Medical Guide

## Medical Handbook for Spagistani Soldiers and Medics

### Medical Menu:

It is recommended to enable the medical menu through ACE. The menu clearly shows all injuries and treatments with a static menu, rather than the moving ACE Interact radial. This gives you a bigger picture of what needs treatment first.

When using the medical menu you can see your patient's condition, large injuries will appear dark red, minor injuries appear light red. If [B] is next to the injury that means it has been bandaged, and the limb will appear blue. You will also to see their triage card in the lower left corner of the menu, which shows who applied medication and tourniquets.

### Tourniquet:

Tourniquets are applied to arms or legs to stop all bleeding from that limb, but also cause increasing pain the longer they are left in place. They are excellent for stabilizing a heavily wounded patient or for treating a mass casualty event. The effects of applying fluids or using auto-injectors on a limb that has a tourniquet applied will not take effect until the tourniquet is removed.

### Bandages:

There are four types of bandages: Field Dressings, Elastic Bandages, Packing Bandages, and Quikclot. We carry Elastic, Packing, and Quickclot. Elastic Bandages should be used to treat all wounds except velocity wounds or minor injuries. Packing bandages are reserved for velocity wounds but can be used in a pinch to treat any large injury. Quickclot is for small wounds or punctures. The larger a wound is, the faster the patient will bleed, the more bandages the wound will require, and the chance of reopening will be greater

### Types of  Injuries:

 Avulsion
 Laceration
 Velocity
 Puncture

### Heart Rate:

The patient’s pulse. Loss of blood will lower it, and medications can affect it.

A good heart rate is between 60 and 120 BPM. Anything lower or higher than that should be evaluated and treated.

### Blood Pressure:

Blood pressure is affected by the amount of blood in the body, blood pressure will decrease if the patient has been bleeding heavily. 120/80 is considered normal blood pressure. The systolic blood pressure (first number) is the one we are measuring.

* Non-Existent: 0-20.
* Low: 20-90.
* Normal: 90-120.
* High: 120 or above.

### Auto-Injectors:

There are four types of auto-injectors:

* Morphine: Reduces pain. Its side effect is that it lowers the heart rate of the patient (60-120 is considered an acceptable heart rate with 80 being average.)
* Epinephrine: Increases the heart rate of the patient. You should only use epinephrine if the patient's heart rate is below 60.
* Adenosine: Lowers the patient's heart rate by a large amount. It should only be used if the patient is above 120.
* Atropine: Lowers heart rate by increments of 20.

### Saline:

Saline is the only fluid we use in the field. It restores blood pressure by replacing lost blood and comes in 3 sizes: 250ml, 500ml, 1000ml. Saline takes time to raise blood pressure but is quick to set up.

### Kits:

There are two types of kits, both only work once the patient is stable (not bleeding). Surgical kits sow up the patients' wounds and prevent them from reopening. A Personal Aid Kit is used to fully heal a patient back to perfect health, including heart rate and blood pressure.

### Steps of Treatment:

1. Tourniquet the affected appendages.
2. Stop bleeding from torso/head.
3. Bandage appendages.
4. Check blood pressure and heart rate.
5. Utilise a Surgical Kit if the patient is not crippled, or a PAK to restore limbs and blood.

### Triage:

When you have multiple casualties, you have to prioritize treatment of the wounded in order, via triage.

* Immediate (Red): Needs immediate care.
* Delayed (Yellow): Needs care soon.
* Minimal (Green): Lowest priority.
* Expected (Black): Going to die, do not treat.

Immediate is for those patients who are heavily wounded and unconscious, as they will die without treatment. Delayed generally refers to either moderate injuries and unconsciousness, or conscious but with heavy wounds. These patients will need help, But aren’t going to be the first to go. Minimal priority is for those patients who are conscious and very lightly wounded. They are in no danger of death from their current injuries. A crippled leg is always at least Delayed during offensive operations where the platoon is moving forwards.

### Cover and Positioning:

When treating a patient in the field cover and positioning is critical to the medic’s ability to render aid and the patient’s safety. Ensure you and the patient are in cover. Non-wounded team members should cover the medic while they tend to casualties unless specifically told to assist with treatment by the medic.

### Standard Combat Life Saver (CLS) Medical Kit:

● 25x Bandage (Elastic)

● 20x Packing Bandage

● 15x QuikClot

● 10x Morphine Autoinjector

● 10x Epinephrine Autoinjector

● 15x Tourniquet (CAT)

● 3x Saline (250mL)

● 1x Surgical Kit

● 1x Personal Aid Kit