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  1. Cooper

    OP: Umbrella- Phase III

    A continuation of our Livonia campaign.
  2. Cooper

    OP: Umbrella- Phase II

    OP: Umbrella- Phase II
  3. Map: Anizay
  4. Stop lookin' at my profile!

  5. Cooper

    OP: Umbrella- Phase I

    New Map: Livonia (Part of the Contact DLC for ARMA3)
  6. The Good Medic's Etiquette As a medic, your philosophy should be to preserve the greater good; and the greater good involves every single member of your platoon. You must be assertive even more than you should be knowledgeable, as you will often find a crowd around a body that will do everything in their power to be unhelpful. You are the one who will get a casualty up and running with maximum efficiency, so make sure everyone knows the boss is on station. To be assertive, you must know to communicate effectively. Keep those around you informed of your actions, talk to whomever you're attending about your treatment. Whenever you arrive at a location, give everyone a quick shout asking if they need you. You're a gift from the gods when mortars land just as much as after a prolonged firefight with many small nicks and scrapes. This also means that you are indispensable normally and should keep your head down during engagements. Travel light to remain mobile, focus on your supporting equipment more than on your rifle. Smokes are your best friend when traversing gaps in cover, so if in doubt, bring more of those rather than extra magazines. Triage, Casualty States and Priorities When sorting through casualties and patients, it's often helpful to call out what is called a triage. This is where your voice is expected to be heard above all the noise and disorganization that usually ensues when it's come to the point of needing one. Casualty states are assigned based on trauma level - there are a number of different, but overall similar routines from all over the world. For this purpose, we're using the UK triage system for short-hand, while ACE uses the US military equivalent. Let us agree on using the Priority (Px) short-hand, seen below, as convention for talking about it. P1: severe injuries, likely already unconscious with blood loss and open wounds requiring immediate attention where any delay can prove fatal (ACE triage card equivalent: Immediate) P2: severe injuries, but stabilized to the point of no longer requiring undivided attention, though should be kept in mind for later (ACE triage card equivalent: Delayed) P3: light injuries that only just require the attention of a medic after P1s and P2s are dealt with; patients can still walk and be useful if necessary (ACE triage card equivalent: Minimal) Deceased: patients beyond help, effectively or actually dead (ACE triage card: Deceased) You may not always have time to update everyone's triage card, but make mental notes about everyone who comes to see you. A mortar victim with six large avulsions will be dead within a minute, whereas somebody emerging from a crashed HMMWV can usually walk it off and talk to you later down the line. To decide which types of injuries dictate what type of reaction, let us move on to... Injuries and Bandages A good craftsman knows his tools. There are 8 types of injuries with 7 types of open, bleeding wounds. Abrasion: A scrape. Slow bleeding, though large ones cause a moderate amount of pain, these are low priority. Avulsion: Tissue forcefully torn away from where it belongs. The most severe type of wound with extreme pain and the highest rate of bleeding -- very high priority. Contusion: A bruise. You cannot fix these with bandages, but they also don't lead to blood loss. They might cause some minor pain and aim shake if on arms. Crush: About as descriptive as it gets, this is tissue that's been crushed under heavy weights. Some bleeding and light pain, low to medium priority. Cut: Occurs from shrapnel or other sharp objects cutting skin and muscle. Light pain, light to medium blood loss depending on size. Low to medium priority. Laceration: Another sort of tear that separates tissue without shearing it off and away. Light pain, slow to medium blood loss. Low priority. Puncture: Caused by shrapnel or long and thin, slow-moving sharp objects. Light pain, slow bleeding. Low priority. Velocity: Deep penetrating wounds often caused by bullets. Extreme pain, medium to fast bleeding. High priority. To treat these, you have four types of bandages at your disposal (*note: ST11 does not use the advanced wound system at this time so, wounds do not have a chance to reopen): Basic: A medium-effect, medium-sealing bandage for your every-day needs. It's the averagest of averages. Packing: Identical effect to basics, high chance to reopen, but excellent delay until a wound bothers you again. Every rifleman's best friend. Elastic: Highest effect, highest chance to reopen, lowest delay. Riflemen stay away! These are for medics to use on severe injuries to prepare for surgery only. QuikClot: Lowest effect, lowest chance to reopen, decent delay. Their low effectiveness means they require high volumes for large wounds, but they are excellent for small ones. Vital Signs To treat someone effectively, you must know which symptoms to treat in the first place. There are three types of vital signs. Heart rate, HR: The fundamental indicator of life.Is affected by drugs as well as physical activity and pain. High: >120 Normal: ~80 Low: <45 Blood pressure, BP: A complicated measure to factor in, so we'll get back to this one later. These are basic numbers for a quick assessment. Is affected by blood loss, inversely then by IVs and to a very minor extent by pulse High: above 150/90 Normal: around 120/80 Low: below 90/60 Pronounced: "120 over 80" Patient response: If you get a response from this action, you might as well have asked the patient directly if he's conscious. Cardiac arrest is the technical term for a heart that has stopped beating. Several things can cause this: Low heart rate (HR below 20) High heart rate (HR above 200) Blood pressure above 260/anything HR above 190, BP x/190+ HR above 150, BP 150+/y Cardiac arrest will kill you if you remain in that state for 2 to 5 minutes, unless CPR is applied periodically. So you see, these aren't just indicators for you to know what's lacking: if they're too much out of whack they will kill your patient. Ideally, you will want all these values to end up around their normal levels once you've finished your treatment. To do so, we're now going to look at... Injections and IV Bags Fluids go out, fluids go back in. You can explain that. Soon. You can directly influence heart rate and blood pressure using your injections. Drugs are applied in their own tab, while IVs are used from Advanced Treatments. Heart rate is influenced by all four autoinjectors: Morphine, Epinephrine, Adenosine and Atropine Morphine drastically lowers pain temporarily but, reduces the HR by an average of 20 per application while also thinning the blood. Thinner blood means increased bleeding, so try to apply morphine at or near the end of your assessment! You can effectively terminate a patient's pulse using this drug, use with caution! Lingers in the system for 15 minutes Within that time frame, 4 applications are usually fatal either due to cardiac arrest (low HR) or respiratory depression (leads to suffocation, not handled in ACE so it's just an "overdose") Epinephrine increases the heart rate depending on the starting value Low HR: Increase by about 15 Normal HR: Increase by about 35 High HR: Increase by about 30 Lingers for 2 minutes and takes 10 applications for an overdose Adenosine lowers the HR and thus reverses the effect of epinephrine Average decrease is 20, higher effect at higher heart rates 6 doses to an overdose Atropine is meant for NBC scenarios which are not currently modelled -- incorrectly lowers HR instead, is redundant About 40% less effective than adenosine 6 maximum doses, but... don't carry these, really Many patients will go out of their way to point out that they can hear their heart beating after you (or themselves) have given them morphine, meaning their heart rate has just dipped below nominal. If all else is optimal, they can literally walk it off and it returns to normal within a minute or two. There is no need to waste an epi on them. Moving on to IV fluids, these are surprisingly easy to summarize as they all (incorrectly) do the same thing: Blood, Plasma and Saline increase blood volume by the amount it says on the label Blood volume, in turn, directly affects blood pressure. The lower your BP, the more blood you will have lost. It's hard to recommend doses with an absolute change in BP. If you find a patient unconscious due to low blood pressure, chances are they'll need more than 1000 ml of fluid. If a patient has just now got the remark "Lost a lot of blood", a single 250 ml or 500 ml bag can fix that issue without a problem. Experiment on your own and do report your findings. Try not to administer more than 1500 ml of fluid at a time. Rather observe the changes, then come back to IVs later if necessary. Avoid wasted resources. Sources and Reference Material https://forums.ahoyworld.net/topic/8319-guide-ace-advanced-medical/
  7. NAVSPECWARGRU 1 SEAL TEAM 11 Orientation (OPNAVINST 1) I. Introduction to SEAL Team 11. A. Topics to be discussed in orientation. 1. Mission and Organization. 2. Customs and Courtesies. 3. Policies and Procedures. 4. Conclusion. II. Organization of SEAL Team 11. A. Introduction to the unit. 1. SEAL Team – Unit used by the United States Navy comprised of approximately 300 personnel, for a wide spectrum of special operations. 2. The teams consists of several platoons, which are then broken down into function specific squads and teams. a. 1st Platoon is our designation, and is comprised of our entire unit. b. 1st Platoon also includes the Operations, Admin, Logistics, Intel, and Training personnel. c. 1st Platoon is then divided as needed to meet mission requirements into either 8-man squads, 4-man fire-teams, or into 2-man reconnaissance teams. III. Customs and Courtesies. A. Customs 1. The “uniform” of SEAL Team 11 is your tag. Whether in game or in Teamspeak they should always be on correctly. Rank and then name such as (PO1 Frogman). 2. Addressing other members of the NAVSPECWARGRU One. a. E-3 and below are typically addressed just by their last name without their rank. b. E-4/5/6 will be addressed as PO3, PO2, PO1, or Petty Officer 3rd/2nd/1st Class or by rank and name. c. E-7/8/9 will be addressed as Chief, Senior Chief, or Master Chief or by rank and name. d. Officers of any grade will be addressed as Sir, or by rank and name. e. The Navy’s birthday is 13 October 1775, and a celebratory function is held every year to celebrate the occasion. f. Non-NCO – Seaman Recruit, Seaman Apprentice, and Seaman. g. NCO’s (Non-Commissioned Officers) – Petty Officers 3rd/2nd/1st Class. h. SNCO’s (Senior Non-Commissioned Officers) – Any Chief Petty Officer. i. Junior Officers – Ensign, Lieutenant Junior Grade, Lieutenant, and Lieutenant Commander. j. Senior Officers – Commander and Captain. B. Courtesies 1. Officers of any grade should be addressed as “Sir” or their rank. 2. Sounding “Attention on Deck” should be done for Commanders (O5) and above when they enter a Teamspeak channel that you may be in. “Carry On” is the command then given to resume normal activity. 3. Saluting is only authorized during awards and ceremonial formations. Saluting in a combat environment is unauthorized and will be dictated by commanders in the AO. IV. Policies and Procedures. A. Zero tolerance hacking or cheating. B. Teamspeak. Keep it clean in public areas. Take chatting to a private channel. C. Forums. No advertising, porn, or flaming. Keep the language clean as the forums are a professional area. D. Servers. Public and Private servers, there is a difference. 1. The public server is our primary tool for recruiting and relaxed play. All policies and procedures still apply. 2. The private server is for organized team play or training sessions. END C.D. Wall
  8. When a teammate goes down: Best Practices ACE Medical Menu By default, you can access the ACE medical menu by pressing H. It will give a detailed self-diagnostic as to your status. Looking at another player and pressing H will provide the same interface but it will show the vitals of the player you were looking at. On the Battlefield What should you do if a teammate suffers an injury on the battlefield? Announce to your nearby teammates that you have a man down. Specify who has been hit (This is helpful for the team leader) using the radio if possible. Eliminate the threat before retrieving or treating the wounded. Deploy smoke if no usable cover is available for treating the patient. Before treatment, test the patient’s responsiveness and heart rate by using ACE interaction and looking at his head, the check responsiveness option will appear. If he does not respond and has no heart rate, he is KIA. If he is responsive and/or has a heart rate, move to the next step. Get the wounded into as safe a position as possible, do not put yourself at unnecessary risk. Note that if you are not the one patching the patient up, provide security instead. Apply tourniquets/CAT to any bleeding limb, and stop all bleeding. Prioritize bigger wounds first in your treatment. Call for assistance in treating the patient if there are too many wounds for you alone to treat. Once bleeding has been stopped, remove any tourniquets. Check heart rate. If low, do not apply morphine as you risk inducing cardiac arrest. If normal or high, apply morphine. (Also note that pain will vanish after 5-10 in game minutes). If the patient is not yet conscious, apply epinephrine. If the patient has lost lots of blood, apply IV treatment. If this is impossible, call for the medic to do so. Once the medic arrives, inform him of what treatment is needed and specifically for which patient. Sources and Reference Material https://beowulfso.com/wiki/ACE3_Advanced_Medical_System
  9. Advanced Wounds *Disclaimer: As of September 2019, this is not an enabled or actively used system for ST11. The information contained in this article is for informational purposes only. The goal of this guide is to replace the outdated medical guides we have and act as a complement to the CSAR guide we currently have. One thing I noticed from my many missions and talks with people is that the Advanced Medical system with wound reopening and what bandages are "best" often vary from person to person. While most of the things I've heard are true to most extents, they often ignore other aspects of the system leading to flawed treatment strategies. The most common one being that Elastic bandages are the best thing for non-medical personnel. Once you've reached the end of this post and read all of the points I hope you will have learned something new. Table of Contents Wound Types Bandage properties Efficiency Reopening Chance Time Until Wound Reopens Bandage Examples Playable Roles Non-Medical Personnel Medical Gear Treatment strategy Medic Medical Gear Treatment strategy Battlefield Triage Personnel Medical Gear Treatment strategy Combat Search And Rescue Doctor Medical Gear Treatment Stratergy Concluding Remarks Sources and Reference Material Wound Types Before we begin talking about bandages or applying medical treatment in general, we need to mention why they are used. In Arma, all units can receive injuries. Depending on the source of injury a unit takes, they will receive different types of wounds. Wounds will also have a different size depending on their severity. Minor, Medium and Large are the three sizes. Each type of bandage will react differently to each type of wound and also the size of the wound. Some wounds are however not as common as others which means that ones goal should be to have the best treatment available for them. The two most common are Avulsions and Velocity wounds, responsible for around 66% of all combat injuries [3]. The full table of different wounds, their sources and effects can be seen below: Bandage Properties The best way to treat a wound is to apply a bandage. When choosing bandages there are 3 main attributes to take into consideration. We will go through all of these and rank all the different bandages in regards to each attribute. The exact properties of each bandage when used on different wounds can be seen below. Reopening chance is given as a value from 0 to 1, where 0 is 0% and 1 is 100% chance of the wound reopening. The MinDelay and MaxDelay values are given in seconds. Efficiency Pretty straightforward, the higher efficiency value a bandage has the more it can cover and treat a wound. A large wound might need 2 or 3 bandages that have low efficiency or it can be closed with a single bandage with high efficiency. For treating Avulsions and Velocity wounds the best you can use is an Elastic bandage, Field dressing and Packing bandage are tied for 2nd place and QuikClot is the least effective. Reopening Chance Once a wound has been closed, it will have a chance to reopen. How big this chance is depends on the different bandages and what wounds they have been applied to. For keeping Avulsions and Velocity wounds closed, the best you can use is a QuikClot, Field dressing is 2nd and Packing bandage and Elastic bandage are equally awful. In fact, Packing and Elastic have a 100% chance of the wound reopening when it comes to treating any type of Velocity wound. Time Until Wound Reopens The least known factor is the time each bandage has before it opens. Each treated wound has a minimum time for which the wound will remain closed. If a wound will reopen, it will happen somewhere after the minimum time has passed but before the maximum time. The exact point is randomized but on average it will happen in between the minimum and maximum value. This is not affected by how much player is moving about. Bandage Examples The best way to understand how each bandage works is to read and full comprehend the above tables. This can take a lot of time and still not make that much sense unless you have some example to connect the theory with practice. Below we provide an injury situation for 4 different soldiers in the form of a story. The times are averaged and the chances for wound reopening are also averaged. This is only an example. Dave and his 4 squad mates, Abraham, Ben, Caroline and Diane are out on patrol when they all get shot from an enemy MMG. All of Dave's friends now have one Large Velocity wound each. They don't have a medic with them but luckily they all have their own bandages with them. Abraham patches up his leg using only Elastic bandages. While he only needs a single bandage to treat the wound, every 80 to 200 seconds his wound reopens and he has to use another bandage. After around 7 minutes Abraham is out of bandages and after 2 more minutes his wound is now open and bleeding. Ben proceeds to use one of his Packing bandages on his bleeding limb. Ben only needs a single bandage to cover his wound but he knows the wound will reopen. The benefit of the packing bandage is that it will take a long time for the wound to reopen. After 1 hour and 10 minutes Ben applies his last packing bandage and will start bleeding in around 23 more minutes. Caroline looks over her wound and pulls out her Field dressing. She only needs to apply a single bandage to close the wound and hope that the wound doesn't reopen. Unfortunately the first two field dressings open up and after 10 minutes she applies the 3rd bandage. This time the wound stays closed and she has one Field dressing left. Diane quickly withdraws her QuikClot bandages and begins to dress the wound. The injury is a bit too large and she ends up using 2 bandages in order to close it. After 23 minutes the wound had a chance to reopen but luckily it stayed closed. Diane has 2 QuikClots left and continues on her mission. Since we all have different roles and mission types it is difficult to make a guide that will give you the best loadouts and strategies for all situations but I will describe a few roles and provide a detailed list of what medical gear you should bring. These roles, their gear and treatment strategies are listed below. Playable Roles Non-Medical Personnel The medical gear you are allowed to bring is limited and thus a lot easier to remember and manage. The only thing that you can adjust is the overall bandage mix you bring with you. Since most people are in a squad that features a medic, they rarely actually need to use their bandages. If they do use them they can often get a re-fill from their medic later or scavenge more from fallen EI or friendlies. What is most important in my mind is for all members of a squad to have good medical equipment that means they can extend their combat effectiveness long enough for another squad's medic to arrive or for a CSAR team to make contact. Medical Gear Total weight - 0.32 kgs Treatment Strategy Before you treat any of your wounds or those of your comrades, you need to make sure that the AO is safe. This does not mean safe in the sense that all EI are dead and objectives cleared but instead means that your treatment doesn't put anyone else at a higher risk. Just imagine how frustrating it would be if an enemy creeps up from a flank you thought a teammate was covering. So while your friend patches their wound you get lit up by a 7.62mm burst and you get killed. A small wound has now indirectly resulted in a causality because someone panicked and failed to provide cover. So always keep a cool head and don't immediately go for your bandages. A quick check of your wounds through the medical menu is always a good idea. This means you know how many wounds you have and how much you are bleeding. A few seconds of light bleeding is not gonna kill you but if all of your body parts are pouring blood you need to inform your medic before you pass out. If a friend is down and injured you call it out, clear the AO and then proceed to help them, not before. Once you are treating yourself or someone else, always cut of the bleeding from any limbs by applying a tourniquet the wounded body part first. If the wound is an Avulsion, use your QuikClots bandages. For this wound type they are really good because once the wound has been closed, it only has a 20% chance to reopen. If the wound does reopen, it will do so between 16m40s to a maximum of 26m40s. If the wound is a Velocity wound, use your Packing bandages. Although the wound has a 100% chance to reopen, it will not reopen until at least 13m20s has passed and may stay closed for a maximum of 33m20s. Both of these bandages types ensure you have plenty of time to get it stitched up before then. If you are treating other types of wounds you are to first use your packing bandages and then use the QuikClots if you run out before the wound is closed. Once the wounds are closed, remove the tourniquet and use the morphine followed up by an epinephrine if the patient is in a fair amount pain. The morphine will remove the pain and lower the heart rate. This produce a loud thumping noise in your ears which the epinephrine counteracts by raising your heart rate. Small amounts of pain are not a good enough reason to apply a morphine. Medic As a medic, you have no limits on the amount of medical equipment you may bring beyond your physical carry capacity. You are expected to bring enough stuff to be able to treat all of your patients and also to be able to resupply your squad while still having enough gear to be combat effective. This means you will need equipment that fit your treatment strategies but also items that fulfill the needs of your squad mates (Non-medical personnel) and enough magazines and smokes to fight the enemy. Do note that this gear list is more flexible and should be adjusted for the size of your squad, how far away friendly backup is going to be and how you will be traveling. Bigger squads means more potential patients and you should increase the amounts of bandages and autoinjector drugs. If you will be hoofing it on foot for longer distance you should consider bringing less bandages and blood in order to reduce your overall weight. You will also need to bring a Surgical Kit to stitch up wounds and a Personal Aid Kit to fix broken limbs. Medical Gear Total weight - 7.26 kgs Treatment strategy With great gear comes great responsibility. Similar to how all non-medical personnel operates when it comes to securing the immediate area, a medic has to make sure that leaving their position to tend to a patient does not bring any other squadmates at higher risk of injury. It's extremely bad and inefficient if a medic through his or her actions manages to indirectly cause more harm than they seek to prevent. This means you don't automatically sprint towards any friends that get downed the second it happens. Instead your job is to stay safe and once the current battle is over, proceed to treat the wounded. Many people fail at this and simply rush into fire in an attempt to save a downed comrade just to be met with a shiny bullet to the head. Congratulations, you died and now your squad has no medically competent personnel. So, always keep yourself and your squad safe by fending of enemies first and treating the wounded second. Remember, you are first and foremost a riflemen, a medic second. Once the smoke clears and most enemies have been dealt with, assess the current health situation of your squad. Usually your squad will keep you updated with their injuries or who has fallen but sometimes in the confusion of battle someone might be forgotten. A radio check is always a good idea after heavy engagements to make sure everyone is still up or if anyone needs immediate attention. Once you have a good understanding of the current status of your squad, it is time to triage. In general, people who are still unconscious should be prioritized ahead of those who are conscious. If any conscious person is really badly injured they should have informed you and then you still want to make sure no unconscious person is worse off. So you've got several patients, some really bad and some with only a few scratches. You need to work quickly to make sure no one dies. Tourniquet all bleeding limbs. If the patient is low on blood, select a limb and apply a blood IV. Next, start patching up the head or torso, starting with the one body part that is most severely injured. Use Elastic Bandages to close the wounds. Once the head and torso are no longer bleeding, start working on any injured limbs. Use Elastic Bandages to close the wounds. Once all wounds are closed, use a surgical kit to permanently close all the wounds. Remove all tourniquets. Apply Morphine and Epinephrine if the patient is in great pain. Use a Personal Aid Kit to fix any broken limbs. This would also restore any blood loss on a player but it is really slow. Should only be used to fix broken limbs. If the patient dies while treating or is found dead, take their dog tag and then place them in a bodybag. This is only to be done if all other living patients have been tended to first. The reason why a medic should only use Elastic Bandages is that they are the most effective at closing wounds. They will not stay closed for long in most cases but you should be able to patch the wounds and then stitch them before they have time to reopen. Another thing to take note of is that some situations will require you to treat multiple patients at the same time to make sure no one dies. This usually means you do step 1 and 2 on all patients in order to slow their bleeding and buy yourself time to patch up one of them at a time starting with the patient who is in the most critical condition. You cannot afford to get tunnel vision and solely focus on a single patient, this is how people end up dying out of neglect. Another item of note is that while your SL has command over you, they should not interfere with the order in which you treat patients. They technically have the authority to make you leave a dying patient to go patch up their paper-cut but any SL worth their salt will not do this. Instead, keep good communication with your SL and tell them how much time you need to treat your patients. This makes both your lives easier. Battlefield Triage Personnel As Battlefield Triage Personnel, or BTP for short, you have one of the most intensive and demanding jobs one can have when it comes to medical roles. Your main function, when you are not engaging enemies, is to keep all your squad members alive by applying the correct bandages for specific wounds and to keep a constant check on the amount of injuries your squad has sustained on an individual basis. The overall combat effectiveness of your squad needs to be structured according to the Medevac SOPs [4] and then communicated to your SL so they can call in for a CSAR team when they deem it necessary. As if this wasn't troubling enough you also have huge limitations on what gear you can bring. You are not allowed to bring Surgical kits, Personal Aid Kits or Blood IV bags. This is the role for those who want to push their skills to the limits in order to stand out from the crowd of average medical personnel. Medical Gear Total weight - 7.03 kgs Treatment strategy Similar to how paramedics are the vital connector from site of injury to the hospital ER, BTP act as a life extension for their squad. In general, the longer a squad is deployed the more wounds the squad will have in total. Each of these wounds will bleed if left untreated and worse yet, they will reopen if treated improperly. Every single wound reopening will require at least an additional round of bandages and more treatment time. This time in turn decreases the overall combat effectiveness of the whole squad. To minimize this a BTP should aim to stabilize patients first and secondly to treat wounds with a focus on keeping wounds closed for long enough that a CSAR team can make contact. While you are equipped to tend to injured people, you are a rifleman first. This means you apply force to neutralize enemy threats before tending to the wounded. Patching up a friendly is of no use if you get overrun and killed in the process. While it's no fun losing a teammate, it is preferable to your squad getting wiped. Priority should be to keep your friends from getting wounds in the first place. Unfortunately, shit happens and once the dust settles it's time to bring out your gear. The same process that medics follow is used here with the exclusion of step 5 and 7 since a BTP does not have a Surgical Kit nor a Personal Aid Kit. Step 2 is different in the sense that Saline IV is used instead of Blood IV. Another difference is that each wound needs to be treated in regards of wound type and overall patient status. If a patient has lost a lot of blood and have several wounds on their limbs, torso and head they need to be stabilized quickly. Once all tourniquets are applied and a Saline IV have been given, the wounds on the torso and head need to be closed as soon possible. This means using the most efficient bandage type, Elastic bandages. If the patient is no longer bleeding or has not lost a large amount of blood, you should instead focus on making sure you use bandages that minimize the chance of reopening and maximize the delay for the wound to reopen. This means that each wound type has an optimal bandage you should use. Below I have listed each wound type and what bandage you should apply to keep the patient combat effective for as long as possible. Abrasion -> QuikClot Bandage Avulsion -> QuikClot Bandage Velocity wound -> QuikClot Bandage Cut -> QuikClot Bandage Laceration -> QuikClot Bandage Contusion -> Elastic Bandage Crush Wound -> Field Dressing Puncture wound -> Field Dressing It should be noted that this strategy will use more bandages during initial treatment but that it will use less in the long run given that wounds are less likely to reopen and need another round of treatment. Another thing to note is that the BTP should not use packing bandages but still carries a few of them in order to resupply his teammates. So you've patched up your friends and now have to summarize the total health status of your squad and report it to your SL or 2iC. If you have 1 person with broken limbs and 2 patients who need stitching of their wounds, you tell them you have "One times Cat 2, Two times Cat 3." and let them call it in to the CSAR. If the request is granted, your SL is in charge of keeping the perimeter safe while you have authority to send people to or away from the CSAR vehicle. You stay close to the vehicle and communicate with the CSAR Doctor and tell them how many patients you have and make sure they get treated in order of priority. Should the CSAR only have time to treat a single patient they have to focus on the most critical one. A common problem is that people bunch up and want to stay close to the vehicle when they do not need to. This is dangerous for everyone and you have to tell people to back off. Only patients currently being treated and the BTP should be close to the chopper at any given time. Combat Search and Rescue Doctor The purpose of a Combat Search And Rescue Doctor, or CSAR Doctor for short, is to take care of patients handed to them by the squad BTPs and get them back to full combat effectiveness in a fast manner. CSAR Doctors are backed up by either a helicopter or an armored vehicle to make their movement fast and keep them relatively protected. This means that they are not really encumbered by a having their bags filled with lots of medical gear. They are also expected to treat more patients than a BTP and are recommended to load up their vehicle with extra supplies for themselves and any BTP who need to resupply their medical gear. Note that only the gear carried by the CSAR Doctor is listed so be sure to pack a few medical bags with the BTP gear and load them into the CSAR vehicle. Medical Gear Total weight - 10.11 kgs Treatment strategy Treat patients similar to how a Medic would treat them. Follow the same steps and prioritize the most serious patients first. If the CSAR is without tasking and a queue of Cat 4 patients are waiting, head towards them and pick them up. If they have not been body-bagged do so prior to loading them into the vehicle. Sources and Reference Material https://ace3mod.com/wiki/feature/medical-system.html#221-wounds-bandages-and-medications https://docs.google.com/spreadsheets/d/1tUvdGi5WCd5GZ3iesZK1-54xzC50iPg7mPy0hw9yEl4/edit?usp=sharing https://www.fuckknows.eu/forums/topic/489-critical-casualty-clearance-a-guide-to-implementing-medevacs-in-arma/ https://github.com/acemod/ACE3 https://www.fkgaming.eu/guides/official-guides/arma-guides/medic/advanced-wounds-guide-r42/
  10. ACE3 Advanced Medical System Same as with basic, when hit an injury is sustained. Different though is that the type of injury and the severity of it are based upon how the damage was done and what caused it. This affects both blood loss and immediate consequences, such as being knocked out or being killed right away. When a player has sustained an injury, this will be indicated by flashing red on the screen; this means the player is bleeding. Abrasions (or scrapes): They occur when the skin is rubbed away by friction against another rough surface (e.g. rope burns and skinned knees). Sources: falling, rope burn, 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. Explosions, gunshots, and animal bites may cause avulsions. Sources: explosions, vehicle crashes, grenades, artillery shells, bullets, backblast, bites. Effects: pain - extremely high, bleeding - extremely fast (depends on wound size). Contusions: Also called bruises, these are the result of a forceful trauma that injures an internal structure without breaking the skin. Blows to the chest, abdomen, or head with a blunt instrument (e.g. a football or a fist) can cause contusions. Sources: bullets, backblast, punches, vehicle crashes, falling. Effects: pain - light, no bleeding. Crush wounds Occur when a heavy object falls onto a person, splitting the skin and shattering or tearing underlying structures. Sources: falling, vehicle crashes, punches. Effects: pain - light, bleeding - extremely slowly. Cut wounds Slicing wounds made with a sharp instrument, leaving even edges. They may be as minimal as a paper cut or as significant as a surgical incision. Sources: vehicle crashes, grenades, explosions, artillery shells, backblast, stabs. Effects: pain - light, bleeding - speed depends on length and size of the wound. Lacerations (tears): these are separating wounds that produce ragged edges. They are produced by a tremendous force against the body, either from an internal source or from an external source like a punch. Sources: vehicle crashes, punches. 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: stabs, grenades. Effects: pain - light, bleeding - slowly. In order to stop the bleeding, all bleeding injuries on every body part requires treatment. This is done by either applying a tourniquet to legs or arms as a temporary solution, or by using bandages to stop the bleeding as a more permanent fix. Bandage Effectiveness *Table Legend: Efficiency: Bandage efficiency, higher is better. Reopening chance: Reopening chance when advanced wounds are enabled, lower is better. Tourniquet: Can only be applied on limbs. Stops bleeding from wounds. Should be taken off as fast as possible and applied only to give medic time to bandage all the wounds. If not taken off for a while it will cause pain to the patient. IVs: Saline plasma and bloodAll three restore the volume of liquid in the blood stream. as a result blood pressure is raised for all of them. Use the appropriate amount depending on the situation (heavy loss of blood, blood pressure too low) (250, 500 or 1,000 mL) Autoinjectors: Morphine Decreases the blood viscosity, suppress pain Epinephrine Raises the heart rate of the patient Adenosine Lowers the heart rate Atropine Lowers the heart rate of the patient Surgical Kit: Is only useful when advanced wounds (reopening) is enabled. Stitch a wound to stop it from reopening. It’s use may be limited to a certain class and / or near a vehicle / facility. It’s use can also be limited according to the condition of the patient, you might need to stabilize him first before using it. PAK: Used to fully heal someone. (Removes any injury, restore vitals to a stable state and reset the medical history, clears all medication in the system.) It’s use may be limited to a certain class and / or near a vehicle / facility. It’s use can also be limited according to the condition of the patient, you might need to stabilize him first before using it. Vitals: NOTE: the systolic blood pressure is the number on the left, the diastolic blood pressure is the number on the right. Blood pressure is affected by the amount of blood lost as well as IVs and medication. Non existent: 0 - 20 systolic. Low: 20 - 100 systolic. Normal: 100 - 160 systolic. High: 160 and above systolic. Heart Rate: The heart rate (pulse) is affected by the amount of blood lost and medications. Low: 45 and below Normal: between 46 and 119 High: 120 and above Cardiac Arrest: A patient will enter cardiac arrest when: The heart rate is below 20. The heart rate is above 200. The systolic blood pressure is above 260. The diastolic blood pressure is below 40 and the heart rate is above 190. The systolic blood pressure is above 145 and the heart rate is above 150. Treatment This is a step by step guide, follow the steps from 1 to 6 in order unless stated otherwise. Keeping the patient’s vitals stable is your first priority. If advanced wounds are enabled make sure from time to time that they didn’t reopen. If a limb has a wound with a high bleeding rate (or multiple) such as a large avulsion or large cut; use a tourniquet immediately on it, otherwise the patient might loose large amounts of blood while you try to treat it. 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. Additional Information: As an infantryman you can use a tourniquet to stop a limb from bleeding, note that this is supposed to be a temporary solution and leaving the tourniquet more than 5 minutes will induce pain. Pain is only suppressed and not removed by default. You don’t have to take epinephrine after you take morphine, just wait until your pulse stabilizes by itself (Provided that you are in a stable condition). Revive System (Advanced Medical): For the following procedure to work revive needs to be enabled. A unit in the revive state will be unconscious and will stay unconscious until it is either woken up or the revive timer runs out. A unit in the revive state can’t die from any source of damage, only the timer reaching 0 can kill it. Each successful CPR will increase the time the unit can stay in the revive state. To wake up a patient the use of a PAK is required. Each successful revive removes a life from the unit, once the lives run out the next time the unit will take fatal damage it will not enter the revive state and will die. Each successful round of CPR (filled up completion bar) increases the time left in the revive state.
  11. ACE3 Basic Medical System ACE3’s basic medical system is quite a bit more complex than Arma 3’s default system, but not really difficult to grasp. ACE3 basic medical is a mixture between the ACE2 and AGM medical systems. All interactions in the medical system are done with the interaction menu. Non-medics can - by default - not perform all actions (Epinephrine and IVs) and their actions take more time as when performed by trained medics. When hit, units start to lose blood depending on the severity of their wounds. Once the level of blood falls below a certain threshold, the unit will fall unconscious and eventually die. Units will also fall unconscious when sustaining large amounts of damage at once or from high amounts of pain. Wounds It’s pretty straightforward compared to advanced, you only have two types of wounds. Yellow: Small - medium sized wound, a single bandage is usually enough. Red: Large wound, 2 or more bandages are usually needed. Bandages All of them have the same effect. Tourniquet Serves no use in basic IVs Use the appropriate amount depending on the situation (low / heavy loss of blood) (250, 500 or 1 000 mL) SalineServes no use in basic PlasmaServes no use in basic BloodRestores the blood of the patient Autoinjectors Morphine removes pain Epinephrine wakes up the patient Atropine serves no use in basic Adenosine serves no use in basic Treatment Step 1: Is the patient responsive? Yes: Ask him if he has wounds / he is in pain. No: Go to step 2. Step 2: Is the patient wounded? Yes: Treat the wounds and go to step 3. No: Skip this step. Step 3: Is the patient in pain? Yes: Give him morphine. No: Skip this step. Step 4: Did the patient lose a lot of blood? Yes: Give blood via IV. No: Go to step 5. No and patient responsive: You’re done. Step 5 If at this point the patient is still not back on its feet it’s time to use an epinephrine Autoinjector. Additional Information: If the revive system is in place your character will not die until the revive timer is at 0. Even if a tank shoots your ass off an epinephrine shot will bring you back up after your wounds are treated. (The timer is invisible and may vary from mission to mission, it also depends on the amount of lives remaining you have.). You can’t do an overdose in basic. Revive System (Basic Medical) For the following procedure to work revive need to be enabled. A unit in the revive state will be unconscious and will stay unconscious until it is either woken up or the revive timer runs out. A unit in the revive state can’t die from any source of damage, only the timer reaching 0 can kill it. Each successful CPR will increase the time the unit can stay in the revive state. To wake up a patient treat all of his wounds, make sure he isn’t in pain and then use epinephrine. Each successful revive removes a life from the unit, once the lives run out the next time the unit will take fatal damage it will not enter the revive state and will die.
  12. Overview: ACE3 provides users with a more realistic medical system and comes in both a basic and an advanced version. Revive System: The revive system lets you bring downed units back up. Upon receiving a deadly amount of damage a unit will fall unconscious for a determined amount of time. In that time a medic will need to treat them and give them epinephrine to bring them back up. Basic Medical: ACE3’s basic medical system is quite a bit more complex than Arma 3’s default system, but not really difficult to grasp. ACE3 basic medical is a mixture between the ACE2 and AGM medical systems. All interactions in the medical system are done with the interaction menu. Non-medics can - by default - not perform all actions (Epinephrine and IVs) and their actions take more time as when performed by trained medics. Advanced Medical: The advanced medical system provides a more complex and detailed medical simulation and is based off the CSE CMS. It focuses on a more realistic model for injuries and treatments, thus resulting in a more important and prominent role for combat medics, and a bigger incentive to avoid getting shot. The system behind advanced medical is designed to attempt to mimic important parts of the human body, as well as react to any injuries sustained and treatments applied in a realistic manner. The available treatments and supplies in advanced medical are based off the Tactical Combat Casualty Care (TCCC) guidelines, which are the same guidelines used by real-life combat medics around the world. Besides the 4 elements introduced by basic medical, advanced introduces the following: More detailed wound system. Accurate blood loss based upon sustained injuries. Vitals, including heart rate and blood pressure. Cardiac Arrest. Various treatment methods such as CPR, different kinds of IVs and a working tourniquet. A basic medication simulation.
  13. OP: Sand Demon- Phase III Join us for another OP, in the plains of Anizay. Please RSVP so we can have an accurate headcount and make accommodations to the mission layout, as needed.
  14. NAVSPECWARGRU 1 SEAL Team 11 Duties and Responsibilities of SEAL Team 11 (OPNAVINST 2) Duties and responsibilities for all members of ST11: 1. Follow the policies and procedures of ST11. 2. Check the forums at least twice a week. 3. Stay active within the unit and have the initiative to train. 4. Attend as many scheduled events whether it be meetings, CAX, or section training. 5. Assisting section leaders with their duties. Operator – The operator carries out the orders of the team leaders. He is responsible for the effective employment of his weapons and for the condition and care of his weapon and equipment. The operators are also cross-trained in a variety of specialties. Assistant Automatic Rifleman – The assistant automatic rifleman assists in the employment of the automatic rifle. He carries additional magazines and/or ammunition boxes for the automatic rifle and is prepared to assume the duties of the automatic rifleman. He is responsible for the effective employment of his rifle and for the condition and care of his weapon and equipment. Automatic Rifleman – The automatic rifleman carries out the orders of the fire team leader. He is responsible for the effective employment of the automatic rifle and for the condition and care of his weapon equipment. Lead Medic – The SEAL Team’s Lead Medic serves as an extension of the Naval surgeons out in the field. He is responsible for delivering pre-hospital, advanced life saving procedures to wounded military personnel and civilians as necessary. The Lead Medic is responsible for training all other operators in basic combat lifesaving techniques and the normal day to day operations in and around the base of operations as it pertains to the medical treatment of the wounded. He is also responsible for updating all team members of the status of wounded personnel during an operation. While medical treatment is his main priority, the Lead Medic is also: Responsible for the training of medical procedures to the unit. Organize training sessions and exercises pertaining to combat lifesaving procedures. Maintain and submit on a regular basis the progress of each member pertaining to medical knowledge and practices in combat situations Assisting in training plans and training operations. Perform daily checks on status of new scripts and addons for the unit that pertain to medical specialties. Assist in organizing training documents for the unit. Serves as a rifleman to help secure areas, maintain security in operations, and to fill in as a vital member of the teams. Corpsman - Perform duties as assistants in the prevention and treatment of disease and injury and assist health care professionals in providing medical care to Navy personnel and their families. They may function as clinical or specialty technicians, medical administrative personnel and health care providers at medical treatment facilities. They also serve as battlefield corpsmen with the Marine Corps, rendering emergency medical treatment to include initial treatment in a combat environment. Qualified hospital corpsmen may be assigned the responsibility of independent duty aboard ships and submarines; Fleet Marine Force, Special Forces and Seabee units, and at isolated duty stations where no medical officer is available. Lead Diver - The Lead Diver is a specialist in all operations pertaining to water rescue and recovery of personnel/equipment in danger of the sea. He routinely performs shallow water rescue procedures to pull wounded and or stranded personnel back to a hazard free treatment area until the Lead Medic/Corpsman has a chance to take over medical responsibilities. During flight operations over land or water, he helps the crew chief and pilot remain aware of surrounding dangers. Trained as an operator, he also fills the role as a team member during ground combat operations where needed. The Lead Diver is the leading authority of the crew when it comes to operations in maritime settings. Responsible for the training of dive procedures to the unit. Organize training sessions and exercises pertaining to combat dive/rescue procedures. Maintain and submit on a regular basis the progress of each member pertaining to dive/rescue knowledge and practices in combat situations Assisting in training plans and training operations. Assist in organizing training documents for the unit. Pilots – The pilots are responsible for the safe transportation of personnel in both training and operations. They are also qualified RTOs to be able to communicate with other ground forces in the area, as well as any teams attached to their aircraft. They are also responsible for the effective employment, care, and maintenance of their aircraft. Sniper - The scout sniper is an operator skilled in field craft and marksmanship who delivers long range, precision fire on selected targets from concealed positions in support of combat operations. They have a secondary mission of gathering information for intelligence purposes. They participate in activities designed to deny the enemy freedom of movement by targeting enemy leaders, crew served weapons operators, radiomen, observers, messengers, and other key personnel with precision fire. Snipers engage vital material targets such as command and control equipment, light armored vehicles, air defense radar, and missile launchers that require precision rifle fire to neutralize. Snipers also conduct close reconnaissance and surveillance operations for the infantry battalion in support of the intelligence section. Assistant Team Leader – The assistant team leader carries out the orders of the team leader. He is responsible for the fire discipline and the control of the team and for the condition, care, and economical use of its weapons and equipment. In carrying out the orders of the team leader, he takes a position to best observe and control the team. Normally, he is close enough to the automatic rifleman to exercise effective control of his fires. In addition to his primary duties as a leader, but not to the detriment of them, he serves as a grenadier and is responsible for the effective employment of the grenade launcher, his rifle, and for the condition and care of his weapons and equipment. The assistant team leaders also assumes command when the team leader is not available. Team Leader – The team leader carries out the orders issued to him by the platoon commander. He is responsible for the discipline, appearance, training, control, conduct, and welfare of his squad at all times, as well as condition, care, and economical use of its weapons and equipment. In combat, he is also responsible for the tactical employment, fire discipline, fire control, and maneuver of his team. He takes position where he can best carry out the orders from higher and observe and control the team. The Team Leader is also responsible for communications with the pilots during training and operations to ensure they are carried out as safely and timely as possible, he also serves as the RTO (Radio Telephone Operator) if one is not present or unavailable. Duties and Responsibilities of Team Leaders: Follow policies and procedures of ST11. Checking the forums daily. Be an active member, playing ARMA and attending unit events. Responsible for in game server administration. Organize training for the unit. Submit training reports upon completion of training regimens. Report to higher regularly with updates on the team. Keep up the good order, morale, and discipline of the unit. Assisting in training plans and training operations. Teamspeak/Game server administration. Organizing training documents for the unit. Insure that platoon members are receiving proper training. Forward and recommend members for awards and decorations. Place new members to billets within the teams. Conduct monthly checks of personnel files.
  15. Cooper

    Awards Criteria

    NAVSPECWARGRU 1 SEAL Team 11 Awards Criteria (OPNAVINST 3) Qualification Badges Naval Parachutist Badge – Successful completion of the basic parachute course consisting of a total of five parachute jumps by any combination of static line jumps or freefall jumps utilizing the MC5 parachute while exercising HALO techniques. This is a prerequisite for completion of the SEAL Qualification Training. Naval Aviator – Demonstrate proficiency as a pilot and completion of five official operations as a pilot. Naval Special Warfare – Successful completion of SEAL Qualification Training (SQT). SQT is comprised of the Naval Parachutist Course, Navy Diver Course, and no less than a Marksman pistol/rifle qualification. The member must also complete five operations in capacity with SEAL Team 11. Personal Awards USN Pistol/Rifle Marksman – Qualify on the small arms range with the M16/M4 service rifle and service pistol. Devices awarded based on level of qualification. USN Training – Submit a unit approved training document and instruct it both in lecture, and on the field. Devices awarded for subsequent awards. USN Recruiting – Recruit a member who stays active for at least 90 days. Devices awarded for subsequent awards. Afghanistan Campaign – Complete fifteen operations in any combination of the Afghanistan theater. Devices awarded for subsequent awards. National Defense – Enlist into SEAL Team 11 during a time of war. Armed Forces Expeditionary – Complete fifteen operations in which a campaign ribbon is not already authorized for. Devices awarded for subsequent awards up to the number of different theaters participated in. USN Good Conduct – Complete six months time in service in good standings. Devices awarded for subsequent awards. Combat Action Ribbon – Completion of fifteen operations that resulted in taking of small arms fire, or indirect fire. Devices awarded for subsequent awards up to the number of different theaters participated in. USN Achievement – Complete fifty operations. Devices awarded for subsequent awards, “V” device is awarded for fifty Combat Action Ribbon qualified operations. This award can also be authorized for any other meritorious achievement. Joint Service Achievement – Complete fifteen operations with at least one other unit. Devices awarded for subsequent awards. USN/USMC Commendation – Complete one hundred operations in capacity with the SEAL Team 11. Devices awarded for subsequent awards, “V” device is awarded for one hundred Combat Action Ribbon qualified operations. This award can also be authorized for any other meritorious achievement. Joint Commendation – Complete fifteen operations with at least two other units. Devices awarded for subsequent awards, “V” device is awarded for fifteen Combat Action Ribbon qualified operations. USAF Aerial Achievement – Complete twenty five operations as a pilot attached to SEAL Team 11. Devices awarded for subsequent awards. This award can also be authorized for any other meritorious aerial achievement. Air Medal – Complete twenty five operations where damage to the aircraft is taken from hostile fire, but returned to base successfully for repairs. At least one module must be in the yellow damage state, and/or awarded for every three confirmed enemy air asset destruction. Devices awarded for subsequent awards, “V” device is awarded for twenty five Combat Action Ribbon qualified operations. Meritorious Service – Two years of active service in the unit in good standing. Devices awarded for subsequent awards. Purple Heart – Become wounded due to enemy actions in at least fifteen operations. Devices awarded for subsequent awards. Bronze Star – Complete three hundred operations as a member of SEAL Team 11. Devices awarded for subsequent awards, “V” device awarded for three hundred Combat Action Ribbon qualified operations. This award can also be authorized for any other meritorious achievement. Silver Star – Complete five hundred Combat Action Ribbon qualified operations. Devices awarded for subsequent awards. This award can also be authorized for any other meritorious achievement. Navy Cross – Complete one thousand Combat Action Ribbon qualified operations. Devices awarded for subsequent awards. This award can also be authorized for any other meritorious achievement.
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