorial

ACE 3 Medical Tutorial

 

This guide will cover everything from the most basic triage even the average rifleman can perform to the most advanced treatments.

We’ll start with the basics:

BANDAGING

View post on imgur.com

 

This guide here, brought to us by United Operations, shows us a few things about proper bandage usage, and a few deeper things.

First, the only two bandages you are ever likely to need are elastic and packing bandages . Elastic is good at treating any sort of wound with the exception of velocity and avulsion wounds. Those you will treat with packing bandages. Be weary that if you treat a wound incorrectly, you’ll have a significantly higher chance of it re-opening. Also, once a wound is treated, that’s it- until it re-opens, or is fully treated, a wound cannot be “topped-off” with another bandage to increase it’s effectiveness. Bandages cannot be stacked.

You won’t ever really need QuikClot or field dressings- as the former simply isn’t specialized enough to be good at treating any one wound and the second is totally useless (unless you want to give these out to players in your gearscript to torture them).

Tourniquets aren’t technically a bandage. I used to never bring these along as they seemed only good for trolling other players (if they are on for too long they can cause a patient pain and eventually death) but after a while I noticed that applying these to limbs with a great deal of wounds increased the patient’s chances of surviving a bleed-out as they will reduce blood flow. A good time to apply one would be a situation like this:

View post on imgur.com

Lastly, you should always prioritize wounds in the order of size and type. I know I’m certainly guilty of the practice, but sewing up a small cut on a player’s face isn’t going to do much good if they have a large avulsion on their chest. Even if you suspect a player to be badly wounded, it’s good practice to check around their entire body, limb by limb, to see which areas need treatment first.

From fastest bleed rate to slowest:

Avulsion
Velocity Wound
Cuts, scrapes, tears (mostly equal bleed rate)
Bruises do not bleed and cannot be treated except with a PAK

Of course, size matters too. A large velocity wound is obviously more important than a small avulsion.

DRUGS

Morphine is an instant-acting pain reliever. Because untreated pain can lead to unconsciousness, you’ll be using morphine very frequently in the field. However, you’ll want to be careful. Morphine is a depressant- it can lower the heart rate very quickly, to the point of putting the player in a lethal coma if too many doses are administered. Your heart-rate will fall about 30-40 beats per use of morphine.

How do I know if it’s safe?

If you don’t have a combat medic on standby, you should first check your heart rate. Self interact; access one of your arms or your head, and “check pulse”.You will most likely find a “normal heart rate”. In ArmA, your “normal heart rate”, when starting off,  is 80. If you take a shot of morphine, it’ll often fall to around 40 beats per minute. This is safe, however you’ll hear your heart pounding loudly in your ears. This happens when your pulse falls below 60 BPM. If you take another shot of morphine while you can hear your own heart beating slowly, you will eventually pass out into a drug-induced coma at around 20 BPM, and your heart will eventually fail if one of your buddies does not perform CPR on you and restart your heart. More on that later. To sum up- you start at 80 BPM, with each shot of morphine your heart will fall about 40 BPM. You go into a coma at 20 and eventually die.

How can I fix a low pulse?

Epinephrine

If you want to fix a low BPM or prevent it from occurring, you’ll either want to contact a combat medic or find some epinephrine, a drug that raises your heart rate and blood pressure.

When giving yourself morphine, you’ll want to then immediately inject yourself with an epi pen. If you do it right, you won’t hear your heart beat. Epinephrine raises your rate by about 20-40 BPM depending on when it was injected and other factors. If used in tandem to fix pain, you will have a BPM of anywhere from 60-100: out of the danger zone. To sum up- give morphine, then epi right afterwards to keep them healthy.

Epinephrine is also good to help a patient re-gain blood; because it raises the blood pressure, a shot used in tandem with saline or a blood bag will speed up the pace at which the heart pumps new blood into the body and replaces what was lost. But be cautious- giving a patient too much epinephrine (2+ doses at once) can give a patient a literal heart attack. Which is where atropine comes in.

Atropine will lower a patient’s HR just like morphine but does not come with morphine’s nasty side effects (higher chance of death). If a patient has a BPM above 140 from an epi overdose, I would recommend a single shot of atropine to counter. This prevents them from going into cardiac arrest, which occurs at 190 BPM. You’ll know you’re near the point of cardiac arrest when your heart begins to pound in your ears, but it’s a very fast pulse.

Another note- heart rate is only raised or lowered by a few things- drugs, getting shot, or inactivity. Physical activity does not raise one’s heart rate significantly at this point.

Lastly, all drugs can only be given in limbs (legs, arms).

BLOOD, PLASMA, SALINE

Saline is by far the most common liquid treatment, used on patients who have lost a significant quantity of blood. Saline doesn’t need to be refrigerated, so it can be carried by infantry medics anywhere.

Saline works by filling up the space that lost blood used to occupy until the heart can pump enough blood to naturally re-occupy that space. That’s it. It’s a temporary blood replacement, used when a patient has “lost a lot of blood”. To treat a patient who has lost a lot of blood, you’ll want to give them a small saline solution and then add more until they have a natural blood pressure and are healthy. Be aware that it only works for so long; it’s a replacement, but only temporary. You can permanently fix a player by giving him Blood

Blood

Blood bags can’t be carried around as they spoil if they aren’t refrigerated, meaning placed in a vehicle or crate inventory, so most medics carry saline. But blood does a better job if you can get your hands on it; it’s a permanent solution. Rather than just filling up a space, it actually “holds” and eventually you will no longer see the “player has lost a lot of blood” pop-up. As with saline, you’ll slowly want to add more and more until the problem is fixed- rather than just give everyone a full liter of blood.

You can tell how bad a player’s blood situation is by checking their blood pressure. Normally, it’s 120/80- once it falls below 70/50, the player falls unconscious until they are given a liquid treatment such as blood. A player dies at 0/0.

I would give a patient 45/30 blood pressure: 4 liters

65/40: 3 liters

85/50: 2 liters

100/60: 1 liter

105-110/70 :500/250 ml

PLASMA

Even after all of this time I am still not certain why plasma was added. It has the same downside as blood yet seems to work the exact same way. Just use blood in vehicles/bases and saline on your person.

Other treatments:

CPR: Used to bring a player back from 0 heart rate. This may need to be done more than once- the record is eleven times. To do this, you must access a downed player’s torso. Player’s BPM will be around 25 if you do it successfully.

Surgical Kit

This will prevent any closed wounds on the player from re-opening.

Personal Aid Kit

Completely fixes any player, no matter how badly injured. Unless they’re dead. Should really only be used for badly injured players or those whose legs have been broken.

To sum up, here’s what you should do if you have a patient who is bleeding, in pain, lost a lot of blood and badly injured:

Bandage, prioritizing wound sizes and types, check pulse, give epi if it is too low, then give morphine, administer saline or blood depending on how bad their BP is, then give PAK to fully heal them.

This will continue to be updated in the coming hours, please feel free to correct any errors.