Medical system for DayZ Part 2: Emergency care for other players

[Roshi (DayZ) 397]

Main idea: a medical screen (similar to the inventory screen) for an unconscious or immobile player. To activate this you would come up close to the injured player and activate a context menu command such as “Initiate medical treatment”. This could be used in the context of an emergency, or to treat non-emergency wounds.

 

This would open a screen similar to the inventory screen:

 

 

(Please note that this is a rough mock-up and is basically to give you an idea of what I mean – obviously just an adjusted inventory).

 

You would have several options, and if the player is bleeding, pulseless or not breathing then the timeliness and order of the interventions would matter.

 

Assessment options could include checking vitals – airway, breathing and pulse. Also blood pressure could be taken with a blood pressure cuff and stethoscope, and temperature could be assessed with a thermometer (e.g. for sepsis). The results of the most recent check could display in boxes (e.g. in the left side of the screen as shown above).

 

In terms of intervention, to maintain playability I suggest these be a little limited whilst allowing for a variety of relevant options to keep some depth. So I would suggest some options:

-          Initiate CPR – essential if you can’t find a pulse

-          Bag mask (if not breathing – if have a bag mask) or mouth-to-mouth

-          Insert artificial airway (not intubating probably, but rather a Guedel which just maintains the airway and keeps the tongue out of the way.

-          Insert IV – could perhaps have up to two lines in to allow faster fluid resuscitation or fluid resuscitation and injection of IV drugs.

-          Disinfect skin – you may want to do this prior to inserting IVs to reduce the chance of later infection.

-          Test blood type

-          Give blood products or saline

-          Use adrenaline – could possibly include IV adrenaline but for simplicity could use epipen.

-          Use morphine – morphine decreases cardiac output but effectively reduces pain.

-          Use IV antibiotics – prophylactic or to start treating sepsis.

-          Remove clothing item(s) – this would require surgical scissors or a knife, and would badly damage or destroy the clothing item, but if the patient is in dire straits and speed is of the essence then this would be a good option. The purpose is to perform a ‘secondary survey’ – i.e. to find any other wounds that have been missed, or to access injuries for treatment. You may need to remove a gas mask for example to access/assess the airway, or vests, shirts and trousers to find wounds or get IV access.

-          Compress wound

-          Irrigate wound – with saline preferably, but water at a pinch (if not sterile then increased risk of infection)

-          Debride wound/remove foreign bodies

-          Suture wound

-          Use defibrillator – AEDs automatically check the ECG and recommend shock or no shock – this would be easy to emulate.

 

This would cover a lot of the likely scenarios you would need to deal with in DayZ. A lot of this could be implemented by the drag and click context menu set up mentioned in part one – self-treatment.

 

It would also be great if a second player could assist in an emergency – e.g. “Assist medical treatment” on the context menu. This assistant could perform assessments or interventions and this could be co-ordinated in direct chat.

 

All this would require a few new items:

-          Scissors

-          Suture kit (or needle and thread)

-          Scalpel (which could be included in a suture kit)

-          Bag-mask

-          Artificial airway set

-          Thermometer

-          Some pre-set kits would be great (as per the current 6 slot medical kits so you would need to replace expendables) – you could have two or three different sized kits.

 

Now I know this probably sounds a little complex to a lot of people, but it is a VERY simplified approach to trauma management and I think adds enough to make being a medic really interesting and would require a bit of basic knowledge. Would be a great way to do things like blood transfusions too. It could be made more complex – e.g. adding lactate and glucose dipsticks for testing blood levels of these substances, but I doubt that would be popular.

 

Other options for the medical system:

-          Fireman’s lift and/or drag unconscious patient option (which has been implemented in Arma II in the past).

-          Stretcher – which would be difficult to implement.

 

For Part 1: Self-management of wounds:

http://forums.dayzgame.com/index.php?/topic/161763-medical-system-for-dayz-part-1-%E2%80%93-self-treatment-of-wounds/

Edited January 4, 2014 by Roshi

[razertx 10]

As an EMT/FF IRL, I love the idea!!

[Flight96 99]

Nice idea, well thought out.

 

However.

 

 

I honestly believe that being able to check, Vitals, breathing and bloodpressure etc etc. Should come with knowledge & EXPERIENCE. It should NOT be something that every starting survivor should have knowledge and ability in. Maybe they can only start off with checking pulses. Hypothetically speaking lets just say that's level 1. The starting point. Then, over time as you check more pulses of other players, you UNLOCK these other medical capabilities. As well as some of these other actions you've listed you know?

 

You should have to LEARN how and where to stick an IV into someone else, you should have to LEARN how to work a defibrillator  unit maybe 'compressing wounds' could be level 1 of THAT aspect of your medical suggestion. Just throwing that out there. Just an opinion.

Edited January 4, 2014 by Flight96

[Roshi (DayZ) 397]

Some example images - in a rough order that you might use...

 

- When you first access the screen:

 

 

- Cutting away gas mask for airway access:

 

 

- Bag-mask (to breathe for the patient):

 

 

- Removal of vest and shirt (with scissors) for IV line access and starting secondary survey:

 

 

- Cutting away trousers to access wound:

 

 

- Cleaning the wound with saline/alcohol:

 

- Suturing the wound:

 

 

- Bandaging:

 

 

Not comprehensive but gives you a few ideas. Also these are obviously just rough mock-ups - I'd anticipate a lot more work on the art and the format - remember this is just throwing some ideas around.

Edited January 4, 2014 by Roshi

[derpdiggler 69]

Bag masks are not something that everyone can use.  It's not as easy as it looks, but I suspect you already know that.   ;)

[Roshi (DayZ) 397]

Nice idea, well thought out.

 

However.

 

 

I honestly believe that being able to check, Vitals, breathing and bloodpressure etc etc. Should come with knowledge & EXPERIENCE. It should NOT be something that every starting survivor should have knowledge and ability in. Maybe they can only start off with checking pulses. Hypothetically speaking lets just say that's level 1. The starting point. Then, over time as you check more pulses of other players, you UNLOCK these other medical capabilities. As well as some of these other actions you've listed you know?

 

You should have to LEARN how and where to stick an IV into someone else, you should have to LEARN how to work a defibrillator  unit maybe 'compressing wounds' could be level 1 of THAT aspect of your medical suggestion. Just throwing that out there. Just an opinion.

Yeah that's true - difficult to see how to implement that except by trial-and-error. AEDs (defibrillators) are actually pretty fool proof as they have been designed for the general public to use. I do think learning effects are important in success.

[Roshi (DayZ) 397]

Bag masks are not something that everyone can use.  It's not as easy as it looks, but I suspect you already know that.   ;)

Yeah true - getting the C-grip and head tilt right is tricky - but generally you have feedback (the farting noise you get when you don't have a good seal or the lack of chest expansion (or breath sounds on auscultation) so it's not inconceiveable that you could learn.

 

I can see a role for a 'medical manual' book in game - say a army medic guide or similar. Either as a reference for the player (which I'd prefer - if you're under time pressure then looking it up is stressful! ) or to enable your character to 'learn' how to put in an IV for example (not my favourite).

[Flight96 99]

I can see a role for a 'medical manual' book in game - say a army medic guide or similar. Either as a reference for the player (which I'd prefer - if you're under time pressure then looking it up is stressful! ) or to enable your character to 'learn' how to put in an IV for example (not my favourite).

This. ^

 

I have seen ALOT of books lying around that don't seem to do anything yet. Shouldn't be too much of a hassle.

[Bohannan (DayZ) 235]

Nice Idea but I really don't see this being potentially implemented until after the game launches and even then it seems like a lot.  The current system needs a little tweaking and I think it would be fine to sustain what the game is trying to accomplish.

[Westoluth 4]

I love this! It would make being a medic a full time job! I also think that, lets say you didn't have a thermometer, you could make a rough estimation, such as, "It feels hot". Essentially with some(not all) tools you could still attempt to do the job, but with less accurate results.

[Roshi (DayZ) 397]

Yeah that sounds good. I've attempted to show something along those lines in the pics where the pulse is 'rapid' - you could replace that with bpm if you have a watch - the advantage being you could see improvement with treatment (e.g

From 150 to 110 say) which might be harder to pick without the watch. Also a more practiced medic might get additional information from the pulse (e.g. The pulse feels weak).

Edited January 6, 2014 by Roshi

[Roshi (DayZ) 397]

A slight aside. A similar screen could be used for looking at dead players to see how they died (and for looting). Access by "Examine body" context menu when in proximity, or merge in seamlessly if the player dies during medical treatment. Rather than the "His name was... he died of..." approach, you could show his body and examine individual wounds, removing or cutting off clothing if necessary. Would also be a good way to identify the dead character by face (if individual faces and/or beards make it in) or tattoos (which it sounds like are already planned). Could also be a good way of getting an emergent bounty system going if you can identify those that you kill.

[yessaul robinovich 42]

many equate individual player skill in dayz with marksmanship. you've gone a long way in creating an outline for dean to implement a medical system that similarly draws upon knowledge and understanding of medical basics that are a fully-fledged skill. please accept my humble beans.

Edited January 13, 2014 by yessaul robinovich

[deewd22 32]

Awesome job mate. Hopefully they implement it or something similar to it

[djporternz 644]

Same as your other post. Rather than enhancing the medical systems in DayZ as they are ATM, this trivialises them to the point of being almost irrelevant. Might as well automate the whole thing and take any player control out of the equation.

 

-1 from me for this one as well.

[Fre4krider 7]

a realistig system is too komplex.
Checking pulse etc was part of Arma2 so i think it's coming back, a few addition would be great but not that much

[yessaul robinovich 42]

if having complex gameplay systems drawing upon real skills rooted in reality is 'too complex' than you're ending up with a game that isn't a true survival simulation, but an fps deathmatch over a really big map.

 

maybe thats the game you want to play in perpetuity, but i (and evidently many, many other people) don't. look at the 'medical system' poll to see what i mean.

[Roshi (DayZ) 397]

Same as your other post. Rather than enhancing the medical systems in DayZ as they are ATM, this trivialises them to the point of being almost irrelevant. Might as well automate the whole thing and take any player control out of the equation.

 

-1 from me for this one as well.

I don't mind people not liking this suggestion but I would like you to be more explicit as to how this trivialises the medical system.

[Roshi (DayZ) 397]

a realistig system is too komplex.

Checking pulse etc was part of Arma2 so i think it's coming back, a few addition would be great but not that much

Yeah this is actually a vast simplification of reality. It aims to be plausible is all. As a suggestion it would be far cry from a final system, which would be subject to revision through the alpha (and beta) process. In my view anything that adds depth and rewards real world knowledge would be great for dayz. Similar things could (and should in my view) be done for hunting/preparing meat, vehicles/mechanics, weapon use/maintenance (all areas where I know next to nothing).

[badman85@gmail.com 14]

love it !  :beans:

if this is not slated to be in the game already i believe something very very similar will be .

will bet anyone $ 5,000 dollars .. $ 5,000 dollars ... and some video tapes that i need to return  :|

 

coincidentally do you have any knowledge in regards to hypothermia ? or see it as a relevant aspect of the game ?

i ask this in relation to your last post , as i am working on a right up concerning shelter , among other things .

 

game play suggests a drop in temperature at night which should justify appropriate clothing & or shelter , depending on health state .

consequently bringing the environment into play regarding cold weather , rain & sickness , which would denote prevention & treatment , ie. the medical system .

 

know its in the mod but my thinking is more on a need for shelter . as weather , shelter & sickness coincide with each other & are prevalent topics in survival cycles . 

 

btw. know the screens are for concept but would hope to see all this executed in first person . that would be truly great mon !

you forgot to wash your hands ... ?

[xRann 126]

Ask and ye shall...have to read http://www.globalsecurity.org/military/library/report/call/call_97-5_section3.htm

 

Causes, field care, and treatment of hypothermia and weather related injuries. Could be added, keeping it "real" to life would make it very brutal and let's face it, it is if not treated and managed early. Many factors would/could be affected. Movement, food/water needs, aim, injuries, consiousness, fatigue, and more so the severity would need to be weighed against how quick and detrimental the affects would add up. I'd dig a much more brutal implementation, but not at the cost of playability.

[badman85@gmail.com 14]

thank you sir .

very nice resource !

[mrzee 8]

I hope by the finalized DayZ product, we have this or something similar.

[Roshi (DayZ) 397]

One thing that should be integrated into the temperature, infection and physical capacity systems is nutrition. Poor nutrition reduces the ability to deal with extremes of temperature (especially cold - shivering is very metabolically expensive). Malnourished people are more susceptible to and more likely to die from infections. Healing requires increased caloric and protein intake (and body protein is mobilised and converted into glucose). The relationship between physical activity and nutrition is hopefully obvious.

[badman85@gmail.com 14]

One thing that should be integrated into the temperature, infection and physical capacity systems is nutrition. Poor nutrition reduces the ability to deal with extremes of temperature (especially cold - shivering is very metabolically expensive). Malnourished people are more susceptible to and more likely to die from infections. Healing requires increased caloric and protein intake (and body protein is mobilised and converted into glucose). The relationship between physical activity and nutrition is hopefully obvious.

thats what i was wondering in regards to fruit & the new bares in the experimental build , they have almost no food / water value in comparison to all other foods in game making them a wast of time to even pick up !

unless nutrition was added , makes since ! dont know if it will happen but just cant see them adding fruits & veges with out a decisive benefit , its not Dean's MO .

referencing the lack of value to fruit from Merino's YouTube med. channel . assuming youv seen his vids . if not highly recommended . 

 

haha i think some of the player base is trying to dodge things like what your suggesting in fear of the game becoming to complicated as apposed to :

" iv been hit 3 times in the chest blood bag me .... ok im back in the fight "

 

Edited January 21, 2014 by Mayhem Smash