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The Advanced Medical System (AMS) is largely similar to the Basic Medical System (BMS) but adds more depth and complexity, especially for medics. it's recommended that you read the the 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
Keeping the patient's vitals stable is your first priority.
Step 1: Is the patient responsive?
- Yes: Ask him if he has wounds / he is in pain and act accordingly.
- No: Go to step 2.
Step 2: Is the patient wounded?
- Yes: Treat the wounds.
- No: Skip this step.
Step 3: Does the patient have a pulse?
- Yes: Go to step 4.
- No: If you are alone provide CPR, if you have someone else get him to do CPR while you treat the patient's wounds. Skip to step 4 or 5 depending on the situation.
Step 4: Did the patient lose a lot of blood?
- Yes: Use IVs to restore the volume of liquid in the blood stream of the patient.
- No: Skip this step.
Step 5: Is the patient in pain?
- Yes and stable pulse: Give him morphine.
- Yes and unstable heart rate: Stabilize the heart rate before administrating morphine.
- No: You're done.
Step 6: is the patient awake now?
- Yes: You're done.
- No: Stabilize his pulse / make sure he isn't in pain or missing blood.
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 |
---|---|---|---|---|---|---|---|
Basic | Highest | Low | Highest | Medium | Low | High | Low |
Packing | Highest | Highest | Highest | Medium | Lowest | Low | Highest |
Elastic | Highest | Low | Highest | Highest | Highest | Highest | Medium |
QuikClot | High | Lowest | High | High | High | High | High |
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 | |
HR < 20 | CA | CA |
HR Normal | – | – |
HR > 150 | – | CA |
HR > 200 | 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 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.