Standard Medical Guide

TMTM’s standard medical system may be confusing to the uninitiated, but this will help you through the process of stabilizing and reviving downed friendlies. Use the table of contents below to navigate through this document. If you are playing Advanced Medical Operations use this guide instead.

Abbreviations

BP = Blood Pressure
PSB = Plasma, Saline, Blood
EPI = Epinephrine
HR= Heart Rate

General Info

Here are some general tips and pieces of advice that you should know whether or not you are a medic.

1. When a person's pulse is below 20 or above 200, they enter cardiac arrest and have 3 minutes (TMTM default) to be resuscitated before they die
2. Bleeding out is also possible regardless of pulse, blood is very important!
3. Performing CPR has a base 40% chance to restore HR, but this can be affected by how much blood the patient has lost.
4. If someone is unconscious, DO NOT give them morphine except as a last resort-consult a medic first.
5. If you have taken morphine you may start to hear your heart rate,
6. Pain increases blood pressure
7. Never take more than one morphine within ~30 minutes
8. If you have lost enough blood, taking morphine can knock you unconscious.
9. You can not give someone too much blood
10. Tourniquets will stop medication and blood from going into your system.
11. Medics apply bandages faster than any regular infantry, so it's better to have a nearby rifleman do CPR if the medic asks for it
12. If someone is providing medical to someone downed do not crowd around them, they will ask for help if needed. The guy who shot them is probably still around!
13. Checking pulse during CPR will give you a false positive, check pulse after each round of Cpr

TMTM Specific Settings (Compared to ACE default)

1. Players bleed 75% as fast
2. IV transfusions are 4x faster

Useful Information

Resource Effects on Pulse and Blood Pressure

Resource	Pulse	Blood Pressure	Notes
PSB	None	Increases based on administered amount	Patients will have no pulse if blood is too low
Morphine	Decreases drastically	Decreases drastically	Will suppress an individual's pain levels. Lasts ~30 mins.
Epi	Increases	Increases	Will increase the chance of individual waking up when stable. Lasts ~2 mins
Adenosine	Decreases	Decreases	Can be used to counteract epinephrine. Lasts ~2 mins

Blood Loss Tables

There are two ways to find BP, one is through the ACE interactions (CTRL + Windows Key) another is through the medical menu (CTRL + H).

Medical Menu

Medical Menu Message	Lower Bound	Upper Bound
No Message	6.0 liters	6.0 liters
Lost some blood	5.1 liters	6.0 liters
Lost a lot of blood	4.2 liters	5.1 liters
Lost a large amount of blood	3.6 liters	4.2 liters
Lost a fatal amount of blood	3.0 liters	3.6 liters
Dead	0.0 liters	3.0 liters

There is no way to check the exact amount other than the prompts in the Medical Menu

• If you go below 3.6 Liters you will instantly fall unconscious.
• You can only wake up if you have 5.1 or more liters
• If you fall below 3.0 Liters you will die

ACE Interactions

Message	Corresponding BP (Systolic)
Can't find BP	0-50*
Low BP	50-90*
Normal BP	90-160*
High BP	>160*

*These numbers are unconfirmed

Defintion of "Stable"

1. Not bleeding
2. Must have at least 5.1 liters of PSB
3. Not be in cardiac arrest
4. HR above 40
5. BR above 50/60

Non-Medic Roles

This section is a step-by-step for every role other than medic in operations. Info learned here can be applied to yourself if you are hurt, specifically steps 1, 3, 5, and 6.

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Step 1

• Report downed friendly over Short-Range radio
  • Report over SR so the medic is notified and the Squad leader or Team leader knows who is down
• Secure the area
  • Do this by popping smoke for cover or killing the enemies that downed the friendly
  • Do not grab them immediately or you might be the next one down

Step 2

• Confirm they are alive
  • If you can check their inventory, walk over their body, or not be able to drag them they are dead, if not they are alive
• Drag to cover
  • Incase a new enemy pops out you won't be shot while healing

Step 3

• Check Vitals
  • Check Pulse, it will be one of these four
    • No HR
    • Weak
    • Normal
    • Strong
  • Check Blood Pressure if there is a HR, it will be one of these 4
    • Can’t find BP
    • Low
    • Normal
    • High

Step 4

• CPR once if no HR
  • Do this to possibly reset their countdown (3 minute timer to death once HR hits 0)
  • Don’t check pulse while CPR is being performed since it will give weak HR

Step 5

• Tourniquet
  • If more than 3 parts of their body is heavily damaged tourniquet the respective limbs to stop the blood loss
  • Do not pump PSB, morphine, epi, or adenosine into tourniqueted limbs since they do not take effect until the tourniquet is removed
• Bandage
  • Focus on chest and head first since limbs can be tourniqueted if needed
• If multiple people are working on the same person call out which part you are bandaging as to not waste time double bandaging the same part
• CPR Again
  • If bandaging it taking too long (over 1.5 minutes) perform CPR again to possibly reset their timer
    • Check Pulse after every round of CPR to see if heart has started

Step 6

• Recheck Vitals & Call over Medic again
  • Check Pulse
    • If no pulse continue to perform CPR
  • Check Blood Pressure
    • If it is any other than “Lost some blood”, Low or Can’t find BP, call medic or pump in blood if you have it

Step 7

• They are “stable” they can be moved to medic if
  • They have a strong HR (don’t check while CPR is being performed since it will give weak HR)
  • If blood pressure is “Lost a Large amount of blood” or higher
  • Isn’t bleeding out

Medic

This section is a step-by-step for the medic role in operations. Remember that you are meant to heal others, do not put yourself in risky scenarios.

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Step 1

• Report downed friendly over Short-Range radio
  • Report over SR so Squadleader or Teamleader knows who is down
• Secure the area
  • Do this by popping smoke for cover or killing the enemies that downed the friendly
  • Do not grab them immediately or you might be the next one down

Step 2

• Confirm they are alive
  • If you can check their inventory, walk over their body, or not be able to drag them they are dead, if not they are alive
• Drag to cover
  • Incase a new enemy pops out you won't be shot while healing

Step 3

• Check Vitals
  • Check Pulse, you will see numbers, it will fall into one of these categories
    • No HR: 0
    • Weak: <55
    • Normal: between 60 - 110
    • Strong: >115
  • Check Blood Pressure if there is a HR, you will see numbers, the numbers below apply to the left side (systolic), it will fall into one of these categories
    • Can’t find BP: 0-50
    • Low: 50-90
    • Normal: 90-160
    • High: 160 and above
  • If they are under “Lost a lot of blood” or 90 BP or they will need blood to wake up

Step 4

• CPR once if no HR
  • Do this to possibly reset their countdown (3 minute timer to death once HR hits 0)

Step 5

• Tourniquet
  • If more than 3 parts of their body is heavily damaged tourniquet the respective limbs to stop the blood loss
  • Do not pump PSB, morphine, epi, or adenosine into tourniqueted limbs since they do not take effect until tourniquet is removed
• Bandage
  • Focus on chest and head first since limbs can be tourniqueted if needed
  • If multiple people are working on the same person call out which part you are bandaging as to not waste time
• CPR Again
  • If bandaging it taking too long (over 1.5 minutes) perform CPR again to possibly reset their timer
    • If possible call someone over to take over CPR so you can focus on bandaging
    • Check Pulse after every round of CPR to see if heart has started

Step 6

• Recheck Vitals once bleeding has been staunched
  • Check Pulse
    • If no pulse continue to perform CPR or get someone else to help
  • Check Blood Pressure
    • If it is any other than “Lost some blood” or under 90 BP pump in blood if you have it

Step 7

• Raising BP
  • Start with 1000 ml of PSB (Plasma, Blood, or Saline they are all the same)
    • If BP is under “Lost a lot of Blood” or 50 BP give at least 2000 ml
  • Wait for BP to raise & check Pulse
    • If no HR continue to CPR

Step 8

• Stable?
  • Is the pulse between 60 and 120?
    • Yes = stable
    • No = Medicine
      • Epi = Raises Pulse
      • Adenosine = Lowers Pulse
      • Morphine = Lowers Pulse
  • Is the BP between 90 - 160?
    • Yes = Stable
    • No = Medicine
      • More PSB = Raises BP
      • Epi = Raises BP
      • Morphine = Drastically Lowers BP
      • Adenosine = Lowers BP

Step 9

• Not waking up?
  • Push Epi if vitals allow
  • Recheck Pulse and BP