Realistic Wounds and treatment for ARMA 3

[rye1 21]

@Betsalel ...LOL. This -

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@CAS Good ideas. Just reading up on "having to find them" - great idea as I hate the way when they are down a big medic symbol comes over their body that you can see from kilometers away. This would put a sense of teamwork into the mix and no running around like headless chickens. That is one improvement they can make to the current, maybe based on difficulty, e.g. "Expert".

@OB1 - hours to recover? We don't want that, me and Tom fully agree - minutes maximum and no longer than 5, we're impatient haha. :D Medevac would be cool if improved upon.... but that could be done by modders and mission makers, we're improving it on the MSO as we speak. If animations were improved for it also, especially when including a stretcher - hopefully modders will do this with ease with the updated engine. I agree, limping, hit detection on where you shot.

Population will make the choice - I think they'd go for a very simple system, probably one that wasn't improved at all! If A2 medical system could be improved as of now, I wonder what people would want...

[Tom1 10]

An improved system with multiple treatment options and the possibility for a medic to stuff up with negative consequences, no more instant healing, first aid for everyone, actual treatment for medics only, extreme cases need medics to stand close by to continue to stabalize. Those are the main things I would reaaally like to see, the rest is just an idea that could be used.

What does everyone think of the body armour idea? As now body armour might as well no be there as it doesn't do much in arma 2.

---------- Post added at 14:11 ---------- Previous post was at 14:09 ----------

I am quite busy this week, but if we could keep the suggestions rolling I shall update the first post with all the favourite ideas.

[OB1 10]

What does everyone think of the body armour idea? As now body armour might as well no be there as it doesn't do much in arma 2.

yeah I suppose. Bis said in their features that soldiers have customizable load outs hope that includes body armour, light to heavy affecting movement maybe ? I don't have any personal experience with body armour so im not sure on the penetration values, but I'm pretty sure it is useless against a 7.62

[rye1 21]

Depends what type, material and level. Tom has all the statistics. But some do not stop AP 7.62. They are only resistant to multiple hits, they may have a good ratio to stop one hit but they are not 100% bullet proof. Some do stop regular 7.62 and above, there are some that can stop quite a lot of rounds, the reason they don't use other types? Weight, cost, practicality, a lot of things.

And you have to differentiate soft armour from hard, soft being kevlar and such - easily penetratable by 5.56/7.62 but it can resist the impact of a 9mm, shrapnel impact and such.

[Tom1 10]

level III armour (used by USMC, ADF, UK, most US Army etc) will stop 2-6 M80 7.62x51mm ball rounds (standard 7.62) at 50 meters depending on how far apart the impacts are. ;)

Body armour makes a HUGE difference, trust me, with proper body armour implimentation USMC versus Russia in arma 2 would require a shit tonne of those black tipped M995 5.56x45mm rounds that only special forces get to use every now and then in their m249s... expensive.

---------- Post added at 16:04 ---------- Previous post was at 15:54 ----------

But with a good wounding system, (one that features an agony system) AP rounds aren't too bad, they atleast tumble more often than the older M855 (being phased out for m855a1 and mk318) meaning it will statistically give a bigger wound profile (although the m855a1 (or m855 when it works properlly) will fragment causing massive a massive permanent cavity (partly because the fragments soften tissue before it is stretched by temporary cavity, meaning unlike other wounds the temp cavity will actually do alot more than stretch the tissue ;)) and will be much harder to treat and will cause more bleeding etc etc.).

[Laqueesha 474]

yeah I suppose. Bis said in their features that soldiers have customizable load outs hope that includes body armour, light to heavy affecting movement maybe ? I don't have any personal experience with body armour so im not sure on the penetration values, but I'm pretty sure it is useless against a 7.62

There is a body armour simulation in ArmA 2. It's basically increased hit points for body armour equipped infantry.

[rye1 21]

There is a body armour simulation in ArmA 2. It's basically increased hit points for body armour equipped infantry.

Which isn't what you want. If it penetrates it should cause the damage... increasing hitpoints doesn't work because you begin to see them take hits they shouldn't.

[Laqueesha 474]

Which isn't what you want. If it penetrates it should cause the damage... increasing hitpoints doesn't work because you begin to see them take hits they shouldn't.

Exactly.

[Tom1 10]

Even with the current 'system' for body armour the armour is penetrated wayyyy too easilly.

[rye1 21]

They should make it; head shot, instant kill, no matter the arguement. You hit the brain group, you are down and out. If it penetrates it should do a great deal of damage; if it doesn't then it doesn't. You could simulate them getting hit by their body moving to the impact, say for instance hit the shoulder and their shoulder is knocked back. It should have no blood splatter when it doesn't penetrate.

They need to have a better formula with multiplyers or something for different ammunition types. So the engine can differentiate AP from ball. If it penetrates it should do a good deal of damage. And better hitlocations/hitdetection so there is no more 2 shots in the head to kill just because they have 'simulated' body armour values.... You can then detect if the place the projectile hit was armoured or non-armoured.

There are some vital places that should be accounted for, brain and spine (CNS), aorta and heart, very high chance in the neck... even a .22 from a weapon with a homemade suppressor can kill when it hits in neck - as heard of in Chechnya.

Other than that I really have no ideas how to simulate body armour in game.

Edited May 29, 2011 by Rye

[Tom1 10]

easy, look at ACE's vehicle damage system. They achieve this by adding another damage value to the ammo's config called vehicleDamage and then shove that in a formula that determains the damage dealt. Do the same for body armour and you have an improved body armour system.

[Laqueesha 474]

Maybe make the torso and head invulnerable to bullets (but not explosives and incendiaries) and only have the legs and arms exposed? It's rough, but it gets the job done when it comes to more powerful body armour. Or, instead of invulnerable, half the damage or lessen by even more, say three quarters? Getting hit in body armour by a bullet still hurts and can do some damage even if the projectile does not penetrate.

Edited May 29, 2011 by Laqueesha

[AirborneCowhead 10]

I'm all for adding to the Medic player's experience, but i'm not sure whether all the OP's points would be the right way to go (although there are some good ideas).

From a realism point of view, if you're hit it's game over. You don't keep playing with splinted legs or a tourniquet on (everyone i've ever splinted in real life has gone on to lose limb(s). Even a non-penetrating hit to your body armour would probably be a show stopper, and can still kill you. If the in-game outcome of the OP's suggestion is that a splinted/tourniqeted/AED'd (Dismounted medics wouldn't have these) casualty gets to carry on after successful treatment then that's just not realistic. In striving for realism it would push the game the other way.

Ways to implement the OP's ideas might be that a player dies and leaves behind a treatable AI avatar that a medic scores points/unlocks benefits for the team by saving, although I guess the saved 'casualty avatar thing' would just have to disappear once that was done. Or get loaded onto CASEVAC for bonus points : ).

I have to admit there was a lot of stuff to read and I skimmed far from all of it, but I wasn't sure if the OP was actually a developer for either the game or a mod, hence I felt the need to reply. I do think there's some good ideas, the medic could do with being sexed up a bit. : ).

Oh, and I don't think anyone uses Quik-clot anymore (the UK doesn't, although there's old stuff still kicking about).

[Tom1 10]

Maybe make the torso and head invulnerable to bullets (but not explosives and incendiaries) and only have the legs and arms exposed? It's rough, but it gets the job done when it comes to more powerful body armour. Or, instead of invulnerable, half the damage or lessen by even more, say three quarters? Getting hit in body armour by a bullet still hurts and can do some damage even if the projectile does not penetrate.

That wouldn't be very realistic though. Modern body armour can stop multiple rifle rounds from close distances, and a non-penetrating round will only bruise and wind th target at worst. When talking about modern body armour, it is important to remember that we are not just talking about kevlar vests, which are designed mainly to reduce the probability of shrapnel and pistol rounds penetrating, in this case rifle rounds (because of their shape) will easilly penetrate the kevlar vest.

Hard armour plates on the other hand are very very tough and will stop multiple rounds and therefore allowing non penetrating rounds to still do damage isn't really realistic, and making a unit invulnerable (except arms and legs) is unrealistic too as the ceramic will crack and shatter allowing rounds to penetrate AND seeing as today (not to mention in 10-15 years time when arma 3 takes place:p) many big and modern militaries are fielding hard armour (USA, UK, Aus & NZL, Russia, Germany... heh, even China) obviously armour piercing ammunition will be used when fighting another 'armoured force'.

@AirborneCowhead, I do believe Quik Clot is still used occasionally as a last resort because it is very dangerous (due to it having to be completely removed before surgery:p) and other methods of administering hemostatic agents (other powders, injections and even bandages and field dressings) are being tested and fielded although the same principles would still apply to a game; haemostatic agents are used to stop bleeding:p

Please read up on the first post, as I am about to update it with some important information mentioned elsewhere in this thread that may be missed by people who don't have time to read more than just the opening post.

I have said this before but the point of a medic system like this is not to make the wounds and treatment super realistic (because in real life the casualties do not just get up and continue fighting) but to improve the realism and authenticity of the flow of modern combat. Modern ammo is designed to wounds and not kill because a wounded man is essentially two men down as atleast one man is required to administer first aid and further medical treatment by a combat medic will slow down the squad thus disrupting their movement/plans. Some have suggested MEDEVAC, and although this is a good idea for single player, in my oppinion it wouldn't work to well in a good chunk of multipayer games as many do not have respawns (hardcore clans and communities that is, the MEDEVAC idea would work wonders in public games with AI that can be switched to and played as by a wounded soldier). Maybe if the MEDEVAC was a module to be put in by the mission designer that had to be synced with an existing (or non-existing just like the artillery module) MEDEVAC vehicle (helicopter, ambulance Humvee, BMP etc etc) that had to be set up would work?

Although a unit getting up and walking after having a medic do his thing is unrealistic, it would still add playability to the game while at the same time giving consequences to the wounded player and every other medic system in arma 2 allows wounded units to get treated then fight, so it is nothing new:p

[Ish 11]

a wall of text nobody is gonna read

I play with ACE2, and most of the players doesnt want to be medic, because the lack of action, he should be always in cover and behind, hidden from bullets. The ACE2 wonds system is good enough, if you want more realism for medics, then I suggest you to play Emergency something sim game

I love playing medic. I even led the SSG medical group for a while. Now I have to admit, that was boring. But that had more to do with how the group operated and not the medic class itself. If im a medic on the front lines, but stay behind the formation of my group, thats fine. As long as i SEE some action, im totally fine with it. I don't necessarily need to fire my own gun during an operation to find it exciting.

We have an ongoing joke within SSG, it comes from a member who asked this, although i don't care to reveal who (and i don't remember anyway) .. "Can I run ahead with ACOG?" Basically.. "Can i go on a lone wolf rambo mission?"

Which is not how we do business lol..

[Tom1 10]

Please dont take notice of previous comments, entire suggested system has been redone and made much much more simple. Read from here on.

---------- Post added at 07:00 PM ---------- Previous post was at 06:30 PM ----------

Post name changed to clear any confusion too :)

[Bee8190 10]

Sounds fun but pardon me if i dare to twist it a little:D

wounded by small arms fire - medic have limited bondages, epipens...you name it and is able to treat such wounds in the open battlefield.

Wounded by multiple small arm fire - medic has the ability to stop heavy bleeding and keep soldier alive by using many bondages and morphine from his limited invertory untill medevac chopper arrives and take soldier back to main base hospital where soldier get healed after some period of time.Medic must look for resupply at this point.

Wounded by heavy caliber or/and explosives - medic needs help with wounded by nearby soldiers, or another medic as soldier bleeds out heavily and must be taken to main base hospital ASAP.Soldiers health regaining slower (simulating operation/s?) or simply takes longer to revive.Both medics must resupply their invertory.

I believe this would bring a lots of fun to the fields for even non medic dudes out there as it would involve real teamplay and pilots would find their job exciting just one more bit too.

[rye1 21]

No epipens, epinephrine is for severe allergies and if used on a bleeding casualty it would make them bleed out quicker. They are not used on these kind of casualties. There are other ways of re-awakening an unconscious casualty like smelling salts, etc.

All wounds would depend on area hit, which could be improved heavily in A3 if the hitdetection was improved upon. We could then know area hit and that alone would allow modders to improve the medical system dramatically, using certain kit for certain areas and conditions.

You mention explosives and I notice no burn treatment is given, but it can be applied the same way as any other treatment, just with specialised items for that category e.g. steroid injections, burn bandages, burn dressings. But it doesn't really matter, a simplistic approach is best.

[Xiones11 10]

Will a bullet being fired out of range (you won't implement truel rifle kill ranges of a mile+ on assault rifles will you?) cause the pain mode of damage or will it just bounce off the vest. I'm asking because getting ing hit by a 50 cal at 4 miles has gotta feel lik getting punched by a train

[ghostnineone 10]

i like americas army's system, it has an injury system and you have to treat injuries a certain way, like an injury would be "gunshot chest, bleeding, patient is not breathing/is having trouble breathing" and you'd have to administer an NPA and treat the gunshot, i havent played it in awhile so i dont remember the specifics, but it doesnt take forever to revive someone, only as long as the medic takes to pick the appropriate options, but i like it because you actually have to assess the patient rather than just press heal or administer bandages and epi

[max power 21]

No epipens, epinephrine is for severe allergies and if used on a bleeding casualty it would make them bleed out quicker.

No. Epinephrine is administered to treat shock to constrict blood vessels to increase blood pressure, and to open constricted bronchioles in the lungs. If the shock is hypovolumic shock, someone with a basic knowledge of first aid would treat things in the primary survey first, those being the ABCs. Once those are addressed, then you treat for shock. So, in your scenario, the medic finds someone who has been shot and the first thing they do is smack an epipen into their thigh and call it a day. Obviously, the first thing to treat would be the bleeding if there is not an airway or breathing problem.

Furthermore, epinepherine is used to treat cardiac arrest, including cardiac arrest due to low blood volume.

Edited July 20, 2011 by Max Power

[rye1 21]

No. You don't use it on a casualty who has been shot. It is strictly used for anaphylactic shock and cardiac arrest for combat medics:- and for cardiac arrest it is hardly used at all as it is a very high-risk procedure for a combat medic. Epinephrine would be a last resort and combined with cardiopulmonary resusitation (CPR) and possibly vassopressin - there is such a high chance of messing it up and causing serious problems and it doesn't even have a 100% chance of restarting the heart even if you do get it right, there is no way it should be used like that.

You don't go around sticking Epipens into people's thighs after they've been shot.

---------- Post added at 06:13 PM ---------- Previous post was at 06:07 PM ----------

i like americas army's system

It's a great way for PVP, really quick and simple. Because they are on such small maps they need to be like that. Arma could easily make it a little bit longer, not to the point of being frustrating but just as AA's version is way too quick. The diagnosis tool on that thing is great, shame it only has 4 options.

[max power 21]

No. You don't use it on a casualty who has been shot. It is strictly used for anaphylactic shock and cardiac arrest for combat medics:- and for cardiac arrest it is hardly used at all as it is a very high-risk procedure for a combat medic. Epinephrine would be a last resort and combined with cardiopulmonary resusitation (CPR) and possibly vassopressin - there is such a high chance of messing it up and causing serious problems and it doesn't even have a 100% chance of restarting the heart even if you do get it right, there is no way it should be used like that.

You don't go around sticking Epipens into people's thighs after they've been shot.

Risky, but somewhat more effective than CPR alone.

So what you're telling me is if you have epinephrine and a man who is in cardiac arrest due to hypovolumic shock, and you don't have vasopressin, you check your watch and continue CPR? Despite its 10% success rate? And this is without the added bonus of low blood volume?

If it's not in the medic protocols, then okay. But seriously? They don't get any deader than dead.

Edited July 20, 2011 by Max Power

[Tom1 10]

@Bee8190, for high calibre weapons like 50cals and 308s we can look at real world statistics and make estimated guesses on how the patient will end up after taking a hit, but I can assure you that the majority of targets who take a 308 or larger to the torso wont live to tell the tale, although there may be some cases which I am happy to look into where 762s and similar rounds may not outright kill a man.

For your second point it sounds like you are talking about a system in which medics are used to stabilize the casualty and are forced to stay near them in order to monitor them and make sure they stay stable until a field hospital/medevac/ambulance heals them, I love the idea and it was actualy included in my previous suggestion (which also had multiple treatment options for wounds so medics had the chance of screwing up - just like in america's army 3 (@ghostnineone) and also had stuff like AED portable defibulators, cpr, smelling salts, IV bags of plasma, cardiac arrest, not breathing status, tourniquets, and more) but my previous suggestion, while much more realistic and in my oppinion would be more fun, it was not everypone's cup of tea and many people did not like the idea, and in heinseight it was too complicated and different for BIS to add as it would also involve ai changes, whereas this new system is perfectly doable for BIS.

I will do some thinking as to how stabalization could be implemented into this system using only first aid kits, morphine, medkits and feild hospitals/medevac/ambulances and reply ASAP, feel free to share any ideas although please dont go off track with stuff like epi and plasma etc, some BIS devs may even think having morphine alongside firstaid kits and medkits may already be unneccesary.

The main intention of this suggestion is to make the flow of the combat more realistic rather than the treatment (rather than previous suggestion which aimed at getting both realistic), but a stabalisation system without going off track could be an awesome addition to the system.

[rye1 21]

You do CPR first if there was no pulse. What you administer depends on cardiac rythmn (AED can detect this) - it could be epinephrine or atropine or both in order but they are seriously last resorts, this is advanced life support and very risky.

As a practical matter, anyone without a pulse in a firefight is dead. Epinephrine usage in a tactical environment is a high-risk procedure with a low percentage of success (particularly since anyone without a pulse in this setting probably doesn't have an intact cardiovascular system). Possible exceptions might be if the medic and casualty are in a "tactical medical care" phase (under good cover/concealment, fire superiority assured by the team). You could get an assistant to begin administering IV drips, stopping and controlling bleeding or even using blood substitutes etc, for hypovolemic shock.

In my opinion it wouldn't be used in game, nor when dealing with gunshot wounds, and it isn't mentioned in this threads OP to be used and there are plenty of other methods for going about it which do the job and allow for a simplistic approach that people can easily get used to:- like CPR for no pulse, smelling salts for unconscious, OPA/NPA for not breathing, anyone can get used to this stuff and making those decisions and that would make the medics role a lot more interesting.