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The Big Medical
Forum » Training » Guides
Joined: 14th Sep 2014
Rank: Inactive Member
Likes 440
1st Aug 2022

With the new medical changes, I find it necessary to update the community on some of the medical practices that they may be used to, as in the new system some of them may be different than what you are used to.



Bandage effectiveness and re-opening has been reverted to default ACE medical values. This means that some bandages work almost opposite of what we are used to.

Elastic is a high effectiveness, but high reopening bandage. Not good if you keep reopening, but good for the big bleed.
Packing is kinda the same as elastic, but the reopening "window" starts later than elastic.
Field dressing is more or less the same as in the old system, a good ol' jack of all trades.
Quick clot may also be kinda the opposite of what it used to be. A low reopening, low-medium effectiveness bandage. Not 100% on this tho.

There are some cheat sheets and guides that can give a rough direction to what they are now.
For example: ... etails/?id=930706887

Auto injectors

One major change is that auto injectors now take a little bit of time to have an effect. Not instant like previously. Also the "overdose" mechanic from the previous system where there was a hard limit (2) on the amount you could give someone in a certain amount of time is not in effect anymore. This has been kinda replaced by the instability an excessive amount of drugs puts on the vitals.

Morphine is much more spicy now. The effects on vitals, especially in a moderate-highly wounded casualty are way more drastic.
Because of this morphine should be used way more carefully now. Mostly on the medics or CMT-trained personnels advice. If you want to use it on yourself, do it at your own risk. The VA won't be covering any myocardial complications you may suffer after your service.
Also the pain relieving effets are stronger and last longer, even after the injection has gone in.

Epinephrine is pretty much the same as before altough it also gives people a bigger change of waking up from unconsciousness. It's use to balance out the effects of morphine on vitals is more important now too.

Adenosine has potential use cases now as the vitals system is more complex and realistic. Mostly for medics to worry about.


The way vitals work in the new system is more complex and realistic compared to the old system. This should give the medics more exiting and challenging situations to deal with (yay).
Generally the vitals are affected more realistically by the casualtys wounds and state than previously.

Heart rate is affected more by medications and other factors such as pain and blood loss now. This may cause confusion as previously the case was usually low vitals=badly wounded, high vitals=mostly good. This is not the case anymore. If your fren gets hit and his heart rate is high, that doesn't automatically mean he's OK for moprhine and he will get up in a few seconds. Also cardiac arrest is a somewhat more rare occurance, as you won't just randomly lose heart rate on a hit to the chest or head. Cardiac arrest is more caused by complications with vitals and such.

Blood pressure is also affected more by medications than previusly. Also, blood loss is a more severe issue than previsously. This is why you should prioritise bleeding control more than previously.

Generally the grunt needs to worry more about the bleeding and then focus on the vitals. The way the new CPR/Cardiac arrest system works is more forgiving, even if you don't start CPR immidiately. Also moving a casualty in this state is not as risky as previously (still don't go on a hike with them).

The Big Death

With the new update, people who get shot and go unconscious will ragdoll. This makes distinguishing dead from alive a bit more difficult, especially in a chaotic mass-casualty situtation. Lack of blood pressure doesn't mean they are necessarily dead anymore. The quickest way of checking if the casualty is still in a "recoverable" state is to see if they can still be carried or dragged. If you can still move them, they are "ALIVE". If not then they are the big dead aka. KIA. This is a bit gamey, but the only real sure way to know ATM.


The new medical system is more realistic in some ways. Blood loss is more severe now, so keep a good eye on your buddy. Leaving them to bleed out for even a minute can move them from a not so serious case to a more serious one.

The medical procedure for the average grunt in case of a casualty is:

  1. Deal with the immidiate threat. Don't get shot by the same guy your buddy did.
  2. Make sure the area is safe(ish) given the circumstances. Don't end up as another casualty.
  3. Drag the casualty back from the immidiate danger to reasonable cover.
  4. Stop the bleeding AS FAST AS POSSIBLE. Use of tourniquets is adviced.
  5. DON'T JUST STICK THEM WITH MORPHINE! Increased heartrate can be a result of pain that the casualty is in and will make the vitals plummet if you give them morphine. If you use morphine AND DON'T KNOW WHAT YOU ARE DOING, you will make the medics job harder later on. If you choose to use morphine regardless, monitor the vitals and balance it with epinephrine if needed. Using morphine-epi combo can be useful in a last ditch situation to maybe get more people into the fight, but it's the exception not the rule.
  6. Check the vitals. Note that a tourniquet limb will not give you a good reading. Also you can only check BP on limbs now.
  7. In case of cardiac arrest provide CPR and call for the medic. Otherwise stabilize them as best as you can. Epi will increase change of awakening.
  8. Once the casualty has stable vitals deal with the potential pain. At this point the medic has probably taken over if the casualty is severe enough.

The new medical is still being adjusted and some of the things may change. We aim to keep the system fairly close to vanilla ACE tho.
I may update this post if major changes are made.

stop randomly giving people morphine REEEEEEEEEEEEEEEEEEEEEEEEEEEE

Signature Picture

"Pain is weakness leaving the body"

Last Edit: 28th Aug 2022 by Grusey
Joined: 14th Sep 2014
Rank: Inactive Member
Likes 440
27th Aug 2022


More bandage info.
Additions to auto-injector info.
The Big Death

Signature Picture

"Pain is weakness leaving the body"

Last Edit: 28th Aug 2022 by Grusey
Forum » Training » Guides
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