ACE3 Adv Medical + Cheat Sheet

A complete practical guide to ACE 3 Advanced Medical

Introduction

The ACE 3 advanced medical system is a medical system which introduces a more realistic and immersive model for injuries and treatments, this results in a more prominent role for combat medics and gives players a bigger incentive to play as a team.

Advanced medical introduces the following:

• A detailed wound system including fractures
  
• Accurate blood loss based upon sustained injuries
  
• Vitals simulation, including heart rate and blood pressure
  
• Cardiac arrest events
  
• Various modular treatment methods such as CPR, IVs, drugs, tourniquet, bandages, splints

Cheat Sheet

I found this cheat sheet made a while ago by Pte Laird, all credits go to him.

This is a quick one stop cheat sheet to the 90% of the advanced medical system.

General patient treatment procedure

Identifying a Patient

As a medic you will have to identify who needs your direct assistance. The following are ways in which you can be alerted to a patient in need...

• The patient calls for help
  
• A bystander calls that a patient requires help
  
• Your mission objective is to treat a patient
  
• You personally see or hear a soldier become injured

All of these can be done on or off the radio, respond in the same means you were contacted.
Once you have identified that a patient requires your help do the following...

• Ask for the location of the patient
  
• Ask for the type of injury the patient has received

If you personally identified the patient just ask those question yourself.

Moving to the Patient

• Can you move to the patient safely?
  
• Can the patient move to you safely?
  
• What can you do to make it safe?
  
• If you are not able to move to the patient or he is not able to move to you try find a solution around the problem (smoke screen and move to cover). If you still can’t find a solution contact your direct commander (SL or PTL)

Treating a Patient

The Following is a step by step guide on treating a patient, you will need understand every part of this guide. After the step by step guide there is more info on how exactly to treat each type of wound.

Follow the steps from 1 to 6 in order unless stated otherwise.
Keeping the patient’s vitals stable is your first priority.
If advanced wounds are enabled make sure from time to time that they didn’t reopen.


Step 1: Is the patient responsive?

Yes: Ask him if he has wounds / he is in pain and act accordingly.
No: Go to step 2.


Step 2: Does the patient have a pulse?

Yes: Go to step 3.
No: If you are alone provide CPR, if you have someone else get them to do CPR while you treat the patient’s wounds. Once stabilized it it important to get a PAK to the patient as soon as possible, this is the only device that will revive the patient. Go to step 6.


Step 3: Is the patient wounded?

Yes: Treat the wounds apply tourniquet to wounded limb and the treat the limb. Take off the tourniquet as soon as you have stabilized that limb. If fractured, do not worry about splints just yet.
No: Skip this step.


Step 4: Did the patient lose a lot of blood?

Yes: Use IVs to restore the volume of liquid in the bloodstream of the patient.
No: Skip this step.


Step 5: Is the patient in pain?

Yes: and stable pulse: Give him morphine.
Yes: and unstable heart rate: Stabilize the heart rate before administering morphine.
No: You’re done.


Step 6: is the patient awake now?

Yes: You’re done. If the patient has fractures, now is the time to apply splints.
No: Stabilize his pulse / make sure he isn’t in pain or missing blood. If stable and no pain, attempt one shot of epinephrine. Otherwise continue to monitor patient and try another shot of epinephrine in 5 minutes.

Why CPR is important and how to revive

ACE 3 Medical system is setup so that if a patient does not have a pulse you must start CPR right away. As soon as the patient's pulse stops, a timer will start. When this timer runs out, the patient will die. CPR will increase the amount of time a patient has before they die. To revive someone from this state (cardiac arrest) you will have to have one person maintaining CPR (a bystander) and you (the medic) will have to stabilise their wounds. Once stable apply a Personal Aid Kit (PAK) to the patient and they will become conscious. Then continue treating the patient (blood pressure/heart rate/pain).
If alone continue CPR until help arrives.

Depending on your mission settings players may die instantly due to high velocity or large calibre shots to the chest or head. Often this is characterised by an instant ragdoll and lack of an unconscious animation. These patients will not be able to be revived no matter what you try. Please consult your mission parameters to find out if this is the case for you.

Wounds, bandages and medications

Abrasions (or scrapes)
They occur when the skin is rubbed away by friction against another rough surface (e.g. rope burns and skinned knees).
Sources: falling, vehicle crashes.
Effects: pain - extremely light, bleeding - extremely slowly.

Avulsions
Occur when an entire structure or part of it is forcibly pulled away, such as the loss of a permanent tooth or an ear lobe. Explosions, gunshots, and animal bites may cause avulsions.
Sources: explosions, vehicle crashes, grenades, artillery shells, bullets, backblast.
Effects: pain - extremely high, bleeding - extremely fast (depends on wound size).

Contusions
Also called bruises, these are the result of a forceful trauma that injures an internal structure without breaking the skin. Blows to the chest, abdomen, or head with a blunt instrument (e.g. a football or a fist) can cause contusions.
Sources: bullets, backblast, vehicle crashes, falling.
Effects: pain - light, no bleeding.

Crush wounds (crushed tissue)
Occur when a heavy object falls onto a person, splitting the skin and shattering or tearing underlying structures.
Sources: falling, vehicle crashes.
Effects: pain - light, bleeding - extremely slowly.

Cut wounds
Slicing wounds made with a sharp instrument, leaving even edges. They may be as minimal as a paper cut or as significant as a surgical incision.
Sources: vehicle crashes, grenades, explosions, artillery shells, backblast.
Effects: pain - light, bleeding - speed depends on length and size of the wound.

Lacerations (tears)
these are separating wounds that produce ragged edges. They are produced by a tremendous force against the body, either from an internal source or from an external source like a punch.
Sources: vehicle crashes.
Effects: pain - light, bleeding - slow to medium speed (depends on wound size).

Velocity wounds
They are caused by an object entering the body at a high speed, typically a bullet or small pieces of shrapnel.
Sources: bullets, grenades, explosions, artillery shells.
Effects: pain - extremely high, bleeding - medium speed (depends on wound size).

Puncture wounds
Deep, narrow wounds produced by sharp objects such as nails, knives, and broken glass.
Sources: shrapnel, grenades.
Effects: pain - light, bleeding - slowly.

Fractures
Limbs can now be fractured. Velocity wounds, Avulsions and crush wounds usually occur at the same time. Fractures cause pain, increased weapon sway (when arms) or inability to jog or run forcing the player into a limp (when legs). Fractures in ACE3 are themselves not fatal. So are far lower on the priority list in regards to treatment. Focus on stabilizing the patient first, then once stable, apply a splint to their fractured limb/s.

In order to stop the bleeding, all bleeding injuries on every body part requires treatment. This is done by either applying a tourniquet to legs or arms as a temporary solution, or by using bandages to stop the bleeding as a more permanent fix.
Bandage Effectiveness


Most of the time in combat you will have velocity, avulsions and puncture wounds. All of these are best treated with elastic bandages and quick clot.

Tourniquet
Can only be applied on limbs.
Stops bleeding from wounds.
Autoinjectors will not take effect on the patient if injected into a tourniqueted limb.
Should be taken off as fast as possible and applied only to give medic time to bandage all the wounds.
If not taken off for a while it will cause pain to the patient.

IVs

All IV's (Saline, Plasma and Blood) restore the volume of liquid in the blood stream, as a result blood pressure is raised for all of them.

Use the appropriate amount depending on the situation (heavy loss of blood, blood pressure too low) (250, 500 or 1 000 mL low, medium and heavy blood loss respectively).
Remember IVs take time to have effect. 1000ml should be enough to treat someone with heavy blood loss. Just wait and monitor their blood pressure.

Autoinjectors


Note: Morphine stays much longer in the system compared to other medications.
IRL Antrophine would increase heart rate.

Surgical kit

Is only useful when advanced wounds (reopening) is enabled.
Stitch a wound to stop it from reopening.
Can be used anywhere.
It can only be used by a medic.
Patient must be stabilized before it can be used.
Will not be removed on use.

PAK

Used to fully heal someone. (Removes any injury, restore vitals to a stable state and reset the medical history, clears all medication in the system.)
It’s can only be used by a medic.
Can be used anywhere.
Patient must be stabilized before it can be used.
Will be removed on use.

Blood pressure

NOTE:the systolic blood pressure is the number on the left, the diastolic blood pressure is the number on the right.
Blood pressure is affected by the amount of blood lost as well as IVs and medication.
If your patients blood pressure is within 20 of the default 120/80 start to provide blood or medication eg. 100/60 (low) you would fix, 160/100 (High) you would fix.

Non existent: 0/0
Low: 100/60 and under.
Normal: 120/80.
High: 160/100 and over.





Heart rate

The heart rate (pulse) is affected by the amount of blood lost and medications.
If your patients heart rate 20 over or under the default (80) you must treat them.
eg. Pulse is 60 provide epinephrine.
Low: 60 and below
Normal: 80
High: 100 and above


Cardiac arrest

A patient will enter cardiac arrest when:
The heart rate is below 20.
The heart rate is above 200.
The systolic blood pressure is above 260.
The diastolic blood pressure is below 40 and the heart rate is above 190.
The systolic blood pressure is above 145 and the heart rate is above 150.

Additional information

• As an infantryman you can use a tourniquet to stop a limb's wound from bleeding, note that this is supposed to be a temporary solution and leaving the tourniquet more than 5 minutes will induce pain.
  
  
• Pain is only suppressed and not removed by default.
  
  
• You don’t have to take epinephrine after you take morphine, just wait until your pulse stabilizes by itself (Provided that you are in a stable condition).
  
  
• Bandages reopen, if your patient has multiple bandaged wounds consider stiching with the surgical kit. This takes some time but will save you more time and resources than rebandaging.

Once treated

Once the casualty has been successfully been treated let them know that they are good to jump back into the fight. If you have not stitched the patient make sure you check up on them from time to time to make sure nothing has reopened and that blood pressure and pulse have remained stable.

If your casualty requires more help than you can immediately provide and you are overwhelmed, continue aid and contact your SL to arrange a CASEVAC.

If your casualty dies under your care or before you are able to reach them (they have no pulse and are not in a revivable state) contact you SL and notify him of the casualty.

Gear and loadouts

Note that this is personal preference and the mission type should be considered when selecting your gear.

20 × Bandage (Elastic)
10 × Packing Bandage
20 × Basic Field Dressing (QuikClot)
2 × Atropine Autoinjector (Optional)
2 × adenosine Autoinjector (Optional)
10 × Morphine Autoinjector
10 × Epinephrine Autoinjector
5 × Tourniquet (CAT)
4 × Saline IV (250ml)
3 × Saline IV (500ml)
2 × Saline IV (1000ml)
3 x Splint
1 × Surgical Kit
5 × Personal Aid Kit (Check the medical settings for this)

Conclusion

Mindset
As a medic your priority is to prevent members from sustaining injuries and to treat injuries once they have been sustained. To do this you need to stay fit and alive. This mean if you don't have to divert your attention from being a medic, you don’t (becoming engrossed in firing at a single low threat target).

You should not carry too much. This causes you to become fatigued and unable to react quickly to a casualty. And position yourself in the safest place possible at all times. If you go down as a medic you and your unit will be FUBAR.

Medics play an extremely vital role. Without a medic who understands the system, the mission is doomed.

The ACE 3 Medical system wiki, along with keybinds and module settings can be found here[ace3.acemod.org].

As a mod, many values are subject to change. The wiki is where these changes will be updated so its best to check it after an update

[Dawofnia]

thank you, this was very helpful. What about biofoam? That's available in the server I play on and am not sure if its better than elastic bandage/what it does lol

[pie]

i dont use ace medical

[juno]

i dont use ace medical

[NOID]

@Twinkerbell those items are not simulated in ACE3 Medical.
@recon2e Thank you!

Remember that this is a mod and some items may have changed from what is described in this guide.
All up to date information is listed here.
https://ace3.acemod.org/wiki/feature/medical-system

[recon2e]

This is really good thank you

[Pop Goes My Pussy]

what about the surgical tools like bone plates, retractors, and clamps??

[Adams]

@NOID thank you

[NOID]

@Adams, this is all set in your mod settings/mission settings. Check those.

[Adams]

Hello I'm wondering if the PAK might be disabled by default and has to be enabled in order for use as even if I stabilize the patient I cannot no matter what or whatever condition the person I'm treating is in, I cannot for whatever reason use the PAK on them or myself.

[NOID]

@NateTheGamingNinja cheers! Updated now