ACE Medical and Wounds System
The medic is a vital part of nearly every infantry squad. He (Or she) is responsible for the combat strength of the entire squad and therefore is a key element for success. Combat medics are trained military personnel who are responsible for providing first aid and front line trauma care on the battlefield. Combat medics are normally embedded with the combat troops they serve in order to easily move with the troops and monitor ongoing health.
Always remember that the medic is a supporter. He is neither point man nor marksman, depending on the formation he should be somewhere in the middle or the back. The most important task for a medic is to stay alive.
Overview of the ACE Medical and Wounding System
The ACE Medical and Wounding System brings a realistic wounding system into ArmA. Using the ACE interaction menus you can assess the health status of yourself and your teammates. When an action is available it will be highlighted.
IFAK (Improved First-Aid Kit) is where you can store your medical supplies. No matter what position you choose to play you should always make sure to keep you IFAK filled with morphine, epinephrine, compresses and bandages. Usually only medics can use epinephrine and medkits.
- Bandages: It is used to stop minor bleeding.
- Compresses: In case of heavy bleeding bandages are just not effective. In real life you need to apply pressure to stop the bleeding. This is done by using compresses and securing them in place.
- Morphine: Drag used to reduced the pain, usually has instant effects.
- Epinephrine: Epinephrine is adrenalin, which helps restart your heart.
- Med Kit: after all the above measures are taken then a med kit can be used to fully heal someone (there are occasions where one can only be fully healed next to a medical facility i.e. mash, hospital, ambulance etc.)
- CPR: CPR is used to extend the lifetime of the casualties.
The above actions should be performed in that order to be effective. There is no point in giving Epinephrine before stopping the bleeding and applying compresses. If you do it is most likely that the injured will bleed out faster.
The med kit should be used under cover. By that time no lifes are in immediate danger. If someone cannot walk he can be helped via the world interaction menu (and he needs to accept by scrolling down and clicking accept). The med kit is the first aid option on the interaction menu, but it takes some time leaving you vulnerable.
Flight medic and combat medic
The main difference between the two is that field medics are usually called in a MEDEVAC or stay back at base while the combat medic stays close with the squad. The biggest advantage of being a field medic is that he has slightly more time to triage the casualties.
Triage is the process of determining the priority of patients' treatments based on the severity of their condition. At its most primitive, those responsible for the removal of the wounded from a battlefield or their care afterwards have divided victims into three categories:
- Those who are likely to live, regardless of what care they receive;
- Those who are likely to die, regardless of what care they receive;
- Those for whom immediate care might make a positive difference in outcome.
The more modern simple triage separated people in four categories:
- The expectant who are beyond help
- The injured who can be helped by immediate transportation
- The injured whose transport can be delayed
- Those with minor injuries, who need help less urgently
As a filed medic you will have a report stating the status of the casualties. How many are dead? How many need epinephrine? How many need morphine? How many need first aid? While in combat though it is not always who needs treatment most, but it comes to the more primitive triage method who - if immediately treated - can make a positive difference in the outcome. After you receive you 9 liner report ask if there is someone needed mostly in the battle and what his condition is. This is who you will need to treat first, for the simple reason that in the end he will buy you more time to save the others.
The same rule applies if you are a combat medic. In this case you might not have time to organize people, but you have the advantage of being at the spot (so you are there faster) and also you have situational awareness. Asking the squad leader if he needs someone up asap and then proceed to taking care of the injured from the most critical to the less one. If people are around doing CPR then ask them about the state of the injuries.
Reaching the wounded
If you are the flight medic then you will be approaching the area in a CASEVAC or MEDEVAC. You should know the state of the landing zone (safe or not) but always assume that things can change fast. Once you are there make sure there is cover and/or concealment. Have the people who were escorting and/or treating the injured set up a 360 degree security. While the medic is treating the injured keep your eyes outward for security unless you are asked to assist. Ask for permission to use smoke on the area. If you need to evacuate people then through the interaction menu select drag and then scroll down to select carry. Once you have reached the vehicle you will use to extract people, use your ACE world interaction key (default key is right windows key) to use the option “load X into vehicle”.
If you are a combat medic then resist the rush to run to your buddies’ assistance. Look around first and assess the situation. How badly is he hurt? Can you get there safely? Do you have cover? Is the cover accessible by the injured? Are there more people to help cover the area while you treat the wounded?
If the firefight is still going on then encourage the wounded to crawl back to your position (which ideally is covered) away from the fire fight. Give them a direction so that it is easy to find you without losing time. Usually a bearing or even just saying move north west from your position will do the trick. Ask the wounded to stop the bleeding and apply compresses if they can do so on their own. Take care of morphine/epinephrine needs and wait until the whole team can bound back and break contact to help you set a covered area to continue with further treatment (first aid).
If the injuries cannot move to a safer location wait for the firefight to stop. There is no point in getting there only to get shot. Do not use the drag option (via ACE world interaction key) to get someone to safety if that is not fairly close. I have found dragging to be most effective when someone is down at corners. You can reach and drag them behind cover without getting exposed. If you use drag to cover larger distances, it leaves you exposed and unable to shoot or see where you are going. If you want to move someone further away then drag and then carry them (scroll down menu) at the desired location. While carrying someone you can shoot and see around you. If you have enough people to help and you need to carry injured to a specific point that is quite away then use a stretcher, it is fast and reliable. Have your stretcher out (ACE self interaction menu, default is right application key) and then put the injured on it (using world interaction key again) then pick up the front, while staying put, someone will get the back (using your scroll down menu). The person who is at the front will control where all are moved. If you try dragging the stretcher alone then it will soon drop resulting in delays or further injuries.
Have people who are helping you call out what they are doing (i.e. applying morphine, applying compresses). The last thing you need in a multi trauma situation is doing things twice.
Used to call in helicopters to evacuate wounded
Line 1: Location of the pick-up site.
Line 2: Radio channel (long- and short range) and call sign of unit carrying the wounded.
Line 3: Number of patients by precedence:
a. Urgent (First Aid)
b. Priority (Epinephrine)
c. Routine (Morphine)Line 4: Special equipment required:
a. NoneLine 5: Number of patients:
a. NoneLine 6: Security at pick-up site:
b. On stretcher
c. Transported to LZ
a. N - No enemy troops in areaLine 7: Method of marking pick-up site:
b. P - Possible enemy troops in area (approach with caution)
c. E - Enemy troops in area (approach with caution)
d. X - Enemy troops in area (armed escort required)
a. Panels (VBS 17 panel)Line 8: Patient nationality and status:
b. Pyrotechnic signal (flare)
c. Smoke grenade, colour
a. BLUFORLine 9: Terrain: Terrain description of pick-up site
e. EPW (Enemy Prisoner of War)
Full form example:
“Super-six 4, this is Apache 1’4. Standby for 9-liner, over”
“This is Super-six 4, ready to copy, over”
“Line 1: Grid 354784
Line 2: Long range 1, short range 1, Apache 1’1
Line 3: Two Alpha, one Charlie
Line 4: Two Bravo
Line 5: Alpha
Line 6: Papa
Line 8: Two Alpha, one Delta
Line 9: Flat field, no obstacles, treeline running N to SE
Read back, over”
(Pilot repeats 9 liner)”Super-six 4 in flight. ETA 8 mikes, out”
Line 1:____________________ LZ
Line 2:____________________ RDO Ch. & Callsign
Line 3:____________________ #Patients
A - Urgent (First Aid). B - Priority (Epinephrine). C - Routine (Morphine)
Line 4:____________________ Special Equipment
A - None. B - Stretcher. C - Bodybag
Line 5:____________________ #Patients Transported
A - None. B - On stretcher. C - Transported to LZ
Line 6:____________________ Security at pick-up site:
N - No enemy. P - Possible enemy (approach with caution)
E - Enemy in area (approach with caution). X - Enemy in area (armed escort required)
Line 7:____________________ Mark of LZ
A - Panels. B - Pyrotechnic signal. C - Smoke signal. D - None. E - Other
Line 8:____________________ Patient nationality and status
A - BLUFOR. B - OPFOR. C - Independent. D - Civilian. E - EPW (Enemy Prisoner of War)
Line 9:____________________________________ Terrain Description
Many thanks to JB
for the 9-liner and to Luke
for being the crash dummie.