The Advanced Medical System (AMS) is largely similar to the [[ACE Medical Basic|Basic Medical System (BMS)]] but adds more depth and complexity, especially for medics. it's recommended that you read the the [[ACE Medical Basic|Basic Medical System Guide]] before this at it lays down a good foundation to make understanding the AMS easier if you're new to ACE's medical system. ===== Wound Types ===== The AMS categorises wounds by specific type instead of simply as Minor or Major, as the BMS does. **As you can see, only Avulsions and Velocity Wounds are imminently life threatening.** ^ Type ^ Description ^ Pain ^ Bleeding ^ | Avulsion | Tissue ripped away | Extreme | Extreme | | Velocity | Bullet / shrapnel wounds | Extreme | Medium | | Laceration | Tears | Light | Light to Medium | | Cuts | Cuts | Light | Depends on size | | Crush | Crush injury | Light | Extremely light | | Puncture | Knives, nails, glass | Light | Slow | | Contusion | Bruise | Light | None | | Abrasion | Scrapes | Extremely Light | Extremely light | ===== Diagnosis ===== ==== Responsive ==== //Accessed from: Head//\\ Tells you if the patient is responsive. ==== Check Blood Pressure ==== //Accessed from: Head, Arms//\\ Tells you the blood pressure of the patient. ==== Check pulse ==== //Accessed from: Head, Arms//\\ Tells you the pulse of the patient. ===== Treatment ===== ==== Step by Step Treatment ==== Step 1: Is the patient dead? (ragdolled) * Yes: Mark as deceased and go to the next patient * No: Go to Step 2 Step 2: Is the patient conscious? * Yes: Tell them to take cover (lie down, get behind buildings), go to Step 3 * No: If it's safe for you go to Step 3, otherwise drag (or let someone drag) if possible and go to Step 3 Step 3: Does the patient have heavy damage? (multiple limbs as well as torso and head that are wounded) * Yes: Torniquet the damaged limbs, call for help and tell assistants what to do, bandage head and torso in that order, go to step 4 * No: Go to step 4 Step 4: Does the patient have multiple wounded limbs? * Yes: Tourniquet the damaged limbs, treat them after another, remove tourniquets * No: Treat limb with most effective bandages at hand (when in doubt, packing bandage) Step 5: Use surgical kit to stitch up the wounds Step 6: Is the patient close to death? (systolic blood pressure below 70) * Yes: Use IVs to raise blood pressure * No: Skip Step 7: Is the patient in pain? * Yes and stable normal pulse: Give morphine * Yes and low pulse: Raise pulse before giving morphine * No: Skip Step 8: Is the patient conscious? * Yes: You're done * No: Periodically check the IV status and their blood pressure, eventually they will wake ==== Bandage ==== //Accessed from: Arms, Legs//\\ Every part of the body can be bandaged if wounded. As in the BMS, head wounds are generally the most serious wounds when bleeding, then torsos and finally limbs. **When bandaging choose them bandage best suited to the wound type. If in doubt, use a packing bandage** (as this is most effective against the two most dangerous wounds). === Bandage Effectiveness Cheat Sheet === ^ Bandage Type ^ Abrasion ^ Avulsion ^ Contusion ^ Crush ^ Cut ^ Laceration ^ Velocity ^ Puncture | Basic | Highest | Low | Highest | Medium | Low | High | Low | Medium | Packing | Highest | Highest | Highest | Medium | Lowest | Low | Highest | Low | Elastic | Highest | Low | Highest | Highest | Highest | Highest | Medium | Highest | QuikClot | High | Lowest | High | High | High | High | High | Medium ==== Tourniquet ==== //Accessed from: Arms, Legs//\\ **Tourniquets can be applied to arms and legs to slow bleeding from them when wounded**. Only use this as a stop gap while you bandage and remove as soon as possible. Prolonged used of a tourniquet will cause pain to the patient. ==== Autoinjectors ==== Autoinjectors are **used to manage pain and heart rate**. === Morphine === //Accessed from: Arms, Legs//\\ * Suppresses pain.\\ * Lowers blood pressure\\ * Lowers heart rate\\ === Epinephrine === //Accessed from: Arms, Legs//\\ * Raise heart rate\\ === Atropine === //Accessed from: Arms, Legs//\\ * Lower heart rate\\ ==== IVs ==== IVs are **used to increase blood pressure**.\\ //Accessed from: Arms, Legs//\\ All IVs increase blood pressure. ==== Kits ==== === Personal Aid Kit (PAK) === * **Fully heals soldier** (resets medical history) * May be limited to certain classes / proximity to vehicle or facility (depends on settings) * May require stable vitals (depends on settings) === Surgical Kit === * Only used if Opening Wounds is enabled * **Stitches a wound closed** * May be limited to certain classes / proximity to vehicle or facility (depends on settings) * May require stable vitals (depends on settings) ==== Maintaining Vitals ==== Ultimately if your patient dies it will be because their blood pressure was too high or too low. Everything you do to treat them will ultimately be in service of //maintaining their vitals//. Failing to do so will result in Cardiac Arrest. **Understanding how how blood pressure and heart rate affect their health of your patient to prevent Cardiac Arrest will make you a much more effective medic.** === Causes of Cardiac Arrest === When checking blood pressure, systolic blood pressure is the number on the left and the diastolic blood pressure is the number on the right.\\ HR = Heart Rate. SBP = Systolic Blood Pressure. CA = Cardiac Arrest\\ If diastolic blood pressure is below 40 and the heart rate is above 190 Cardiac Arrest will also result. | | SBP Normal | SBP > 145 | SBP > 260 | HR < 20 | CA | CA | CA | HR Normal | -- | -- | CA | HR > 150 | -- | CA | CA | HR > 200 | CA | CA | CA === Blood Pressure === Lowered by: * Blood loss Raised by: * Blood / Plasma / Saline Categories: * **Non existent:** 0 - 20 Systolic * **Low:** 20 - 100 Systolic * **Normal:** 100 - 160 Systolic * **High:** 160+ Systolic === Heart Rate === Lowered by: * Morphine * Atropine Raised by: * Epinephrine Categories: * **Low:** 45- * **Normal:** 46 - 119 * **High:** 120+ ===== Dangers ===== * Epinephrine should NEVER be used in case of cardiac arrest as it might make the patient harder to treat or kill them. * Giving too much morphine to a patient (more than one every 10 minutes) will put him in cardiac arrest due to low blood pressure ===== Acknowledgement ===== This document is largely a reformated verion of the [[http://ace3mod.com/wiki/feature/medical-system.html#2-2-4-additional-informations|official ACE documentation]] and a work in progress document authored by: * Russels * Riley * KmO * zebraminge * Dick Nixon Many thanks for laying the ground work for this document.