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Basic First Aid

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This article is based on the SMCSS Principle.
This article is an abbreviated & simplified form of UOTC Tactical Combat Casualty Care.

Intent

This article is supposed to deliver a quick overview over the following topics:

  • What are the most basic features I should know concerning the ACE medical system?
  • How should I react ingame, when a player near me becomes a casualty?
  • What is first aid and how am I gonna use it to help?

ACE Medical Features

ACE integrates an awful lot of factors concerning their advanced medical system. Still all are needed and supply players with an indepth tool for simulation. Some of the more important facts about those features that you should definitely know and be able to remember are listed below:

  • Blood volume is the most critical value (default: 6.141 liters)
  • Wounds bleeding speed is based on size and type
  • Tourniquets are useful items!
  • Do not adminster any drugs onto yourself or others in aims to preform first aid.
  • ACE supplies a medical menu, way more handy than the 3D radial menu activated by default
  • Prevent injuries in the first place, by correct use of cover and character stances

Wounds, Bandages & The Tourniquet

Starting of with the most important wounds:

Name Likely Cause Bleeding
Velocity Wound Projectile penetration Small: Medium
Medium: Fast
Large: Heavy
Puncture Wound Projectile & Shrapnel penetration Small: Lower
Medium: Medium
Large: Fast
Avulsion Explosions, backblast, shells Small: Lower
Medium: Lower
Large: Medium
Cut Vehicle crash, explosive shrapnels, backblast, stabbing Small: Lowest
Medium: Lower
Large: Medium


Followed by the bandages:

Picture Name Application
Ace3 elasticbandage.png
Elastic Bandage Large Wound Coverage
Reopening Very Likely
Use when many wounds need to be closed fast
Ace3 packingbandage.png
Packing Bandage Medium Wound Coverage
Reopening Very Likely
Use when many wounds need to be closed fast
Ace3 bandagebasic.png
Bandage (Basic) Medium Wound Coverage
Reopening Likely on Velocity & Puncture Wounds
Use to close small/medium wounds
Ace basicfielddressingquickclot.png
Basic Field Dressing
(QuikClot)
Small Wound Coverage
Reopening Unlikely
Use to bandage small wounds or wounds which reopened


And at last the tourniquet and its effects:

Ace3 tourniquetcat.png
Tourniquet Immediately stops all bleeding on the applied limb
Does NOT bandage wounds
Will cause severe pain when not removed in less than 5 minutes

ACE Settings Recommendations

UOTC recommends to change the following ACE settings to set values:

  • Pain Effect Type: Colour Flashing
  • Style of menu (Medical): radial
  • Use Medical Menu: Enabled
  • Re-open Medical Menu: Yes
  • Display interaction menues as list: Yes
  • Set a key like 'H' or 'J' via esc->controls->configure addons->ace for the Medical Menu
  • Rebind your default grenade-throw key

Clarification Of Priorities

TCCC, the priciple all these follow on actions are based on, is centered around:

  • (First Priority) Care For The Casualty
  • (Second Priority) Avoiding Additional Casualties
  • (Third Priority) Completing The Ongoing Mission

Reaction To Casualty

  1. Engage the enemy!
  2. Avoid additional casualties!
  3. Announce: "{Player|Role} is hit!"
  4. Gain fire superiority!

All other conciderations and orders in reaction to the situation are the responsibility of the FTL or the Fireteam Member currently in control of the situation.

Care under Fire

After the situation is under control and sufficient fire superiority is gained, the next step on the way to first aid needs to be done.
This step is called Care under Fire and is as well part of the TCCC.

  • If reengaged by the enemy while executing any of the following points:
  1. Abort treatment.
  2. Fire back until effective enemy fire stops.
  3. Continue ‘Care Under Fire’.
  4. Repeat as necessary.
  • Search for a route that offers maximum available cover.
  • Search for a position of best available cover to later evacuate the casualty to.
  • Briefly inform FTL about your plan & wait for permission.
  • Move to the casualty as planned.
  • Apply tourniquets to all bleeding limbs.
  • Drag the casualty to cover & inform FTL that you will start first aid.
  • Ask FTL to request medical assistance.

First Aid Procedures

After the casualty has been evacuated to the close by covered position, the actual first aid procedure needs to be started.
This guide will explain you the most basic functionality you need to know, to hopefully keep your buddy alive.
To be able to successfully provide first aid and maintain the casualty in stable condition until a CLS or Medic arrives, you need to know the basics about ACEs medical system.
To quickly pull these back into mind go back and read Wounds, Bandages and the Tourniquet

Entry Condition for Basic First Aid:

  • Tourniquets are applied to ALL bleeding limbs
  • Guide assumes additional limb wounds
  1. Assess wounds on torso & head
  2. Bandage torso then head wounds from large, over medium to small
  3. Bandage wounds on tourniqueted limbs, again from large, over medium to small
  4. When all wounds are bandaged, remove the tourniquets
  5. Reasses the wounds frequently until stitched by a Medic

Continuous Casualty Care until Superseded:

  • Frequently check the casualties heart rate
  • Frequently check the casualties blood pressure
  • Medical help should be on the way by now
  • If the heart (no heart rate) of your patient stops and the blood pressure drops to 'low', immediately start CPR and do not stop until the casualty dies (rag doll) or medical personnel tell you to

A Scenario

The following small scenario is supposed to be a help in understanding the following actions described in the next few sections.
Scenariobasicfirstaiduotc.png

  • A fireteam sized Element is making their way along a natural corridor.
  • Enemies are to be expected, so Unit A (Fireteam Leader) decides to use successive bounding to approach the west
  • The FTL made essential mistakes: Instead of positioning himself (Unit A - FTL) and the Automatic Rifleman (Unit B - AR) in the position of Unit C and D he exposes the fireteams support element to an unknown arc from the north to the west end of the natural corridor. This exposes the Buddy Team with roughly 70% of the fireteams fire power to the possible enemy and positions it in a location with no available hard cover; These are fatal tactical decisions.
  • Unit A is in Position covering to the north west, Unit Bravo is still moving through open area.
  • Suddenly Unit A and B are engaged by an enemy firing along the corridor
  • Unit B can be observed taking two hits and falling to the ground.
  • Unit As reaction to the enemy fire is immediately moving a meter south to hide behind natural concealment in hope to escape enemy observation.
  • The Fireteam now automatically enters the stage of 'Reactions to a Casualty'

Scenario Reaction To Casualty

Tactical Situation:

  • BT1 FTL (Unit A) is pinned by enemy fire, but can observe the fires.
  • BT1 AR (Unit B) is hit and fell to the ground, he is not moving and is considered unconscious.
  • BT2 GRND (Unit C) is behind hard cover at the support position observing the situation.
  • BT2 RF (Unit D) is behind hard cover at the support position observing the situation.

Actions that could occur - example:
The FTL, who did move to concealment, and is not recieving any direct enemy fire decides to issue a WaitOut to higher and asses his FT.
FTL(343): FLASH! FLASH! Alpha, Contact, wait out! SL(343): Alpha in Contact, break. Bravo hold, over.
FTL(DIR): AR Down! AR Down!
FTL(DIR): Fireteam count!, GRND(DIR): Grenadier UP!, RF(DIR): Rifleman UP!
The FTL now knows that most of his fireteam is UP and would participate in the action to gain fire superiority over the enemy. He issues a contact report.
FTL(DIR): Contact, North West, Near, Rifle!, GRND(DIR): Grenadier, seen!, RF(DIR): Rifleman, seen!
Both Units C and D have seen the general location of the enemy position. In the past seconds the FTL was able to evaluate the current contact:

  • No additional fires have started even though the enemy knows where his FT is.
  • The rate and type of enemy fire seems stable and seems to be issued by a maximum of two enemy rifleman.
  • The majority of his FT is in cover or concealment.
  • Bravo FT is on standby to maneuver with the help of the SL to support Alphas effort of fire superiority.

The FTL decides to initiate fire control messures to gain fire superiority over the enemy. FTL will not fire, as he would compromise his concealment.
FTL(DIR): Grenadier, North West, Contact, M320, medium rate, FIRE! GRND(DIR): NW, medium rate, firing!
FTL(DIR): Rifleman, North West, Contact, rapid rate, FIRE! RF(DIR): NW, rapid rate, firing!
FTL(343): Alpha, contact report, over. SL(343): Send, over. FTL(343): Contact as follows: Two rilfes; engaging Alpha with effective fire; NW, near of Alpha (grid nor range are identified); Time now; Alpha, one man down, suppressed, trying to gain fire superiority, requesting Bravo to maneuver ASAP, How Copy, over.
SL(343): I copy, enemy team, NW of Alpha, mandown, pinned, fire superiority; stand by, out.
SL(343): Bravo, Squad Lead, status, over. BFTL(343): Bravo, halting, security, read for maneuvers, over. SL(343): Bravo, ACK, break; Bravo move to my location....
The Squad Leader is preparing additional actions for Bravo FT to establish fire supperiority.
Before hand he informs the Platoon Leader about the contact and his intent to gain fire supperiority with goal of evacuating a wounded player.
Eventually the SL repositioned Bravo to a position of slight elevation giving them good eyes onto the enemy location.
Bravo then initiates suppressive fires onto the enemy.

Scenario Care under Fire

FTL of Alpha is informed about the other FT opening up and soon enemy fire intensitiy lowers drastically.
FTL(DIR): Enemy is supressed, normal rate, normal rate! GRND and RM confirm the order vocally.
FTL(DIR): I will move to <UNIT B> and drag him 3 meters south behind the bushes to this small ditch. Adjust rate as necessary. Again GRND and RM confirm verbally.
The FTL has about 5 meters from himself to Unit B. For a situation und fire this is a lot of ground to move through while being sporadically fired upon.
FTL decides to shoulder his weapon, as he will be quicker that way crouch run to the casualty and drop on the ground behind him. Part of his approach is concealed by his current concealment.
FTL(DIR): I am moving in 5 seconds! FTL stands up crouched, runs to the casualty and drops to the ground prone. Immediately a few bullets are fired in his general direction.
In response GRND and RM increase their rate of fire onto the enemy and the FTL leans right while prone to shortly increase the ammount of supression.
FTL(DIR): FTL is OK, applying treatment! FTL opens his medical menu and switches to the casualties overview. The casualties status is as follows:

  • Has lost a lot of blood
  • Red right arm (medium+ wounds)
  • Bright Red torso (one medium+ wound)

FTL applies tourniquet to the arm. FTL(DIR): Evacuating in 5 seconds! Increase suppression! The FTL goes into crouched position, ACE interacts with Unit B and starts to drag the casualty south wards. As the suppression has been increased only one shot is taken by the enemy, trying to hinder them from moving the casualty.
FTL arrives at secure position with the casualty. FTL(DIR): Slow rate, slow rate for one minute after that watch and shoot! Starting first aid, <UNIT C> inform SL!
GRND now uses the short range radio to inform SL about success of retrieving the casualty and that the FTL started to apply first aid and the CLS is requested at their position.

Scenario First Aid

FTL and casualty did arrive on the semi secure position a few meters south. All necessary informations have been relayed. FT stoped fireing and now is in watch and shoot.
FTL now follows the Basic First Aid Prodecure from above to treat the listed wounds:

  1. Torso: Large Velocity Wound; Action: Elastic Bandage until closed (had to apply two)
  2. Right Arm: Medium Avulsion; Action: Packing Bandage until closed (had to apply one)
  3. All bleeding is stopped. FTL removes the tourniquet (On removal do check if the tourniquet was moved to the right players, some time the casualty does not get back his CAT).
  4. FTL checks the casualty's heart rate; ACE return: normal (anything inbetween 55 and 110 bpm)
  5. FTL checks the casualty's blood pressure; ACE return: low (This correlates to the blood volume lost)
  6. FTL tells team that the patient is stable and to maintain position until the CLS arrives.
  7. On the thrid check of heart rate and blood pressure the heart seems to have stopped. FTL immediately starts CPR actions on Unit B.
  8. A few seconds later the CLS arrives and the FTL informs him about the casualties status.

Scenario Casualty Evacuation

  • CLS told the FTL to continue CPR for now. A bag of 1000ml saline was applied by the CLS to the casualties not wounded left arm.
  • A pen of epinephrine is applied to the casualty by the CLS when 25% of the saline went into the circulatroy system. This increases the heart rate by a random value inbetween 10 and 20 bpm.
  • Actions result in the casualty's heart starting to beat again due to injection of adrenalin, additional blood volume and CPR combined.
  • The CLS releases the FTL from his duties.
  • CLS now drags the casualty further back through already cleared territory to the platoons CCP, constantly stopping to reassess the casualties status.
  • On the CCP he gives an overview to the medic and asks him for permission to be released to be able return to his unit.
  • On arrival at his unit he contacts the Alpha FTL reports his actions and (if necessary) resupplies the FTL with bandages from his backpack.
  • The unit is now clear to continue combat actions with reduced strength.

Things you should never do

- To Be Continued -