Combat Medical System

[raptor 6 actual 13]

Concept

Many players have made mention that they would like to see a correctly made medical mod. In recent months, the Combat Medical System team has strived to put together an in-depth treatment plan that is both realistic and enjoyable at the same time. If you've ever played as a squad medic, you realize that you are basically just another rifleman handing out bandaids to people. Here at CMS, we're wanting to make you a more valuable and reliable asset to your squadmates.

Each minute counts, and every procedure you perform can make the difference between life and death.

Can you make the cut?

Development Team Members

Currently, we have seven main members on our team that devote much of their free time to scripting, researching, brainstorming, advising, and to refining our ideas into ArmA's game engine.

Our members are as follows:

Glowbal

Riouken

Rye

DocScarle

Derdoe

FM

Aydan aka- SnakeDoctor

Raptor 6 Actual

Contact us via BIS forums or by posting here.

Edited February 7, 2013 by Raptor 6 Actual

[columdrum 11]

Sounds terrific, thats system would be perfect from my point of view. Even if the timer its not realistic, the main problem of the wound systems its that usually or the soldier its ok, a bit wounded( need small heal), or death, and there is no intermediate state( for example on ACE wounding , yes you can be really injured and black out... but you will be death 99% of times because you will die before any medic reach you).

Right now we usually play with ACE wounding + only medics can use morphine + my revive(only 1 life, no respawn). All that makes the medic really important, also causes some situations where you need to evacuate wounded people... But your system would be even better.

I dont have much time right now, and the time i have i usually work on other projects (mainly some scritps and UNS mod). Once i finish those projects i would be really pleased to help you out :D

[raptor 6 actual 13]

Thx Columdrum for replying. Any time in the future that you're available I'd appreciate the help. Obviously, I'm not asking for people to sit there and write out an entire suite of scripts for me. I am busy learning and doing as much as I can on my own. I've just gotten to a point that I can't do this alone. I am hoping to get a dedicated team together much like ACE or even ACRE has.

I will continue to work at my pace and get some resized (BIS forum appropriate KB sized) photos of the work I DO have done. I am making models and working on the rhythms as we speak so as to kick start alot of things. GranQ has given me permission to look over and use his version of the medical chain module, and if anyone was curious, I have spoken to the guys over at ACRE, and received permission to use my version of the ACMC logo.

[Spartan 163 0]

You need a test patient just send me a PM. I would like to help with this.

[maturin 12]

So what will be the effects of Morphine. That's what I've always wondered about ACE wounds. Is it completely silly to be combat effective while on morphine?

[raptor 6 actual 13]

Thx Prototype, I'll send you a PM in the morning.

@maturin- Morphine will still be untilized for pain management. I plan on doing away with Epi since it really only has a place if the patient were dead and we were doing CPR on them. But, most likely in a combat environment, medical efforts would be centered on people with a higher likeliness of being treated with a successful outcome.

I do want to use Atropine instead of Epi. Atropine auto injectors are given out as an antidote for NBC attacks.

Sorry to answer this question in such a long format, but I've never personally been shot, so I can't say how morphine would affect my combat effectiveness. I would think that the pain would prevent me from concentrating on staying in the fight, or.....it definitely would make me a little loopy while trying to hold a steady aim.

A normal combat medic will be able to stop the bleeding, apply a compress, start an IV, and a few other procedures, but after that, they will receive a message stating "You've done all you can for him. He needs to be transported to a trauma center!"

Once in the helo or the ambulance, they can hook up the patient to the heart monitor for more advanced treatment options.

[tyrspawn 10]

Before you waste your time keep in mind that hitpart eventhandler doesn't currently work in dedicated multiplayer environments.

[riouken 15]

Before you waste your time keep in mind that hitpart eventhandler doesn't currently work in dedicated multiplayer environments.

Yes but the HandleDamage EH still returns the selection name (ie.. part of the model that was hit) and you can script a function to handle this see this post :

http://forums.bistudio.com/showthread.php?113418-HandleDamage-EH-explained-(-poor-man-s-getHit)&highlight=event%20handler

As Celery explains its the poor mans getHit.

[rye1 21]

Hey dude. Sounds great. Quick-clot, used anymore? I have heard of a few units (MIL and LE) adopting celox as a replacement for. Atropine isn't JUST used for NBC/CBRN attacks, I wouldn't limit its use to just that, that's a rare event in Arma anyhow; I know a few SWAT guys who even keep MK1 auto-injectors and all kinds of stuff in the team lockers for those events. Epinephrine is mainly used in ALS in a controlled setting like the hospital, as stated by many manuals including the Rangers Medic Handbook it clearly states its use for anaphylaxis only. I'm glad you're trying to phase away from it. If you need any help, give me a PM. I've intubated, gave CPR, given these kinds of drugs so here to help.

In terms of morphine affecting combat effectiveness, they used to have an SOP to disarm troops who had a certain amount of morphine.

Read more on that here:

http://www.specialoperations.com/Specialties/Medicine/Urban.htm

http://www.specialoperations.com/Navy/SEALs/SEAL_Medicine.htm

P.S. The heart monitor and so on sounds like you're working towards more of a diagnostic setting? I.e. work out WHAT'S GOING ON before doing something like injecting a drug.

Edited July 7, 2012 by Rye

[raptor 6 actual 13]

I appreciate everyone's comments and PMs. The guys that sent them all have great ideas and I hope to get everybody together to start on the project more. there is still a lot to think of and in my case, take out due to complexity issues.

As always, comments are welcome pertaining to the mod......even if it's a comment on what the name should be...lol.

[riouken 15]

As always, comments are welcome pertaining to the mod......even if it's a comment on what the name should be...lol.

CMS - Combat Medical System

[raptor 6 actual 13]

Sounds good to me, lol. Will work on updating the logo soon.

[short_German 1]

i think this idea is great and is exactly what is required to enhance gameplay i have a few ideas they may help you

1 usage of medical items such as tourniquets, quick clot, splints, stiff-neck, and iv drips possibly also blood types for transfusions at the shock trauma unit

2 different injuries i.e. with the ace system you can jump off a building and then get healed with a bandage i believe it would be better if your ability to walk would be influenced and if a splint rather than a bandage would have to be applied

3 Amputations. i think in the SLX mod it can happen that body parts get amputated it would be great to apply this in a realistic way so that if a solider steps onto a land-mine he does not die but has his legs blown off !!

4 functioning field hospital with trauma team and casevac i.e. in the event of an injury a player fills out a casevac request and calls in a helo that takes the casualty to a shock trauma Centre where he is then treated appropriately by AI this would com in handy if one plays with a very small team.

also below there is a link with intel that may help you and also i believe that it would be more beneficial if every solider could stop bleedings as every solider can apply field dressings and tourniquets

http://www.google.de/imgres?q=casevac+request&um=1&hl=de&client=safari&sa=N&rls=en&biw=1280&bih=583&tbm=isch&tbnid=Kk8W3WCSrvnz-M:&imgrefurl=http://www.medtrng.com/special_operations_command_centr.htm&docid=wOfXSqpxEI6sUM&imgurl=http://www.medtrng.com/Image302.gif&w=565&h=266&ei=EcX8T5qNFIXf4QTLu62PBw&zoom=1&iact=hc&vpx=438&vpy=94&dur=6149&hovh=154&hovw=327&tx=125&ty=135&sig=104096247990202942786&page=1&tbnh=70&tbnw=148&start=0&ndsp=20&ved=1t:429,r:16,s:0,i:122

http://www.skedco.com/Public/Images/products_original/XMS-20-9-Line.jpg

Edited July 11, 2012 by short_German

[raptor 6 actual 13]

Thanks for the ideas, love the thinking there.

In some of the addons I'm working on, I'm making a set of mobile Trauma unit "containers" that can be put together to form a MASH type of setup. They look like the CONEX containers or CHU's that I had modelled, but need to finish them up to get them in game.

Though I like ACE and the rest of my team does, trying to get in touch with Sickboy is like trying to get in touch with the head director of the CIA. I know a lot of people want a separate mod from ACE...I could sway either way.

The team of people that have PM'd me will make the final decision as we discuss things. I'm out of town until tomorrow, but hope to start on all of this more soon.

[short_German 1]

i dont think a separate mod from ace would be that great i think it work best in combination giving you the option with modules in the editor for medical system and casevac/mash in the simplified current ace version or a more highly advanced system because it would be a greate shame if this would turn out to be incompatible with ace especially as many people use it

PS hers another website with kit that may help

http://www.google.de/imgres?q=casevac+request&um=1&hl=de&client=safari&sa=N&rls=en&biw=1280&bih=583&tbm=isch&tbnid=JmWHXjgWszIrHM:&imgrefurl=http://www.skedco.com/Military/extreme-medicine-publications-and-videos/xms-20-9-line&docid=3U57jcVIlcf3TM&imgurl=http://www.skedco.com/Public/Images/products_original/XMS-20-9-Line.jpg&w=1024&h=1686&ei=EcX8T5qNFIXf4QTLu62PBw&zoom=1&iact=hc&vpx=832&vpy=4&dur=730&hovh=288&hovw=175&tx=112&ty=130&sig=104096247990202942786&page=1&tbnh=129&tbnw=85&start=0&ndsp=20&ved=1t:429,r:5,s:0,i:87

[raptor 6 actual 13]

So I'd like to welcome Riouken to the team. He's been gracious enough to start helping on the heart monitor and creating the module. We're still looking for another scripter or two, and I could use some help in a while on finishing up some small models for the pack. It's nothing as hard as texturing or creating things for an aircraft, just things like Morphine syretes, packages, etc. that will have a proper look if a player drops the items from his inventory to the ground.

As of now, I've been studying up on American and British based medical procedures called "Tactical Combat Casualty Care." It's basically got three different phases, 1) Care under Fire, 2) Tactical Field Care, and 3) CASEVAC Care. For an example of what will happen, during the "Care under fire" phase, if there is a firefight going on, no bandaging will be available, only application of a tourniquet. Dragging of carrying of the patient will be available. Bandaging takes up too much time while possibly taking effective fire from the enemy. But, say the fighting has stopped, then more options will be available such as, placing a nasophyrngeal airway tube into the nose for breathing, or removing the tourniquet to apply a bandage or compress. Using an eventhandler to determine if rounds are being fired around the victim will play a part in this.

I still plan on having some medicine administration available, some splinting, applying of spinal immobilization in certain cases, and application of tourniquets. IV administration and the heart monitor will only come during the CASEVAC phase, since most combat medics don't carry alot of these items on their person due to a multitude of factors. But, I'd love to exclude providing CPR to patients as ACE offers and again, no more Epinephrine. The cost of lives and material needed to resuscitate a victim out on a battlefield far outway the proven results of the practice out in the field. Therefore, I really don't want it in.

Obviously, treatment out on a battlefield is very different as opposed to civilian medical practice, so it's taking time for me personally to think out a detailed plan on how it should all flow together. It's still a major Work In Progress, but fortunately, Riouken seems to have some great skills. We could always use more help to ease the workload. He did mention that CBA would probably (most likely) be a required addon in conjunction with the module.

Anyhow, I hope to update you all again with the progress, but I probably won't make as many until we make more monumental steps forward. I am making a project page on Dev-Heaven.net to help in keeping things organized. Hope to talk to you all soon.

Edited July 15, 2012 by Raptor 6 Actual

[jefferspang 2]

... As always, comments are welcome pertaining to the mod......even if it's a comment on what the name should be...lol.

Incredibly Comprehensive Realistic Advanced Medical Project Suite [iCramps]?

edit: on a more serious note, would you be aiming to include continuous treatment in-flight (i.e. in a CASEVAC helicopter) for a more immersive 'PJ' gameplay?

Edited July 15, 2012 by JeffersPang

[short_German 1]

Incredibly Comprehensive Realistic Advanced Medical Project Suite [iCramps]?

edit: on a more serious note, would you be aiming to include continuous treatment in-flight (i.e. in a CASEVAC helicopter) for a more immersive 'PJ' gameplay?

great idea for example in the puma casevac helicopter, the huey casevac from the unsung mod and also in a Blackhawk casevac model there are medic seats inside the aircraft it would be amazing if you could drag a patient into the helo and if he is injured he ends up in one of the slots for casualties he can then be stabilised and treated by the medic inflight to keep him alive i can imagine a system where if an ai is in the slot he does so automatically and if a player is in the slot he takes the job should no player or ai be in the medic slot the casualty will not be treated and could die inflight unless already stabilised the same should be don with ambulances.

---------- Post added at 13:11 ---------- Previous post was at 12:10 ----------

during the "Care under fire" phase, if there is a firefight going on, no bandaging will be available, only application of a tourniquet. Dragging of carrying of the patient will be available. Bandaging takes up too much time while possibly taking effective fire from the enemy. But, say the fighting has stopped, then more options will be available such as, placing a nasophyrngeal airway tube into the nose for breathing, or removing the tourniquet to apply a bandage or compress. Using an eventhandler to determine if rounds are being fired around the victim will play a part in this.

would it not be a viable option that a PJ is treating a casualty behind cover while others are providing cover fire so that he can apply morphine via auto-injector, tourniquet and apply field dressings such as the israeli or H-bandages to stop bleeding. ???

[raptor 6 actual 13]

great idea for example in the puma casevac helicopter, the huey casevac from the unsung mod and also in a Blackhawk casevac model there are medic seats inside the aircraft it would be amazing if you could drag a patient into the helo and if he is injured he ends up in one of the slots for casualties he can then be stabilised and treated by the medic inflight to keep him alive i can imagine a system where if an ai is in the slot he does so automatically and if a player is in the slot he takes the job should no player or ai be in the medic slot the casualty will not be treated and could die inflight unless already stabilised the same should be don with ambulances.

For this, I'd like to have something close to what VBS has for picking a spot in a vehicle. Or, something like you stated, where you walk, carry, or drag a patient up to the helo or ambulance, and then instead of "Load Mr. Peanut into the HH60G" as ACE offers, you'd actually get a GUI that allows you to choose which litter spot or seating option you'd like.

would it not be a viable option that a PJ is treating a casualty behind cover while others are providing cover fire so that he can apply morphine via auto-injector, tourniquet and apply field dressings such as the israeli or H-bandages to stop bleeding. ???

I am going by the TCCC guidle lines that "suggest" not providing in-depth medical care whilst in a firefight. The reasons are that every man, if capable, aid in maintaining or achieving maximum fire superiority. If the patient can move to a safe area, then he should do so. If he can't move on his own, then he should lie back and not move so as not to draw any more fire. The medic or other squad mates may put their lives in danger trying to drag him out of harm's way, or by trying to treat him, and again, every person that you take away from the firefight is one less asset to the squad and the ultimate goal of completing the mission.

What players do in-game, is obviously up to them. Players in a game where you can run out, get hit, die, and then respawn take many more risky chances than real life combat soldiers. I am just taking well thought out protocols from the TCCC courses taught by USSOCOM.

[short_German 1]

i see what you mean Raptor 6 Actual

i personally think that it would be best to have recommended guidelines and leave it up to the player what to do with casualties

and not restricting them for example for the following reasons

1 your defending a emergency casualty collection point like a house or an LZ however you are under fire and the medic or other player in charge cant see to his patients as the location is being shot at occasionally and the event handler you mentioned before prevents treatment.

2 you have completed a mission and on the retreat to extract point a team member gets shot your team gets pinned down and you can't stabilise him during a potentially lengthy firelight

what i believe is the solution is that you are only restricted on what you can do pending on equipment carried. with different treatments taking different lengths of time.

i can imagine that the system could work with an invisible clock as you said before that can get slowed down and stopped pending on injury by different measures undertaken if the injury is past a certain point it can only be slowed down but not stopped unless the casualty is on the operating table in the shock trauma unit (the table could be like a vehicle slot where you can pace an injured person) for further care. it would be great to have an option to casevac and treat via ai but thats a different matter.

I sincerely hope that this system will also allow accurate injuries on AI because when we play an EOD mission and an AI team mate gets injured we do everything to save them we have even casevac't enemy ai before.

keep up the work on this as it is exactly what arma needs.

[raptor 6 actual 13]

After a year of trying to combine the .ogg file I made personally in Adobe After Effects with the display of the LifePak 15 heart monitor, Riouken has helped bring them together ingame.

Keep in mind that this is very alpha version and that I'm working on more heart rhythms. But, here's the link:

Each rhythm will correlate to a specific health value and will have Blood pressure and heart rate info posted on it. The heart monitor will only be available in the helo or Ambulance though. Hope you enjoy.

[m1n1d0u 29]

a simple idea but have you planed to add a sort of blood loss and quantity ? like dayZ i think it can be really cool and imersive if you see one of your mate just bleed out when he get shot anyway nice progress i really like that and give me alot of ideas !

[rye1 21]

Sinus tachycardia.

[raptor 6 actual 13]

Lol, yes, at the moment it is. I actually reworked it and slowed the rate down though. I have V-fib done, and now working on Asystole. I'm not sure what I'm really wanting to do with it all, but it's being done none-the-less.

[rye1 21]

Haha slowed down? Combat heart rate 145 bpm!

Edited December 6, 2013 by Rye