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Advanced Combat Medicine

Advanced Combat Medicine is an expansion of ACE Medical, introducing many missing considerations for casualty care during ops.

ACM is designed for:

• Players seeking a realistic and challenging medical system within Arma with a focus on pre-hospital care, prioritizing authenticity whilst keeping it managable and engaging.
  
• Units that want to include realistic medical care as part of their ops, treating casualties in-field according to unit designated levels of medical care or via MEDEVAC according to settings, defining which injuries render casualties combat-ineffective until they reach a higher level of care.

Hosting a wide range of medical equipment, treatments, and medications, each one has a use, side-effects and contraindications, medics are required to keep track of their patient vitals and think about their treatments to provide the best chances of survival.

Additionally ACM includes several QOL improvements for ACE mechanics related to medical as well as zeus modules and mission scripts for testing and training.




- New Items:

• Pressure Bandage
  
• Emergency Trauma Dressing
  
• Elastic Wrap

- Airway management
- Airway collapse and obstruction
- Manual Maneuvers:

• Head-Tilt-Chin-Lift
  
• Head Turning
  
• Recovery Position

- Airway Adjuncts:

• Guedel Tube
  
• NPA
  
• i-Gel

- Breathing ability affected by airway compromise




- Breathing simulation
- Oxygen Saturation - Affected by respiration rate, blood volume, airway, chest injuries, cardiac output
- Respiration Rate - Reaction in response to oxygen deprivation and medication
- Chest Injuries:

• Pneumothorax
  
• Tension Pneumothorax
  
• Hemothorax

- Breathing, blood pressure and heart rate affected by injury severity
- Chest Injury Diagnosis:

• Inspect Chest
  
• Stethoscope

- Chest Injury Management:

• Chest Seal
  
• Needle Chest Decompression
  
• Thoracostomy (+ Chest Tube)

- Pulse Oximeter:

• Measure Pulse Rate
  
• Measure SpO2

- Bag-Valve-Mask
- Pocket BVM
- Portable Oxygen Tanks




- Cardiac Arrest:

• Shockable Rhythms (Ventricular Tachycardia, Ventricular Fibrillation)
  
• Non-Shockable Rhythms (Asystole, PEA)

- CPR changes:

• Continuous action
  
• Requires consistency to be effective

- Reversible Cardiac Arrest:

• Tension Hemo/Pneumothorax
  
• Hypoxia
  
• Hypovolemia

- Automated External Defibrillator (and Monitor):

• Defibrillation for shockable rhythms
  
• Display EKG
  
• Display SpO2 waveform (+ pulse rate)
  
• Display EtCO2 waveform (+ respiration rate)
  
• Measure NIBP
  
• AED mode (audio)

- Fluid Resuscitation:

• IV/IO access, with differing flow rates (14g IV/16g IV/FAST1 IO/EZ-IO)
  
• Flow rate dependant on fluid administered
  
• Effective Blood Volume (Red Blood Cell Count)
  
• Platelets given dependant on fluid

- Field Blood Transfusion

• Blood type of donor tracked
  
• Loss of effectiveness on delay from donation to transfusion

- Fluid Overload from fluid transfusions
- Internal Bleeding
- Blood Types (SteamID) - Either based on blood type ratios or manually set for each player
- Check Pulse changes:

• Active action
  
• No longer reads exact pulse rate

- Check Blood Pressure changes

• Capillary Refill Time
  
• Manual blood pressure checking via pressure cuff and stethoscope

- Coagulation (Platelets):

• Slows bleeding
  
• Clotting of small and medium wounds
  
• Slowing and clotting internal bleeding
  
• Lowers chance of wounds/bandages reopening

- Medication:

• Epinephrine (IV/IM)
  
• Morphine (IV/IM)
  
• Fentanyl (IV/IM)
  
• Ketamine (IV/IM)
  
• Adenosine (IV)
  
• Amiodarone (IV)
  
• TXA (IV)
  
• Naloxone (IN)
  
• Penthrox (Inhale)
  
• Paracetamol (PO)
  
• Lidocaine (IV/IM)
  
• Ondansetron (IV/IM)
  
• Calcium Chloride (IV)
  
• Esmolol (IV)
  
• Ertapenem (IV/IM)

- Medication Administration:

• Dosing of medication, based on patient weight or desired effect
  
• Use of 1ml, 3ml, 5ml, and 10ml syringes
  
• Allow pre-drawing medication
  
• Differing effects of IV and IM medication

- SAM Splint
- Universal Splint (ACE)
- Actions for waking up patients:

• Shaking
  
• Slapping
  
• Ammonia Inhalant

- Tourniquet Effects - Limited limb effectiveness depending on tourniquet application time




- New system for reinforcement of player casualties
- Enables conversion of player casualties into AI ones, making it so infantry players spend less time unconscious while allowing medics can take their time with their casualties
- Medics decide when to convert casualties, based on injury or unit SOP
- Made to be used with respawn tickets, to encourage proper MEDEVAC, playable without
- Requires some setup, check the documentation[docs.google.com]




- Extra actions for patient treatment in vehicles
- Variable patient resting vitals (SteamID)
- Accurate CPR rate (100-120)
- More accurate blood pressure and heart rate vitals
- Tourniquet times marked in medical menu
- Zeus modules for testing
- Testing scenario
- Spawnable boxes with medical equipment (Zeus)
- Visuals for oxygen deprivation
- Changes for ACE instant death
- Extra treatment log entries for certain ACE actions
- Casualty movement:

• Carry and load patients directly into vehicle
  
• Unload and carry patient directly from vehicle
  
• Assist Carry action to speed up pick-up animation

Polish Translation - Thanks Kowalski!
German Translation - Thanks Dane!

All translations are done by community members, if you'd like to submit your own let me know on the discord.[discord.gg]



To help with learning/testing, ACM comes with a training scenario with a casualty spawner and all relevant equipment, accessible from the main menu. Also available as a workshop item here.

Written documentation available here: ACM Documentation [docs.google.com]

[discord.gg]