Medical Manual

First Aid Providers and Field Medics are responsible for treating and taking care of the wounded personnel out in the fields. Can usually be found either in the back of the formation or with the team leader. In practical sense they’re the people ensuring as many as possible survive after an engagement.

## Equipment

### Bandages

* **Standard Bandage:** All around average bandage.
* **Packing Bandage:** Utilized best for velocity wounds.
* **Elastic Bandage:** Used to bandage wounds that cover a large area.
* **QuikClot:** Used to cover minor wounds.

### Drugs / Injectors

* **Morphine:**Used to combat severe pain, however dangerous due to it lowering the heart-rate.
* **Epinephrine**: Used to combat extremely-low heart-rate, it increases the heart rate drastically, dangerous to use on a stable heart rate.
* **Adenosine:** Used to combat extremely-high heart-rate, it decreases the heart rate drastically, dangerous to use on a stable heart rate.

### Other (IV, Kits, etc.)

* **Tourniquet (CAT)**: Slows down blood loss, effectively cuts off blood supply to limb. (Can only be applied to limbs).
* **Splint**: Used to heal fractures, change of fracture if shot in limb is 80%, and as the most commonly wounded areas of the body, this item is extremely essential to not just a first-aid-kit, but all medical kits.
* '*IV'***(Blood, Saline, Plasma)**: The difference between the three is non-existent in ArmA, they all provide fluids for the patient. Could be dangerous to use if providing too much fluids.
* **Sugrical Kit**: Used to stich wounds, provides the best possible in-field heal.
* **Personal Aid Kits:** Also known as a 'full heal', rarely given and provides a full-heal but only can be used on stable patients.

## Patient Status

### Blood Pressure and Heart Rate

Blood pressure is measured with two terms: Systolic and Diastolic When you check for blood pressure you get a number like this: 1**20/80** - **120** is the Systolic blood pressure and **80** is the Diastolic blood pressure. Usually we look after the Systolic blood pressure, but beware of the Diastolic rate since under a specific condition a patient could enter a cardiac arrest (mentioned below).

#### Patient’s optimal and non optimal (Systolic)

* Blood pressure higher than 160 is very high.
* Blood pressure of 140 is high.
* Blood pressure of 120 is perfect.
* Blood pressure of 100 is low.
* Blood pressure below than 80 is very low.

#### Applying IV

* If blood pressure is 100 then give 250ml of IV.
* If blood pressure is 80 then give 500ml of IV.
* If blood pressure is lower than 60 then give 1000ml of IV.

*Keep in mind blood pressure is of course influenced by the heart-rate*

#### Patient’s optimal and non optimal heart rates

* Heart rate higher than 120 is very high.
* Heart rate of 100 is high.
* Heart rate of 80 bpm is perfect.
* Heart rate of 60 bpm is low.
* Heart rate below than 45 bpm is very low.

### Cardiac Arrest

A cardiac arrest is a sudden loss of blood flow resulting from the failure of the heart to pump blood effectively.  A Cardiac Arrest will occur under these circumstances:

* 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.

## Procedures

**Patient is bleeding**:

* If it’s a limb apply tourniquets to prevent severe blood loss (Arms or Legs).
* Apply bandages to wounds (quikclot for long term use, like when no medic is available).
* When all body parts are fully bandaged and you no longer see “bleeding” then the last step is to be stitched by a medic.

**Patient has fractured limbs:**

* Get the patient to a secure area since his aiming or/and moving abilities are severely weakened.
* Apply splint the splint to the fractured limb.

**Patient is unconscious:**

* Stabilize the patient with bandaging and stitching wounds if possible.
* Check heart rate if too low or high use autoinjectors unless no heart rate, then CPR.
* Check blood pressure and give patient IV if necessary.
* If patient is in pain then give him morphine as long blood pressure and heart rate isn’t too low

### Patient Evaluation and Prioritization

There are times where several people are injured and you need to evaluate and prioritize who gets help first and so on. You have to be discriminative to ensure that as many people as possible survive after a contact with the enemy or other incidents. You as the medic have to evaluate and classify if a person is lightly wounded or critically wounded.

Evaluating the patient is a brief look over their medical menu and see what kind of injuries they have, and classify them accordingly from minor to critically injured. You also have to evaluate if the injuries presented are treatable with current equipment. The Medic also gets the last call if a person is a lost cause or not. A “lost cause” would be a heavily injured person that has a survival chance of pretty much zero. What can contribute to this is a lack of supplies, the amount of damage on patient or patient is in a non reachable spot to treat or drag into a safe position. Your leader will also contribute a valid opinion in these cases.

Prioritization of patients come after you have evaluated who is the most injured and work up to the least injured one. A tip is to command or “advice” your comrades to patch themselves up, making your job easier and the flow a whole lot better.

You might encounter a leader or squadmate that demands immediate treatment, but you can override these demands if you deem someone else more critical. In the medical field you have the expertise and greater judgement of who is critical and your what your own capabilities are.

## First Aid Provider

These guys are usually less equipped and mostly carry bandages, tourniquets, painkillers/morphine and perhaps epinephrine. It’s worth noting that first aid providers can actually use advanced medical equipment like a surgical kit and applying IVs, but are rarely equipped with these resources.

## Field Medic

These medics are mostly well equipped and at least better equipped than first aid providers. They will carry equipment like a surgical kit, IVs, King LTs and such. They might have a trade-off that they have more specialized equipment and a lower amount of bandages

## Combat Notes

When you are out in the fields your leader will usually form the whole team into certain formations. You as the medics are one of the squad’s most important assets, and as mentioned earlier you would be either in the back or at the safest position in the formation.

There are situations where you are in an active firefight, but squadmates are injured and need medical attention. Normally you are going to assist in the firefight until :

* Your leader orders you to treat the injured.
* The situation de-escalate or momentary pause in the firefight.

Note that In certain situations you might be severely lesser equipped than a standard rifleman and aiding in firefights is either not possible or not adequate. You might also be given a policy of treating injured as first priority rather than assisting in combat.