Version 1 / 7min read / Updated Tue 03 Nov 2020 / 242 views
Advanced medical introduces the following:
- A detailed wound system, including fractures
- Accurate blood loss based upon sustained injuries
- Vitals simulation, including heart rate and blood pressure
- Cardiac arrest events
Various modular treatment methods such as;
Philosophy and Approach
UNITAF uses medical in a unique way so much so we have needed to modify the way ACE Medical works, to achieve our aims. In this section we'll outline our philosophy and approach to a medical system. This approach is what influences most decisions in relation to changes in medical procedures.
The most obvious starting point is while we simulate real military operations, death and serious injury in our system are a game mechanic. In real life you get no second chances, and seen as this is a game, while so called "One Life Only" is a viable system, its not one that we use. The scale starts with One Life Only the closest to Real on the Realism scale you get, and right on the other end it deals with a simple revive or respawn system like you might see on a fast paced first person shooter such as Call of Duty.
To stay as close to the real side of the scale is important because we want to avoid carelessness of action - which brings us on to Consequence.
The most important element of a medical system is to provide consequence to actions, catching a shot in the arm should provide a small inconvenience for the player, and being hit 5 times in the chest should provide a much greater one. We have never used respawns or reinsertions as a primary method of player consequence primarily because they are no consequence to the player at all. Reinsertions deal with a second consequence of casualties which is that on the wider unit.
All persons in a team, squad, platoon and company have to deal with casualties as they mount - whilst still focusing on their objectives at large. They have to make quick decisions on how to deal with any situation as it arises. A respawn and reinsert system provides consequence and burden to the larger force, since they have to deal with temporary breakdown of chain of command, element size and the re-insertion (whether by air or land) to an area of operations.
The issue at large is nobody cares too much when John Smith dies; he'll be back soon, we won't need to waste any medical supplies, and we won't need to get his body back either. For John Smith, it's a cosy ride back to the AO from base, with a fresh load carry. The fact is, John Smith has to care so much, that he takes calculated risks and not careless action, so much so that he avoids being hit at all.
So any medical system needs to burden both the Player and the Unit at large, by providing enough of a deterrent to a player to be more careful in the future and to ensure that the Unit not only deals with the consequence of the Players action, but also deals with their body too.
Our primary reason for existence is large scale teamwork and so any medical system has to ensure that players need to work together to achieve any given objective. That means that no one player can do an entire process on their own. Each medical role has it's own responsibilities and medics and infantry must work together to deal with and overcome casualties, and crucially - players must work as a team to avoid them in the first place. Any system must have an over-arching message of "no man left behind"
In respect to the above, a core breakdown of the system is below - If you're familiar with ACE medical, below is a brief outline of some of the major settings as they do change over time not all settings are listed here.
- Blood Loss (50% of Default but modified by the UNITAF Mod to slow closer to fatal)
- Wound Reopening / Advanced Bandages (ON)
PAK Usage (Medics Only, not CLS)
- In smaller operations, PAK may be permitted "in the field"
- In larger operations, PAK is only permitted "off the field" requiring Medical Vehicles or Facilities
- Primary Weapon must be slinged or holstered before you can tend to any casualties
- Morphine Usage (ALL)
- Epinephrine Usage (CLS or Medic)
- Fracture Chance (0.3)
- IV Usage (Medics Only, not CLS)
- PAK Consumed (YES)
- Stitching Kit Consumed (NO)
- Stitching Location (Anywhere)
After being hit by an IED, a player would become a CAT-I IMMEDIATE casualty and would be unconscious, meaning they can hear but not communicate nor see anything. They would have a number of wounds on every limb, and would be bleeding profusely. Because they have not died and respawned immediately the chain of consequence starts. The players unit now has to act fast to reach the casualty and stop the bleeding as soon as possible. For the players unit it means concealing the position and dragging or carrying the casualty to a safer position, so a Combat First Responder (CLS) can start work. Other players in the unit will assist if a CLS is not yet present. The CLS will stop all bleeding using a combination of Tourniquets and Bandages, the number needed will depend on the seriousness and quantity of wounds.
If blood was stopped before too much was lost, then the CLS himself would be able to deal with this patient, but in this scenario blood loss would be so rapid the CLS is unlikely to be able to do so, which is where the Squad or Platoon Medic comes in. These medics carry IV for Blood, and can introduce more blood into the system, so when called by the CLS the Squad Medic turns up, and introduces blood to the system, while the CLS can continue to deal with wounds as required.
Once the casualties blood has reached a non-critical state, the Medic will re-triage him as CAT-II DELAYED as the casualty is no longer at immediate risk of death since he is not bleeding nor fatally low on blood, should there be other CAT-I IMMEDIATE casualties nearby, the medics would now deal with those first, with our casualty remaining unconscious.
After some time, more blood is introduced, CPR is performed as required, and if needed Epinephrine introduced to the system, which should bring the Casualty back to a conscious state, triaged as CAT-III MINIMAL the player is now able to tend to his own wounds and defend himself if required. Medics would finish dealing with wounds using Stitching Kits or PAKs and then the player would be sent on their way.
In the scenario above, it's highly likely that the casualty would be moved either to a land based medical facility or vehicle, or be picked up by a medical emergency response team (MERT), be treated off-field and then returned to their unit.
The above example demonstrates that as a casualty, you will spend time unconscious appropriate to the injury - compounded by the skill and availability of medical support, and that your unit will deal with the consequence and logistics of your treatment. The message in summary is to force players and units a like, to act in a way that is risk adverse, much like one would do in real life, to avoid loss of life. And to be less careless and more considerate when deciding both player action and unit action. All actions we take must consider the minimum loss of life during execution at all times.
UNITAF Standard Operating Proceedures (SOP) are adapted primarly from US Army Training and Doctrine Command (TRADOC). Our written and audio proceedures are a combination of the following primary source materials, as well as our own learnings, modifications and adaptations:
- US Army Techniques Publication, Infantry Platoon and Squad (ATP 3-21.8)
- Soldier’s Manual of Common Tasks Warrior Leader Skills Level 2, 3, and 4 (STP 21-24-SMCT)
- The Warrior Ethos and Soldier Combat Skills (FM 3-21.75 / FM 21-75)
- Leadership Development (FM 6-22)
- Dyslexi's Tactics, Techniques, & Procedures for Arma 3 (TTP3)