ACE3 Advanced Medical System

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This page is a Work-In-Progress WIP

This continually evolving documentation covers the particulars of the ACE medical system and the BSO configuration. Not every ACE medical guide is applicable to every other community and how they use ACE medical, hence this guide.

What is the ACE medical system?

A system designed to add complexity, challenge, and value to medical elements of Arma 3, as the vanilla system is not suited to the gameplay style of BSO due to its excessive speed and over-simplicity.

Why Advanced?

ACE features two mission-dependant medical system settings: basic or advanced. The settings of each can be tweaked, however BSO uses the majority of the advanced medical features in the pursuit of making medical gameplay more engaging, and enjoyable, especially for the medic class which becomes more prominent.

An additional incentive to not get shot is added through adding treatments which only medical classes can provide. Advanced medical introduces the following on top of what the basic system adds as a foundation:

  • -Basic simulation of medications
  • -Blood loss depending on injury severity and size
  • -Vital signs
  • -More accurate player hitpoint values
  • -Tourniquet
  • -Heart rate & blood pressure
  • -More than 4 treatment methods as opposed to basic

Types of wounds

The following are the types of wounds you will encounter in missions. Later in the guide you will see how each can be treated. Note that each type of wound can be minor, medium, or large in size, requiring various levels of treatment.

Abrasion: Occurs when skin is rubbed away against a rough surface. Caused by falling and lesser vehicle crashes. Causes light pain and slow bleeding.

Avulsion: Occurs when body matter is forcibly lost. Causes lots of pain and fast bleeding. Caused primarily by shrapnel from explosives.

Contusion: AKA bruises, caused by forced trauma that injures tissue without breaking the skin. Causes light pain. Caused by backblast, lesser vehicle crashes, falling, and ricochets.

Crush: Occurs when a heavy physics object falls onto a player. Causes light pain and slow bleeding. Caused by falling, physics related occurrences, and vehicle crashes.

Cut: Occurs when sharp material slices body tissue. Causes light pain and speeds of bleeding that depend on size. Caused by vehicle crashes, shrapnel, and backblast.

Laceration: AKA tears, is a separating wound which creates ragged edges produced from high forces. Causes light pain and speeds of bleeding that depend on size. Caused by vehicle crashes and shrapnel from explosives.

Velocity: Caused by an external object entering the body and high speed. Causes lots of pain and speeds of bleeding that depend on quantity/size. Caused by shrapnel and bullets.

Puncture: Typically deep but narrow wounds caused by sharp objects. Causes light pain and slow bleeding. Caused by shrapnel.

Bandage effectiveness

Refer to the following chart. The four available bandages have varying effectiveness depending on the wound type and size (The higher the effectiveness the better).


Note: Bandages do not stack.


This is a temporary solution to bleeding which can only be applied onto limbs. It stops bleeding by constricting circulation through pressure on the skin. It should be taken off the patient ASAP (within 5 minutes), else it will cause pain for the patient and eventually unconsciousness, followed by death. Once a tourniquet has been removed from a patient, it will be added to the inventory of whoever removed it. It is not a disposable item.

Note that Tourniquets interfere with blood pressure and heart rate readings. If you find that you or a teammate are unable to walk or are passing out regularly, it’s possible that a tourniquet is still applied to a limb and needs removing.


Saline, Plasma, and Blood IV bags all replenish lost blood from a patient. Note there are different bag sizes which come in 250, 500, or 1000 ml. If available, use the correct bag size depending on how much blood has been lost from the patient. Use of any quantity of IV bags will increase blood pressure. IV treatment is not instantaneous.

Note that if the game appears desaturated and monochromatic, you will require IV treatment or risk falling unconscious.


These are medications which are used in certain situations and can affect/cancel each other.

Morphine: Suppresses pain the patient is suffering. Blood viscosity is reduced which in turn reduces blood pressure. Do not apply Epinephrine as a result of lowered heart rate after applying Morphine. Your heart rate will return to normal in roughly 5 minutes. OD Warning: Applying too many doses of Morphine within a short span will cause Cardiac Arrest. Do not apply more than one dose of morphine within 10 minutes.

Epinephrine: Increases the heart rate of the patient. Counteracts the heart rate lowering effects of Adenosine and Atropine. OD Warning: Applying too many doses of Epinephrine within a short span will cause Cardiac Arrest. Do not apply more than one dose of Epinephrine within 10 minutes. After applying Epinephrine to a patient, and they keep falling unconscious, check their blood pressure.

Adenosine: Lowers the heart rate of the patient. See Morphine OD warning.

Atropine: Lowers the heart rate of the patient. See Morphine OD warning.

Blood pressure

Systolic pressure refers to the amount of pressure in your arteries during contraction of your heart muscle. Diastolic pressure refers to your blood pressure when your heart muscle is between beats. Blood pressure is affected by the amount of lost blood, IV’s, tourniquets and medications from autoinjectors. Only medics can view blood pressure details of themselves and of patients.

Note that the way to phrase blood pressure is systolic over diastolic, with the former being the top number and the latter being the bottom. Eg, a normal blood pressure would be 100 over 160.

Status Systolic Diastolic
Critical 0 20
Low 20 100
Normal 100 160
High 160 160+

Heart Rate

This is affected by the amount of lost blood and medications. You can check you or a patient’s heart rate by using ACE interaction and looking at a limb, then use the option to check heart rate. Medics will be granted more detailed information, whereas a non-medic will see “You find a normal heart rate” or something similar.

Status Rate
Low 45
Normal 46-119
High 120+

Cardiac Arrest

This occurs under the following circumstances:

  • Heart Rate is <20
  • Heart rate is >200
  • Systolic blood pressure is >260
  • Diastolic blood pressure is <40 and the heart rate >190
  • Systolic blood pressure is >145 and the heart rate is >150

The latter points appear complicated, however they should be viewed as the worst possible results for blood pressure and heart rate combined. Apply CPR in case of cardiac arrest.


Used to keep a player alive if they have a critically low heart rate. The patient’s heart rate will be ~25 upon success. From here, provided the patient is not wounded, you can use Epinephrine to increase their heart rate and bring them back to consciousness.

Interfacing & Treating

In order to start treating another player, hold down your ACE interaction key (windows by default) while looking at the player in question. Healing particular body parts can be done by looking at the part you need to treat, eg, left leg. If you see no option to treat the patient’s left leg, you are likely out of range and will need to move yourself or the patient closer. Patient note: stay still when you're being treated. To the left of your screen, you will see a brief overview of your patient. This will also appear in self-interaction. You will a list of injuries and applied equipment/treatments (in this case a tourniquet). Below it is a log of actions you have performed on the patient.


The icon for a wounded body part will appear red or yellow. Red icons indicate the body part is seriously wounded. Yellow icons indicate the body part is lightly wounded. You will be granted a list of treatments available to you as you hold your ACE interaction key whilst looking at a wounded body part. These treatments will depend on your role and what supplies you have. Some treatments, eg IV, may be available only to medic classes. In this specific example, we can see that the patient’s left leg is heavily injured from multiple bruises, avulsions, and velocity wounds. The patient is also in pain, has lost lots of blood, and has had a tourniquet applied. In this case, we will need to:

  1. Bandage the patient’s wounds as quickly as possible starting with the largest
  2. Remove the tourniquet once all bleeding has stopped
  3. Check heart rate and blood pressure
  4. Apply morphine (The patient may become conscious at this stage)
  5. If the patient is not yet conscious, apply Epinephrine
  6. Treat the lost blood with an IV fluid bag if possible

The patient will now be able to return to the fight. The purpose of reviving the patient at step 3 or 4 before applying an IV is so that he can move if the possibility of incoming fire arises. In that situation, the patient will be able to move himself into the nearest safe position for further treatment. The mission Medic role will likely be the only personnel capable of performing step 6, unless any other players have enhanced medical training.

The interaction menu can be configured to meet your personal requirements and tastes in ACE settings.

ACE medical menu

By default, you can access the ACE medical menu by pressing H. It will give a detailed self-diagnostic as to your status. Looking at another player and pressing H will provide the same interface but it will show the vitals of the player you were looking at.

On the Battlefield

What should you do if a teammate suffers an injury on the battlefield?

  1. Announce to your nearby teammates that you have a man down. Specify who has been hit (This is helpful for the team leader) using the radio if possible.
  2. Eliminate the threat before retrieving or treating the wounded.
  3. Deploy smoke if no usable cover is available for treating the patient.
  4. Before treatment, test the patient’s responsiveness and heart rate by using ACE interaction and looking at his head, the check responsiveness option will appear. If he does not respond and has no heart rate, he is KIA. If he is responsive and/or has a heart rate, move to the next step.
  5. Get the wounded into as safe a position as possible, do not put yourself at unnecessary risk. Note that if you are not the one patching the patient up, provide security instead.
  6. Apply tourniquets/CAT to any bleeding limb, and stop all bleeding.
  7. Prioritize bigger wounds first in your treatment. Call for assistance in treating the patient if there are too many wounds for you alone to treat.
  8. Once bleeding has been stopped, remove any tourniquets.
  9. Check heart rate. If low, do not apply morphine as you risk inducing cardiac arrest. If normal or high, apply morphine. (Also note that pain will vanish after 5-10 in game minutes).
  10. If the patient is not yet conscious, apply epinephrine.
  11. If the patient has lost lots of blood, apply IV treatment. If this is impossible, call for the medic to do so.
  12. Once the medic arrives, inform him of what treatment is needed and specifically for which patient.