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Posted: Fri May 29, 2015 7:50 pm     Super secret spam barrier
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ACE Medical Explained


ACE3 introduces a new medical system. While it's heavily influenced by @agm and @cse it is very different from both of them.
There are three major levels of complexity: 
  • "basic" - close to agm. Morphine makes pain go away, epi wakes you up.
  • "advanced" - adds heart rate and blood pressure
  • "advanced with advanced wounds" - adds wound re-opening and makes it so only the right type of bandage will effectively stop a wound
"basic": most like @agm however it lacks the ability to set a time penalty for non-medics which is why we can't replicate the exact settings we used with @agm :( 

"advanced": before we start
  1. Ignore the documentation on the ace3 wiki. It's incomplete and, in some cases, even wrong.
  2. All the information here comes straight from the source code of v3.0.1 of @ace3.
  3. I might still get a few things wrong and I sometimes won't bother to give exact numbers
With that out of the way, let's get started:

People have three main vitals: blood pressure, heart-rate (pulse) and pain. There is a fourth variable viscosity which measures how thin your blood is.The game allows you to check heart-rate and blood-pressure. You can see if somebody is in pain on the triage card on the left hand side of the screen.

If your vitals are 'bad' you will go unconscious and if they are really bad you'll additionally enter cardiac arrest.

There are three ways to die (in order of likelihood)
  • instant death from massive damage [we disable that on our servers]
  • being in cardiac arrest for too long (too long can be anything from 2min to 5min, ace loves randomization)
  • bleeding out entirely (not a timer, literally means you have no blood left in your body. You'll usually die of cardiac arrest before you get here)
Keeping somebody alive and concious require keeping their blood-pressure and heart-rate in the "normal" range.
This is roughly 50-150bpm (aim towards 80) for the heart-rate and 50/30-150/90 for blood-pressure.

To manipulate a person's vitals you have the following four tools: 
  • morphine  - reduces pain, but lowers heart-rate and viscosity (makes blood thinner => bleeding is quicker)
  • epinephrine - increases heart-rate
  • atrophine - normally reduces heart-rate but if the heart-rate is below 45bpm it will actually increase it
  • IV bags - all of them will increase blood pressure. Saline will thin the blood, Plasma will thicken it, Blood doesn't change viscosity.
    !!! blood and plasma bags will decay/perish if carried around with you for too long. Keep them pretend-refrigerated inside a vehicle/ammocrate.
    All injectors take around 30-45seconds to start showing effects after injection. IV's will slowly run in the background (see triage card)
When somebody gets hit and passes out, you need to do the following things

  • Check pulse 
    no pulse -> cardiac arrest -> start performing CPR (torso option) immediately. Ideally have somebody else do this so that you can continue to treat.
  • Check for and stop bleeding (it will say "Bleeding" in the left-hand side triage card UI if somebody is bleeding. They usually will be ;)
    -> Find the injuries (red crosses on body parts).
    -> For bleeding extremities, apply tourniquets to temporarily stop/reduce the bleeding.
    -> Treat head/torso injuries first (with potential injured extremities tourniquet'ed)
    -> Keep the tourniquet on while bandaging extremities, remove it once all injuries on the extremity are bandaged
  • Re-check pulse and check blood pressure
    no pulse -> same as before, get on that CPR
  • Get the vitals into a normal range:
    Atropine to reduce heart-rates. Epinephrine to increase heart-rate.
    Remember that any increase/decrease in heart-rate will increase/decrease blood-pressure, too!
    If blood pressure is low, you probably want to give an IV. Blood is obviously ideal but usually not available.
    Use saline when in the field but remember it thins the blood. If possible counter-act this by later giving plasma (e.g. once MERT arrives with blood/plasma)
  • Check pain
    If they are in pain, give them morphine
    Remember, morphine lowers heart-rate/blood-pressure and thins the blood! Have enough 'spare room' with the pulse and make sure all bleeding is stopped!
  • Re-check their vitals every 10 seconds for 30-45 seconds
    Because morphine influences their vitals you might have accidentally made them worse-off in your attempt to relieve pain ;)
  • You are done
    The patient should have woken up at some point during this process. They might also (very likely) have come to and passed out several times. That's perfectly fine just tell them to hold still and keep calm.


For those that want some more specific information I'm adding some more technical stuff in the spoiler
Spoiler
"advanced wounds": Same as advanced but bandage and wound types have to be matched in order to be effective. Bandaged wounds can also re-open unless properly stitched up with a "surgical kit".You can look up the bandage type <-> wound type mapping here: http://ace3mod.com/wiki/feature/medical-system.html#3.1.5-bandage-types.


Unlocked so discussion about functionalities and such can be had here. No opinions/preferences please! Posts will be moved/deleted!

Feedback about the medical system testing (opinions!) is still posted Private Discussion->ACE 3 FEEDBACK.


Last edited by Alexander on Sat May 30, 2015 11:55 am, edited 4 times in total.

Posted: Sat May 30, 2015 10:51 am     Super secret spam barrier
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There seems to be a lot of confusion over what the actual settings/realities on the server ('LITE' mission) are. Things with * are changeable, others are simply how the (basic) system works

  • * basic medical system
  • * only medics can use epi [we can only change this by disabling the medic/non-medic separation]
  • all bandages work equally well in basic model, healing 0.8 damage. (Damage is per body part, 0 = no damage, 1 = total damage)
  • morphine removes 0.4 'pain' (again 0-1 range). There is no overdosing system available in ace3 basic
  • if you have low blood, you pass out
  • if you have high pain, you pass out
  • if totally fixed up you will eventually wake up.[no more options to influence that, though]
  • if you have no blood, you die [i.e. there's no "down timer" like there was in agm]
  • you can 'diagnose' people (head interaction) and get the usual concious/bleeding/pain info
  • Surgical Kits (and, iirc, tourniquets) don't do anything in basic mode
  • Personal Aid Kits (PAKs) are easy-mode items that do the same job as bandage/morphine/epi, just in a single action
  • * PAKs are consumed upon use [alternative: they stay after being used, like e.g. the big medikit in vanilla]
  • * PAKs can only be used by medics [alternatives: everybody, or only 'doctors' (i.e. only certain medics)]
  • * PAKs can only be used in medical facilities/vehicles (afaik, need to check mission) [alternatives: everywhere/just in facilities/just in vehicles]
With the basic system there aren't really many options. There are only two ways to separate medics from non-medics: epi usage and/or magical-PAK usage.
The option that we really want (non-medics being slower) simply doesn't exist. This means that, with basic medical, medics are either incredibly critical (because only they can epi) or pretty much pointless (because everybody can quickly bandage, morphine and epi)


Posted: Sat May 30, 2015 11:04 am     Super secret spam barrier
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clyde (in a different thread) wrote:
[....] set so medics are the only ones that can fully heal you.
What do you mean by "fully heal"? People keep using that term "fully heal" but I never quite get what people mean by that. 
There was nothing in agm that couldn't be "fully healed" by a non-medic so what should "not fully healed" mean? Being unconscious? Broken legs/bad aim (like ace2 did it) simply aren't an option in ace3 yet :(


Posted: Sat May 30, 2015 11:17 am     Super secret spam barrier
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Full heal means the PAK (Personal Aid Kit) as it works right now. Using the PAK is basically reseting the player to full health. Alexander told me yesterday that the code is very simple and it sets the player to full health again.
In practice that means that it will:
Spoiler
Broken legs, burn wounds and air system management will maybe later find a way in ACE3.


Last edited by Alexander on Sat May 30, 2015 12:03 pm, edited 2 times in total.
spoilered out some stuff that I'll add to the beginning posts soon


Posted: Sat May 30, 2015 11:48 am     Super secret spam barrier
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clyde wrote:
So if you use advanced settings what can you set medics to be able to do that non-medics can't do? And can non-medics always heal eachother to 100% health (or to a level that doesn't hinder their movement, vision etc.) no matter what settings are used?

In advanced (without advanced wounds) the 'medic exclusive' things are the IV bags. Everything else can be used by everybody. (i.e. other than in basic, epi cannot be/is not restricted to medics only. This makes sense since epi is no longer a 'wake up stick' but simply one of four tools required to stabilize vitals)
Additionally in advanced there's a (technical) difference between 'normal healing' and PAK-healing. Normal healing might remove all negative effects but might leave sub-optimal vitals (i.e. slightly increased heart-rate, low viscosity, etc). PAK will restore everything to normal, including heart-rate and viscosity.

In advanced (WITH advanced wounds) you can use the surgical kit (SK) as another differentiator. (SK has options 'everyone/medic/doctor' and 'everywhere/med_facilities/med_vehicles/med_facilities&med_vehicles'). Only the SK allows you to stop a bandaged wound from re-opening. (SK will not magically reset your vitals)


Mefirst wrote:
Full heal means the PAK (Personal Aid Kit) as it works right now. Using the PAK is basically reseting the player to full health. Alexander told me yesterday that the code is very simple and it sets the player to full health again.

I don't think that that is what most people mean by "fully heal". It seems like most people mean something like ace2's system where non-medics could stop bleeding, give morphine and (depending on setting) give epi, but only medics could use a "first aid kit" to restore broken legs and a general 'shaky aim'.


EDIT: I've massively cleaned this thread up, please re-read the last few posts.


Posted: Sat May 30, 2015 12:20 pm     Super secret spam barrier
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clyde wrote:
Why has my post in here been moved to the thread we were told to not discuss this subject in?
I moved the one where you stated an opinion over to the feedback track but I think I answered all your questions anyway, right?


Posted: Sat May 30, 2015 3:10 pm     Super secret spam barrier
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Cupcake wrote:
Am I thinking wrong here? So I gave a guy morphine yesterday cuz he was in pain, shortly after, he was on the ground with a stopped heart. Do you mean, directly kill him as in, Die die or faint? If I didnt give him CPR and Epinephrine to kickstart his heart, he would be dead, otherwise it's pretty easy to manage. Or do you mean something else? o-o might be confused
Yeah, I mean you can't insta-kill someone with morphine like you were able to do with @agm (we had that 'feature' disabled, though).What you saw is how it's supposed to happen: Somebody was injured => they probably had a low-ish heart rate already => you gave them something that lowers their heart rate => they passed out. Bad medic-ing but nothing that can't be fixed with a few punches to the chest and an epi. Similar to how n00b medics in @agm would keep pumping you with epi just to have you pass out immediately afterwards because you were still bleeding and low on blood xD


Posted: Sat May 30, 2015 3:58 pm     Super secret spam barrier
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Yep, that's how atropin works in ace3. I have no idea if that's realistic but I'd assume it is since it'd be fairly odd behaviour otherwise. I think you should probably start to use Atropin if you actually want to lower the heart-rate since using too much morphine will thin their blood quiet significantly => next time they get shot they'll bleed out quicker. But yeah, counter-acting morphine with epi seems to be work fairly well.


Posted: Tue Jun 30, 2015 2:47 pm     Super secret spam barrier
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Yesterday I and Moeses tested medical system. Here are the results:
 
Time to die. Just shoot and wait:
6min 35sec– 10 shots to the right leg (5x LV,2xMV, 3xLA)
7min 25sec– 10 shots to the right leg (3xMV, 6xLA, 1xMA)
7min 25sec– 2 shots at each arm and leg
4min 57sec– 22 shots (4 head, 2 arms, 8 torso, 8 legs)
 
LV – Large Velocity Wound
MV - Medium Velocity Wound
LA – Large Avultion Wound
MA - Medium Avultion Wound
 
- 10 shots to the right leg, waited until blood pressure reached 1/1 or 0/0, then  put tourniquet, bandaged wounds, removed tourniquet
6min 35sec– just wait
6min 30sec- + administer saline (blood pressure raises very slow)
6min 14sec- + administer blood
 
- 10 shots to the right leg, waited until blood pressure reached … then  put tourniquet, bandaged wounds, removed tourniquet,administered saline
 
Survived – put tourniquet at blood pressure 65/43 ,bandaged wounds, removed tourniquet, waited 10min and start treating, administered
morphine and epi at 90/60
 
Survived –started treating at blood pressure 39/26, administered morphine and epi at
54/36, keep administer saline, patient awoke at blood pressure 82/55. Overall 11min
from 10th shot.
 
- for fun, tourniquet test
 10 shots to the right leg, waited until blood pressure reaches 87/58, then  put tourniquet,DID NOT bandage wounds, administered morphine, epi and saline. Patient awoke at some point and able to move.
Remove tourniquet, patient fell unconscious when blood pressure dropped, put tourniquet,  DID NOT bandage wounds again, administered morphine, epi and saline. Patient awoke at some point again and I left him at this state till the end of the testing. He passed out 2 times because the pain returned. Morphine and epi did awake him.
 
During the test patient never fell at cardiac arrest.

By the way, i was shot at the arm, bandaged it and for 2hours and 50min i was in pain during the test and pain did not wear off over time.
 
Conclusion:
If patient has 0 blood pressure try administer PAK or leave him and move to the other casualty.
 
toDo: find the  minimal blood pressure at which patient can stay unconscious and not die.


Posted: Thu Jul 09, 2015 6:15 pm     Super secret spam barrier
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Here is some new info:
I dig thought @ace3 v3.1.1 medical source code and able to create a test mission that shows additional internal data like:
Blood Volume, amount of Pain, inReviveState condition.

Hereis the mission. Put it in your *Arma 3\MPMissions\ and launch it thought multiplayer.
Thought the scroll wheel menu you have access to Arsenal and you can start/stop spaming medical info.
You have also access to zeus.

How to test if you are alone.
Start spaming medical info, go to zeus, spawn friendly medic, gain control over the medic and shoot yourself:)
Spaming stops if you respawn, you shold start spaming again.

And now to the fun part, the results:
There is a state, so called ReviveState. You fall into this state if:
- if the blood volume drops below 30 (magical ace number). 30 blood volume ~ Blood Pressure 35/23 (unaffected by morphine and epi)
- you have multiple injuries (~2 Velocity or Avultion wounds in the head or  6 torso wounds or 12 limb wounds )
- being in cardiac arrest for 120 to 720 sec

When you are in ReviveState the times starts (set to 300sec on public, called Max Revive Time in the editor ACE Revive Settings).
When the timer drops to 0, you will die. Only thing that can bring you back to life from this state is PAK.

Bugs:
If you die being ReviveState, after respawn you will still be in the ReviveState. If you then fall unconscious from taking minor damage again the only thing that can bring you back to life is PAK, but if your vitals are good you will not die after 300s.
That explains weird bug when you have good vitals and you are still unconscious.

Tips:
So after you bleed out and respawn ask medic to PAK you.
If you are the medic check patient Blood Pressure first.

See Ya Around


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