ACMS

1.0.16

# ACMS – Changelog

## New
- **ACMS Config in game:** Admins change the server settings in a menu (Options → ACMS → ACMS Config). Pick a profile (Normal, Advanced, Full MilSim), search for a setting or browse the groups. Changes apply right away, everybody else can look at the values.
- **Paramedic list in the menu:** Admins appoint or withdraw paramedics for the players in the session and remove old entries.
- **Triage:** Paramedics look a casualty over and hang a triage tag on them: red (immediate), yellow (delayed), green (minor), black (dead). The window checks breathing, circulation and consciousness and suggests a class. The colour shows as a label under the name and as a card on the chest. An overview lists casualties within 30 m and shows when a tag is outdated. New item: Triage Tag.
- **Triage settings:** Only paramedics may triage, and the colour can be limited to paramedics.
- **Large-bore IV cannulae:** 18G (green) and 14G (orange). Fluid runs in about 1.5 and 2.5 times as fast. Up to four cannulae, one per limb, sizes can be mixed.
- **Blood bags for every blood type** (0+, 0−, A+, A−, B+, B−, AB+, AB−), filled and ready to use. Bags of different types no longer stack together.
- **Blood on screen:** Animated blood drops after a hit. Options → ACMS → Blood on screen: full, reduced, light, off.
- **Controller cursor:** The full-screen treatment menu, the settings menu and the triage window work with the left stick and A.

## Improved
- **Ambulances** start with two cooled blood bags of every blood type, and the fridge gives you the bag of the type you chose.
- **Hypothermia wrap** takes much less room and fits into small bags.

## Fixed
- A tourniquet that was taken off is gone from the casualty and the treatment menu, and the wounds bleed again.
- A saline bag in one arm no longer blocks a second bag (e.g. blood) in the other arm.
- You can no longer put an oxygen mask on a casualty while a bag-valve mask is on their face.

1.0.15

# ACMS – Changelog

## New
- **Fullscreen treatment menu:** The menu now also comes as a full-screen view: pick a MARCH letter on the left, a body part on the patient, and click a treatment on the right. Checks show their result right in the menu and take as long as they do at the patient. Switch under Options → ACMS → Treatment menu layout.
- **Bag-valve mask (BVM):** Ventilate a casualty by hand. The mask sits visibly on the face, and an oxygen cylinder can be connected.
- **Blood cooler rucksack:** Takes only blood bags and keeps them cool. Mission makers can turn any backpack into one with a component.
- **Blood from a worn backpack:** Rescuers can take blood bags out of a teammate's or casualty's backpack without them taking it off.
- **Check infusion:** Shows what runs in and how much of each bag has gone in (percent and ml).
- **Take your own CWMP** from the self-treatment menu.
- **Blood type check:** The transfuse entry tells you if the bag fits the casualty.
- **New checks:** Search for bleeding, airway and head, carotid pulse, body temperature.

## Improved
- **MARCH menu:** The Monitoring group is gone. Every letter now holds its own checks next to the treatment.
- **Wounds:** You choose tourniquet, dressing or hemostatic gauze yourself.
- **Fresh blood** can be used right away (spoils after 30 min without cooling).
- **CWMP** can be given at any time, not only for pain.
- **Stopped heart:** Hang a bag on one and you get a hint what actually helps.
- **Trainer report:** names a transfusion reaction, the fluids given and the blood that was missing.
- **Checks** also work on awake casualties.

## Fixed
- The pulse oximeter now follows the casualty when dragged or carried.
- A casualty's clothes bag is deleted together with the casualty.

1.0.14

New
Stethoscope: listen to a casualty’s lungs and heart at the chest. It reports the breath sounds of the right and the left lung separately, so you can tell on which side a chest injury is. Open wounds hiss over the wound.
Chest injuries have a side. Needle decompression is now done on the left or the right side of the chest. A needle on the wrong side does nothing.
Hypothermia (server setting hypothermia.enabled, off in Normal): wounded, unconscious or bled-out casualties lose body heat. Cold makes bleeding worse and stops casualties from waking up. A hypothermia wrap (Radial menu, group H) keeps them warm and brings them back. Casualties can be examined for cold skin.
Improved
AED and pulse oximeter screens now glow, so they can be read at night.

1.0.13

ACMS – Changelog
Improved
Treatment menu: the class of a bleed (arterial, venous or capillary) is now shown next to the selected body part.
Fixed
Oxygen mask is shown on the casualty again.

1.0.12

ACMS – Changelog
New
Medical Trainer: place the trainer table in the Game Master editor (Filters → ACMS). At the ACMS logo you can call up a training casualty – random, minor, serious or critical – to practise on, and send it away again.
Endotracheal tube is now visible on the casualty, for everyone around.
ACMS settings tab: the ACMS options (treatment menu, notifications) now have their own tab in the settings menu.
Improved
Unconscious screen: now black and a bit more see-through, without the black bar in the middle.
Fixed
Muffled sound no longer stays on after waking up or joining a server.
Removed
Nasopharyngeal airway (NPA). Secure the airway with head tilt, suction, recovery position or intubation instead.

1.0.11

**ACMS – Update**

**New: treatment menu look**
• The radial menu has a new look: the selected entry grows and the neighbours make room, with a smooth animation. Controller and mouse work as before.
• Patient overview in the middle of the menu: a body diagram that shows where the casualty is hurt (wound type per zone), where tourniquets and dressings are, the name of the patient, the zone you point at and the recent treatment log. With a pulse oximeter on, it also shows pulse and SpO2.
• 69 new white action icons (IV/IO, dressings, pulse oximeter, stretcher and more); drug icons carry a short drug label.
• The menu names who you are treating ("Treating: Name"), and the key opens the menu for the casualty you are looking at, not just the nearest one.

**New: fingertip pulse oximeter**
• Attach it at the arm (left or right hand). It stays on the index finger and shows live SpO2 and pulse on its own screen. No signal in cardiac arrest, with very low blood pressure or with a tourniquet on that arm. An awake casualty can take it off themselves from the self-treatment menu.

**Changed**
• The red screen edge only pulses while you have an untreated bleed. Pain and blood loss show a calm, steady edge instead.
• "Get medical advice" names the real cause when air cannot get in (blocked or partly blocked airway, blood in the airway, wrong tube position, chest injury, drugs slowing the breathing) instead of just "too much CO2".

**Fixed**
• Waking up as a player: the player's machine re-checks consciousness when the state arrives, and "Get medical advice" lets an awake-but-stuck casualty up again. Still being investigated: some players may stay down, please send logs (search for `ACMS_WAKEDBG`).

1.0.10

1.0.9

**ACMS – Hotfix: waking up as a player**

**Fixed**
• Players who were knocked out could stay on the ground even though the casualty card already showed them as "Responsive". AI casualties were not affected. Players now get up when the casualty wakes.
• "Get medical advice" now also helps in that case: if a casualty is awake but still held down, it lets them up again and says "The casualty is coming round."

1.0.8

1.0.7

# ACMS Update

**Waking up**
- Reworked the wake-up system: casualties no longer get stuck unconscious after treatment, and no longer stand around "unconscious" on their feet
- Game and ACMS are checked against each other every second and put right if they disagree
- "Get medical advice" now also tells how long until the casualty comes round (e.g. "in about 2 min")

**Blood**
- Blood bags now show their state: a flat clear bag while empty, a full bag with blood once filled
- Blood vignette and hit flash are darker (deep blood red instead of bright red)

1.0.6

**Blood & vitals**
- Every player now sees the same blood type on a patient
- Ambulances start with 3x O- and 3x O+ blood bags
- New pulsing blood vignette while you bleed untreated, are in severe pain or have lost a lot of blood (server setting: ui.bleedVignette)
- Hit flash uses the same blood texture

**Treatment**
- Self-treatment works from the inventory with a bandage or tourniquet: the weapon is lowered, the item taken, the animation started
- "Apply bandage" hint shows up while you bleed
- Choose per player (Settings > Gameplay) whether the treatment menu opens at the body or with a key (default: period / View + R3)
- Treatment radial menu uses the right stick on controller

**Audio**
- Injury screams are much louder and carry about 50 m

**Fixes**
- Tourniquet rings are put back on the limb if they get left behind
- Unconscious state is re-checked after a knock-out

1.0.5

# ACMS Update

**Oxygen cylinder**
- Now carried in both hands with its own carry animation (the rifle is lowered when you take it)
- Fixed the physics/collision error when spawning it

**Waking up**
- New action **Get medical advice** next to the casualty card
- Tells you why an unconscious patient isn't waking up: low blood, heart rhythm, oxygen, CO2, pain, ketamine or a wound that still bleeds
- Only shown on request, never automatically

**Game Master**
- New right-click action **ACMS: Full Heal**
- Resets health, wounds, tourniquets, blood, pain, breathing, IV/IO access, drugs and heart rhythm
- A casualty who is out wakes up at once

**Endotracheal tube**
- Fixed the placed-tube prefab and made the item fit into bags (1x1)
- Added warnings to the log if it can't be attached
- Visibility at the mouth is not confirmed yet

**Technical**
- Faster loading of the medic list on big servers
- New texts in English and German

1.0.4

** New**
• **Debrief for the Game Master:** anyone logged in as admin / GM can choose "Show debrief" at a dead patient – cause of death, what was wrong when the heart stopped, what was done and what should have been done. Optionally the server also shows it to nearby players when a patient dies (setting trainer.enabled)

**Ambulances with blood:** the UAZ and the Humvee ambulance now carry 2 cooled bags of every blood type in the fridge (capacity 24)

• **Blood pools:** bleeding patients leave pools of blood that grow with the blood lost and fade after 15 minutes

• **New icons** in the treatment menu

**🔧 Changes**
• **Medication:** an awake patient is only given a drug when it helps him – painkillers for pain, TXA for bleeding, calcium when it is missing, atropine for a pulse that is too slow. Epinephrine and amiodarone only in cardiac arrest

• **AED sound:** full volume up to 3 m, fading out and gone by 18 m (it used to reach 22 m)

1.0.3

**🔧 Fixes**
• Xbox / console: vanilla texts (e.g. in the Game Master content browser) showed raw keys – the console platforms now inherit from PC like the base game does
• Bleeding loop: after being bandaged a patient woke up, kept bleeding and went down again – each waking reset the blood to 100 %. The game's own bleeding no longer runs alongside the ACMS wounds
• Patient deleted when put down: setting down a carried patient could delete the character as well. The helper seat is now only removed once the patient is out of it
• Suction pump, endotracheal tube, oxygen cylinder and mask did not fit into any backpack – sizes adjusted (max. 25 cm)
• IO drill: if you carry both a cannula and a drill, both ways are offered
• The mod no longer fills the console with debug messages
**🩺 New**
• **Rub sternum:** once everything is treated, a pain stimulus can bring the waking forward with a chance
• **Recovery position / roll back onto the back** now stand directly in group A of the radial menu instead of a submenu

1.0.2

* Possible Xbox Display Bug fixed

1.0.1

1.0.0