KAT - Advanced Medical REWRITE

OFFICIAL GUIDE
https://steamcommunity.com/sharedfiles/filedetails/?id=2020940806

Last update - 1. November 2022

Authors:
MiszczuZPolski
Filemon

Contributors:
Rookie Cookie
Onion

Users of the hereby document are kindly asked to report any mistakes to the authors.
Distribution restriction: Approved for public release, distribution is unlimited. Claiming authorship is forbidden.
The guide is based on the mod source code available on GitHub and Developers’ experiences and knowledge.

Special thanks to:

● KAT, ACE and other related mods developers thanks to whose efforts we can enjoy the KAT mod
● Beviin Skirata and other guides authors whose works inspired Filemon to come up with his own guide from
which the hereby document evolved
● KAT Discord community
Preface

KAT mod users are encouraged to delve into add-on settings that can be found in the game after the mod
is installed. It applies both to new users and all users after every new update of the mod is released. Adjust
all the settings according to your needs or learn about the settings that the host is using. Also, check your
settings before posting any bug reports.

In order to access the medical menu, press H while looking at a player/ AI. While in a vehicle, you can
access the passenger's medical menu via ACE, passengers category. Navigating in the menu is done by
pressing body parts and tabs related to different medical actions on the upper left part of the menu screen.
Remember to verify if you do not access your own medical menu by checking the nickname in the upper left
corner of the menu screen. If a player/ AI is dead, it is impossible to access the carrying/ dragging tab.

Medical actions can also be undertaken through the ACE menu (press windows while looking at object/
player/ AI) but it is considered inefficient with current complexity of the mod.

Wound types mechanics derive from ACE and no details are presented in this guide. In general, Avulsions
and Velocity Wounds are the most severe wounds, Cut Wounds and Lacerations are less dangerous and all
the remaining wounds cause little bleeding with Contusion being an exception - it causes no bleeding at all.
Carrying a bleeding patient doesn’t speed up the bleeding process.

Bandage mechanics derive from ACE and no details are presented in this guide. Authors suggest using
elastic bandage when speed is prioritized over durability, using quikclot bandage provides the best
endurance and packing bandage provides the most balanced solution for speed, wound coverage and
endurance.

Contents

Preface 2

Items Featured in the Mod 3

Fluids 6

Essential Values 7

Recovery Position 7

Cyanosis 7

Lungs Treatment 8

Cardiac Arrest Treatment 8

Surgery 8

Kidney Function 9

Coagulation 9

Appendix: Complete Aid Procedure 10

 Items Featured in the Mod

A feature introduced by this mod enables you to find all the medical-related items under a dedicated
“Medical” category in the arsenal. Please note that not all items are required for a successful treatment -
some are auxiliary and can help you improve your performance. Using some items may require medical/
doctor permissions - check your/ host in-game addon settings. Most medicines do not work instantly - you
need to wait for the full effect. Pain reduction is given in a 0-1 scale, 1 being an ability to suppress severe
pain. Pain Suppression Exceeding the “0,5” point on the pain scale brings a risk of losing
consciousness randomly. It’s worth considering that hits to the head have a higher chance of causing
unconsciousness than hits to other body parts. Some items do not allow self-treatment, in certain cases it is
a matter of settings.

Glossary of terms:
● BP - Blood Pressure
● HR - Heart Rate
● Bradycardia - HR drops by 40 BPM within 2 minutes and lasts for 20 minutes
● Max dose - Max number of uses within the time a medicine remains in the body before overdose.
Overdose leads to unconsciousness. Max dose can randomly be higher by 1.

Colour Meaning Letter Meaning

red One time use only C Shockable Cardiac Arrest treatment medicines
orange Depends on settings S Surgery items
yellow No limit L Limbs T Torso H Head

Time in Max
Name Description Conditions Action
the body dose

Supressess pain (0,8), decreases HR,

Morphine 30 min 4 - L
decreases BP

Adenosine Decreases HR, decreases BP 2 min 6 - L

Increases HR, increases BP, boosts wake-up

Epinephrine 2 min 10 - L
chances

Increases HR, increases BP, slows down

Norepinephrine 6 min 12 IV/ IO inserted L, T
bleeding and transfusion

Increases HR, decreases BP, speeds up

Nitroglycerin 6 min 12 IV/ IO inserted L, T
bleeding and transfusion

Decreases HR, increases BP, slows down

Phenylephrine bleeding and transfusion (more than 6 min 12 IV/ IO inserted L, T
norepinephrine)

Suppress pain (0,3), increase HR slightly,

Painkillers 10 min 10 - H
decrease BP, 10 pills per item
 Ammonium Increases HR, activates the ACE wakeup
30 sec 10 Unconscious H
Carbonate script, 10 uses per item

Equivalent of a packing bandage applied

every 6 seconds to all parts of the body for
TXA 10 min 3 IV/ IO inserted L, T
120 seconds (see Coagulation for more
details)

Stitches a wound every 6 seconds until all

EACA 10 min 10 IV/ IO inserted L, T
wounds are stitched/ the patient dies.

Suppresses pain (0,8), increases HR,

Ketamine 15 min 4 IV/ IO inserted L, T
increases BP

Suppresses pain (1), decreases HR,

Fentanyl 15 min 2 IV/ IO inserted L, T
decreases BP

Suppresses pain (0,6), decreases HR,

Nalbuphine 15 min 4 IV/ IO inserted L, T
decreases BP

Increases AED chances (by 8% - 20%), 33%

C Amiodarone 2 min 4 IV/ IO inserted L, T
chance to cause bradycardia

C
Lidocaine Increases AED chances by 8% 2 min 4 IV/ IO inserted L, T
S

C Atropine Increases HR, treats bradycardia 2 min 4 IV/ IO inserted L, T

Treats morphine, fentanyl and nalbuphine overdose in 1:1 ratio

Naloxone - H
and clears their all effects

AAT Kit Used for needle decompression and fluid draining - T

Chest Seal Dressing used for treating pneumothorax - T

Unconscious, no
Guedel Tube Prevents obstructions from happening. H
occlusion

Unconscious, no
King LT Prevents obstructions and occlusions from happening. H
occlusion

Enough inventory
Field Blood space, donor has at
Used to to take blood from players/ AI L, T
Transfusion Kit least 3.6l of blood
(default settings)

L, T,
Surgical Kit Used for wounds stitching - H
 Personal Aid
Removes all injuries Patient is stable -
Kit

16g IV Intravenous needle, used before administering fluids on limbs - L

Intraosseous needle, used before administering fluids on the

FAST IO - T
torso

Automated External Defibrillator, the X-series version has a Unconscious, not

AED T
vitals monitoring function undergoing CPR

Stethoscope Allows the diagnosis of thorax injuries - T

Accuvac A device used to remove occlusion from airways Unconscious H

No active pulse
Pulse Oximeter Monitors HR and Sp02 oximeter on L
patient’s body
IV Stand Allows administering saline from a stand - - -

Stretcher Enables transporting wounded soldiers - - -

Helistretcher Enables transporting wounded soldiers by a helicopter - - -

S Bone Plate A metal piece screwed into a bone - L

S Clamp Used for clamping a wound - L

Personal Aid Kit equivalent that only affects a chosen body

Dressing
S part. Debride wounds and then apply NPWT Dressing on a - L
vacuum
selected body part

S Retractor Used for exposing fractures - L

Used for performing incisions and wounds debriding (only if

S Scalpel - L
used for wounds debriding it is not a single use item)

S Etomidate Suppresses pain, reduces HR, anesthetic 45 sec 10 IV/ IO inserted L, T

Reduces BP, sedates the patient, 33% chance

S Lorazepam 1 min 3 IV/ IO inserted L, T
to cause bradycardia

S Flumazenil Removes the sedation 1 min 3 IV/ IO inserted L, T

Fluids

All fluids featured in the mod do not expire. Blood is divided into groups and must be administered
according to the scheme below. You can view the scheme through “Blood Groups Cheat Sheet” which can
be found in the arsenal and opened using the ACE menu. The symptom of wrongly given blood is a
significant HR drop. It should be treated with painkillers. Blood pressure does not play a crucial role in mod
mechanics.
Administering fluids requires establishing a needle (if enabled in add-on settings):
● 16g IV - Limbs without tourniquets only
● FAST IO - Torso only, causes pain
16g IV can randomly become obstructed while TXA or EACA are pushed. When fluids stop flowing through
the needle, use the “inspect catheter” action to check for obstructions. In order to clear obstruction, use the
“Saline Flush” action. Saline Flush requires at least 30 ml of saline that must be administered during the
action. Removing a IV during fluid administration results in regaining some fluids.

Donor
0- 0+ B- B+ A- A+ AB- AB+
AB+ OK OK OK OK OK OK OK OK
AB- OK NO OK NO OK NO OK NO
A+ OK OK NO NO OK OK NO NO
A- OK NO NO NO OK NO NO NO
Recipient
B+ OK OK OK OK NO NO NO NO
B- OK NO OK NO NO NO NO NO
0+ OK OK NO NO NO NO NO NO
0- OK NO NO NO NO NO NO NO

pH change (see Kidney

Volume Coagulation Factor (see Coagulation)
Function)
1000 ml +800 12
Blood 500 ml +400 8
250 ml +200 4
1000 ml -750 0
Saline 500 ml -350 0
250 ml -150 0
1000 ml +500 15
Plasma 500 ml +250 10
250 ml +100 5

Status Effect Liters of Blood in the Body

Lost Some Blood 5,1 - 6
Lost a Lot of Blood 4,2 - 5,1
Lost a Large Amount of Blood 3,6 - 4,2
Lost a Fatal Amount of Blood 3,0 - 3,6
Essential Values

Ideal set of vitals

Heart Rate (HR) Blood Pressure (BP) Oxygen Saturation (SpO2)
80 bpm 120/80 mmHg 100%

Extreme vitals values (default settings)

Lethal saturation < 65%
Lethal amount of blood < 3l
Min. saturation required for recovery 85%
Saturation leading to unconsciousness 75%
HR required for recovery 40 bpm
Amount of blood required for recovery 5,1l (“lost some blood” status)
Amount of blood required for establishing HR 3,6l (“Lost a Large Amount of
Blood” status)
HR interval required for successful patient reorientation 70 - 100 bpm
BP interval required for successful use of Ammonium Carbonate 110 - 130 mmHg
Min. HR for perfusion (SpO2 level will keep dropping if HR is lower) 20 bpm

Recovery Position

Recovery position - Prevents occlusions and obstructions from happening, clears the airway but makes
certain actions unavailable until the recovery position is canceled.

Conditions for the action to appear

Unconscious Not in recovery position No Guedel Tube
No King LT Not in a vehicle Not in a stretcher

Canceling the action

Carrying Dragging Putting into a vehicle

Action prevents you from using following items/ actions on the patient
Guedel Tube King LT Accuvac Chest Seal AAT Kit
Overstretch Turn Around AED CPR FAST IO

Cyanosis

Checking cyanosis is a way of estimating the SpO2 without the use of medical items. Cyanosis can be
checked on arms without tourniquets or on the head.

Status SpO2 level (default settings)

No Cyanosis <90 ; 100>
Slight Cyanosis <75 ; 90)
Mild Cyanosis <66 ; 75)
Severe Cyanosis <0 ; 66)
Lungs Treatment

Thorax injury results in SpO2 loss even if no occlusions/ obstructions are present. In hardcore mode
(settings) checking for thorax injury is done through auscultating lung sounds and requires using a
stethoscope and listening to the sounds, outside the hardcore mode it will show up in the overview on the
chest. More than one thorax injury might be present. Pneumothorax might develop into Tension
Pneumothorax over time if not treated. Fluid Draining and Needle Decompression require AAT Kit.

Thorax Injury
Lungs Sounds Treatment
Type
Pneumothorax ● Chest Seal
Tension Pneumothorax sound ● Auscultate
(short breath) ○ The same sound is still heard -
Tension perform Needle Decompression
Tension Pneumothorax Action
Pneumothorax ○ Regular lungs sound - no action
● Auscultate
Hemothorax sound ● Chest Seal
(cracking) Hemothorax ● Fluid Draining
Hemothorax Action ● Auscultate

Cardiac Arrest Treatment

● Determine Cardiac Arrest, start monitoring vitals using AED X-series (if available) and use “check
rhythm” feature (available both in AED and AED X-series):
○ “Shock advised” (VF/ PVT) - administer shock. Using epinephrine/ amiodarone/ lidocaine
(always followed by a shock) in the order mentioned is advised after the first shock fails.
Repeat starting from epinephrine if lidocaine fails. "Shock Advised"
○ “No shock advised” (Asystole) - do not administer shock. Use epinephrine and 3 intervals of
CPR instead. Timer till death slows down by 50% during CPR. Repeat the sequence until HR
is restored. "No shock advised"
Check rhythm between steps. If you cannot determine the cardiac arrest type, treat it as asystole.

Surgery

Determine the fracture type by clicking on a limb and choosing “Check Fracture” in the “Examine Patient”
medical menu tab. Treating surgical fractures should be done quickly so that the patient doesn’t fall out of
anesthesia which leads to cardiac arrest.

● Simple Fracture (apply splint or perform following procedure)

○ Push Lidocaine/ Morphine
○ Perform Closed Reduction
● Surgical Fracture
○ Push Lorazepam to sedate the patient (if conscious)
○ Push Etomidate for general anesthesia and reapply it every 40 seconds
○ Perform the Incision with a scalpel
○ Expose the fracture with a retractor
○ Compound fracture
■ Irrigate the wound with 250 ml of saline
○ Comminuted fracture
■ Clamp the wound with a clamp
○ Perform the open reduction with a bone plate
○ Push Flumazenil to remove sedation
○ Reorient the patient or use ammonium carbonate
Kidney Function

Checking Kidney function is done through the Examine Patient tab (“Check Breath” action used on head).
Kidney function is dependent on pH coefficient which mod mechanics measure in 0-1500 scale. Upon
reaching 1500, effects coming from all states are reset. The script checking values is run every 20 seconds.
Particular pH intervals result in one of the following states occurring:

● Normal
○ pH ≥ 750
○ 50 points restored each 20 seconds until 1500 is reached

● Pressure
○ pH > 0 ⋀ pH < 750
○ A script imitating a “medicine” is run
■ 15 sec till max effect
■ 20 minutes in the body
■ HR increases by 30 BPM
■ BP increases
○ 25 points restored each 20 seconds until 750 (Normal) is reached

● Fail
○ pH = 0
○ 50% chance of Cardiac Arrest and Kidney Function Arrest
○ no pH points are restored

● Restoring ideal pH level

○ Dialysis in a medical vehicle
○ Administering fluids until pH 1500 is reached (see Fluids)

Check Breath Result “pH” Value

Stink (harsh and metallic) <0 ; 250)
Mild (slightly fruity) <250 ; 750)
Good (ok) <750 ; 1500>

Coagulation

The mod adds the coagulation factor - a feature which expands the system of wounds clotting. A script is
run each 8 seconds to check for the player's condition, namely: HR and bleeding wounds. If the HR of at
least 20 BPM is present and there is at least one bleeding wound, clots (“Unstable Cloth” bandage) start
appearing on wounds. Each player starts with 10 factors - they are used for clotting wounds (one factor per
one wound) and restored by administering fluids (see Fluids). Max 30 factors.
● If coagulation is enabled, pushing TXA causes the system to replace the “unstable cloth” with more
durable packing bandage on clotted wounds - TXA does not cause wound clotting on its own.
● If coagulation is disabled, TXA works as described in the items list above.
Appendix: Complete Aid Procedure

Hereby procedure is an example of steps required to bring an unconscious person back to full health. The
procedure doesn’t elaborate on which medications to use but focuses on desired effects which may require
using certain medicines.

● Tourniquet injured limbs.

● Bandage head and torso - in massive bleeding TXA and EACA can be helpful.
● Monitor vitals using AED X-series feature or use a Pulse Oximeter on a limb without a tourniquet or
ignore this step.
● Check airways: Airway Protection from best to worst
○ Occluded: Use accuvac or perform head turning until airways are cleared.
○ Obstructed: Perform head hyperextending until airways are cleared.
○ Clear: Use King LT or Guedel Tube.
● If a fatal amount of blood was lost, administer 1 liter of fluids.
● If no pulse is present, perform the Cardiac Arrest Treatment. If AED is used, check the rhythm
between steps.
○ AED → Shock advised
■ Epinephrine → shock → amiodarone → shock → lidocaine → shock → repeat
○ AED → No shock advised/ AED not used
■ Epinephrine→3x CPR→repeat
● Check the SpO2 or check Cyanosis. If cyanosis is present or Sp02 level is dropping, perform
Lungs Treatment.
○ Regular sound
■ Lungs are not a problem, check airways
○ Pneumothorax sound
■ Chest Seal
■ Auscultate
● The same sound: Needle Decompression → Auscultate
● Regular sound: No action needed
● Hemothorax sound ⬇
○ Hemothorax sound
■ Chest Seal → Fluid Draining
■ Auscultate
● Regular sound: No action needed
● Pneumothorax sound ⬆
● Check Breath to check Kidney Function.
○ Normal
■ No action needed
○ Pressure
■ At least “Lost Some Blood”: Administer Blood or Plasma or Perform Dialysis
■ No Blood Loss: Perform Dialysis
○ Fail
■ Less than 5 liters of blood: Administer 1l of blood or even more plasma
■ More than 5 liters of blood: Perform Dialysis, watch for cardiac arrest
● Bandage and stitch wounds. Remove tourniquets.
● Perform Surgery on broken bones. If available - use splints for simple fractures.
● Administer fluids until “lost some blood” status is achieved.
● Use Ammonium Carbonate or use the “Reorient Patient” feature or use epinephrine to boost
wakeup chances and wait.