ACE3/docs/_posts/2019-12-31-ace3-version3130.md

---
title: ACEREP  #00010
description: Status report on ACE3 version 3.13.0
parent: posts
image: /img/news/191231_medical1.jpg
author: alganthe, mharis001
layout: post
---

This post marks the release of ACE3 v3.13.0 and, as a result, the public release of the medical rewrite. The [previous news post]({{site.baseUrl}}/2019/12/18/medical-rewrite.html) provided perspective on the guiding principles and goals of the medical rewrite. In this post, we detail the key changes of the rewrite in order to give users a better starting point as they explore ACE3's new medical system.

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As the name suggests, the medical rewrite was a complete overhaul of the medical system. The majority of the changes and improvements were made to the code base and as a result will not always be noticeable to end users. However, a better code base sets the stage for easier and faster development of the system in the future, opening possibilities for more features.

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        <img src="{{site.baseUrl}}/img/news/191231_medical1.jpg" alt="A medic treating a wounded soldier while another holds security."/>
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### Medical Settings

Customizability through settings has always been at the heart (no pun intended) of ACE3's medical system. Immediately, users will notice the absence of any differentiation between _basic_ and _advanced_ medical and the removal of some settings. Instead, the settings have been cleaned up and changed to offer granular control over the system, all while keeping it clear exactly what each setting does. The settings are also sorted into more approachable sub-categories.

Most of the changes described below can be controlled and fine tuned (or even disabled) to better suit the needs of individual users and communities.

### Fractures

Fractures are a new addition to the medical system. A direct hit to a limb has a chance to cause a fracture, a fractured limb will cause a person to be at a severe disadvantage. Leg fractures will cause a person to limp whereas arm fractures will lead to severe aiming shake.

The only way to treat a fracture is by using a splint. These are single use and anyone can apply one to themselves or others.

Fractures are shown as a bone overlay on their associated limb on the body image displays. The color of the bone describes the current state of the fracture:

- a red bone indicates an untreated fracture.
- a blue bone indicates a treated fracture (and may prevent the patient from sprinting depending on settings)

Lastly, fractures have a unique set of sounds that play when they occur and **induce severe amounts of pain**.

### Damage and Vitals

Changes have been made to the way damage is handled, only direct hits to the torso or head can be immediately fatal if the incoming damage is high enough. All other wounds induce bleeding and later cardiac arrest.

Pain is now part of the vitals loop, meaning that pain caused by an injury will affect heart rate. Severe amounts of pain and blood loss can cause the heart rate to reach extremely high values and make the patient run the risk of cardiac arrest.

In those scenarios adenosine can be used to reduce the heart rate while open wounds are treated, morphine could also be used but it has a much longer time in system than adenosine.

Bleeding requires consistent attention otherwise you risk the patient going into cardiac arrest. Consequently, cardiac arrest scenarios will be much more common, learning to treat them accordingly will be crucial.

The first signs of trauma induced cardiac arrest are:

- large amount of blood loss.
- the heart rate will quickly rise, at this stage fluids and possibly adenosine could save the patient.
- the heart rate and blood pressure are zero, at this point there is only a small amount of time available to take action.

Once a patient enters cardiac arrest the best option is to designate multiple people to work on the patient. One being assigned to procuring CPR non-stop until vitals return, others treating open wounds, providing fluids and checking vitals.

### User Interface

Body image coloration has been improved to better describe the current state of the patient as follows:

- Light Yellow to Dark Red: bleeding wound(s), darker means faster bleeding rate.
- Dark Blue: bandaged wound(s).
- Light Blue: stitched.

These colors are now also used for the interaction menu medical icons. In addition, limbs with tourniquets appear with a circle around the medical cross.

Wound descriptions are prefixed to indicate if they are bandaged `[B]` or stitched `[S]`.

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### Feedback Effects

Pain effects have been reworked to cause less visual strain while still maintaining their intensity. In addition, there are now four pain effect types: white pulsing, chromatic aberration, pulsing blur, and only high pain blur.

Unconsciousness in now preceded by a ragdoll and unconsciousness effects have been reworked.

### Stitching and IVs

Stitching no longer requires the patient to be stable, instead, it can be performed whenever a patient has any stitchable wounds. A stitchable wound is a bandaged wound on a body part that does not have any bleeding wounds.

Self stitching can now be controlled through a setting (disabled by default).

Similarly, self IV transfusion can also be controlled though a setting (enabled by default). A setting to control the flow rate of IVs was added.

### Items

Atropine has been removed and will be replaced with adenosine if item conversion is not disabled through settings.

As mentioned previously, a splint item was added to serve as the treatment for fractures.

Equipment sharing has been properly implemented and is controllable through its setting. It can either be:

- enabled, and set to use the patient's equipment first.
- enabled, and set to use the medic's equipment first.
- or, disabled completely.

### Other Changes

Medical AI has received several healing logic improvements and should respond more consistently to different situations.

It is faster to treat others than yourself, medics are also faster in performing treatments. Carrying animations have been sped up.

### The End Things

The [feedback survey](https://forms.gle/5pKeXMJ5hfZYjuxZ6) is still available and we will continue to utilize user feedback to balance the new medical system and fix any issues with future ACE3 releases.

The change log for ACE3 v3.13.0 can be found [here](https://github.com/acemod/ACE3/releases/v3.13.0).

We are still in need for translations for some languages within the ACE3 project. Please have a look at [this GitHub issue to track the progress and what languages lack translations](https://github.com/acemod/ACE3/issues/367){:target="_blank"}. Any and all help with this is very appreciated.

Make sure to [follow us on twitter](https://twitter.com/intent/follow?screen_name=ace3mod&tw_p=followbutton){:target="_blank"} and to [like our facebook page](https://www.facebook.com/ACE3Mod/){:target="_blank"}.