Medical Treatment

This procedure document provides a brief overview of the casualty treatment methods used by medical personnel.

Identify your patient

As a medic, your primary job is to identify who needs assistance, and where. Finding the patient is often relatively simple - generally if someone is hit, a bystander will call for you, or the patient will notify you themselves over radio. It's important to be clear when responding to these calls, and (if possible in a calm, collected voice) determine the location and type of injuries the patient has.

Relocate to your patient

Once the patient's location is known, it's important to prioritise your own safety while moving. Designate a treatment location - that might be at your current position if your patient can be brought to you, or on the patient's location, or a safe place nearby. Set up an action plan to get yourself and your patient there, taking into account what can be done to make the area safer - fortifications, vehicles, smokescreens, squad movements, and security. If no obvious solution is present, contact a section commander or platoon leader to make a solution happen.

Treat your patient

The following is a basic, step-by-step guide for casualty treatment. It is important to understand every single step of this guide. Note that keeping vitals stable is always the top priority, and with advanced medical enabled, bandaged wounds can re-open at any time. You should be familiar with a number of tools available to you for treating casualties; these are outlined in the Equipment section of this wiki, under Standard Medical Equipment and Advanced Medical Equipment.

Step 1: Check response

  • If the patient is awake, you can infer that their vitals are at least somewhat stable.
    • Immediately task them with applying tourniquets/bandages or providing security.
    • Proceed to Step 4 and start general treatment.
  • If the patient is unconscious, do a quick assessment of their wounds.
    • Especially note whether they have a lot of chest or head wounds.
    • Continue to Step 2.

Step 2: Stop heavy bleeding

  • Apply tourniquets to all bleeding limbs.
  • If heavy chest or head wounds are present, bandage them now.
  • Task a soldier to continue bandaging if feasible. This will give you a head start later.
  • Act quickly. Staunching blood loss buys precious time to ascertain the state of the patient.

Step 3: Check vitals

  • Check patient's blood pressure (BP). The important value is diastolic (the left number).
    • A good diastolic BP is around 120. A soldier can operate anywhere upwards of 60.
    • IV fluids take time to apply. The lower the BP, the more you should prioritise IV treatment.
    • Patients with BP lower than 20 are unlikely to survive, so prioritise others in a triage scenario.
  • Check patient's heart rate (HR).
    • A good HR is between 60 and 90. A soldier can operate anywhere between 45 and 120.
    • In the event of no pulse, you have a ten minute timer to induce a HR before the patient dies!
      • Task a soldier to provide CPR if feasible. This prolongs the timer and may induce a HR.
      • If nobody can provide CPR, defibrillate the patient now.
  • Remember that tourniquets interfere with measuring BP/HR or applying medicine/IVs.

Step 4: Treat wounds

  • Bandage any undressed wounds, starting with the most severe, then stitch them.
    • If there are a lot of wounds, you may find it practical to do partial stitches.
  • Remove tourniquets as soon as limbs are stitched.

Step 5: Treat vitals and pain

  • Restore the patient's HR, aiming for 60+ BPM.
    • If the patient has no pulse at this time, defibrillate them to induce a starting HR of 40.
      • A single application of epinephrine will then achieve the target HR.
      • If the patient has pain, a second round of epinephrine followed by morphine is ideal.
    • Epinephrine raises HR by 20. Do not apply excessive epinephrine.
    • Morphine lowers HR by 20. Do not apply more than one morphine every ten minutes.
  • Restore the patient's BP, aiming for a diastolic value of 120.
    • Each 1,000mL of IV fluid raises BP by around 20.

At this point, your patient should be conscious and ready to go. A fully stitched soldier with a stable heart rate, blood pressure, and managed pain can be given a clean bill of health to head out into the battlefield and get shot again.

Cheat Sheet

This chart is not specific to this unit, but presents much useful ACE3 Advanced Medical information. Elastic bandages should be used when you're about to stitch the patient. Quick Clot bandages are better for prolonged fights, or when medical attention will not be possible in the next 5 minutes.