Hemostasis

1.0.11

ESA Autoinjector
- New side effect: vision appears slightly harsher while the ESA works and clearly harsh on an overdose. During the exhaustion afterwards, vision appears slightly dull. Only the player on the ESA sees it.
- Item description and field manual (EN and DE) updated with the new side effect.

1.0.10

ESA Autoinjector
- Fixed: the effect now works in multiplayer. Before, it only worked on the server and players barely felt it.
- Stronger effect under heavy load: carried weight costs much less stamina while the ESA works.
- New: stamina recovers faster while the ESA works.
- Takes effect a bit sooner after the injection.
- Shorter exhaustion phase afterwards.
- Unchanged: wounds bleed faster, higher heart rate, slight weapon sway, overdose risk.
- Note: the ESA helps against fatigue, not against the speed loss from heavy gear. A heavily loaded soldier can keep going much longer, but is still slower than without the load.

First Aid Kits
- Fixed: the IFAK and AFAK no longer appear between the legs after changing other gear (gloves, backpack) or loading a saved loadout.
- Fixed a material error on the AFAK.

1.0.9

Balancing
- TXA: now lasts about 90 seconds instead of 45. Strength unchanged. A second dose within a few minutes still lowers blood pressure strongly, a third still causes unconsciousness.
- Freeze-dried plasma: now takes half the space of a saline bag. It is now half of saline in space, weight and restored blood volume, plus its bleeding control.

Field Manual (EN and DE)
- Sections updated to the new duration.

1.0.8

New: IFAK and AFAK
- Two new first aid kits that carry medical supplies only.
- IFAK: individual kit for every soldier.
- AFAK: larger kit for combat lifesavers and anyone carrying supplies for others. Holds about twice as much as the IFAK, including fluid bags.
- Both are worn in a new first aid kit slot in the equipment list. You carry either an IFAK or an AFAK, not both.
- Only medical items fit (tourniquets, dressings, gauze, injectors, fluids, splints and more, including ACE items). Everything else is refused.
- Picked-up medical items go into the kit first.
- The kits are not shown on the character.
- The treat patient wheel, ACE's menu and the health view find items in the kit as usual.
- Available in the arsenal under Heal.

Field Manual (EN and DE)
- New section 2-5: Medical Equipment (IFAK, AFAK, medical backpack and medical kit).

1.0.7

ew: ESA Autoinjector
- New ephedrine-based stimulant for soldiers carrying heavy loads.
- Takes effect shortly after injection and lasts for several minutes.
- Reduces fatigue under heavy load: you can keep a fast pace for much longer. Without a heavy load the effect is barely noticeable.
- Side effects: higher heart rate, all bleeding (including internal bleeding) is faster, slight weapon sway.
- When it wears off, a period of exhaustion follows: stamina recovers more slowly.
- Overdose: a second dose within a longer period causes a racing heart, heavier bleeding and strong sway. A third dose can stop the heart (CPR needed).
- Available in the arsenal under Heal. Shows in the medication log like the other injectors.

Treat Patient Wheel
- New layout: the first ring now has Body, Medication and Vitals. Body opens the body parts.
- Every ring below the first now has a "Back" entry.
- The wheel now updates while open. If a wound changes (for example another medic treats the patient), the entries update right away, and you stay in the ring you are in.
- New: Vitals. Check pulse, blood pressure, breathing and SpO2 directly from the wheel.
  - Each check takes about as long as ACE's own check. The wheel stays open and shows the result in the entry.
  - Results stay visible until the wheel is closed.

Tourniquet
- Phenylephrine or plasma active when the CAT is removed: re-bleed chance 20 points lower.
- TXA active: re-bleed chance 40 points lower.
- These don't add up; only the strongest one counts.

Check Injuries
- Shows "Splinted" if any arm or leg has a splint.
- Shows the hematoma class (Class I/II/III Hematoma).

Fixes
- Forceps: the removal animation no longer plays twice.
- Forceps, Surgical Kit and CAT go back into the inventory after each use. This fixes items being invisible in hand or needing to be put away before they could be used again.
- Chest seal: no longer offered on the chest when there is no pneumothorax (for example with only a hematoma). This was an ACE issue that affected all menus.
- TXA and ketamine now appear in ACE's medication log with time and medic, like the other injectors.

Field Manual (EN and DE)
- New section 7-10: ESA (effect, side effects, exhaustion, overdose).

Known Issue
- The plasma or saline bag is sometimes not rendered. Minor, will be looked at later.

1.0.6

New: Surgical Kit
- New reusable item for treatment at a medical tent.
- Treats internal bleeding (hematoma) or a splinted fracture. One use treats one injury and takes 25 seconds.
- Only works at a placed medical tent, not in vehicles, helicopters or with a carried medical kit.
- It is now the only way to cure internal bleeding and fractures. Bandaging the torso at a medical tent no longer cures internal bleeding.

Splint Rework
- The splint now stays on the limb and stabilizes the fracture instead of healing it.
- A splinted limb has no limp, no weapon sway and no pain while moving.
- A splinted leg cannot sprint, even after the fracture has healed. Take the splint off to sprint again.
- An arm splint has no extra effect.
- The splint is reusable:
  - On other players: use the new "Remove splint" interaction on the arm or leg.
  - On yourself: use the "Remove tourniquet" button in the health view. If a tourniquet is on the same limb, it comes off first.
  - The splint goes back into your inventory, or lands on the ground if the inventory is full.
- The health view shows "Splint applied" and "Fracture (splinted)". The treat wheel shows "Splint applied".

Freeze-Dried Plasma Rebalance
- Plasma now slows all bleeding, including internal bleeding, to half for 5 minutes from the start of the bag. Before, it was 70 % only while the bag was running.
- Volume and weight unchanged. Saline restores more blood, plasma controls bleeding better.

Hemostatic Gauze
- Packing a wound now always takes 12 seconds, on yourself and on others.

Settings
- New option under Settings > Gameplay: "Hemostasis: Treat patient interaction".
- Turn it off if you prefer ACE's own treatment menu. It is saved per player and on by default.

Fixes
- The forceps now show their detailed model while held in hand.

Field Manual (EN and DE)
- Updated the sections on fractures, blood replacement and internal bleeding for the splint, plasma and surgical kit changes.

1.0.5

Field Manual
- German edition "Feldhandbuch Gefechtserstversorgung" reworked: tighter wording, sections combined onto fewer pages (now 29 pages instead of 37), clearer evacuation priorities and handover.
- New section on Metoprolol in both editions (lowers heart rate and blood pressure; not for casualties with blood loss). The following medication sections are renumbered.
- German edition: section 7-1 now lists all available injectors with their section numbers.
- German edition: the internal bleeding chapter now shows the three hematoma icons (Class I–III), so players can match them with the icons in the health view.

1.0.4

New: Freeze-Dried Plasma
- New item in the arsenal: Freeze-Dried Plasma, an alternative to saline with its own look.
- Restores lost blood like saline, but only about half as much per bag.
- While it runs, it slows all bleeding by about 30 %, including internal bleeding.
- Weighs half as much as a saline bag.
- Hung like a saline bag. Only one bag (saline or plasma) can run at a time.
- Shows up in the "Treat patient" radial menu under Medication.
- When to use which: saline for casualties whose bleeding is under control, plasma for casualties who are still bleeding or have internal bleeding.

Field Manual
- Blood Replacement and Internal Bleeding sections updated in the English and German edition to explain saline vs. plasma.

1.0.3

Balance
- Hemostatic Gauze is now for heavy bleeding only. Light and moderate bleeding must be closed with a field dressing. On heavy bleeding the gauze still closes the wound permanently. The tooltip and item description are updated to match.
- Internal bleeding (hematoma) now only develops from trauma. A blackout counts only if it happens right after a gunshot, explosion, impact (falls, vehicle crashes) or melee hit. Blackouts from medication (TXA, ketamine, morphine) or from slow blood loss no longer cause internal bleeding. Shrapnel left in the head or torso still causes internal bleeding after its time limit, as before.

Field Manual
- The Field First Aid Manual has been rewritten as a structured field manual (FM HMS 1-01) with numbered chapters and sections, a quick reference and MEDEVAC/handover formats.
- New section on Naloxone (reversing a morphine overdose).
- Updated sections on hemostatic gauze and internal bleeding to match the new rules.
- New item: German edition "Feldhandbuch Gefechtserstversorgung", available in the arsenal next to the English manual.

1.0.2

New: Treat Patient
- New interaction "Treat patient" on other soldiers, next to "Check Injuries". It opens a radial menu for treating the casualty, built on the vanilla radial menu, so it works the same with mouse and with a controller.
- First ring: Head, Chest, Abdomen, Left Arm, Right Arm, Left Leg, Right Leg and Medication.
  - Every body part shows the icon of its most urgent wound (bleeding, heavy or light shrapnel, fracture, internal bleeding, tourniquet applied).
  - Hovering a body part lists all its wounds, e.g. "Heavy bleeding, 1x heavy shrapnel, Fracture".
- Second ring: only the items you carry that can actually be used on that body part, shown with a 3D preview and the number you carry.
  - Drugs and fluids (morphine, saline, TXA, ketamine and ACE injectors) are under Medication.
- A "Back" entry in every second ring returns to the body parts. The normal back key works as well.
- Choosing a treatment takes the item into your hand and starts the normal treatment animation on the casualty. All existing treatment rules still apply.
- The menu closes automatically when you move away or the casualty is moved away.

Fixes
- Reusable items (tourniquet, forceps) no longer keep the last treated casualty as their target. Treating yourself after treating someone else now works correctly.

1.0.1

Fixes
- Inventory: the status icons (pain, hematoma, shrapnel, and the vanilla bleeding and fracture icons) were partly hidden behind the equipment slots at some resolutions. The icon column is now moved to the left so all icons are fully visible.
- Item tooltips: Splint, Forceps, Hemostatic Gauze, TXA and Ketamine showed the tooltip hints of the vanilla items they are based on (e.g. the Splint showed "Restricts bleeding while applied"). Each item now has its own correct tooltip hints:
- Splint: treats a fracture on an arm or leg, single use
- Forceps: removes one piece of shrapnel, leaves a bleeding wound, reusable
- Hemostatic Gauze: closes any bleeding including heavy, single use
- TXA: slows all bleeding for a short time, lowers blood pressure, overdose possible
- Ketamine: strong pain relief, no limping or weapon sway for a few minutes, tunnel vision, overdose possible

1.0.0