Introduction to the NACA-score (for advanced medics)

[scout2win]

Since this is generally feedback for medics who can't maintain their cool when situations get heated I'll just post this here, hope this is the right place.

I am writing this not to push for this system to be implicated immediatly, but as a further help for medics to classify injuries and decide who to prioritise. Especially new medics or CSAR doctors can profit from this real-world system, as it makes most big decisions for you and helps medics maintain structure and a clear overview of the situation. Now I know this system may seem unintuitive or complicated at first but the NACA-score is one of the easiest and most intuitive systems out there. It is not perfected for military use, but it can give you a good overview about any situation and help maintain a clear head when there are multiple patients. There would be other scoring systems like the Abbreviated Injury Scale, but that is way too complicated. 

I will now explain the NACA-score in its original form and then try to adapt it for ARMA usage.

The score works similarly to the CAP system we've been using sporadically during MEDVAC missions: A roman numeral from 1-7 is used to classify the patient's injury, with 0 being "uninjured" and 7 being "very deadened".

• NACA 1 - Minor injury/disturbance: e.g. an abrasion; no medical intervention required
• NACA 2 - Moderate: e.g. moderate cuts, exsiccosis; no emergency medical procedures neccessarry
• NACA 3 - Moderate to severe: e.g. femur fracture; medical treatment required
• NACA 4 - Severe: e.g. vertebral injury; lack of medical treatment could cause death
• NACA 5 - Acute danger/extreme: e.g. severe heart attack/multiple arterial bleeds; condition can lead to imminent cardiac arrest
• NACA 6 - Respiratory/cardiac arrest: this score is usually given AFTER a positive resuscitation
• NACA 7 - Death: this is not "theoretical death" as in the patient is being resiscitated right now, NACA 7 means death and no coming back

If you memorize some of these conditions, understanding and using my ARMA-NACA score will be fairly easy i reckon. Here we go:

• NACA 1 - Minor: e.g. abrasion; soldier can use his own bandages; no need to consult a medic
• NACA 2 - Moderate: e.g. cuts which could reopen; medic might be required if the wounded soldier does not have the proper bandages
• NACA 3 - Moderate to severe: e.g. broken leg; obviously a medic is required, but there is no immediate life threatening condition
• NACA 4 - Severe: e.g. severe cuts on more than one body part, patient is responsive; medical treatment required, as the wounded soldier might not have enough bandages on him to stabilise his condition
• NACA 5 - Extreme: e.g. multiple avulsions, patient is UNRESPONSIVE; medical treatment required urgently
• NACA 6 - Acute extreme: e.g. ALL body parts are affected, patient is UNRESPONSIVE (the medical menu basically looks like @mrrbatty after he's been in the sun for too long); medical treatment required IMMEDIATELY, untreated condition would result in death within the next minute
• NACA 7 - Death: ALWAYS check for a pulse, sometimes the ragdoll-effect is clearly noticable, sometimes downed people are just having a cheeky lil nap

 

I am using this system already, even if I don't say it out loud, in my mind i am sorting people through this system to gain a clear overview of the situation and stay calm. Hope this was helpful to you, let me know if you have suggestions for changes. 

[mrrbatty]

1 hour ago, scout2win said:

(the medical menu basically looks like @mrrbatty after he's been in the sun for too long)

I despise you. 

Also moved to right section.

[scout2win]

tell me that isn't an accurate description though

@mrrbatty thanks for moving it, didn't know where to put it

Edited May 30, 2017 by scout2win

[Mihax209]

That sounds like a really good system overall, I just have one little nit-picky thing:

1 hour ago, scout2win said:

NACA 7 - Death: ALWAYS check for a pulse

I believe that in ArmA if you check a corpse's dead body corpse's pulse it tends to despawn, which could cause major issues if that body had something valuable on it, e.g. LR, Explosives, etc. It seems that the only decent way to check deadness is to look for whether or not his gun fell out of his hands (I believe that whenever you ragdoll the gun always falls off).

 

Unless this has been fixed already, in which case discard everything I just said

Edited May 30, 2017 by Mihax209
I'm a tit.

[Slouchy Orc]

So with regards to the de-spawning dead bodies when you check them, this is what I do (and teach) to see if someone is dead so checking someone's pulse and potentially losing important equipment.

1. Is their gun in their hands, if someone is dead the gun will be on the ground out of their hands. If their are simple unconscious the gun will stay in their hands, and may potentially glitch into the ground which is why I have a 3 set process to see if someone has bitten the dust. 
2. Is their head moving? If someone is unconscious their head will move side to side. This is a pretty obvious thing to notice if you have the time to look at them for a few seconds. This may not always happen but I have never seen it not.
3. Did they rag doll when they were shoot? If you see someone rag doll, they are dead. The only time this is not the case is if they are ran over by a friendly vehicle.

Good example of this in action is if you see Meat Wall #3 go down after a hail of bullets from a machine gunner. He didn't rag doll, but he could have bleed out once he hit the ground. So after popping a smoke for cover, you look at his head but his Bergen is blocking the way since he wasn't sure what uniform to take so he took all of them. Once you get to him, you see his gun is clearly in his hands and has you open the menu to move his body to cover via dragging, you see his head moving. From those 2 points you know he is alive without risking losing the precious uniforms he brought. Hope that is helpful cause that is what I teach in my simple sessions

[BonSie]

A simple way to check if someone is dead is just to check if you can carry him. If you can carry him he is alive, in ARMA you can't carry a dead guy. Same with bodybags.

[Sarissa]

14 minutes ago, BonSie said:

A simple way to check if someone is dead is just to check if you can carry him. If you can carry him he is alive, in ARMA you can't carry a dead guy. Same with bodybags.

 

1 hour ago, Slouchy Orc said:

 

1. Is their gun in their hands, if someone is dead the gun will be on the ground out of their hands. If their are simple unconscious the gun will stay in their hands, and may potentially glitch into the ground which is why I have a 3 set process to see if someone has bitten the dust. 
2. Is their head moving? If someone is unconscious their head will move side to side. This is a pretty obvious thing to notice if you have the time to look at them for a few seconds. This may not always happen but I have never seen it not.
3. Did they rag doll when they were shoot? If you see someone rag doll, they are dead. The only time this is not the case is if they are ran over by a friendly vehicle.

 

Yeppers. Nice way to check as well is ACE over their heads and look for a dogtag option.
If you can take em, they dead.

[gadsada]

This may seem silly considering i did this as medic alot of the time.

But despite being a very non-immersive way to check if someones dead or not i found it to be a stupidly useful way, dunno if it's 100% foolproof though.

 

See from what i know, the living have collision models, since the game wants us to respect the living. 

The dead don't and we can trample over them all we like.

 

So if (as Slouchy so eloquently put it) 'Meat Bag #3' has just gone down or has been spotted downed, i personally usually try to walk over them. If i can then welp i just trampled the dead and moved on as quick as can be with me life. If not then i have to deal with this object blocking my path of desired movement, typically by helping said object get up and get out of the way of it's own accord.

[Numinous]

This can actually be simplified down into 4 categories instead of the expanded 8, as in a Combat medical environment, it is quicker, and less resource insensitive to lump similar levels together. 

 

Green

Also MINIMAL

• These are the walking wounded
• These should be treated by self-aid or Combat Life Saver
• They can be used to continue the mission but may need to play an augmented role
• Injuries may include small burns, lacerations, abrasions, and small fractures

Yellow

Also DELAYED

• These patients are more seriously injuried
• They may eventually need surgical intervention
• Their general condition allows for treatment to be delays without endangering life or limb
• Medical treatment (splinting, pain control, etc.) will be required but it can wait
• Injuries may include hemodynamically stable patients with large soft tissue wounds, long bone fractures, intra-abdominal or thoracic wounds, or burns to less than 20% of total body surface area

Red

Also IMMEDIATE

• These patients require immediate life saving intervention
• Locate these individuals as quickly as possible
• If not triaged and treated, they will die
• Injuries may include hemodynamically unstable patients with airway involvement, chest or abdominal injuries, massive external bleeding, or shock

Black

Also EXPECTANT

• In these patients, survival would be highly unlikely
• If able, they should receive comfort measures, pain medications
• Injuries may include penetrating or blunt head wounds and those with absent radial pulses

 

Really its just all about understanding Tactical Combat Casualty Care (TCCC or TC3)  and how it functions.  Certain things take priority.  Where as a traditional EMT / EMT-P (Paramedic) would know always check your ABCs, in TCCC it is actually proper to handle massive bleeding first, which many would have assumed just falls into be, and at the end, H is added to address the head.  Now, how does all this apply in Arma?  Simple. 

Handle Major Bleeding First
Proceed head to toe with injuries.
Fluid Management.
Good to go

In the end so long as air goes in and out, and blood goes roundy roundy, we are all good.