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Gditz

Testing the Ace Medical system

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I've recently done a few test on the Ace Medical system to learn more about the underlying mechanics in the medical system and how things actually work. I'll embed the three videos where I go through the test but first I'll summarize what I've learned from all these test so far. Most things are common knowledge but some are still often debated.

1. Moving a unit (Dragging, Carrying or just moving by walking) does not lead to wounds being reopened.

2. Staying stationary or being restrained will not prevent wounds from reopening.

3. Technically, it is not a wound that reopens, it is the bandage that fails. So if a wound takes 2 QuikClots to close, one of those bandages might reopen and you would then have a partial wound reopen. Both might also open or they might both stay closed. The odds for these events given a Large Avulsion that needs 2 QuikClots is, 4% that both open, 32% that only one bandage opens and 64% that both stay closed. Given the same wound you would only need 1 Elastic bandage and it would have a 70% to reopen and a 30% chance to stay closed.

4. We all know that morphine can be trapped in a limb if you tourniquet it first and then push drugs into that limb. While drugs can be stopped this way, it will not prevent any IV fluids to go into the patient. So even if a patient has tourniquets on all 4 limbs you can still make sure they get their blood back quickly. 

5. Once a patient has had all their fluids restored, the remaining plasma, saline or blood is removed. This means one shouldn't give more blood to a patient than necessary since it will be wasted.

6. A tourniquet will stop any and all bleeding from the limb it is applied to. The limb will resume bleeding if the tourniquet is removed before limb has been bandaged.

7. Using Elastic bandages instead of QuikClots leads to severely increased amount of wounds getting reopen and also decreases the time for the wounds to reopen. Switching from Elastic to Packing largely increased the time for wounds to reopen but did not change the chance for wounds reopening.

8. Applying a bandage to a limb that only has closed wounds (in other words, the body part shows up as blue) does not prolong the reopening time and it does not lower the chance for reopening. This will have the same effect as bandaging a white body part, waste of a bandage.

9. Applying a single tourniquet and leading it on will produce pain after around 27 minutes. The pain increases at a steady pace and after around 20 minutes the pain reaches a threshold and stays constant.

10. Applying 4 tourniquets on a patient and leaving them on will induce pain in around 3 and a half minutes.

11. Pain from tourniquets will not make you pass out.

12. Medium Velocity wounds will bleed out faster than Medium Avulsions. A single Medium Velocity wound will make a patient bleed and die after around 14 minutes if left unattended while a single Medium Avulsion will make a patient bleed and die after around 35 minutes if left unattended.

13. Small Velocity wounds will bleed out faster than Minor Avulsions. A single Small Velocity wound will make a patient bleed and die after around 29 minutes if left unattended while a single Minor Avulsion will make a patient bleed and die after around 70 minutes if left unattended.

 

The videos are long and without any audio commentary. All the setting and the total 8 hours of tests can be seen if one really needs something to sleep to.

If you have anything you are unsure about in the medical system or want me to get to the bottom of, let me know. Are there any other medical myths that we can bust?

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Could you explain this chart, I've looked at it many times and I have no idea how to read it

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Efficiency is the same as a healing spell in a fantasy game. Wounds do not reopen earlier than minDelay seconds and will definitely reopen after maxDelay seconds at the latest. Reopening chance is probably rolled once a minute or so, or rolled per minute and the amount of overshoot decides how far into the minute it opens; but that is just guesswork.

You don't exactly need to remember all the numbers, the only piece you'd use is calculating how many bandages you need to fully heal a limb. What you need to understand is tendencies. Packings have the same healing value as Basics, but better reopening stats (minDelay is your most valuable stat here). Elastics reopen after roughly 1-1.5 minutes, the others stay on for a good 8-15 minutes (actually, its exactly ten times as long on Elastics). QuikClots have amazing reopening stats, but a fraction of the healing value.

Keep in mind that only the reopening stats of the first bandage you use on a bodypart count. This all leads to a rough guideline on how to treat things:

  • A part that needs multiples should be started with QuikClot > Packing > Basic > tourniquet, and then spamhealed with Elastic > Basic > Packing.
  • NEVER start a bodypart with an Elastic, unless you are prepared to immediately stitch it. Better to slap on a tourniquet and go scavenging, RHS units tend to carry Packing+Basic. Conversely, try to not use QuikClots for spamhealing.
  • A part that only needs a single bandage is best served with a Packing, maybe a Basic.
  • Your loadout should be focused on QuikClots and Elastics.
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Players and AI react differently; even with the ADV Wounds applied to both.

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45 minutes ago, Nova said:

Could you explain this chart, I've looked at it many times and I have no idea how to read it

[chart]

Each bandage has 4 attributes, Efficiency, Reopening Chance, MinDelay and MaxDelay.

Efficiency is pretty straightforward, the higher efficiency value a bandage has the more it can cover and treat a wound. A large wound might need 2 or 3 bandages that have low efficiency or it can be closed with a single bandage with high efficiency. Higher values are better as it means it can cover larger wounds with less bandages.

Reopening Chance means that once a wound has been closed, it will have a chance to reopen. How big this chance is depends on the different bandages and what wounds they have been applied to. 0.7 means that a wound has 70% to reopen after the DelayTime has passed. Lower values are better becuase it means lower risk of reopening.

Time until wound reopens is the least known factor is the time each bandage has before it opens. Each treated wound has a minimum time for which the wound will remain closed. If a wound will reopen, it will happen somewhere after the minimum time has passed but before the maximum time. The exact point is randomized but on average it will happen in between the minimum and maximum value. This is not affected by how much player is moving about. Values are given in seconds and higher values are better.

20 minutes ago, Blutze said:

Reopening chance is probably rolled once a minute or so, or rolled per minute and the amount of overshoot decides how far into the minute it opens

The chance for reopening is basically a single dice roll done a single time when the bandage has been applied If the bandage is going to open, the time is equal to MinimumDelay + random*(Maximumelay - MinimumDelay) where random is a variable generated and between 0 to 1. The code that handles that function call has the following code:

TRACE_1("",_reopeningChance);
// Check if we are ever going to reopen this
if (random(1) <= _reopeningChance) then {
    _delay = _reopeningMinDelay + random(_reopeningMaxDelay - _reopeningMinDelay);
    TRACE_1("Will open",_delay);

 

23 minutes ago, Blutze said:

QuikClot > Packing > Basic > tourniquet

The very first thing you should do when treating someone is to tourniqueted all their limbs that are bleeding. This will stop all bleeding from those limbs and lets you focus on other parts that cant be tourniqueted. 

 

25 minutes ago, Blutze said:

Keep in mind that only the reopening stats of the first bandage you use on a bodypart count.

No, the values of one bandage are not given or overwritten because you apply bandages in one specific order. All bandages and their properties will still be the same regardless of the order they are applied. So if you treat a wound with a QuikClot and an Elastic you will have a high chance for the Elastic to reopen, a small for the QuickClot to reopen. There is no combination matrix or code I have seen to make this happen.

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6 minutes ago, Sarissa said:

Players and AI react differently; even with the ADV Wounds applied to both.

This may very well be true, I have not had the chance to try all this out on players and it would be interesting to see what those differences are. I plan on doing this in the future but even if AI and Human players are different, the code used is clear and I have also evaluated footage from roughly 25 missions I've done as medic to get more data but its difficult to isolate and make sure that an effect is not due to something else. If anyone wants to volunteer as guinea pigs I would be more than happy to prod them :)

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Posted (edited)

That was a priority list, not an ordered list of actions. Just trying to highlight that you should leave the part unbandaged if all you have is Elastics, at least if that entire string of conclusions doesn't fall apart from the beginning. Might rephrase the thing.

Haven't played World of Warcraft in three bloody years and I'm still thinking in priority lists, fucking hell.

 

Oh and the thing with the first bandage counts is what @Rorkiy told us in his training session. Did you look at the code for the "every bandage reopens on its own" theory? Not in the mood to dig through that many classes, doing that enough at work already.

Edited by Blutze
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2 hours ago, Gditz said:

If anyone wants to volunteer as guinea pigs I would be more than happy to prod them :)

If you see me on TS, just poke me and I'd happily help

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Posted (edited)

On 2017-07-16 at 19:31, Blutze said:

Oh and the thing with the first bandage counts is what @Rorkiy told us in his training session. Did you look at the code for the "every bandage reopens on its own" theory? Not in the mood to dig through that many classes, doing that enough at work already.

This is the first I've heard of it and I can't say it makes any sense to me at all. Why would the 2nd bandage you apply have only the same reopening chance, MinimumDelay and MaximumDelay but disregard the efficiency? Regardless of how it came to be I decided that I might as well document how switching up bandage types actually work.

In the test below I gave 4 soldiers 5 wounds each from the same weapon. All limb wounds required 2 bandages each and the torso, due to armor, required either 1 Elastic or 2 QuikClots. Every time a wound was treated, a QuikClot was first applied followed up by an Elastic. As a reference, the second patient was not given any Elastic bandage treatment and used only QuikClots.

If the Elastic inherits the reopening chance from the QuikClot, they will each have 20% chance for avulsion and a 50% chance for velocity wounds to reopen. The time it would take for them to reopen would be somewhere between 1000 to 1600 seconds for avulsions and 800 to 2000 seconds for velocity wounds.

If the Elastic keep their original property when being applied after another bandage, have 70% chance for avulsion and a 100% chance for velocity wounds to reopen. The time it would take for them to reopen would be somewhere between 100 to 160 seconds for avulsions and 80 to 200 seconds for velocity wounds.

The latter turned out to be true, Elastics do NOT inherit the values from QuikClots and should NOT be used in this manner. In the test they open up well before 800 seconds had elapsed and at a statistically significant number of times to rule out that we simply were unlucky with the rolls. The final result is every patient needed to use around 13 QuikClots (range from 11 to 16) to permanently keep all wounds closed. Every patient except the reference also had to use 5 elastic bandages. This means that every single patient, in the long run, bled more, used more bandages and also spent a longer time in treatment than the reference patient who only used QuikClots.

TLDR: "first bandage counts" is not a correct treatment strategy. Wounds should only be treated with the best bandage for that wound, regardless of if the wound has been partially closed or not.

Edited by Gditz
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Interesting. Elastics have the worst reopening stats for all wound types, so whats their point anyway? Can't be just for the few cases where you absolutely know youre gonna stitch it immediately, with nobody getting hurt before you can do so. Or are they not as rare as I think?

If you wanna keep doing these, I would be delighted to get confirmation for @Slouchy Orc's theory of dragging/carrying increasing bleedout rates. You are right that it should usually be easy to just tourniquet or bandage everything, but there can definitely be situations where the medic's bag can't be recovered and you have to transport somebody across the map.

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3 minutes ago, Blutze said:

Interesting. Elastics have the worst reopening stats for all wound types, so whats their point anyway? Can't be just for the few cases where you absolutely know youre gonna stitch it immediately, with nobody getting hurt before you can do so. Or are they not as rare as I think?

The point is that they can close large wounds really quickly and with fewer bandages but like you said, they will reopen really fast. As you have already mentioned its basically only useful for medics because they can stitch them up as soon as its all closed. I tend to only use Elastics as medic after I've tourniqueted the limbs and then finish up with a stitch. If there is no time to do all that I tourniquet all limbs, give them blood and fix  the head and torso with Packing or QuikClots to buy time and move on to the next patient/retreat.

10 minutes ago, Blutze said:

If you wanna keep doing these, I would be delighted to get confirmation for @Slouchy Orc's theory of dragging/carrying increasing bleedout rates. You are right that it should usually be easy to just tourniquet or bandage everything, but there can definitely be situations where the medic's bag can't be recovered and you have to transport somebody across the map.

That sounds like a good thing to test and I will try to get to it as soon as I get back from my vacation. I don't think the dragging or carrying increases bloodrates but I am not 100% sure yet.

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