Medical Operations - First aid

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The FM outlines our core skills, policies and guides to ensure every member stands ready for the mission ahead.

• As soon as a person is wounded, you should immediately inform your Chain of Command about the incident and the casualty.
• Provide a brief report that includes the number of casualties and the location, which will help in planning an immediate medical response.
• Use clear and concise communication to ensure the message is understood.

• Prioritise safety by first winning the firefight to reduce further risk to yourself and the casualty.
• If the situation is too dangerous to administer first aid on the spot, use the ace interaction to drag or carry the casualty to a safer location, such as behind cover or a concealed area away from immediate threat.

Bleeding

• Quickly apply tourniquets to bleeding limbs or bandages if no other areas are wounded. 
• Aim for this to take no longer than 30 seconds. 
• If there's significant blood loss, call for advanced medical help.

Airway: Check the airway in the medical menu. 

• If occluded, turn the head until it's clear. 
• If obstructed, hyperextend the head within 2 meters to maintain clearance.

Beating Heart:

• Check pulse
• If there's no heart rate
  • Perform CPR for two minutes by selecting it when the chest is highlighted. 
  • Re-check the pulse afterward.

Evacuation: 

• Move the casualty to a Casualty Collection Point (CCP) for medical personnel to take over.

Above: An infographic summarizing first aid procedures for bleeding control, airway management, resuscitation, and casualty evacuation, with specific instructions for severe blood loss and shock treatment.

After addressing life-threatening bleeding and airway issues, assess the casualty for other injuries.

• Start with untreated wounds on the head and chest. 
  • Bandage these areas thoroughly because you can't use tourniquets here, and injuries to these regions can be critical.
• Move on to limbs with the least severe wounds. 
  • This helps to stabilise the casualty but also streamlines the process for incoming medical personnel.
• After bandaging, if you identify any broken limbs, apply splints.

Continue to monitor the casualty's condition by regularly checking their breathing, bleeding, and consciousness.

• Repeat the treatments from Steps 3 and 4 as necessary this includes;
  • checking and reapplying bandages
  • ensuring airways remain clear
  • monitoring for signs of circulation.
• Stay with the casualty until they regain consciousness or until medical personnel arrive. 
• Provide updates to medical personnel upon their arrival and assist as directed.

If you are instructed by medical personnel or your duties require you to rejoin your unit, ensure that the casualty is left in capable hands before departing.

When giving first aid to a patient, follow the following steps:

• Minimize long term blood loss in 30 seconds or less (time it takes to apply 4 tourniquets or 3 bandages)
  • if unsure, tourniquet wounded limbs
• Manage the airway
• Perform further treatment as needed

Abrasions (or scrapes)

• They occur when the skin is rubbed away by friction against another rough surface.
• Sources: falling, vehicle crashes.
• Effects: pain - extremely light, bleeding - extremely slowly.

Avulsions

• Occur when an entire structure or part of it is forcibly pulled away, such as the loss of a permanent tooth or an ear lobe.
• Sources: explosions, vehicle crashes, grenades, artillery shells, bullets, backblast.
• Effects: pain - extremely high, bleeding - extremely fast (depends on wound size).

Contusions (Bruises)

• Also called bruises, these are the result of a forceful trauma that injures an internal structure without breaking the skin.
• Sources: bullets, backblast, vehicle crashes, falling.
• Effects: pain - light, no bleeding.

Crush wounds (crushed tissue)

• Occur when a heavy object falls onto a person, splitting the skin and shattering or tearing underlying structures.
• Sources: falling, vehicle crashes.
• Effects: pain - light, bleeding - extremely slowly.

Cut wound

• Slicing wounds made with a sharp instrument, leaving even edges.
• Sources: vehicle crashes, grenades, explosions, artillery shells, backblast.
• Effects: pain - light, bleeding - speed depends on length and size of the wound.

Lacerations (tears)

• These are separating wounds that produce ragged edges.
• Sources: vehicle crashes.
• Effects: pain - light, bleeding - slow to medium speed (depends on wound size).

Velocity wounds

• They are caused by an object entering the body at a high speed, typically a bullet or small pieces of shrapnel.
• Sources: bullets, grenades, explosions, artillery shells.
• Effects: pain - extremely high, bleeding - medium speed (depends on wound size).

Puncture wounds

• Deep, narrow wounds produced by sharp objects such as nails, knives, and broken glass.
• Sources: shrapnel, grenades.
• Effects: pain - light, bleeding - slowly.

Fractures

• Fractures cause pain, increased weapon sway (when arms) or inability to jog or run forcing the player into a limp (when legs). 
• Fractures in ACE3 are not fatal. So are far lower on the priority list in regards to treatment. 
• Focus on stabilising the patient first, then once stable, apply a splint to their fractured limb/s.

Wherever practically possible using the correct bandage is essential for efficient wound management.

• Elastic Bandage: Quick closure for many wounds; use when speed is key and durability isn't crucial.
• Packing Bandage: Ideal in combat; designed for immediate bleeding control.
• QuickClot Bandage: For non-combat situations; speeds up clotting when stitching isn't an option soon.
• Field Dressing (Basic) Bandage: A versatile option when others aren’t available; useful for initial wound care.

Considerations

• Situation: Combat status and resource availability.

Chooses based on the situation, wound type, and available resources for best outcomes.

Use tourniquets to temporarily prevent bleeding from all the wounds on a limb, when individually bandaging the wounds would result in unacceptable blood loss.

• Prioritise the treatment of wounds by evaluating the severity and rate of blood loss. 
• Address the most severe wounds first to reduce overall blood loss, and then proceed to less critical wounds, employing appropriate bandaging techniques.

Use splints to temporarily treat broken limbs, until a personal aid kit can be used to restore full usage of the limb later.

Airways can become blocked when a casualty is unconscious, when rendering first aid the airway should be checked to see if it is blocked or occluded if this is not treated, then it will result in death of the casualty.

Airways can be cleared by turning or hyperextending the head or by using other advanced medical equipment. Once clear, a patient can be placed in the recovery position.

Assess the airway with “check airways” and categorize as one of the following states:

• Clear
• Occluded
• Obstructed

Above: The location of the "Check Airway" action and the result as seen in the activity log

Turn the patient's head to clear the occluded airway of the patient if an Accuvac is not available.

Above: Action as seen in the medical menu

Hyperextend the patient's head to clear the obstructed airway of the patient, and stay within 2m of the patient during the process.

Above: Action as seen in the medical menu

Place the patient into a recovery position to keep the airway clear, if they:

• are stable
• do not need to be moved

Pain is typically caused by wounds and the prolonged use of tourniquets. Increased pain can effect weapon sway, stamina, vision and cause audible moaning. Combat wound medication pills can be used to suppress pain for first aid, however more advanced suppression is possible using morphine or fentanyl.

• Administer or take combat wound medication pills to decrease pain by about 20%
• Limit frequency of consumption to no more than 6 pills every 6 minutes to avoid overdosing
• Be aware of side effects:
  • a slight increase in heart rate
  • a decrease in blood pressure

You can check the pulse of any non-tourniqueted bodypart and the result returned will be descriptive for non-medical personnel or an accurate value for medical personnel, the possible results are:

• No heart rate (0)
• Low heart rate (1-60)
• Normal heart rate (60-100)
• High heart rate (100+)

Some drugs will influence heart rate.

After identifying a patient with no heart rate

1. Perform CPR for at least 30 seconds
2. Check pulse
3. If no heart rate, repeat

Checking a patient's pulse whilst someone else is performing CPR or checking pulse on a limb with a tourniquet placed will provide an erroneous reading.