Medical System - A comprehensive Look

[booty_from_hawaii 14]

As a real life EMT, I would definitely be interested in seeing a medical system that is simple yet revolves around role play.  Things like blood pressure, heart rate, bleeding control, saleen, etc.

 

Here's how I would imagine the medical system to be programmed:

 

Each civilian normally has 5 liters, or 5000mL of blood volume. A single gun shot would cause blood loss ( 2mL per second on the limb, and 4mL per second on the chest or abdomen) Stab wounds are also a possibility. Multiple gun shot wounds or stab wounds would multiply the bleeding affect. 

 

Normal blood pressure = 120/80, normal heart rate = 75. Each 1/2 liter (500mL) of blood loss causes a 10 point loss in blood pressure. Each time the blood pressure drops 10 points, the heart rate increases 10 points. (I can explain why if you want).

 

***Any blood pressure under 80/40 will cause the patient to pass out, any blood pressure under 50/10 will cause the patient to "die", but can still be resuscitated with CPR. A player will be able to function normally with wounds for an amount of time until his low blood pressure causes the player to pass out. This will allow the player to continue the gun fight with wounds, or give the player enough time to apply first aid to himself or a teammate. However, if a player passes out, he will need a medic to administer fluids for him to wake back up. At that point the player can either refuse further treatment, or elect to go to the hospital/be treated in the ambulance until the blood pressure is stabilized. The incentive for transport to the hospital being that a medic can give fluids to a patient up to 140/ 100 for an extra buffer of health!!! This will encourage role play. 

 

Okay so here's an example: one gun shot wound to the chest = 4mL of blood loss per second. 1 minute = 240mL of blood loss, therefore a person loses 1000mL or 1 liter of blood in approx. 4 mins per gunshot wound to the chest or abd. That means it would take 16 mins to die from one gunshot wound, and 10 mins for a player to pass out from a gun shot wound to the chest or abdomen. Double that time for gun shots to a limb. Now, of course more gun shot wounds would cause a multiplication of blood loss, so be careful out there! Maybe armor would deflect 5 bullets before losing its effectiveness???

 

There are 7 "compartments" on the human body. 1) The chest 2) The head 3) The abdomen 4) the Right arm 5) the left arm 6) the R leg 7) and the L leg. 

Head injuries: Laceration, fracture, gun shot wound...maybe a helmet deflects one or two bullets before losing its effectiveness???

Chest injuries: Laceration, broken rib, gun shot wound...maybe a Kevlar vest deflects one or two bullets before losing its effectiveness???

Abdomen injuries: Gun shot wound, laceration.

Limb injuries: Gun shot wound, laceration, open fracture (bleeding), closed fracture (non-bleeding)

Blood volume, blood pressure, and heart rate chart:

Volume: 6000mL, BP: 140/100, HR: 55-------

Volume: 5500mL, BP: 130/90, HR: 65------

Volume: 5000mL, BP: 120/80, HR: 75-----

Volume: 4500mL, BP: 110/70, HR: 85-----

Volume: 3500mL, BP: 100/60, HR: 95-----

Volume: 3000mL, BP: 90/50, HR: 105------

Volume: 2500mL, BP: 80/40, HR: 115 (Pass out)-----

Volume: 2000mL, BP: 70/30, HR: 125-----

Volume: 1500mL, BP: 60/20, HR: 135-----

Volume: 1000mL, BP: 50/10, HR 145 (DEATH)-----

Volume: 500mL, BP: 40/10, HR: 0 (Can still be saved with CPR)-----

Volume: 0mL, BP: 30/0, HR: 0 (NOT able to resuscitate and must respawn)

 

CPR and Resuscitation:

 

CPR can be administered by anyone, and will prevent the pressure from dropping if all wounds are bandaged successfully. However, it can only be administered if the player "dies", i.e. blood pressure at 50/10 or less.

 

If the patient "dies", they can still receive defibrillation by a medic. However, defibrillation will only work if the blood pressure is 90/40. So...the medic will need to give saleen up to 90/60 in order for the defibrillation to work. This will also encourage teamwork between the two medic partners. A patient who has been successfully resuscitated via defibrillation MUST be transported to the hospital by the medics and MUST receive the health buffer of 140/100.

 

Now let's apply this type of scenario to a whitelisted server...

"New life rule" does not apply unless you actually re-spawn. The time it takes to transport a patient who has received defibrillation is enough time to make his return to the fight reasonable.

Since the medics are a neutral entity, they cannot be within a certain distance to an active gunfight, therefore the victim's teammate will have to be able to carry the victim away from the gunfight and toward the medics. A feature to load an unconscious player into a vehicle would significantly aid this process.

Example: Officer down, teammate stops the bleeding, carries him to the patrol car, loads him into the patrol car, drives him 200m (or whatever) to the medics on stand-by, medics commence patient care. The officer can either wait for his comrade to be healed, or drive back to the gunfight.

OR...depending on EMS AND POLICE policies, there might be tactical medics equipped with vests and helmets that are permitted to go into an active firefight and operate ONLY TO STABILIZE AND TRANSPORT THE VICTIM BACK TO THE NEARBY AMBULANCE VIA CARRY ANIMATION.

 

After reviewing this system and looking at practical application, most of the time the bleeding can be stopped by applying bandages to yourself, therefore medics will rarely be needed unless a person suffers multiple gun shot wounds over time. With that said, personnel who are not trained in first aid, i.e. civilians....would have a lower probability of successfully applying a bandage compared to a police officer who would have a higher probability due to police training. (Medics having 100% success rate). These probabilities/percentages can be programmed into each type of player character. Bleeding control is very important, since bleeding is what drops your blood pressure.

 

Trauma and Medical conditions:

-Gun shot wound to the chest: 4mL of blood loss per second (requires "Occlusive dressing" or blood pressure will continue to drop)

-Gun shot wound to the abdomen: 4mL of blood loss per second (requires "Trauma dressing")

-Gun shot wound to the head: 8mL of blood loss per second (requires "Trauma dressing")

-Laceration: 4mL of blood loss per second for lacerations to the head, chest or abdomen, and 2mL of blood loss for lacerations to any limb (from stabbing or blunt force trauma, i.e. non-bladed weapons or fists)...(blunt force trauma with probability of 1:10 to cause a laceration), stabbing = 100% probability of laceration. Requires "Medium gauze"

-Fractured limb (from MVA a.k.a. motor vehicle accident higher than 35mph) OR (fall from higher than 20 feet)...could be an open fracture or closed fracture, open causes bleeding. Requires "Cardboard Splint"

-Fractured spine (from MVA a.k.a. motor vehicle accident higher than 50mph) OR (fall from higher than 35 feet)....causes neurogenic shock, which instantly drops the blood pressure to 80/40 (passes out). Requires "C-collar and Spine Board"

-Dehydration: Not drinking enough water will cause the blood pressure to slowly drop. Maybe 1mL per minute? Player will eventually pass out and need medical treatment. Requires "Saleen Bag"

-Low blood sugar: Not eating will cause your blood sugar level to slowly drop, causing you to pass out. Maybe 0.5 points per minute? Normal blood sugar: 70-140mg% (pass out at <40mg%). Requires "Oral Glucose" (can be store bought) if they are conscious...or "Saleen Bag" followed by "Dextrose 50%" if they are unconscious. via medic only

-Smoke inhalation: A result of not cooking meth properly, causes the player to have decreased run speed and inability to eat or drink. Also causes decrease in shooting accuracy. Requires "Oxygen Mask" by a medic. Resolved after 5 mins of O2 therapy.

-Drug overdose: Causes the player to pass out, slowly lowering the heart rate. A heart rate less than 40 causes death. Requires "Mucosal Atomization Device" by medic.

-Emphysema: A result of chronic smoking. A condition that causes decreased stamina or slower run speed. Requires "Oxygen Mask" by medic. Resolved after 2.5 mins of O2 therapy

 

EMS equipment:

-An ambulance and gurney where you can take the gurney out of the ambulance first(animated), roll the gurney to the patient with the crew member holding it (animation), then load the patient on the gurney, then roll the gurney back to the ambulance with the patient on the gurney, and finally load the patient into the ambulance (animation). Both crew members should be able to sit in the back of the ambulance with the patient in order to treat them further. 

-Blood pressure cuff (to take blood pressures) https://www.google.com/search?q=blood+pressure+cuff&source=lnms&tbm=isch&sa=X&ved=0ahUKEwj55afs-qrhAhUKsZ4KHRv6CAUQ_AUIDygC&biw=1920&bih=937

-Small gauze (band aid): 

-Medium gauze (4x4): https://www.google.com/search?biw=1920&bih=937&tbm=isch&sa=1&ei=yfOfXL7ALsfj0gKa_JmwCw&q=4x4+gauze&oq=4x4+gauze&gs_l=img.3..0l7j0i8i30l3.35879.38439..38548...0.0..0.161.1040.0j8......1....1..gws-wiz-img.......0i67.XilFtcmrn6A

Large gauze (trauma dressing) for bleeding control:  https://www.google.com/search?biw=1920&bih=937&tbm=isch&sa=1&ei=MvufXJXAFOaM0gL_1I3gDQ&q=large+trauma+dressing&oq=large+trauma+dressing&gs_l=img.3..0.8702.9827..10055...0.0..0.125.726.0j6......1....1..gws-wiz-img.......0i7i30.LPNNAsFsE9Y#imgrc=m2umye0WXEeN8M:

-Occlusive dressing for gun shot wounds to the chest. https://www.google.com/search?biw=1920&bih=937&tbm=isch&sa=1&ei=8POfXO6SOqqu0gLOspHoCA&q=occlusive+dressing&oq=occlu&gs_l=img.1.0.0i67j0l4j0i67j0l4.68636.70332..71616...0.0..0.234.851.0j5j1......1....1..gws-wiz-img.....0..35i39.fEq8cUpVREE

-0.9% sodium chloride intravenous access (saleen bag) with 500mL, and 1000mL sized bags. Each bringing up the blood pressure 10 and 20 points respectively. Blood pressure cap is 140/100. All Saleen bags have a 30 second cool down. (cannot spam) https://www.google.com/search?biw=1920&bih=937&tbm=isch&sa=1&ei=WPSfXJKkBcHQ-gS19JHQCw&q=sodium+chloride+IV+1000ml&oq=sodium+chloride+IV+1000ml&gs_l=img.12...4933.8605..10477...0.0..0.120.586.0j5......1....1..gws-wiz-img.ruLwtBAA3FQ

-Automated External Defibrillator (AED): To revive patients out of cardiac arrest (death). AED sound effects implemented would be awesome...https://www.soundsnap.com/tags/defibrillator

-Oxygen mask for people who have smoke inhalation or emphysema (difficulty breathing). Oxygen resolves the problem, however it takes 5 minutes. https://www.google.com/search?biw=1920&bih=937&tbm=isch&sa=1&ei=Y_SfXNOnEdfy-gTjqrXwDA&q=non+rebreather+mask&oq=Non+rebr&gs_l=img.1.0.0l10.234764.242845..244519...3.0..0.121.1292.0j11......1....1..gws-wiz-img.......35i39j0i67.RvRq1vkGfXY

-C-collar and spine board for people who've been in car accidents or falls. (placeable on the gurney with mandatory transport to hospital) 

https://www.google.com/search?biw=1920&bih=937&tbm=isch&sa=1&ei=b_WfXOHcIpLi-gT0lYBg&q=c-collar&oq=c-collar&gs_l=img.3..0l2j0i30l8.3459.5030..5363...0.0..0.227.1055.0j7j1......1....1..gws-wiz-img.......35i39j0i67.S4gVa6l0jr8

https://www.google.com/search?biw=1920&bih=937&tbm=isch&sa=1&ei=dfWfXOO0KJbm-gSFy5vgAQ&q=spine+board&oq=spine+board&gs_l=img.3..0l10.17469.19114..20479...0.0..0.132.1324.0j11......1....1..gws-wiz-img.......35i39j0i67.HuaWMdFt_SY

-Cardboard splint (for fractured arms and legs) https://www.google.com/search?biw=1920&bih=937&tbm=isch&sa=1&ei=ivWfXIazMM-X-gSIzL-QCg&q=carboard+splint&oq=carboard+splint&gs_l=img.3..0i10i24.19098.25398..25504...4.0..0.134.2142.0j18......1....1..gws-wiz-img.......35i39j0i67j0j0i10j0i24j0i30.-yajqhMBXSc#imgrc=_

-Mucosal Atomization Device (Naloxone aka Narcan for overdose patients) restores heart rate and blood pressure and wakes the patient up. https://www.google.com/search?q=mucosal+atomization+device&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjG-8Xn_KrhAhWC4J4KHQoECBYQ_AUIDygC&biw=1920&bih=937

Oral Glucose to treat hypoglycemia (low blood sugar) and can be purchased at the store over the counter. https://www.google.com/search?biw=1920&bih=937&tbm=isch&sa=1&ei=2PWfXMS-LsnK-gSrk5noCQ&q=Oral+Glucose&oq=Oral+Glucose&gs_l=img.3..0l10.18524.18524..19279...0.0..0.124.124.0j1......1....2j1..gws-wiz-img.AO4UB-sga34

Dextrose 50% https://www.google.com/search?biw=1920&bih=937&tbm=isch&sa=1&ei=7PWfXLe_LJTi-gT8tKioBw&q=Dextrose+50% &oq=Dextrose+50% &gs_l=img.12..0l10.44163.44163..44923...0.0..0.120.120.0j1......1....2j1..gws-wiz-img.-yju_UHYx7E#imgrc=o9SEii_vUDFZgM:

 

I think these implementations would really help add some features to the combat system as well as increase probability of role play between EMS, civilians, and the police force. After all, this is a role playing game. I believe a good medical system would really add appeal and value to the game. Feel free to DM me if you have any questions or if there is any way I can assist further. I would love to see something like this in the game and be part of the training/leadership team for EMS as I have real world experience. Mahalo from Hawaii and EMS Honolulu!

Edited March 30, 2019 by booty_from_hawaii

[booty_from_hawaii 14]

I'm hoping this system is possible to create!

Edited August 14, 2018 by booty_from_hawaii

[Anonymous_Citizen 75]

On 8/14/2018 at 4:37 PM, booty_from_hawaii said:

I'm hoping this system is possible to create!

 

It is possible, and I would prefer a realistic medical system. Thanks for this, hopefully, the developers can use it as a blueprint later on in development.

[Jmx10001 12]

this idea could influence more than just job it could effect the economy, health care, peoples lives...... this can effect everything with in the game (may be im over exaggerating) but this 1 thing could effect lot of aspects with in the game making it more realistic, because people would have to eat food to stay healthy also drug over dose (and other condition relating to unsafe use of drugs) could lead to social and medical services.   

[ColonelKimmers 11]

I for one am a fan of this system, and I know some ArmA 3 mods (although maybe not as far to this extent) has some-what realistic medical systems.

I'd definitely buff players like most games do though (however, this could also encourage the use of bodyarmour/protective gear). Being able to die too easily/quickly causes a lot of people to have frustration and blame their own incompetence on the game's mechanics.

If it does not end up in the base game, I'd definitely like to see it as a mod on a private server. However unfortunately they don't have a stance on mods yet, and may not come to one years until after the release.

[booty_from_hawaii 14]

On 9/25/2018 at 8:19 PM, ColonelKimmers said:

I for one am a fan of this system, and I know some ArmA 3 mods (although maybe not as far to this extent) has some-what realistic medical systems.

I'd definitely buff players like most games do though (however, this could also encourage the use of bodyarmour/protective gear). Being able to die too easily/quickly causes a lot of people to have frustration and blame their own incompetence on the game's mechanics.

If it does not end up in the base game, I'd definitely like to see it as a mod on a private server. However unfortunately they don't have a stance on mods yet, and may not come to one years until after the release.

 

Thank you so much for your feedback. I definitely agree with buffing the characters. I tried to imagine this medical system in implementation, and with the ability to stop the bleeding with civilian bandages and the significant time it takes to actually pass out, it seems as though it would be balanced with this design. Of course, testing would have to be done to make sure quick deaths are not possible. 

Medical system mods for arma3 are numerous, but none of them had roleplay in mind, they were simply brought into communities like Arma3Life as a mod. It would be awesome to see a medical system similar to this be implemented into Identity with role play in mind from the very beginning. Although this design is quite ambitious, I believe it will enhance RP and bring the crowds. People love roleplay (including A TON of very famous streamers on Twitch) and I'd love to see this game succeed! <3

 

Edited March 30, 2019 by booty_from_hawaii

[booty_from_hawaii 14]

***UPDATED 3/30/19***

Edited March 30, 2019 by booty_from_hawaii

[Paratus 2,230]

Our medical system has been designed for quite a time, although this thread is such a great wealth of information that I've bookmarked it so that we can use it in our next review. Thanks!

PS: You're going to see a tiny bit of this works when we show off the weapons in a video quite soon.

[booty_from_hawaii 14]

Is this game still being worked on?

[LuckyDuck 1,444]

17 hours ago, booty_from_hawaii said:

Is this game still being worked on?

Yes