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--- medical:medics [2020/06/12 10:02] – [Managing Time] hinds
+++ medical:medics [2025/08/03 14:24] (current) – external edit 127.0.0.1
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 ====== Overview ======
+   * Basic In-game Medical Process
    * Triage
    * Proactive Treatment
    * Managing Supplies
    * Managing Time
+===== Basic In-game Medical Process =====
+This will be short and sweet, unlike the rest of this page, because you should already be acquainted with the UI and all the tools at your disposal. As a result, telling you the order to use them in doesn't take a whole lot of real estate.
+**Step 1: Assess the casualty.** Unconscious or not? If unconscious, do they have a heart rate? If they don't have a heart rate, they're in cardiac arrest, and you need to get someone doing CPR on them straight away. What types of wounds do they have? How will you treat them? Is the casualty's heart rate or blood pressure substantially different from the nominal?
+**Step 2: Stabilize the casualty.** Implement your plan. Use the resources at your disposal to tourniquet and/or bandage all wounds. Make sure to call out what you're treating if you're working in tandem with a helper.
+**Step 3: Finalize the casualty.** Use your surgical kit to stitch wounds so they won't reopen. Use fluids, if necessary, to restore fluid volume. Use medications to affect the casualty's vitals (more on vitals later) or treat pain as needed.
+Now move on to the next casualty and repeat the process.
+Make sure to bark at the peasants (riflemen) nearby to make them hold security while you move and work.
 ===== Triage =====
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 ====== Appendix A: Unconscious Casualties - How do? ======
-This is really not that complicated. In ACE Medical, people //remain// unconscious because something is wrong with them. It's possible to be knocked out temporarily by taking substantial damage in a short period of time, or taking a non-lethal round to the head, or being blown up, and so on. These alone don't always keep you unconscious. Something needs to be wrong to remain unconscious. Ultimately, there are only three things that can be wrong with someone, and they are all interrelated, so really, there is only one thing that can be wrong with them. The three interrelated things are: heart rate, blood pressure, and blood volume.
+This is really not that complicated. In ACE Medical, people //remain// unconscious because something is wrong with them. It's possible to be knocked out temporarily by taking substantial damage in a short period of time, or taking a non-lethal round to the head, or being blown up, and so on. These alone don't always keep you unconscious. Something needs to be wrong to remain unconscious. Ultimately, **there are only three things that can be wrong with someone**, and they are all interrelated, so really, there is only one thing that can be wrong with them. The three interrelated things are: heart rate, blood pressure, and blood volume.
-You lose blood volume by bleeding, and you most commonly begin bleeding by being shot. When blood volume begins to drop significantly, blood pressure will drop significantly as well. There will be a period of time during this process that the heart rate spikes to try and compensate for the lack of blood in the system (i.e. trying to keep pressure nominal by pumping faster), but eventually the heart rate will also drop.
+You **lose blood volume by bleeding**, and you most commonly begin bleeding by being shot. When blood volume begins to drop significantly, blood pressure will drop significantly as well. There will be a period of time during this process that the heart rate spikes to try and compensate for the lack of blood in the system (i.e. trying to keep pressure nominal by pumping faster), but eventually the heart rate will also drop.
-So, what does this mean? It means that people who have bled a bunch are going to pass out. How do you fix it? Stop them from bleeding more and give them fluids, just like normal. How do you wake them up? You can't, not directly. ACE makes checks on a fixed cycle with a percent chance for the unconscious casualty to wake up at the end of each cycle. You can boost that chance by a fixed value using epinephrine. However, they will only wake up on a successful check if everything is "good" with them, meaning that something isn't wrong with them. It's kind of the "the missile knows where it is by knowing where it isn't" thing, right?
+So, what does this mean? It means that **people who have bled a bunch are going to pass out**. How do you fix it? Stop them from bleeding more and give them fluids, just like normal. How do you wake them up? You can't, not directly. ACE makes checks on a **fixed cycle** with a percent chance for the unconscious casualty to wake up at the end of each cycle. You can **boost that chance by a fixed value using epinephrine**. However, they will **only wake up on a successful check if everything is "good" with them**, meaning that something isn't wrong with them. It's kind of the "the missile knows where it is by knowing where it isn't" thing, right?
 What about cardiac arrest?
-It's basically the same process, except now they have no heart rate (hence the term cardiac arrest). One of the vitals' values has gone in to a "critical" range and it's very bad and the casualty's heart has stopped because it's very bad. Someone performing CPR has a fixed percentage chance to be "successful" and boost the casualty's heart rate somewhat while also adding time on to the casualty's "death timer."
+It's basically the same process, except now they have no heart rate (hence the term cardiac arrest). One of the vitals' values has gone in to a "critical" range and it's very bad and the casualty's heart has stopped because it's very bad. Someone performing **CPR has a fixed percentage chance to be "successful"** and boost the casualty's heart rate somewhat while also adding time on to the casualty's "death timer."
-While someone is extending this timer for you, you need to be treating whatever is causing the casualty to be in cardiac arrest. In 99% of cases (barring player negligence or mischief) it's because they've been drained of blood by being repeatedly perforated by little metal objects. When you correct whatever the issue is to an acceptable degree, the casualty will come out of cardiac arrest (but still be unconscious) with a heart rate probably in the triple digits but definitely not ~30. If you're still seeing 30 BPM the casualty is still in cardiac arrest.
+While someone is extending this timer for you, you need to be **treating whatever is causing the casualty to be in cardiac arrest**. In 99% of cases (barring player negligence or mischief) it's because they've been drained of blood by being **repeatedly perforated by little metal objects**. When you correct whatever the issue is to an acceptable degree, the casualty will come out of cardiac arrest (but still be unconscious) with a heart rate probably in the triple digits but definitely not ~30. **If you're still seeing 30 BPM the casualty is still in cardiac arrest**.
-For the record: if it's taking you in the range of five minutes to bring a single casualty (with no one else taking your attention for treatment etc) out of unconsciousness or cardiac arrest, then you're probably doing something wrong. It is entirely possible to bring up //at least// two or three casualties in that amount of time. As with anything, it //could// be the game, but don't be too quick to blame the mod or the game. Double-check what you're doing and make sure your process is good and then start to investigate if something is jacked up on the game's end.
+For the record: if it's **routinely** taking you in the range of **five to ten minutes** to bring a //single// casualty (with no one else taking your attention for treatment etc) out of unconsciousness or cardiac arrest, then you're //probably// doing something wrong. It is entirely possible to bring up //at least// two or three casualties in that amount of time. As with anything, it //could// be the game, but don't be too quick to blame the mod or the game. **Double-check what you're doing and make sure your process is good** and then start to investigate if something is jacked up on the game's end.
 ====== Appendix B: Vitals - what do? ======
-For reference, the nominal values are: 80 BPM heart rate, 120/80 mmHg blood pressure, and 6 liters blood volume.
+For reference, the **nominal values** are: 80 BPM heart rate, 120/80 mmHg blood pressure, and 6 liters blood volume.
-Recall that heart rate, blood pressure, and blood volume are all interrelated, and look back at the nominal values. Now consider that you check a casualty's vitals (heart rate and blood pressure) and see 140 BPM and 110/75. What does this mean? Without looking anywhere else, you can safely assume the casualty has lost an appreciable amount of blood. If you look at just the blood pressure and think, "Hey, this blood pressure is pretty close to nominal. No problem!" you're missing the other half of the story: that the heart is working overtime to address the lack of fluid in the system.
+Recall that heart rate, blood pressure, and blood volume are **all interrelated**, and look back at the nominal values. Now consider that you check a casualty's vitals (heart rate and blood pressure) and see **140 BPM** and **110/75**. What does this mean? Without looking anywhere else, you can **safely assume the casualty has lost an appreciable amount of blood**. If you look at just the blood pressure and think, "Hey, this blood pressure is pretty close to nominal. No problem!" you're **missing the other half of the story**: that the heart is working overtime to address the lack of fluid in the system.
-There's not really any definite in-game way to see the "exact" amount of blood lost, and that's fine. The game tells you in the info panel to the right of the paper doll: "lost some blood," "lost a lot of blood," "lost a large amount of blood," "lost a fatal amount of blood," and so on.
+There's not really any definite in-game way to see the "exact" amount of blood lost, and that's fine. T**he game tells you in the info panel to the right of the paper doll**: "lost some blood," "lost a lot of blood," "lost a large amount of blood," "lost a fatal amount of blood," and so on.
-Typically you want to be considering using fluids on someone who has "lost a lot of blood" or worse. Beneath that, you don't really need to treat it. If there's half-liter bags available, and you have nothing else to do, maybe you do that. But otherwise, save the fluids for when you need to keep people standing through 75 minutes of being shot at.
+Typically you want to be considering using fluids on someone who has "lost a lot of blood" or worse. Beneath that, you **don't really need to treat it**. If there's half-liter bags available, and you have nothing else to do, maybe you do that. But otherwise, **save the fluids for when you need to keep people standing** through 75 minutes of being shot at.
-What if someone's heart rate somehow spikes to 250 BPM? Or blood pressure goes up to 200/X? That's basically never going to happen, but there are outcomes for all of those types of things in the mod's code.
+What if someone's heart rate somehow spikes to 250 BPM? Or blood pressure goes up to 200/X? That's basically never going to happen, but there are outcomes for all of those types of things in the mod's code. They can cause cardiac arrest, but again, not necessarily something to worry about because they won't occur under usual gameplay circumstances.
 ====== Appendix C: How to Practice ======
-Simple. Turn on AI unconsciousness in the ACE Medical settings and shoot some poor AI, then treat them. You turned on AI unconsciousness so that they can pass out rather than just outright die. You can treat them (and save them, or fail saving them) the same way you would treat players, although AI are (in our default settings) a little more fragile than human-controlled units.
+Simple. **Turn on AI unconsciousness** in your local ACE Medical settings and **shoot some poor AI**, then treat them. You turned on AI unconsciousness so that they can **pass out** rather than just outright die. You can treat them (and save them, or fail saving them) the same way you would treat players, although AI are (in our default settings) a little more fragile than human-controlled units.
-If you want to practice the more macro-level concepts, you can devise scenarios for yourself to solve. What if you have three wounded: one who is conscious, one who is conscious but bleeding heavily, and one who is in cardiac arrest. You have no one else to help you. Who do you treat first? What do you prioritize working on? Who do you communicate with to get extra help if you think you need it?
+If you want to practice the more macro-level concepts, you can **devise scenarios for yourself to solve**. What if you have three wounded: one who is conscious, one who is conscious but bleeding heavily, and one who is in cardiac arrest. You have no one else to help you. Who do you treat first? What do you prioritize working on? Who do you communicate with to get extra help if you think you need it?
-It might sound goofy but the first time you take the role and can't figure out what to do during a particular situation, you might see the value in having ran through a couple examples in your head before. You could also get some other players together and create these scenarios in-game to practice "for real." Like many things, the more saddle time you have, the better-prepared you are.
+It might sound goofy but the first time you take the role and can't figure out what to do during a particular situation, you might see the value in having ran through a couple examples in your head before. You could also **get some other players together** and **create these scenarios in-game to practice "for real."** Like many things, the more saddle time you have, the better-prepared you are.